Problem Caused By Being Overweight

There are various reasons why people are overweight. These include genetics (suggested by studies of twins), overeating, stopping smoking, alcohol consumption, lack of exercise, a change in life style, more energy intake than energy expenditure (taking into account resting metabolic expenditure), environmental factors, sodium retention, hidden food allergies, major depression/anxiety/other psychological, medical illness, medications, during and after pregnancy, cultural (perceptions on obesity), and socioeconomic factors.

In the US, 20 to 30% of children are either overweight or at risk of becoming so. Kids who weigh too much are at a greater risk of becoming heavy adults, are more likely to suffer from low-esteem and have a greater chance of developing health problems such as diabetes.

Set Point Theory

Obesity is not strictly the product of sloth and gluttony. Everybody has a weight that their body can defend and most people know what that weight is. You lose a little weight, but tend to bounce back to your original weight again and again. That weight is called the “set point”. Although weight is influenced by what and how much one eats, and by such things as exercise, ordinarily it will revert to its most comfortable level.

One thing that is not well recognized is the fact that weight loss itself is not a particularly difficult problem. If a human being is put on an 800 or 1000 calorie diet, they lose weight. There do not appear to be a large number of people who have undesirable responses to a 1000 calorie diet that prevents them from losing weight: the few claims that have been investigated have not held up to scrutiny. In other words, there are no people who are totally resistant to weight loss. However, the vast majority of humans are very resistant to the maintenance of a body weight below whatever their set point is.

A person’s set point is the approximate weight and fat percentage that their body settles into during adulthood. Body fat is actually regulated by the brain’s weight regulating mechanism in the hypothalamus. This mechanism chooses the amount of body fat it considers ideal for the body’s needs and then works tirelessly to maintain that level.

The regulating mechanism controls body weight in two critically important ways. First, it has a profound effect of the amount of food you eat. It is responsible for dramatically increasing or decreasing appetite to maintain the set point weight. As you lose weight, it signals hunger; as you gain weight, it reduces appetite. Second, the regulating mechanism can trigger the body’s systems to waste excess energy if you overeat or conserve energy if you don’t eat enough. Energy conservation may lead to muscle loss and a slow down of the endocrine system due to the body’s attempts to protect its fat stores for use in the future. In addition, less muscle mass means the body requires still fewer calories.

An individual’s set point is genetically determined. There are those who are able to eat anything and everything they desire and still maintain a low body fat percentage, but others who continually struggle with their genetic set point and constantly diet and exercise to lose weight. Often this weight loss is a loss of both muscle and fat tissue. Once they stop dieting, those who have battled fat loss incorrectly or are simply unable to maintain the proper lifestyle will inevitably return to their original body composition or gain additional body fat. The subsequent weight gain consists primarily of fat tissue.

If you go to a doctor and tell them you need to lose weight, the doctor is not likely to tell you that are at your set point, so there is not need to treat you. That thought usually has nothing to do with how people are treated. The diet industry also is not based primarily on medical complications, but cosmetics and profit.

One way to rationalize the treatment of obesity is to treat only individuals who have medical causes and complications. Treat the individual who has hypothyroidism, hyperlipidemia, gall bladder disease, or type II diabetes, to the point where the cause and risks are reduced. Don’t treat the obesity per se. Treat the cause or the body fat content until you relieve the metabolic consequences. It turns out that just a 10% body fat reduction can produce increases in insulin sensitivity and blood pressure reduction.

Leptin

Molecular biologists first identified leptin in 1994. Since then, the fat hormone has been the subject of intense speculation among scientists. Leptin has prompted research into eating disorders, obesity and diabetes. The obesity hormone leptin appears to reduce cravings for sweet foods by targeting taste receptors on the tongue. Therefore, it is possible that a lack of leptin, or the body’s failure to respond to the hormone due to defects in leptin receptors (leptin resistance), may contribute to the so called sweet tooth that affects so many.

