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Need to Lose Weight? 3 Simple Steps Tell You If You Need to Lose Weight: Part 1 PDF Print E-mail
Written by Richard L. Lipman M.D.   
Thursday, 19 March 2009 18:49
Do you need to lose weight?
In Part 1 of this series you will see how to determine if you fit into the risk profile for complications of obesity.  In Part 2, you will see the risks.
To lose or not lose weight? It depends not only on you weight and height, but on how much of the fat is around your abdomen. Fat around and inside the abdomen causes serious problems.

Here are the three steps to tell you if you are at risk and what you can do:

1. Your Body Mass Index(BMI) 30

2. Waist Circumference: women more than 35" - Men more than 40"

3. Risk factors: high blood pressure, diabetes, high cholesterol,


If you answer yes to anyone of these you are at risk for heart disease,
diabetes, high cholesterol, cancer and strokes.


See which fat distribution best fits you: Here are the three categories:

Which pattern best fits your size?


1.  "10- or 20-pounders” who  want to lose weight for mainly aesthetic reasons

Obesity-waist_circumferencecrop
2. Overweight and do  not yet have the metabolic syndrome


3.Obese people with the metabolic syndrome and some/ all of the complications of obesity including high blood pressure, diabetes, high cholesterol and polycystic ovaries.


Obesity or  Overweight?  The differences :

The first issue  is the definition of obesity. Although I tell my patients that their ideal weight is the weight they feel comfortable with and the weight they can maintain without feeling anxious or deprived, everyone wants a number. We need to be careful here, because “ideal weight” based on fashion trends, celebrities’ physical appearance, or an idealistic body image rarely reflects healthy weight.

Here are some of the guidelines to help you decide if you are just overweight or obese and at risk:

NIH Guidelines on Weight Problems:
In 1998, the National Institutes of Health correlated excess weight with different health problems and determined three guidelines for defining overweight and obese individuals. They use these three measurements: 1. Ratio of body weight to height (BMI), 2. Circumference of one’s waist, 3. Presence of risk factors related to heart disease

1. Body Mass Index: (BMI)

The ratio of body weight to height is called the body mass index (BMI), and reflects the total fat as related to one’s height.  Find your height on the left side and follow the line until it intersects with the line representing your weight, as listed at the top:


BMI4cropped

Blue Zone: If your BMI is in the blue zone, you are underweight;
Red Zone: If it is in the red zone, you are of normal weight for your height;
Green zone:  You are overweight;
Yellow zone: You are obese or morbidly obese.

B
MI may give false information for individuals with a lot of muscle mass, because the extra weight may be muscle mass and not fat.


2. Circumference of the waist relates your obesity to significant medical problems:
This is the most definitive  measurement to determine if the belly fat has produced obesity related  medical problems  because it relates the extra weight to body function. Excess food is stored in every increasing fat cells around and inside the abdomen. It's the fat cells inside of the belly that make new dangerous chemicals that go into the blood stream. Studies reported in Science in October 2008 suggest fat cells can even make   more fat  cells.                                                                                       FATTEXTNORMALNOFAT


Clumped together, the fat cells just below the skin of the  abdomen—surrounding all of the  vital organs—are no larger than a bar of soap, but are the cause of all obesity-related medical problems. Since measuring the inner fat is difficult and expensive, researchers use the circumference of the waist as a good proxy since it correlates with the critical amount of inner fat responsible for the development of all of the complications related to obesity.
Fat cells are in yellow inside & outside of abdomen
click on figure: To see effect of gaining 20 lbs.
See a video of how your fat cells interact with your body.


