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" Unknown The National Health and Nutrition Examination Survey (NHANES) data of 2003-2004 reveals that about one-third of adults in the United States are overweight, and 32.
2 percent are obese.
A person is considered overweight, when there is an excess of body weight compared to set standards.
The excess weight may come from muscle, bone, fat, and/or body water.
When the excess weight specifically comes from an abnormally high proportion of body fat, the person is considered obese.
Obesity is a growing problem in the United States.
In 1974, the Framingham Study implicated obesity in the development of cardiovascular disease and its consequent mortality.
Researchers reported that for each 10% increase in weight , there was a striking 30% increase in coronary heart disease (CHD) incidence in men, whereas a 10% weight reduction correlated with a 20% reduction in CHD incidence.
Two large studies have subsequently confirmed this negative association of obesity with coronary heart disease.
In 1999, results of the PROCAM study, which monitored more than 23,000 employees in northwestern Germany for cardiovascular events, were published.
After 8 years of observation, the data showed that at a BMI 30 kg/m2, the incidence climbed steeply to 70 per 1000 men.
A similar correlation was found in women.
In the Nurses' Health Study involvingmore than 115,000 U.
S.
women, the risk of a major coronary event rose in tandem with increasing BMI levels.
Obesity is also associated with increased risk of diabetes mellitus, high blood pressure, dyslipidemia andvarious cancers, including breast and colon.
They also suffer from more gall bladder disease and ostioarthritis.
Obese people often feel rejected, unattractive, or suffer social discrimination.
Even the renowned British poet, playwright and actor, William Shakespeare retorted, "Thou seest I have more flesh than another man, and therefore more frailty.
" According to the World Health Organization (WHO) criteria, overweight is defined as a BMI of 25-30 kg/m2; while obesity is a BMI >30 kg/.
BMI is defined as the individual's body weight in Kg divided by the square of their height in meters.
Inthe US, it is generally calculated by using the formula 703 multiplied by the body weight in lbs and divided by the square of the height in inches.
BMI can also be determined using a BMI chart.
These are readily available in the doctors offices or on the internet.
These usually display BMI as a function of weight (horizontal axis) and height (vertical axis) using "contour lines" for different values of BMI or colors for different BMI categories.
Since abdominal fat is more dangerous, a waist circumference of >35" in a woman and >40" in a man, together with a BMI of 25-35 kg/m2 or more, indicates a much higher cardiovascular risk.
"Some people are born to fatness.
Others have to get there.
" Poet Les Murray.
Obesity has a complex etiology involving physiologic, biochemical, genetic, environmental, cultural, socioeconomic, and psychological factors.
It can result from medical conditions such as hypothyroidism and polycystic ovarian syndrome.
Stressful life situations and depression are also associated with weight gain.
Many medications also cause weight gain or impede weight loss.
Psychoactive medications, especially antidepressants, antipsychotics, and antiepileptics, progestational steroids, antihistamines, and corticosteroids, among others, can increase weight in some individuals.
Diabetics often gain weight when prescribed insulin or sulfonylureas.
Losing weight is beneficial.
Even a modest 5% weight loss can cut a man's risk of dying by 12%.
The seemingly small ( 5%-10% ) weight loss have been attributed to a predominant reduction in visceral fat -- as much as 30% of visceral fat.
And this accounts for the huge benefits reaped.
Abdominal collection of fat is more dangerous compared to fat carried elsewhere in the body, such as the hips and thighs.
Fat in the abdomen contains high levels of triglycerides; reduced HDL cholesterol and HDL2 cholesterol levels; elevated apolipoprotein B, and an increased proportion of dense LDL particles.
All these are associated with increased coronary disease risk.
Weight loss also improves diabetes mellitus, high blood pressure and abnormal lipids.
"Imprisoned in every fat man, a thin one is wildly signaling to be let out.
" Cyril Connolly, British Critic.
Weight loss can be achieved by several methods.
Reduced caloric intake and increased caloric combustion are healthy ways of reducing weight.
The former can be achieved by eating less caloric dense foods and by cutting down the portions of meals.
The latter is achieved by regular aerobic and muscle building exercise.
Behaviour therapy combined with diet and exercise becomes the gold standard for a weight loss program.
Medication may be used for short tem to jump start the weight loss program.
Medications are usually indicated, based on the NIH guidelines, for a patient with a BMI of >/=30 kg/m2 or a patient with a BMI of 27-30 kg/m2 with comorbidities such as hypertension, diabetes, hyperlipidemia, sleep apnea, or arthritis.
Pharmaceutical ways of achieving weight loss include prescription medications for long term use such as orlistat and sibutramine.
Orlistat inhibits fat absorption.
This helps in weight loss as the typical western diet derives about 40% of its calories from fat.
Sibutramine suppresses appetite byinhibiting the reuptake of norepinephrine and serotonin in the central nervous system.
Surgery is usually reserved for the extremely obese who have been unable to respond to medical and other therapies or are suffering from complications.
Patients with a BMI >/=40 kg/m2 or >/=35 kg/m2 with comorbid conditions can be given a Roux-en-Y gastric bypass or similar procedure.
Gastric with or without a bypass limits food intake and absorption, and is among the most effective treatments developed thus far.
"He's so fat, he can be his own running mate.
" Comedian Johnny Carson.
So lose your running mate today.
You will not only feel and look better, you will also live a better and longer life.
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