Leptin, a hormone produced by fat cells, is involved in weight regulation. It is thought that the hormone signals the brain when fat cells are full, but exactly how the hormone controls weight is not entirely clear. Animals and humans without leptin, or with defective leptin receptors, become obese. As one becomes fatter, the body makes more leptin and the likelihood of leptin resistance increases . Men whose bodies produce more insulin also tend to have increased leptin levels.

Exercise decreases the amount of leptin in the blood of both overweight and normal weight individuals. Recent research shows that only 3 hours of exercise per week lowers leptin levels by about 10%. Exercise can lower the levels of leptin no matter how fat a person is. Lowering leptin levels reduces the risk of leptin resistance seen in obesity; raising leptin levels does not appear to be an effective weight loss mechanism in humans. However, trials have shown that large supplemental doses of leptin can result in some weight loss in obese individuals.

In short, leptin levels should be kept within the normal range: low levels can result in food cravings and higher levels tend to suppress appetite but are also associated with tissues becoming less sensitive to the hormone and contributing to craving and more weight gain. Exercise can lower leptin levels, but caution must be taken in some individuals that levels do not go too low. Researchers have long been busy searching for the key to safely control a person’s weight. It remains to be seen if they will ever be successful. Products like Leptoprin and Anorex do not contain leptin, though their high price would suggest otherwise.

Research on leptin levels indicate that once weight is lost, the key to maintaining the loss, in spite of increased calorie consumption, is exercise!

Ghrelin

The recently discovered “hunger hormone” called ghrelin is gaining a solid reputation for regulating how much food we eat and how much weight we gain. Pronounced (GRELL – in), it is produced mainly by the stomach, although it is also made in other organs, such as the intestines and the kidneys. Ghrelin has been dubbed the hunger hormone because in previous experiments people given the hormone became so ravenous, they ate markedly more than their usual food intake. So, increased ghrelin equals increased hunger.

Another study found that in slim people, ghrelin levels peaked right before a meal but rapidly declined soon afterwards. In contrast, levels of the hunger hormone were lower than average in obese individuals, but they remained steady before and after a meal, suggesting obese people might still feel hungry after eating.

Although scientists only identified ghrelin in 1999, more than 200 papers on the substance have already been published. Ghrelin acts to stimulate food intake but blood levels are reduced in obese patients suggesting that this mediator represents a key regulator of food intake. Metabolism[/glossary] 2002;87: pp.3997-4000, 4005-4008]

Nearly two-thirds of American women are either clinically “overweight” or “obese.” As women are more at risk for being overweight or obese than men, and women are at risk for gaining weight as they age, postmenopausal women are a particularly vulnerable population.

 


Signs, symptoms & indicators of Problem Caused By Being Overweight

Symptoms - Cardiovascular  

Heart racing/palpitations



Symptoms - General  

Fatigability



Symptoms - Metabolic  

Difficulty losing weight



Symptoms - Respiratory  

Easily being short of/always being short of breath or normal breathlessness




Conditions that suggest Problem Caused By Being Overweight

Circulation  


 


 


Digestion  


Lab Values  


 


Lifestyle  

Minimal sitting or doesn't sit

Please see the link between sitting and Diabetes.



Metabolic  


Counter Indicators
Metabolic  


Musculo-Skeletal  

Gout / Hyperuricemia

Gout is strongly associated with obesity, hypertension, hyperlipidemia and diabetes.



 

Osteoarthritis

Forcing joints to carry more weight than they were designed for often results in premature failure.



Organ Health  

Glomerular Disease

Overweight people are at incresed risk for proteinuria caused by declining kidney function.



 

Gallbladder Disease

Obesity in both men and women increases the risk for gallstones. This may be a result of lower levels of bile salts relative to cholesterol in the bile causing a higher risk for cholesterol supersaturation and the formation of stones.



