Weight Loss
Weight loss is a widely spread concern in our society. Whether for pure aesthetic or for health reasons, weight loss is most commonly controlled by diets and, more rarely, by surgery.
Many factors come into play when trying to lose weight by yourself or under supervision of a specialist. There are tons of ways to lose the desired weight, from the stapling of the stomach to the method du jour. In all cases, an effective weight loss has to go through and for a healthy body.
Overweight
Fats (lipids) are used to store energy in the body, like sugars (carbohydrates). If sugars can store a bit of quickly usable energy, fats can store a lot of energy in little space, in cells called adipocytes.
When stored fats overgrow fats that are spent, cells grow and create an overweight. Only when these adipocytes cells arrive at saturation do they multiplicate to store fat, and then obesity is on the line.
There are various methods for assessment of weight. In addition to the mass, we have to address the weight/size ratio.
The most common evaluation method is the body mass index (BMI). It is obtained by dividing weight (in kilograms) by the square of height (in meters) of a person. A normal BMI for an adult is between 18.5 and 25. We speak of overweight between 25 and 30, of obesity for a BMI over 30, and morbid obesity beyond 40.
There is another calculation of overweight: waist/hip ratio. For a healthy weight, men must have a less than 1 ratio and a less than 0.85 ratio for women.
It should be noted that, in addition to the different morphology of men and women, the fats are also distributed differently for each. First, fats represent 20 to 25% of a woman’s healthy weight, but are responsible for only 10 to 15% of the man’s. This weight typically accumulates on the thorax and the abdomen of a man, on the hips and thighs of a women. Finally, in both cases, overweight is harmful and can lead to cardiovascular problems for anyone, adding possible joints problems for women.
Causes
Overweight is often the result of an imbalance between total energy intake and the amount of energy expenditure. If the amount of calories provided by carbohydrates, fats and proteins is greater than the energy expenditure, the body stores a portion of the contribution in the form of fat in the adipose tissue.
Regarding food, amounts are usually not the only variables to control. Quality plays even more in the balance. It is important to distinguish energy intake of whole sugar versus refined one, or a cold-pressed oil compared to the heat extracted ones, which eliminates much of the beneficial contributions, for example.
Food
The types of lipids in nutrition are as follow, with the properties for the body :
Sterols:
- Cholesterol (2 / 3 of which is produced by the liver): The cholesterol provided by food is not usually harmful. But the excessive production (or too low) by the liver from fats eaten, increases cardiovascular risks. In blood tests, we must also distinguish "good " (HDL) and "bad" (LDL) cholesterol, only involved in cardiovascular disease. It is the relationship between the two need to monitor, more than the total cholesterol.
- Phyto-sterols (oils, cocoa, fruits, vegetables): Regulation of cholesterol levels. Anti-inflammatory properties. Reduced risk of cancer and prostate hyperplasia. Strengthening the immune system. Increased DHEA levels.
Tocopherols:
- alpha (Vitamin E), Beta, Gamma, Delta Oil (except palm and copra): Antioxidants decrease cardiovascular risk and cancer.
Phospholipids and sphingolipids (egg, soy, wheat germ): Useful to brain (neurons) and cell membranes.
Fatty acids:
- Saturated (meat, butter, cream, corn oil, etc.): Increased cardiovascular risk (U.C.V.), the doses consumed by the majority in most developed countries. The food industry often prefers fat substitutes to butter, but they are even worse, acknowledging the Trans-unsaturated they contain:
- Unsaturated "Trans" (refined oils, chips and fries industry, fried, butter-free pastry, supermarket bakery, solid margarines, biscuits, drinks, crackers, industrial pastry, bread crumbs, quiches, industrial pies and pie doughs, sauces, salad dressing, industrial mayonnaise, beef fat, lamb, dairy products): highly increased risk U.C.V. [9]: increase in bad cholesterol (like butter), but also decreasing of the good one.
- "Mono-unsaturated, like omega-9: (Olive oil, vegetable oil, fat from duck, goose, chocolate): Decreased Risk U.C.V.
- Poly-unsaturated Omega-3 (nut oils, soybean, canola oils, currants, cassis, olive, fat fish, shellfish): Decreased Risk U.C.V., but can cause cardiovascular and immune disorders. The omega-3 requires enough omega-6 to be assimilated, but the doses of omega-3 consumed in developed countries are (much) too low compared to omega-6.
- Poly-unsaturated Omega-6 (oil of grape seeds, sunflower, nuts, corn, soybean, canola, olive, chicken fat): Decrease Risk U.C.V., but can cause cardiovascular and immune disorders. Sometimes, obesity is found in infants or foetuses. The mother’s nutrition, too rich omega-6, is at stake, and even the composition of milk powder, similar to that of milk from mothers consuming too much of omega-6.
Consumption of sugar provides energy in the short term, but it can not be stored as it is in the body. A portion of the sugar consumed can be used immediately to provide energy when necessary (in the following minutes), another part is stored in the liver and muscles (used in the next few hours), and another will be turned into fat to be stored in the fat layers.
