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Ask the Medical Expert Archives 2000-2004

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March 2000

Q. I am about 50 pounds overweight. I have tried dieting on my own without much success. I probably don't exercise as much as I should. What can I do?

A. In the US, we are in an epidemic of obesity. 54% of US adults are overweight or obese. 25% of US children are overweight or obese. Obesity is defined as an excess of body fat that can be calculated by using the body mass index (BMI). BMI is calculated by dividing one's weight in Kilograms, divided by their height in meters squared: BMI = Kg/meters squared. Overweight is defined as a BMI of 25 to less than 30. Obesity is defined as a BMI of 30 or greater. Obesity is a major risk factor for multiple diseases including heart attacks, diabetes, high cholesterol, high blood pressure, certain cancers, gallstones, and degenerative arthritis. Obesity should be thought of as a chronic disease, and treatment therefore is multifaceted and lifelong.

Fortunately, there are several things one can do to lose weight. First of course is a prudent diet and exercise. There are several different "diets" being advocated. I believe that one that is well balanced with low fat, high fiber and overall low caloric (therefore also being careful to limit total carbohydrates) is best. The American Heart Association has such diet recommendations. Also, I believe that some of the group weight loss programs such as weight watchers, can be a very helpful adjunct for people to stay on track. Of course, before taking on an exercise program, you should check with your personal physician to make sure he believes it is safe in your case.

Also, there are now at least 2 FDA approved drugs for treatment of obesity; Meridia and Xenical. On average, one can expect to lose 5 - 10% of their body weight with these meds in conjunction with diet and exercise. This may not sound like much, but studies show that even this amount of weight loss is often associated with significant reduction in blood pressure and improved glucose control. Also, for refractory obesity, surgery such as gastric bypass is an option that can be very effective. Obviously, there are some risks of surgery as well, but in the hands of an experienced surgeon, they can be minimized.

For more info: The American Heart Association: http://www.americanheart.org

Also: Overeaters Anonymous : 1-505-891-2664

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