 

Increased Risk of Diabetes ll

Scientists have discovered a hormone that may explain the link between diabetes and obesity – a tantalizing finding that could someday lead to new treatments for the disease. The hormone, dubbed resistin, is produced by fat cells and prompts tissues to resist insulin, the substance the body needs to process blood sugar, researchers reported in the scientific journal Nature. Diabetics produce too little insulin or cannot use it efficiently. This will probably result in new drug treatments, but emphasizes the need for weight reduction.



Respiratory  

Asthma

Being overweight increases the risk of asthma. [Arch Intern Med 1999;159: pp.2582-8] Obese people with asthma may improve their lung-function symptoms and overall health status by engaging in a weight-loss program. A controlled study found that weight loss resulted in significant decreases in episodes of shortness of breath, increases in overall breathing capacity, and decreases in the need for medication to control symptoms. [BMJ 2000;320: pp.827-32]



 

Sleep Apnea

Most patients with obstructive sleep apnea are overweight and typically have a short, thick neck



Risks  

Increased Risk of Coronary Disease / Heart Attack

Even if you never become diabetic, high levels of insulin contribute to cardiovascular risk by increasing the process of atherosclerosis. Insulin increases the rate at which cholesterol-laden plaque builds up on arterial walls. The abnormally high levels of insulin produced by all overweight individuals, diabetic or not, is an independent risk factor for early cardiac death.



Uro-Genital  


 

Menorrhagia (Heavy Periods)

Chronic menorrhagia and PMS is usually the result of deficient progesterone secretion or constant adipose-released estradiol from obesity or recent substantial weight loss.



 

Amenorrhea

Women who are obese often experience amenorrhea as a result of excess fat cells interfering with the process of ovulation. Also, according to a 2002 study, nearly 30% of obese women with PCOS had amenorrhea. (The rate was lower (4.7%) in women with normal weight.) In PCOS, increased androgen production produces high LH levels and low FSH levels, so that follicles are prevented from producing a mature egg.




Risk factors for Problem Caused By Being Overweight

Diet  

Overconsumption

High glycemic index foods are linked to overeating and obesity. In a study of adolescents, avoiding high glycemic index foods allowed them to eat all they desired but actually resulted in less calories consumed daily, indicating less of a tendency to overeat. [Pediatr Adolesc Med 2000:154: pp.947-951] High glycemic index foods are linked to overeating and obesity. A sample list of these foods can be found on our web site.



 


 


 


Habits  


 

Lack of Sleep

A good night’s sleep can help beat obesity, scientists have revealed, as research suggests being overtired can make you fat. Lack of sleep has been found to create a hormone imbalance, which increases the appetite and leads to putting on weight, it is claimed.

Even partial sleep deprivation was found to be a factor in body weight regulation, with research suggesting a good night’s sleep could have a significant impact in the fight against obesity. Research found that over a third of Americans were obese and more than a quarter get less than six hours sleep a night.

Insufficient sleep is known to raise the risk of metabolic disturbances, particularly insulin resistance, obesity, and type 2 diabetes.

In another report: Sleep deprivation caused a 30% decline in the insulin sensitivity of fat cells of healthy, lean young adults, according to a study in the Oct. 6, 2012 issue of Annals of Internal Medicine.



Hormones  


 


 


Lab Values - Chemistries  

(Very) low HDL level



Counter Indicators
Lab Values - Chemistries  

Excellent HDL level



Lifestyle  

Sitting/sitting way too much or average sitting

Please see the link between sitting and Diabetes.



Medications  

Birth Control Pill / Contraceptive Issues

If you’re concerned about gaining weight from the Pill, you should talk to your healthcare professional about which combination of hormones is right for you. An equal number of women tend to lose weight as gain weight while taking a birth control pill.



Mental  

Stress

Some people respond to stress by eating. “Stress Eaters” use food as a drug to deal with external stressors such as work, deadlines or finances. Carbohydrates are often the craved foods because they increase levels of serotonin in the brain, which has a calming effect and helps induce sleep. Stress Eaters often use candy, cookies, pretzels, etc. on the job to relieve stress and are unaware of the reason behind it. A habit of eating in response to stress may lead to obesity.



