Author: Dr. Ricardo Kotliroff
Obesity is a serious condition characterized by having over excess of body fat relative to a person’s height. Thus, obesity is distinct from merely weighing too much.
A person’s weight in kilograms represents a composite of the weight of muscle, bone, fat, and body water. Body Mass Index (BMI) is found by dividing a person’s weight in kilograms by his height in meters.
Adults with BMIs greater than or equal to 30 are considered obese, according to the World Health Organization (WHO). In contrast, adults with BMIs greater than or equal to 25, but less than 30, are considered overweight.
Causes & Risk Factors
Obesity is a preventable condition, however, there are factors that can influence it including genetics, height, age, certain diseases, and behavior. Additionally, metabolic functioning plays a significant role in obesity due to the many hormones that regulate appetite, food intake, storage of fat tissue, and insulin resistance in the human body.
Research has demonstrated that variants in certain genes may increase hunger levels and overall intake of food. Nevertheless, most cases of obesity likely result from interactions among several genes as well as behavioral factors. A person has a higher risk of being obese if at least one parent is/was obese. Illnesses that can influence weight gain and obesity include Cushing’s disease and Polycystic Ovary Disease.
Behaviors associated with increased weight and obesity include lack of physical activity, overeating, eating high-fat foods, being addicted to sugar, and certain medication use. The WHO believes that an increase in energy-dense (high caloric), high-fat foods is responsible for the global rise in obesity.
Over time, when a person consumes more calories from foods and beverages than is burned in activities, obesity occurs. The ideal balance between intake of calories and use of calories differs for everyone. Additionally, medications associated with weight gain include steroids, antidepressants, anticonvulsants, certain anti-diabetic medications, oral contraceptives, anti-hypertensives, and antihistamines.
Statistics on Obesity
The WHO estimates that over 1.9 billion adults (39% of the world’s population) were overweight in 2014. Of the overweight adults, more than 600 million (13% of the world’s population) were obese.
Signs & Symptoms
Signs and symptoms of obesity include abnormal accumulation of fat in the body, extremely high BMI, and addiction to sugar.
Being obese increases the risk of many serious conditions including:
- Orthopedic conditions: arthritis, body pain, problems with physical functioning
- Type 2 diabetes
- High blood pressure
- Elevated triglycerides and cholesterol in the blood
- Coronary heart disease
- Obstructive sleep apnea and difficulty breathing
- Fatty liver disease
- Gallbladder disease
- Certain cancers including endometrium, breast, and colon
- Depression, and anxiety
Thus, obesity results in a huge reduction in the quality of life.
Obesity is also a leading cause of death worldwide. Being obese decreases life expectancy by an average of 6 to 7 years, while having severe obesity (defined as a BMI greater than 40) is associated with a decrease in life expectancy of 10 years. In Europe, excess weight is estimated to cause 1 million (7.7% of) deaths annually.
Diagnosis by a healthcare practitioner includes evaluation of signs and symptoms, body fat measurements, BMI, and lifestyle and diet assessment.
Body fat can be determined by a variety of methods, such as using calipers to measure thickness of skin, hydrostatic weighing (weighing underwater to measure breakdown of muscle mass and body fat), BOD POD (a computerized chamber that calculates muscle mass and body fat), bioelectrical impedance (calculates ratio of body fat), and dual energy x-ray absorptiometry (measures percent and specific locations of body fat). Some of these diagnostic techniques are available only at certain research institutions.
Although BMI is not a direct measurement of body fat, BMI typically correlates with values from direct measurement of body fat.
Beneficial Effect of Losing Weight
If a person is obese, losing even 5 to 10 percent of his total weight can prevent or delay some serious diseases, such as type 2 diabetes, stroke, and complications of cardiovascular disease. An example of 5% to 10% reduction in weight in a 200-lb person is a loss of 10 to 20 pounds. This type of weight loss has also been shown to reduce blood pressure, cholesterol levels, and even the overall rates of death.
Conventional Medical Therapy
Conventional medical treatment, which consists of a weight-loss phase and a maintenance phase, includes:
- Changes to diet to replace unhealthy foods with healthier options
- Increased physical activity
- Bariatric surgery
- Vagal nerve blockade
Unfortunately, long-term weight maintenance due only to changes in lifestyle has a low success rate that ranges from 2% to 20%.
