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Obesity

Obesity is the term used to describe the accumulation of excessive body fat.

The Body Mass Index (BMI) is used to measure Obesity. BMI is calculated by dividing the weight of a person in kilograms by the square of their height in metres. A person with a BMI between 25 and 30 is defined as overweight and a person with a BMI over 30 is defined as obese. There are three classes of Obesity. Class one Obesity is moderate and is diagnosed in a person with a BMI between 30 and 34.9. Class two Obesity is severe and is diagnosed in a person with a BMI between 35 and 39.9. Class three is very severe and is diagnosed in a person with a BMI of 40 or above.

FACTORS INFLUENCING OBESITY

Environmental: A number of environmental factors influence Obesity, including socioeconomic status (people from lower socioeconomic groups are more likely to be obese), a large food intake and lack of exercise.

Regulatory: Other factors influencing Obesity include pregnancy, an increase in fat cells and fat tissue mass during infancy and childhood, brain damage, certain medications, psychological factors (leading to eating disorders such as binge eating disorder) and hormonal disorders.

Genetic: Genes do play a role in how the body stores fat and how hungry a person feels or how long it takes to feel full.

HEALTH RISKS
Obesity can reduce life expectancy by up to nine years. It also increases a person's risk of developing a range of health-related problems, including:
• Diabetes
• Heart disease
• Stroke
• Osteoarthritis
• High blood pressure
• Gallstones
• Infertility
• Depression

Combined with a lack of exercise, Obesity contributes to one third of cancers of the colon, breast, kidney and stomach.

OBESITY AND PREGNANCY
Women who are obese prior to pregnancy may be at increased risk of birth defects developing in their children. Clinical studies have found that babies born to obese women are more likely to suffer from neural tube and heart defects. The reason for this increased risk amongst obese women is unclear. There are several possible mechanisms, which include development of the foetus being adversely affected by abnormalities in glucose metabolism, insulin or other hormone levels. Overweight and obese women are also at higher risk of gestational diabetes, which has been linked to an increased risk of birth defects. Research indicates that obese women may require additional nutrients, such as folic acid, to prevent birth defects.

TREATMENT OPTIONS
As with all conditions your Doctor should be consulted to diagnose and treat this condition.
Your Doctor can recommend a weight management programme to suit your needs and monitor your progress at regular intervals. Your Doctor may recommend a combination of the following:
• Long-term change in eating patterns.
• Behaviour therapy - modification and reinforcement, nutrition education, increase in physical activity.
• Medications.
• Surgery.

DIET HINTS
• Eat a variety of nutritious foods including wholegrain breads and cereals, vegetables and legumes and fruits.
• The diet should be low in fat (particularly saturated fat), sugar and salt.
• Limit alcohol intake.

VITAMINS/MINERALS/HERBS
Always consult your Doctor before taking any supplement or herbs.
• Multivitamin supplements can be beneficial for people on a restricted diet.
• Chitosan is a shellfish product, which has been found in some studies to result in weight loss following supplementation. It may not be suitable for people with shellfish allergies and pregnant and breastfeeding women
• Chromium may assist weight loss as it can improve blood sugar balance and reduce sweet cravings.
• Essential fatty acids may assist weight loss, as these are required by the body to burn fat as fuel. A good example is Flaxseed oil or fish oil.
Some herbs are used in non-prescription weight loss preparations. These include Gymnema sylvestre and Green tea.
• Gymnema sylvestre can assist to regulate blood sugar levels, therefore can be beneficial as a weight loss supplement. A study found that Gymnea syvestre facilitated a reduction in excess body weight and BMI, while promoting healthy blood lipid levels.
• Green tea has been shown in studies to increase thermogenesis, the body's ability to burn energy.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints. A combination of moderate, regular exercise and a sensible diet is more effective in the treatment and prevention of Obesity than either alone.
2. Forget the 'fad' diets. These may cause an initial weight loss, which is often the result of fluid loss from the body. Losing too much weight too quickly can be dangerous and may cause the body to gain even more weight when normal eating resumes. Concentrate on low fat, healthy food and exercise to achieve long-term weight control.
3. Remember that even a modest weight loss of 5-10% can help to improve and control the complications of Obesity.
4. If you have any queries about medications your Doctor may have prescribed as part of your weight management programme, ask your Pharmacist for advice.
5. Avoid alcohol. The average alcoholic drink contains approximately 500 kilojoules and is of little nutritional value.
6. Have regular exercise. Thirty minutes of moderate exercise, three to four times a week is recommended to maintain fitness and a healthy weight. Before undertaking any strenuous exercise, always start with a complete medical check-up.
7. Drink 6 to 8 glasses of fresh, filtered water each day. The water will help to keep the bowels regular and prevent constipation.

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