Symptoms - Food - Beverages  

Sugared soft drink consumption

A new review of available research pinpoints exactly how much soft drinks and other sugary beverages contribute to weight gain and obesity in the United States. Just one extra can each day can add as much as 15 pounds to your weight over the course of a single year.

The review of 30 nutritional studies conducted over the past four decades also revealed a number of other facts, including:

*Soft drinks contribute about half of the additional sweeteners in the average American diet, and that amounts to a third of all carbohydrate calories consumed.

*Limiting a child’s intake of soft drinks over a year lowered his or her risks of obesity.

*Consuming more sugary drinks led to higher weight gains and greater obesity risks.

A nutritionist commenting on the review noted that satiety studies show that people do not compensate for calories from beverages by consuming less food. As a result, when caloric beverages are consumed, those calories are simply added on top of the rest of the total daily caloric intake. [American Journal of Clinical Nutrition August 2006; 84(2): pp.274-288]



 

Low-calorie soft drink consumption

According to a study by researchers at the University of Texas San Antonio, middle-aged adults who drink diet soft drinks may be drastically increasing their risks of gaining weight later on.

The study monitored the weight and soda-drinking habits of more than 600 normal-weight patients aged 25-64. When researchers followed up on the patients some eight years later, they discovered that:



Symptoms - Metabolic  

Having high % body fat



 

Long/short term history of obesity or moderate history of obesity



 

Apple-shaped/pear-shaped body when overweight or having abdominal fat



Counter Indicators
Symptoms - Metabolic  

Having very low/having average % body fat



 

Having low/having average % body fat



Uro-Genital  


 



Problem Caused By Being Overweight suggests the following may be present

Autoimmune  


Circulation  


Diet  


Hormones  

Low HGH (Human Growth Hormone)

Dr. Brett Jancques, ND reports that all of the obese individuals tested thus far by AAL Reference Laboratories were found to have low growth hormone levels. Testing was accomplished through 24-hour urinary growth hormone measurements. [Townsend Letter, Feb/March 2002, Vol 223/224; pp.74-78]



 

Low SHBG

SHBG levels respond to extreme changes in body weight, decreasing in obese patients.



Mental  

Stress

Some people respond to stress by eating. “Stress Eaters” use food as a drug to deal with external stressors such as work, deadlines or finances. Carbohydrates are often the craved foods because they increase levels of serotonin in the brain, which has a calming effect and helps induce sleep. Stress Eaters often use candy, cookies, pretzels, etc. on the job to relieve stress and are unaware of the reason behind it. A habit of eating in response to stress may lead to obesity.



Metabolic  



Problem Caused By Being Overweight can lead to

Aging  


Circulation  


 


Digestion  


Environment / Toxicity  


Inflammation  

Chronic Inflammation

A higher BMI is associated with higher CRP concentrations, even among young adults aged 17 to 39 years. These findings suggest a state of low-grade systemic inflammation in overweight and obese persons. [JAMA.1999;282: pp.2131-2135] Fat cells produce inflammatory mediators.



Lab Values  


 


Metabolic  


Musculo-Skeletal  

Osteoarthritis

Forcing joints to carry more weight than they were designed for often results in premature failure.



Organ Health  

Increased Risk of Diabetes ll

Scientists have discovered a hormone that may explain the link between diabetes and obesity – a tantalizing finding that could someday lead to new treatments for the disease. The hormone, dubbed resistin, is produced by fat cells and prompts tissues to resist insulin, the substance the body needs to process blood sugar, researchers reported in the scientific journal Nature. Diabetics produce too little insulin or cannot use it efficiently. This will probably result in new drug treatments, but emphasizes the need for weight reduction.