Prescription weight loss medications, which have been used in patients in whom the potential benefit justifies the risk, include Phentermine, Orlistat, Lorcaserin, Qsymia, Buproprion, Naltrexone, and Liraglutide. Phentermine is an appetite suppressant. Orlistat decreases absorption of fats, fat-related calories, and certain vitamins, thereby promoting weight loss. Qsymia is a combination of phentermine and topiramate.
However, prescription medications for weight loss may cause problematic side effects. For example, orlistat may result in stomach pain, unpleasant bowel movements, and issues with the kidneys; Lorcaserin may cause headaches, dizziness, and fatigue; while Qysmia may cause problems with the heart and eyes, as well as suicidal ideation.
Importantly, patients taking prescription medications for weight loss require frequent monitoring by a physician. Other limitations of prescription medications for weight loss are that they do not work in all patients, and for those that do experience the weight loss, the effects may be temporary rather than a cure. Many patients taking prescription weight-loss medications eventually regain the lost weight once the medications are stopped. In addition, no obesity medications have been proven to decrease some of the harmful side effects of obesity like heart disease or death due to heart disease.
Bariatric surgery, including laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass, bilioduodenal diversion with duodenal switch, and gastric sleeve, is reserved for patients with extreme obesity (i.e., a BMI equal to or greater than 40). Like with all invasive procedures, bariatric surgery has risks associated with the procedures. In LAGB, the use of an inflatable band changes the stomach into two pouches connected by a small channel, thereby restricting the amount of food and liquid that can be held by the stomach. Gastric banding patients must be compliant in dramatically decreasing the amount of food consumed.
Surgeons performing gastric bypass create a small stomach pouch and route it to a part of the small intestine, where most calories will be absorbed. The bypass results in reduction of intake of food, and decrease in calories absorbed. Following gastric bypass, side effects may include faintness, a well as gastrointestinal symptoms including nausea, bloating, and diarrhea. Gastric bypass patients must take multivitamin supplements.
In biliopancreatic diversion with duodenal switch, most of the stomach is removed, the middle section of the small intestine is closed, part of the small intestine is connected to the duodenum, and part of the intestine is reattached in order to allow the flow of digestive fluids and bile. While in gastric sleeve surgery, part of the stomach is removed surgically.
Regardless of whether obese patients are treated with prescription medications or bariatric surgery, weight loss that is not monitored well or cycles between losing and gaining weight is associated with complications. Problems that can arise from these weight fluctuations can include electrolyte imbalance, cardiac arrhythmia, gallstones, excess uric acid in the blood, depression, and binge eating disorders.
Vagal nerve blockade is a relatively new treatment method for patients who have failed weight-loss programs and have a BMI of 35 to 45 and at least one medical condition related to obesity. When the stomach is empty or full, the vagal nerve sends messages to the brain. In vagal nerve blockade, a device is implanted under the skin of the abdomen. The medical device transmits intermittent electrical pulses to the vagus nerve in the abdomen, thereby circumventing the normal signals that the brain receives from the vagus nerve.
Alternative treatment includes over-the-counter (OTC) appetite suppressants, diuretics, and homeopathic treatments.
Some OTC supplements have become very popular as ways to lose weight, but their efficacy is questionable and not without side effects. Although OTC ephedra, which contains ephedrine, can cause temporary weight loss, a harmful side effect is high blood pressure. Despite use of the OTC mineral, chromium, to attempt to decrease body fat, scientific research has not proven that chromium causes weight loss. Additionally, even though hoodia is marketed as an OTC appetite suppressant, no large-scale clinical trials have been performed to prove the benefit or safety of hoodia.
Use of OTC diuretics and herbal laxatives result in loss of weight from water, not fat. Also, the fact that diuretics and herbal laxatives reduce potassium can result in problems with muscles and the heart.
In contrast, as an alternative method of therapy, homeopathy seeks to treat the patient, rather than just the disease. Homeopathy is an effective method of healing acute and chronic conditions, as claimed by millions of patients worldwide and thousands of homeopathic doctors.
Our proprietary therapeutic methods are based on a belief that all humans possess certain foundational energy sources within their core, and that a person’s energy balance is tied directly to his/her state of health and wellbeing. When these energy sources are disturbed, whether from internal or external forces, disease occurs.
Our homeopathic treatments seek to neutralize these disturbances and restore a person’s natural, optimal energy balance.
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