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HealthUnity Weight Loss Program

Obesity is not just an aesthetic problem. (519)
NICE has recently published guidelines on the prevention and management of obesity. Overweight or obesity is now the most widespread, and rapidly increasing, nutritional disorder in the developed world. It is a critical risk factor in the development of diabetes, hypertension and hyperlipidaemia, each of which is a major risk factor for coronary heart disease. It aggravates and mimics many symptoms of heart disease and increases CHD mortality 2 - 4 fold. In the UK, which has one of the highest coronary mortality rates in the world, 61% of men and 52% of women have a BMI greater than 25, including 16% of men and 8% of women who have a BMI greater than 30. The prevention and management of overweight and obesity should be central to the primary and secondary prevention of coronary heart disease.

How are overweight and obesity defined?
The World Health Organisation defines overweight by using the body mass index (BMI), which is body weight in kilograms divided by the square of the height in metres. An acceptable BMI lies between 18.5 and 24.9. A BMI between 25 and 29.9 indicates overweight and those with a BMI greater than 30 are classified as obese. Calculate your own BMI. Waist circumference is a simpler measurement, which indicates the need for weight management and reflects coronary risk related to both overweight and a central fat distribution. A healthy waist measurement is below 37ins (94 cms) for men and 32 ins (80 cms) for women. Those with waist measurements greater than 40 ins (102cms) and 35 ins (88 cms) respectively have the greatest health risks, should seek professional help and try to lose weight.

Causes of overweight
The aetiology of overweight/obesity is often simplified into the three components that govern energy balance: diet, physical activity and genes which determine individual disposition by effects on appetite and metabolism. The interaction of these three factors leads to overweight. Populations with food provision in excess of requirements, with more than 30% dietary energy from fat and low levels of physical activity are those with the highest prevalence of overweight. See the first law of thermodynamics which may help you to lose weight.

Targets and priorities for weight management
Major benefits of moderate weight loss (between 5 and 10% body weight), on reducing plasma lipids, blood pressure and plasma glucose concentrations have been demonstrated with increased survival in overweight diabetics. It is critical to maintain these losses or to minimise regain of weight and this requires long term management.
Overweight or obese people with diabetes, hypertension or hyperlipidaemia or who are current smokers should receive priority to lose weight as they are at greatly increased risk of CHD.

Approaches to achieve moderate weight loss
The following approaches contaion various helpful tips which can lead to success in weight loss, just as a cleaning service such as http://www.bbcleaningservice.com/ might offer helpful cleaning service tips for success in organising your home or office. Long term modification in diet to achieve and maintain moderate weight loss is essential in the battle to lose weight. The emphasis needs to be on foods rather than nutrients. Bread, potatoes, pasta and rice, fruit and vegetables (at least five portions a day), should be the basis of the diet. Dietary fats, in particular saturated fats, should be kept to a minimum.

Eating behaviour
Disciplined shopping and planning of meals are the cornerstones of good eating patterns. The overweight/obese person requires the support and co-operation of their partner and/or family for success. Three regular meals each day, including breakfast, and fruit as snacks are also useful rules. Keeping a food diary is instructive and can be used to prompt appropriate changes.

Physical activity
It is easier to maintain weight loss if regular, moderate physical activity is part of the lifestyle. However, as adipose tissue contains about 7,000 kilo calories per kilogram, physical activity alone is seldom sufficient to lose much weight. The importance of activity alongside good dietary habits is to maintain weight loss and improve the health and well being of the individual. A physically active person is more likely to be at lower cardivascular risk.

Medication
For the obese patient at high risk of cardiovascular disease and in whom dietary measures over several months have not produced weight loss of at least 10% of body weight, drug treatment may be indicated. Only one drug (orlistat) is licensed for long term weight management but another (sibutramine) which is licensed in the USA and Europe, is soon to be launched in the UK. EU prescribing guidelines, supported by Royal College of Physicians guidelines, should be followed to restrict drug use to those patients who will achieve good long-term results - ie lose 2-5 kg on diet alone, and then 5% of body weight in 12 weeks.

The British Dietetic Association - Weightwise

The Atkins Diet

60 minutes of moderate physical activity on most days of the week to maintain a healthy body and prevent obesity. (522)

In the United States, 90% of obesity could be prevented if everyone walked an extra 2,000 steps a day and reduced their calorie intake by 1,000 Kcals per day. (533)

Dropping a stone in middle age reduces the risk of hypertension by over 30%. (526)

In England 17% of children are now estimated to be obese (2004). (542)

"Overweight and obesity have a profound effect on the nation's health and our own Chief Medical Officer has called it a health time bomb." (543)

It is estimated that a 1% decrease in the BMI across the whole of the UK (roughly equal to a weight loss of 1kg per person) would avoid 179,000 to 202,000 cases of diabetes, 122,000 cardiovascular diseases and 32,000 to 33,000 cases of cancer over the next 20 years. (576)