 

Gallbladder Disease

Obesity in both men and women increases the risk for gallstones. This may be a result of lower levels of bile salts relative to cholesterol in the bile causing a higher risk for cholesterol supersaturation and the formation of stones.



 

Fatty Liver

It is known that fat accumulates in the liver with a number of conditions, the most common being obesity.



Respiratory  

Sleep Apnea

Most patients with obstructive sleep apnea are overweight and typically have a short, thick neck



Risks  

Increased Risk of Alzheimer's / Dementia

Less well known is the fact that if you have a big belly in middle age the chances that you could suffer from dementia are tripled.



 

Increased Risk of Coronary Disease / Heart Attack

Even if you never become diabetic, high levels of insulin contribute to cardiovascular risk by increasing the process of atherosclerosis. Insulin increases the rate at which cholesterol-laden plaque builds up on arterial walls. The abnormally high levels of insulin produced by all overweight individuals, diabetic or not, is an independent risk factor for early cardiac death.



 

Increased Risk of Hypertension

Being overweight is a significant risk factor for the development of hypertension. The prevalence of hypertension in the U.S. is greatly increased by the fact that one quarter to one half of all adults (results differ by study) are overweight. Although the association between higher body fat and blood pressure has been recognized for years, recent studies have discovered a 50 to 300% higher incidence of hypertension among adults who consider themselves overweight compared to those classified as normal weight. Similar findings are revealed from studies involving children and young adults, in which the connection between weight and blood pressure has been observed to be very strong.

Two proposed mechanisms underlying this correlation are the stimulation of sodium retention and increased catecholamine release, which are results of increased sodium sensitivity and hyperinsulinemia. Age, gender, and race are also part of the equation and so should be considered when studying preventive interventions. Hypertension and obesity treatment are necessary to avoid potential morbidity and mortality from coronary heart disease or stroke.



 

Increased Risk of Prostate Cancer

Obesity was associated with a 2.5-times greater risk of prostate cancer, although men who were merely overweight did not show an increased risk. In this study, a BMI of 25 or more was not related to prostate cancer risk, but having a 30-plus BMI was. The findings are backed up by Swedish, Danish and Irish studies that have suggested an association between obesity and prostate cancer risk, but the link is still controversial. [British Journal of Urology International 2003;91: pp.482-484]



 

Increased Risk of Breast Cancer

Women with ‘apple-shaped’ bodies may be more likely to develop breast cancer than their ‘pear-shaped’ counterparts. Harvard researchers studied breast cancer risk among postmenopausal women who had never used hormone replacement therapy (HRT) and found even greater risks, with larger-waisted women appearing to be 88% more likely to develop breast cancer than smaller-waisted women. HRT use can increase the risk of breast cancer, regardless of waist size. Exactly why fat distribution affects breast cancer risk is not fully understood but perhaps, the researchers speculate, upper or central body fat is deeper and may be closer to the important organs and glands that regulate hormone balance than fat in the other areas of the body. These hormonal changes may be responsible for the increased risk of the cancer.

[American Journal of Epidemiology December 1999;150: pp.1316-1324]



 

Cancer / Risk - General Measures

Apart from excess stimulation by estrogen in breast and ovarian cancer, obese people are more prone to cancer, although it is still uncertain why.



 

Increased Risk of Kidney Cancer

A high-fat diet and obesity may increase the risk for RCC.



 

Increased Risk of Pancreatic Cancer

At least two studies have found that obesity significantly increases one’s risk of developing pancreatic cancer. [JAMA. 2001;286: pp.921-929]



 

Increased Risk of Ovarian Cancer

Examples of cancers linked to obesity are breast and ovarian cancer – it is thought that the excess estrogen produced by obese patients increases their chance of developing hormone-sensitive versions of these cancers.



 


 


 

Increased Risk of Lung Cancer

Researchers used data from a study of lung cancer patients in New York from 1982 to 1985. They focused on patients who had never smoked, or those who hadn’t smoked in the last 10 years, then took into account physical data on patients’ heights and weight. Researchers found that study subjects who were at the most extreme levels of obesity had the highest risk of lung cancer. The study is a first for linking being overweight to lung cancer; it has previously been shown to play a role in breast, uterine, and colon cancer.

