Presentation Obesity
Presentation Obesity
To define obesity we use body mass index (BMI) which used as a parameter for measuring overall risk of heart disease in obese person.
BMI = weight (Kg) / Height (m2) If BMI < 18.5 under weight 18.5- 24.9 Normal 25- 29.9 Over weight 30- 34.9 Class I obesity 35- 39.9 Class II obesity > 40 Class III obesity N.B. Over weight person with large abdomen are generally worse health than equally obese people (fat distributed around their hips and limps)
Causes
Eating too many calories and not getting enough physical activity are the main causes of obesity, especially in combination. But many factors can contribute to obesity.
Risk factors
Factors that increase your risk of being obese include: 1- Diet Regular consumption of high-calorie foods, such as fast foods, contributes to weight gain. High-fat foods are dense in calories. 2- Inactivity Sedentary people are more likely to gain weight because they don't burn calories through physical activities. 3- Psychological factors Some people overeat to cope with problems or deal with emotions, such as stress or boredom.
4- Genetics
If one or both of your parents are obese, your chances of being overweight are greater. Your genes may affect the amount of body fat you store and where that fat is distributed.
5- Age.
As you get older, you tend to be less active. In addition, the amount of muscle in your body tends to decrease with age. This lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs. If you don't decrease your caloric intake as you age, you'll likely gain weight.
6- Smoking
Smokers tend to gain weight after quitting. This weight gain may be partially due to nicotine's increase (metabolic rate). Smoking also affects taste; quitting smoking makes food taste and smells better.
7- Pregnancy.
During pregnancy a woman's weight necessarily increases.
8- Medications.
Corticosteroids and tricyclic antidepressants, in particular, can lead to weight gain. So can some high blood pressure and antipsychotic medications.
3- Medical problem
Uncommonly, obesity can be traced to a medical cause, such as low thyroid function, excess production of hormones by the adrenal glands (Cushing's syndrome) or other hormonal imbalances, such as polycystic ovary syndrome. A medical problem, such as arthritis, can also lead to decreased activity, which can result in weight gain.
10- Alcohol.
Drinking alcohol adds calories to your diet just one regular beer is about 150 calories. Additionally, excessive drinking can stimulate your appetite and make you less likely to control portion sizes.
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Complications
If you're obese, you're more likely to develop a number of potentially serious health problems. These may include:
2- Diabetes.
Obesity is a leading cause of type 2 diabetes. Excess fat makes your body resistant to insulin.
5- Stroke Obesity is associated with atherosclerosis including arteries in your brain. If a blood clot forms in a narrowed artery in your brain, it can block blood flow to an area of your brain. The result is a stroke. 6- Osteoarthritis Excess weight puts extra pressure on the joints and wears away the cartilage that protects them, resulting in joint pain and stiffness. 7- Sleep apnea This serious condition causes a person to stop breathing for short periods during sleep and to snore heavily. The upper airway is blocked during sleep, which results in frequent awakening at night and subsequent drowsiness during the day. Most people with sleep apnea are overweight, which contributes to a large neck and narrowed airways. 8- Cancer In women, these include cancers of the breast, uterus, cervix, ovaries and gallbladder. Overweight men have a particularly higher risk of cancers of the colon, rectum and the prostate.
11- Hirsutism.
Aromatase enzyme in adipose tissue converts androgen to estrogen hormone but in obese person not act perfectly so increase androgen. Obesity can also contribute to gout, a joint disorder.
Treatment
The first goal in dealing with obesity is to achieve and maintain a healthier weight . The amount of weight you need to lose to improve your health may be much less than what you feel you need to lose.
I- Dietary changes
Consuming fewer calories is an important factor for successful weight loss. To lose weight and keep it off, eat moderate amounts of nutrient-rich, low-fat, low-calorie foods. Follow these fundamentals of healthy eating.
Think 'energy density.' Energy density is the number of calories in a given volume of food. Choose low-energy-dense foods, which include a lot of fresh fruits and vegetables.