Dr Annemarie Koster reports in the American Journal of Epidemiology in 2008:
"The association between waist circumference and mortality among 154,776 men and 90,757 women aged 51–72 years, all -cause mortality was assessed over 9 years of follow-up (1996–2005). After adjustment for BMI and other co-variates, a large waist circumference (fifth quintile vs. second) was associated with an approximately 25% increased mortality"


You  Are At Risk if:
Men-       waist: 40 inches or greater
Women- waist: 35 inches or greater

See the exact risk related to your waist circumference


3. Risk factors and heart disease:
The presence of risk factors related to heart disease must be considered when you are evaluating whether or not you need to lose weight.  If you have three or more of the conditions listed below, you are at high risk for cardiac problems. Moreover, if you also have a high BMI or a large waist circumference, you are considered to have metabolic syndrome. Here is a March 2009 update on risk factors from the American Heart Association:

1.    Age: males older than 45 years and females older than 55 years
2.    Family history of heart disease
3.    Cigarette smoking
4.    High blood pressure
5.    Elevated LDL cholesterol

"Burn" the fat- reduce the problems: The good news is that when one is losing weight, the fat deposited inside the abdomen is the first to be used and burned for fuel.  However, the only way to start this process is by reducing the food intake or significantly increasing the amount of exercise (we are talking about daily hours of real working out in the gym) in order to create a calorie deficit. The decrease of just an inch or two in waist circumference corresponds to a relatively large reduction of fat in the abdomen, and consequently significantly reduces health complications caused by obesity.


Metabolic Syndrome =  3/5 risk factors + high BMI or high waist circumference:
About 15 years ago, scientists from medical schools at several universities began to notice an unusual group of health problems occurring together: hypertension, high cholesterol, high fat content in the blood, diabetes, and an unusual collection of fat around the waist (instead of being equally distributed over the body). This cluster of medical problems is known today as metabolic syndrome.



25% of Americans have Metabolic Syndrome:
More than 25 percent of the U.S. population has metabolic syndrome. Some researchers believe that if obesity continues to increase with no significant improvements, 80 to 90 percent of us will suffer from Metabolic Syndrome by the year 2030.


Firs sign of Metabolic Syndrome can be a stroke or heart attack:
Very few complications of the Metabolic Syndrome can be detected before it’s too late. The first is often a heart attack or a stroke; other individuals will find out during a routine health evaluation that they have developed diabetes or hypertension.


Metabolic Syndrome is  caused by:


  • Genetic predisposition
  • Environmental factors
  • Too much food in
  • Too little energy out.

Consequently, similar to treatments for hypertension, diabetes, or high cholesterol, the first step for anyone needing to lose weight is to change their lifestyle.

Criteria for the Metabolic Syndrome: March 19, 2009 American Heart Association
Update

The following table shows you several of the many sets of criteria for the diagnosis of metabolic syndrome. Having three out of the seven criteria is sufficient to establish that you have the condition.

Risk Factor

High Risk Category

Waist Circumference

Women: greater than 35 inches
Men: greater than 40 inches

Body Mass Index (BMI)

BMI equal to or higher than 30
BMI at 27 and other risk factors present

Low Good Cholesterol (HDL)

Women: lower than 50
Men: lower than 40

High Bad Cholesterol (LDL)

Higher than 160 with one risk factor
Higher than 130 with two risks

High Blood Sugar

Fasting sugar higher than 100

High Blood Pressure

Higher than 140/90

High Triglycerides

Higher than

What should you do if you have or think you have Metabolic Syndrome?
The obvious solution is to force your body to burn the fat stored in your cells for energy, instead of using the food that you ingest. The only way to do this is by creating a caloric deficit at the point of food intake. All of my successful patients confirmed to me that it is much easier not to eat that bagel, than having to go to the gym and work an extra 50 minutes to burn off that same bagel. Yes, you can create additional caloric deficits by exercising, but that is simply much harder to do and to sustain.


How the 100 Calorie Secret can help you:
Like my patients, you will use your personal 100-calorie diet secrets to successfully manage your hunger, satisfy your cravings, and effectively limit your food intake to achieve your goals. For those with diabetes, hypertension, and heart disease this weight loss program can make all the difference together with your regular physician.

Last Updated on Monday, 16 November 2009 11:49
 
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