Researchers are unsure why being obese plays a role in lung cancer; some researchers suggest it’s related to hormones such as higher levels of estrogen and insulin. In addition, being overweight puts an added strain on the lungs, reduces lung capacity, and increases asthma risk. [American Journal of Epidemiology Sept. 2000]



Uro-Genital  

Amenorrhea

Women who are obese often experience amenorrhea as a result of excess fat cells interfering with the process of ovulation. Also, according to a 2002 study, nearly 30% of obese women with PCOS had amenorrhea. (The rate was lower (4.7%) in women with normal weight.) In PCOS, increased androgen production produces high LH levels and low FSH levels, so that follicles are prevented from producing a mature egg.



 

Menorrhagia (Heavy Periods)

Chronic menorrhagia and PMS is usually the result of deficient progesterone secretion or constant adipose-released estradiol from obesity or recent substantial weight loss.




Recommendations for Problem Caused By Being Overweight

Amino Acid / Protein  

Tryptophan / 5 HTP

Although used chiefly as an antidepressant, preliminary evidence from three small double-blind placebo-controlled clinical trials suggests that 5-HTP may also help people lose weight. It is thought to work by raising levels of serotonin, which in turn may influence eating behavior. A typical therapeutic dosage of 5-HTP is 100 to 300mg 3 times daily.



Animal-based  

CLA (Conjugated Linoleic Acid)

In animals, CLA helped repartition their body weight, decreasing fat and increasing lean body mass. One human study confirms this, while another denies it. The debate continues.

A study shows that obese or overweight people who took CLA supplements every day for six months lost 3 pounds more than those who took a daily pill containing only olive oil, which doesn’t include CLA (placebo). “All effects were independent of diet and exercise,” Einerhand told reporters, adding that waist size and waist-to-hip ratio also dropped in the CLA group (waist size dropped by about 1.2 inches). As for BMI, “individuals with the highest BMI responded best to CLA,” the researchers write. [Digestive Disease Week 2006, May 20-25, 2006]

Another recent study came to a different conclusion. In March 2006, researchers reported in the American Journal of Clinical Nutrition that obese people who took CLA supplements for a year didn’t lose more weight than those who took a placebo.

However, another study supports its use!

Long-term supplementation with conjugated linoleic acid (CLA) reduces body fat mass (BFM) and increases or maintains lean body mass (LBM). However, the regional effect of CLA was not studied. The study aimed to evaluate the effect of CLA per region and safety in healthy, overweight and obese adults.

A total of 118 subjects (BMI: 28-32 kg/m2) were included in a double blind, placebo-controlled trial. Subjects were randomised into two groups supplemented with either 3 x 4 g/d CLA or placebo for 6 months. CLA significantly decreased BFM at month 3 (Delta=- 0 x 9 %, P=0 x 016) and at month 6 (Delta=- 3 x 4 %, P=0 x 043) compared with placebo. The reduction in fat mass was located mostly in the legs (Delta=- 0 x 8 kg, P<0 x 001), and in women (Delta=-1 x 3 kg, P=0 x 046) with BMI >30 kg/m2 (Delta=-1 x 9 kg, P=0 x 011), compared with placebo. The waist-hip ratio decreased significantly (P=0 x 043) compared with placebo. LBM increased (Delta=+0 x 5 kg, P=0 x 049) within the CLA group. Bone mineral content was not affected (P=0 x 70). All changes were independent of diet and physical exercise. Safety parameters including blood lipids, inflammatory and diabetogenic markers remained within the normal range. Adverse events did not differ between the groups.

It is concluded that supplementation with CLA in healthy, overweight and obese adults decreases BFM in specific regions and is well tolerated. [Lipid Nutrition, press release; Mar 2007]



 

Fish Oil / Krill

An Australian study has determined that daily doses of fish oil containing omega-3 fats can, when combined with exercise, act as an aid to weight loss.