Healthy foods include vegetables, fruits, grains and lean sources of protein, including beans, fish, low-fat dairy products and lean meats. high-fiber carbohydrates are good source rather than table sugar and other sweeteners.
carbohydrates.
Cut back on sweets. Reduce fat. Because fat has more than twice the calories
of carbohydrate and protein, reducing the fat content of your diet is an important way to cut calories.
A- Group weight-loss programs. B- Individual weight-loss programs. C- Popular diets. 1- The Atkins diet 2- The Zone 3- South Beach Diet 4- Sugar Busters 5- Grapefruit diet 6- Cabbage soup diet
Increase physical activity 1- body metabolism 2- appetite 3- Good mentality and emotionally 4- Loss of muscle mass 5- Burns calories
1- Motivate yourself 2- Make lifestyle changes a priority 3- Have a plan 4- Set small goals 5- Surround yourself with good examples 6- Avoid food triggers
The two main prescription weight-loss medications are: 1- Sibutramine (Meridia10, 15 mg). Mechanism Changes your brain chemistry, making you feel full more quickly by inhibiting reuptake of serotonin, dopamine and norepinepherine Side effects 1- Increased blood pressure 2- Headache and dry mouth 3- Constipation and insomnia Contraindications 1- With MAOI 2- Seizures 3- Congestive heart failure Dose One capsule (10 mg) once daily half hour before Breakfast
N.B Orlistat decreases the absorption of certain fat-soluble vitamins for example, vitamins A, D and E. If you're taking this drug, your doctor will recommend that you take a daily vitamin supplement to prevent potential nutrient deficiencies. If you're among those who can benefit from weight-loss medication, you'll likely need to take it indefinitely. When drug treatment is stopped, much or all of the excess weight generally returns.
Even if you qualify for weight-loss drug therapy, the drugs might not work for you. And, if they do work, their effects tend to level off after six months of use.
Over-the-counter products.
Over-the-counter (OTC) diet products promise to help you shed pounds by raising your metabolism or suppressing your appetite. Their side effects, however, can be dangerous.
Mechanism
This drug can slightly suppress your appetite.
Side effects
1- High blood pressure 2- Heart rate irregularities 3- Heart attacks, strokes and death. 4- Insomnia, nervousness, tremors and seizures
2- Bitter orange
Touted as an "ephedra substitute" but may cause health problems similar to those of ephedra.
4- Phenylpropanolamine (PPA).
Related to amphetamines and un safe due to higher risk of hemorrhagic stroke
5- Phenyl alanin.
Act as appetite suppressant via release of cholecystokinin delay gastric emptying rat and give sense of satiety. Also regulate thermogenesis so help in burning of fats.
7- Pyruvate.
Pyruvate supplements seem safe, but claims of boosting metabolism and decreasing appetite
9- Hoodia.
The claims say it decreases appetite.
Side effects
Can cause diarrhea, gastrointestinal problems flatulence and other
Side effects
Can cause complaints bloating and other gastrointestinal
13- Chromium.
Reduce body fat and builds muscle because it may affect carbohydrate and fat metabolism. a- insulin receptor sensitivity utilization of glucose b- Enhance penetration of amino acid inside muscle cell N.B.Cause serious side effects, such as kidney damage, especially when taken in large doses
15- Fibers.
It Difficult in digestion so delay gastric emptying rate and give sense of satiety
Here are some of the specific operations, representing these two categories: 1- Vertical banded gastroplasty
Nicotine increases the release of a brain chemical called dopamine, which makes you feel good. Getting that dopamine boost is part of the addiction process. Your degree of addiction depends in part on how much you smoke and how long you've smoked.
Signs and symptoms 1- You can't stop smoking. 2-You experience strong withdrawals ymptoms when you try to stop. (anxiety, irritability, restlessness, difficulty concentrating, headache, drowsiness, stomach upset, even constipation or diarrhea). 3- You keep smoking despite health problems. 4- You give up social or recreational activities in order to smoke.
