Weigh Less and Live Longer - Article
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| Wed, 09-01-2004 - 5:11pm |
Not long ago, obesity was seen mainly as a cosmetic problem. The purpose of dieting was to improve your appearance, especially in time for bathing-suit season. Exercise was a way to tighten bulges around the stomach and thighs. As a last resort, there were diet doctors, although they were regarded with suspicion—even within the medical community—for popularizing fad diets and preying on people’s vanity.
In just the last few years, however, the medical view of overweight, or excess body fat, has undergone a sea change. No longer just a cosmetic problem, it is now known to be a public health problem of the same magnitude as smoking. Indeed, government statistics list overweight as the second-leading cause of preventable death in the United States, after smoking. By increasing the risk for a variety of serious diseases—for example, heart disease, stroke, gallbladder disease, and several forms of cancer—overweight and its more severe form, obesity, cause 280,000–325,000 deaths in this country each year. For many people, losing weight is not an act of vanity; it’s a struggle for survival.
The dangers of excess weight have come to light at a time when the rates of overweight and obesity are soaring. More than half of all adults in the United States are overweight, and 26% are obese—an increase of more than 50% in the last three decades. Obesity rates are rising dramatically among children, too, an ominous sign for the future health of our population.
Of course, as anyone who has ever tried knows, losing weight is easier said than done. And as hard as it is to shed pounds, keeping them off is even harder. The vast majority of people who are fortunate enough to lose weight regain it within five years. That’s true even of people who have lost weight under a doctor’s guidance or by using prescription medications. It’s no wonder that many people who have repeatedly tried to slim down throw up their hands in frustration and assume that nothing works. In the process of trying, however, we spend more than $33 billion a year on weight-loss products and services.
What are people spending their money on? Spending has shifted in recent years away from weight-loss programs and specialty foods and toward over-the-counter weight-loss pills and preparations. The removal of the prescription medication fenfluramine (part of the well-known “fen-phen” combination) from the market due to potentially dangerous heart-valve problems created a demand for new weight-loss products. Next, Congress allowed the creation of an entirely new category of unregulated dietary supplements which are now available to consumers. Wild claims and marketing slogans have enticed almost 100 million Americans to purchase these dietary supplements, many of which contain a grab bag of ingredients never tested for safety nor proven to aid in weight loss.
The good news is that many people can lose weight and keep it off, as this report will explain. (See How to Lose Weight.) In just the last few years, researchers have learned a great deal about the biological causes of weight disorders. Dozens of genes have been identified that contribute to the problem, and researchers are beginning to tease out their influence on how much we eat, how full we feel, how fast we burn calories, and other functions that determine weight. Prescription weight-loss medications on the market today can temporarily manipulate some of these functions. In addition, dozens of potential weight-loss compounds are currently under investigation, in the expectation that they may effectively target other weight-regulating functions. The hope is that some of these compounds will safely enable more people to lose more weight than ever before.
But, as this report will explain, losing weight isn’t just about taking medications. It’s about altering behavior that leads to weight gain. You will to need to determine why you are overweight. For example, many people gain weight because they find themselves in situations that lead to overeating—the traveling business person who frequently eats in restaurants, or the mother who nibbles the snacks left on her children’s plates. Others overeat in response to stressful or emotional situations. And for some people, the major problem is that they burn fewer calories because they have too little physical activity.
To reverse the trend toward weight gain, you will need to devise a plan that targets your particular problem. Behavioral modification, structured eating plans, support groups, and medical intervention are some of the options that have been shown to help people control weight. You will also need to set reasonable goals. New insights into the causes and treatments of overweight have led to a re-evaluation of the goals of weight-loss treatment. As recently as a few years ago, the goal was thinness or some “ideal” body weight, but it is now clear that such goals can be unrealistic and counterproductive.
But despite vigorous programs of diet and exercise, most significantly overweight people do not become thin, and those who do so rarely remain thin. The natural mechanisms that regulate weight and energy balance work to keep your weight in a relatively narrow range. In the current food-saturated environment, these mechanisms can keep your weight in a range that is too high. Over the long term, dieting, exercise, behavioral therapy, and weight-loss medications can help reduce your weight to the lower end of this range, but most current therapies are unlikely to reduce your weight to an entirely different, lower range.
Therefore, a more realistic goal for standard weight-loss treatment is to lose 7–10% of your starting weight. Even such modest reductions can lead to significant improvements in health by lowering blood pressure, cholesterol, blood sugar, and other risk factors for life-threatening disease. Ending up thinner and healthier than you had been—and staying that way—is the ultimate measure of a successful weight-loss effort.

Kerstin


everyone read!
Fear
Hugs, Brenda
Kerstin
Fear