The study examined 68 overweight and obese people over a period of three months. They were divided into four groups: one that took fish oil but did no exercise, one that exercised (45-minute walks or running three days a week) but took no fish oil, one given both, and one given neither.

Those who both took fish oil and exercised lost an average of 4.5 pounds over the course of the study, even though they were given no dietary restrictions. None of the other groups lost any weight at all. The combination worked because the omega-3s increased fat-burning ability by improving the flow of blood to muscles during exercise.

Omega-3s have also been shown to boost brain functioning and cut the risk of stroke. [The Age July 31, 2006]



Botanical  

Ma Huang (Ephedra equisetina)

Contrary to commonly reported stories, 3 months of intermittent or continuous treatment with an ephedra-containing weight-loss product containing ephedra, but not caffeine, had no effect on heart rate or blood pressure and there were no cases of serious adverse effects reported in a well-controlled study of 279 healthy, overweight people. 33% of patients on intermittent treatment and 48% on continuous treatment experienced adverse effects deemed non-serious such as dry mouth, headache, insomnia, nervousness, agitation, constipation, and/or diarrhea. [Experimental Biology 2002, April 20-24, 2002, New Orleans, LA, USA. Abstract]



 

Hoodia gordonii

In 2001 Phytopharm completed a double-blind, placebo-controlled clinical study in overweight, but otherwise healthy volunteers using the P57 extract from Hoodia gordonii. The participants were split into two groups, one group received the P57 and the other received a placebo. Both groups were told to continue their normal diet and exercise. The results were as follows:

When comparing the P57 group to the Placebo group:

* The P57 group had a statistically significant reduction in body fat

* The P57 group had a statistically significant reduction in caloric intake

* The P57 had no adverse side effects

On average the P57 group ate about 1,000 calories a day less than those in the control group. To put that in perspective, the average American man consumes about 2,600 calories a day; a woman about 1,900.



 

Irvingia Gabonensis (African Mango)

Significant improvements in body weight, body fat, and waist circumference as well as plasma total cholesterol, LDL cholesterol, blood glucose, C-reactive protein, adiponectin and leptin levels were observed using a specific extract of Irvingia Gabonensis (IGOB131) in the experimental group compared with the placebo group [Lipids in Health and Diseas2009, 8:7doi:10.1186/1476-511X-8-]



 

Kelp / Seaweed

fücoTHIN is a natural, whole food based supplement that is made with a proprietary concentration of fucoxanthin combined with pomegranate seed oil, for a patent-pending formula that is naturally thermogenic. fücoTHIN has been studied by scientists for many years and is the only formula that has human clinical research to confirm its thermogenic effect.



 

Green / Oolong / BlackTea (Camellia sinensis)

70 moderately obese patients received 2 capsules of a green tea extract morning and midday for 12 weeks. This extract contained 27mg of epigallocatechin gallate (EGCG) and 150mg per day of caffeine. Mean body weight and waist circumference decreased by over 4%. The effect on thermogenesis (calorie burning) was greater than that which would have been caused by equivalent amounts of caffeine. This effect was not accompanied by an increased heart rate as seen with the sympathomimetic drugs used to treat obesity! Green tea (extract AR25) is an effective treatment for obesity, possibly due to its ability to inhibit lipases and stimulate thermogenesis. [Phytomedicine 2002;9: pp.3-8]

In a Swiss study, a daily dose of 270mg EGCG (the amount in 2 to 3 cups of green tea) caused men to burn 4% more energy – about 80 extra calories a day. Green tea did not increase heart rate, and the calorie burning was not due to caffeine.



 

Hydroxycitric acid (Garcinia cambogia)

A well-controlled trial of hydroxycitric acid failed to produce any significant weight loss compared with placebo. This was a 12-week double-blind study in which overweight subjects were randomized to receive 1500mg of hydroxycitric acid daily or placebo.