Complications
Lungs. Smoking is the cause of most cases of lung cancer. Smoking is also the primary cause of other lung problems, such as emphysema and chronic bronchitis. Heart and circulatory system. Smoking increases your risk of dying from cardiovascular disease, including heart attack and stroke. Smokers have a higher risk of stroke that nonsmokers do; the more you smoke, the higher your risk. Cancer. Smoking is a major cause of cancer of the esophagus, larynx, throat (pharynx) and mouth and contributes to cancer of the bladder, pancreas, liver, kidney, cervix, stomach, colon and rectum, and some leukemias. Appearance. The chemicals in tobacco smoke can dry and irritate your skin, as well as promote wrinkles. Smoking also yellows your teeth, fingers and fingernails. Fertility. Smoking increases the risk of infertility and miscarriage in women and the risk of impotence and infertility in men.
Pregnancy
and
newborn
complications.
Mothers who smoke while pregnant increase the risk of low birth weight, preterm delivery and impaired lung
function in their newborns.
Cold, flu and other illnesses. Smokers are more prone to illnesses, such as colds, flu or bronchitis, than nonsmokers are. Senses. Smoking deadens your senses of taste and smell, so food isn't as appetizing as it once was.
Treatment
The benefits of quitting
Lung function normally declines with age. Smoking worsens that decline. Quitting smoking won't undo permanent damage, but it will slow the decline.
Just 20 minutes after your last cigarette, your heart rate goes down. Twelve hours later, the carbon monoxide levels in your blood return to normal. Your lung function improves and your circulation starts to get better between two weeks and three months after your last cigarette. Between one and nine months after quitting, your risk of infections drops and coughing and shortness of breath decrease. After one year, the risk of coronary artery disease drops by half. After five to 15 years, your stroke risk will be the same as that of a nonsmoker.
1- Nicotine patch (Nicoderm CQ, Nicotrol, Habitrol, others). The nicotine patch provides a steady release of nicotine.
Dose Patches must be replaced every 24 hours for 8 week or longer.
Pros:
The patch is easy to use and provides a steady release of nicotine. It's available without a prescription and in various doses (15mg step-1), (10 mg step2) and (5mg step three). This flexibility allows you to manage your withdrawal symptoms and cravings, as well as to taper the amount of nicotine you receive gradually.
Cons:
You can't quickly adjust the amount of nicotine in the patch in response to cravings. The patch may cause itching and irritation where it's applied. Other side effects may include headache, dizziness, upset stomach and blurred vision. Occasionally, patches may cause sleep disturbances and vivid, colorful dreams. Removing the patch at night may help.
2- Nicotine gum (Nicorette, others). This is a gum-like resin that delivers nicotine to your blood through the lining of your mouth. It's available in a 2-milligram dose for regular smokers and a 4-milligram dose for heavy smokers. Dose The maximum number of pieces a day is 20, though you'll probably chew less. Nicotine gum is recommended for 12 week, with a maximum of 24 week.
Leukoplakia appears as thick, white patches on your gums or on the insides of your cheeks.
3- Nicotine lozenge (Commit). This is a tablet that dissolves in your mouth and, like nicotine gum, delivers nicotine through the lining of your mouth. The lozenges are also available in 2- and 4-milligram doses. Dose These nicotine one lozenge / replacement products weeks, by prescription 2hr for six are available then gradually increasing the intervals between lozenges over the next six weeks. These nicotine replacement products are available by prescription in the form of nasal inhalation and nasal spray
B-Non-nicotine medication
Medications that don't contain nicotine include: Antidepressants.
The antidepressant drug bupropion increases the level of dopamine, the chemical that's also boosted by nicotine, in your brain. As with many medications, bupropion (Zyban) has side effects, including sleep disturbance and dry mouth. If you have a history of seizures or serious head trauma, such as a skull fracture, don't use this drug. Another antidepressant that may help is nortriptyline (Aventyl, Pamelor).
Varenicline (Chantix).
This medication acts on the brain's nicotine receptors, decreasing withdrawal symptoms and reducing the feelings of pleasure you get from smoking. Potential side effects include headache, nausea, an altered sense of taste and strange dreams.