Archive for the ‘Weight Loss’ Category
EATING DISORDERS: THE MIXED MESSAGES OF OUR MEDIA – THE MEDIA APPROACH WEIGHT LOSS MIGHT BE HELPFUL
Saturday, June 18th, 2011SMART DRUGS FOR MAXIMUM MENTAL PERFORMANCE: XANTHINOL NICOTINATE
Sunday, April 17th, 2011WEIGHT PROBLEMS: WE’RE ALL EATING EXPERTS
Wednesday, May 12th, 2010Everyone possesses preconceived notions regarding eating. We often behave as if we’re experts on diet, primarily because we’ve absorbed so much information – much of it false – as we’ve "shopped" through the vast diet marketplace. For instance, many individuals don’t think they are eating too much; some actually think they don’t eat enough, or they’re eating too many carbohydrates or too much protein. To better understand eating behavior, it is first necessary to separate why you are eating from what you are eating.
Years ago my comments would have been significantly different: When I am eating I feel great. I love food. I love to taste. I definitely love to crunch. Hook forward to eating and often decide in advance what I am going to eat and when I am going to eat it.
I did not say, "When I eat, I feel comfort." I no longer experience that feeling when I eat. I turn to other things or people, not food, for comfort. I did not say, "When I eat, it masks the pain." I no longer use food to minimize or eliminate emotional pain. Also notice that I did not say, "When I eat, I feel less stress." To be honest, I sometimes feel more stress when I sense that I am overeating. I did not say, "When I eat, I don’t feel as lonely." Eating no longer is my "friend." For so many individuals struggling with their weight, overeating is not the issue. Overeating is the consequence of some other factor in their life.
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WEIGHT LOSS/BODY-BUILDING
FAT LOSS: SELECTION OF PATIENTS FOR DRUG TREATMENT
Friday, May 8th, 2009Drug treatment for obesity falls into a philosophical ‘no-man’s land’ when it comes to patient selection. On the one hand, it has been argued that obesity should be like any other lifestyle risk factor such as hypertension and high blood cholesterol and treated with drugs automatically if lifestyle measures fail. Blood pressure and cholesterol are just like body fat, the argument goes, because excess levels of all of them are mainly due to the interaction between a susceptible genotype and a ‘pathological’ environment and they all have serious health consequences. Drs Ravussin and Bogardus from Phoenix, Arizona, have highlighted the similarity with essential hypertension (with no apparent secondary cause) by labelling some obesity as ‘essential’ obesity. Protagonists in this argument say that obese people are discriminated against because obesity carries connotations of sloth and gluttony and all that is needed is a bit of self-help.
On the other hand, governments and medical insurance companies are very reluctant to pay for drug treatment of obesity. A simple calculation of the number of obese and overweight people multiplied by the cost of the drug sends them ducking for cover or bouncing the question back and asking which drugs should come off the subsidised list to allow the obesity drugs on and still remain within the budget. Needless to say, the full gamut of options between the two extremes are used to select patients for drug treatment.
One lesson which is slowly being taken from blood pressure and cholesterol drug treatment to obesity treatment is the concept of absolute risk. The question doctors are asking more and more before prescribing drugs is not ‘how high is the person’s blood pressure or cholesterol?, but ‘at this level of blood pressure or cholesterol, what is the patient’s risk of a heart attack or stroke?’ To answer the first question, one only needs to measure the parameter being treated, but to answer the second question one needs to look at the patient and factor in the patient’s age, sex, past history, smoking habits and the like. For blood pressure and cholesterol, there are tables available to insert all of these factors and come up with an overall assessment of cardiovascular risk to treat the blood pressure or cholesterol on that basis. Unfortunately, such tables are not available for obesity, but clearly, the assessment should include:
• body size, e.g. BMI
• complications, e.g. diabetes, hypertension
• impact of obesity on physical, psychological and social functions
• other relevant factors such as family history of obesity and complications and personal history of weight gain and loss.
The overall extent of overfatness and its consequences can then be evaluated for each individual and this forms the basis for treatment decisions, especially those which can have significant negative as well as positive effects such as drug treatment and surgery.
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