It is advisable to consume complete cane sugar because it contains all the nutrients contained in sugar cane. Once processed and refined it contains 50 to 60 times less minerals and no more vitamin (rapadura contains vitamins B1, B2, B5 and E).
Eat only full sugar instead of white sugar would equalize our diets by providing all the nutrients missing from refined sugar and significantly reduce the number of dental cavities (calcium, potassium and magnesium reduce the acidity of the saliva-friendly bacteria).
In all cases, it is important to keep sugar consumption to a minimum: like all simple sugars, vitamins and minerals are needed to metabolize sucrose (mainly vitamins B1 and magnesium). Eating refined sugar in large quantities monopolizes these essential resources and creates deficiencies.
An adult eats an average of 100 grams of sucrose per day, over 70% of which in the added form in processed products. However, the recommended daily intake in carbohydrates are from 200 to 250 grams, less than 10% of which in the form of simple carbohydrates.
Whether white or whole, sugar still contains 4000 kilocalories per kilogram, equivalent to 17,000 kilojoules. Moreover, it creates a dependency that can lead to hypoglycemia, diabetes and obesity. Eating a lot of sugary foods does not automatically produce these disorders if they are associated with a balanced diet: a balanced diet is not based on a simple-sugars / complex-sugars, but on the glycemic index calculation for all the food you eat during the day.
In a very paradoxical way, some diets can cause weight gain. For example, if there is a loss of muscle mass, the metabolism slows down its work and overweight returns very quickly. Most of the examples related to this phenomenon are diets focused on protein intake.
Consequences
Someone with an overweight (or obesity) problem may go through several drawbacks. This is a phenomenon that holds constant attention in the medical research world and is subject to many studies.
In addition to the physical problems, overweight can lead to psychological and social complications and even, in extreme cases, lead to the loss of cognitive acuity.
Treatments
Bariatric Surgery
The surgery is to restrict the absorption of food, decreasing, in fact, the daily caloric intake. It is a great technique, reserved in the case of obesity with major failure of various attempts at dieting. Psychological evaluation and monitoring are needed.
It includes a set of techniques that can be classified into two main types of interventions.
- The first ones aim at reducing gastric capacity (the volume of the stomach) and / or reduce the rate of stomach emptying in order to get the feeling of satiety faster (gastric ring).
- The second ones, known as mixed, associated with this gastric restriction, create a system of derivation in the digestive tract to reduce nutrient uptake by the intestins. These techniques are practiced by incision of the abdominal wall (laparotomy) and, in recent years, almost all can also be performed laparoscopically.
Analysis of available data indicates that the different types of surgery are effecient and safe.
On the whole, mixed techniques, which involve restriction gastric and intestinal malabsorption, are more effective than interventions that only reduce stomach capacity.
Although they are not free of complications, laparoscopic techniques provide many advantages, such as a reduction of the duration of hospitalization. Only two laparoscopic approaches are quite developed and their effects are well enough known to no longer be considered experimental.
In the long term, weight loss surgery significantly reduces mortality in patients who have benefited of it.
Patients who suffer a significant loss of weight should be monitored annually by a multidisciplinary team which, in addition to the surgical team (particularly attentive to the early and late complications), includes nutritionists, psychologists and medical specialists. A plastic surgery is often necessary.
Non-drug treatments
They are intended, in principle, to reduce weight by caloric restriction. Among the methods used, there is diet, physical activity and individual support.
Diets
A diet rich in fruits and vegetables is the basic in dieting.
- They are of several kinds:
a balanced and moderate caloric restriction offers a reduction of 600 calories per day compared to the usual ration. This is the most efficient weight loss technique because it reduces the weight of approximately 5 kg in one year.
- food changes without caloric restriction: reducing fat, increasing fruits, cereals and vegetables. The effect is small but not insignificant: 2 kg a year.
- the Mediterranean diet, which has been proven efficient in terms of prevention of cardiovascular diseases. It is suggested in patients suffering from hypercholesterolemia, where there is coronary artery disease.
- diets with very low calories: fewer than 800 to less than 600 kcal / d. They can be sources of deficiencies if they are extended. Sudden deaths have even been reported.
- diets low in fat lipids, in which they are accounted for only 10 to 15% of inputs.
- diets low in carbohydrates (Atkins diet), but rich in fat and protein, imposes no restriction of calories, but will increase the feeling satiety. Serious secondary effects were reported.
- fasting, limiting feeding to drinks only. This method exposes to serious health hazards.
In practice, nutritional advice without follow up often offers moderate results and that are limited in time
(high probability of regaining weight).
Physical activity
Several studies have shown that the addition of physical activity on a diet is more effective than each of the elements taken separately. Activities are not necessarily found in sports, some will prefer to use physical activities, like walk or light training. There is a need to encourage regular physical activity through in a simple and accessible way.