Vegetables are interesting but lack a sense of purpose when unaccompanied by a good cut of meat.

Fran Lebowitz

Who is obese

Scale weight is a total measure of bone, muscle, fluid, organs, and fat. Weight measurements reflected by the bathroom scale or compared to standard height and weight tables does not allow for weight changes which occur due to aging, exercise, or frame size. Therefore, more emphasis should be placed on body composition and healthy lifestyles with less on body weight alone.

Fat distribution can influence a person's risk of disease. Fat carried around the waist and in the abdominal area, characterized by the "apple shape", is associated with an increased risk for many medical problems such as heart disease, cancer, high blood pressure, and diabetes. Fat that is mostly distributed around the buttocks and thighs is associated with a lower risk of developing these diseases.

As much as 50 to 75 percent of obesity has genetic influences. Just what those genetic influences are that affect body weight have not been identified.

Research points to differences in appetite control and energy expenditure. It is important for obese people not to hold themselves responsible for their condition.

Fasting diets for weight loss may be right for obese persons who have serious weight-related medical problems. Rapid weight loss is the primary advantage of using these diets. This may be helpful in motivating the individual to continue with the program. This may help to support lifestyle changes which are needed for continued weight loss.

Medically supervised fasts are very low calorie diets which provide from 400 to 800 calories per day. While most of these diets are low in calories, the protein provision is very high. The purpose of these diets is to promote fat loss, not muscle loss. The high protein content helps prevent large losses of muscle tissue. Electrolytes, vitamins and minerals are also supplemented.

Proper use of these diets requires close monitoring and follow-up. To promote lasting weight loss, lifestyle changes must be made by the dieter while on the fast.

To achieve lasting weight loss, commitment must be given to making real changes in eating patterns. Individuals are who not committed will gain back their weight.

Bulimia nervosa is an eating disorder that is estimated to be present in up to 5 percent of teenage and young adult women. It is characterized by binge eating followed by purging and other behaviors such as vomiting. Laxatives, diet pills, water pills, exercise or fasting may also be used.

Overweight or overfat?

Many people may actually be overfat but not overweight. Fat can also be hidden throughout the body. A person may be overfat without the appearance of being overweight. As we age, muscle tissue is replaced with fat. This occurs despite regular exercise.

Many people are motivated to diet by wanting to be thin and attractive like the models we see everywhere - on TV and in magazines. What is far more important is that a leaner body reduces the risk for certain diseases.

Studies show that a 20 percent increase in body weight increases the risk for heart disease, high blood pressure and diabetes.

Appetite suppressant medicine

Obesity is a chronic disease that affects many people and often requires long-term treatment to promote and sustain weight loss. As in other chronic conditions, such as diabetes or high blood pressure, long-term use of prescription medications may be appropriate for some individuals

Brand names of the most effective prescription diet medications on the market today are: Phentermine, Adipex-P, Fastin, Ionamin, Bontril, Plegine, Tenuate, Xenical.

While the FDA regulates how a medication can be advertised or promoted by the manufacturer, these regulations do not restrict a doctor's ability to prescribe the medication for different conditions, in different doses, or for different lengths of time.

People respond differently to appetite suppressant medications, and some people experience more weight loss than others. Some obese patients using medication lose more than 10 percent of their starting body weight- an amount of weight loss that may reduce risk factors for obesity - related diseases, such as high blood pressure or diabetes.

Maximum weight loss usually occurs within six months of starting medication treatment. Weight tends to level off or increase during the remainder of treatment. Studies suggest that if a patient does not lose at least four pounds over four weeks on a particular medication, then that medication is unlikely to help the patient achieve significant weight loss.

Over the short term, weight loss in obese individuals may reduce a number of health risks. Studies looking at the effects of appetite suppressant medication treatment on obesity-related health risks have found that some agents lower blood pressure, blood cholesterol, triglycerides (fats) and decrease insulin resistance (the body's inability to use blood sugar) over the short term. Long-term studies are currently being done to determine if weight loss from appetite suppressant medications can improve health.

When considering long-term appetite suppressant medication treatment for obesity, you should consider the following areas of concern and potential risks. Currently, all prescription medications to treat obesity are controlled substances, meaning doctors need to follow certain restrictions when prescribing appetite suppressant medications. Although abuse and dependence are not common with non-amphetamine appetite suppressant medications, doctors should be cautious when they prescribe these medications for patients with a history of alcohol or other drug abuse.

Most studies of appetite suppressant medications show that a patient's weight tends to level off after four to six months while still on medication treatment. While some patients and physicians may be concerned that this shows tolerance to the medications, the leveling off may mean that the medication has reached its limit of effectiveness. Based on the currently available studies, it is not clear if weight gain with continuing treatment is due to drug tolerance.

Definitions and terms on this page

FDA

• Food and Drug Administration: A government agency that oversees public safety in relation to drugs and medical devices. The FDA gives approval to pharmaceutical companies for commercial marketing of their products.

Fat blocker

• Drugs that block the absorption of fat or calories, and lose substantial weight.

Overweight

• Weighing more than is normal, necessary, or allowed, especially having more body weight than is considered normal or healthy for one's age or build.

Appetite

• An instinctive physical desire, especially one for food or drink. Decreased desire to eat is termed anorexia, while polyphagia (or "hyperphagia") is increased eating. Disregulation of appetite contributes to anorexia nervosa and cachexia, or oppositely, overeating.

Diabetes

• Any of several metabolic disorders marked by excessive discharge of urine and persistent thirst, especially one of the two types of diabetes mellitus.

Diet

• A regulated selection of foods, as for medical reasons or cosmetic weight loss.


• A solutions designed to reduce or suppress the appetite.

Fat

• Any of various soft, solid, or semisolid organic compounds constituting the esters of glycerol and fatty acids and their associated organic groups.

Obesity

• The condition of being obese; increased body weight caused by excessive accumulation of fat.

Stress

• A state of extreme difficulty, pressure, or strain.


• A physical and psychological response that results from being exposed to a demand or pressure.

Suppress

• To curtail or prohibit the activities of.


• To inhibit the expression of (an impulse, for example).


• To bring to an end forcibly as if by imposing a heavy weight.

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