In another study, also conducted double-blind, placebo-controlled and randomized, researchers sought to see whether hydroxycitric acid supplementation could increase fat oxidation in human subject. The researchers found no significant effect.

[JAMA 1998; 280: pp.1596-1600, Int J Obes Relat Metab Disord. 1999; 23: pp.867-873]



 

Herbal Combinations

12 cases of acute liver injury were associated with the use of two Chinese herbal weight loss supplements in Japan. The products, Chaso and Onshido, were found adulterated with a variant of the appetite depressing drug fenfluramine. [ Ann Intern Med 2003;139(6): pp.488-92]



Diet  

Weight Loss

Weight loss is important, but dieting is not the answer. For those consuming a lot of fructose, either from fruit or hidden sources of HFCS (high fructose corn syrup), reducing fructose consumption improves leptin sensitivity, which reduces cravings both for sweets and calories. Please see the link between Overweight and Fructose Avoidance.

US scientists conducting a comprehensive review of dieting research have concluded that dieting does not work.

The study is published in the April, 2007 edition of American Psychologist, the journal of the American Psychological Association. Researchers at the University of California, Los Angeles (UCLA), reviewed 31 long-term studies lasting between 2 to 5 years.

UCLA associate professor of psychology and lead author of the study, Traci Mann said: “You can initially lose 5 to 10 percent of your weight on any number of diets, but then the weight comes back.” “We found that the majority of people regained all the weight, plus more,” she added.

The researchers found a very small minority of study participants managed to sustain weight loss, while the majority put all the weight back on, and more in the longer term. “Diets do not lead to sustained weight loss or health benefits for the majority of people,” said Dr Mann.

Dr Mann and colleagues sought to determine the long term effects of dieting and address the question “Would they have been better off to not go on a diet at all?”. So they analyzed every study they could find that followed people on diets for 2 to 5 years. Studies that take less than 2 years are “too short to show whether dieters have regained the weight they lost,” they said. They discovered that it would have been better for most of them if they had not gone on a diet at all. “Their weight would be pretty much the same, and their bodies would not suffer the wear and tear from losing weight and gaining it all back,” explained Dr Mann.

Their findings show that:

— People on diets typically lose 5 to 10 per cent of their weight in the first 6 months.

— But 33 to 66 per cent regain more than what they lose within 4 to 5 years.

Dr Mann and colleagues suspect the real situation is actually even worse; the figures do not really reflect reality, making diet studies look better than they are. They say there are a number of reasons for this:

— Many participants phone or mail their results in themselves, without an impartial assessor.

— A lot of studies have a below 50 per cent follow up rate; and the people who put on a lot of weight are less likely to stay in touch.

UCLA graduate student of psychology and co-author of the study, Janet Tomiyama said that “Several studies indicate that dieting is actually a consistent predictor of future weight gain.”

One study in particular that they looked at found that men and women who took part in a weight reduction program gained significantly more weight than those who did not over the same period of time.

Tomiyama mentioned another study, this time looking at links between lifestyle and weight in 19,000 healthy older men over four years. This study found that, “One of the best predictors of weight gain over the four years was having lost weight on a diet at some point during the years before the study started,” she said.

Also, in many studies with control groups, the people in the control group very often were better off than the participants who dieted.

Dr Mann suggests that eating in moderation and exercise do make a difference. Although they were not looking at exercise in particular, Dr Mann said that: “Exercise may well be the key factor leading to sustained weight loss. Studies consistently find that people who reported the most exercise also had the most weight loss.”

One study following obese patients discovered that:

— Among those followed for under 2 years, 23 per cent of patients had regained their weight loss.

— Among those followed for more than 2 years, 83 per cent had regained their weight loss.

Another study found that 50 per cent of dieters weighed 11 pounds (5 kilos) more than their starting weight 5 years after their diet.

Among the health hazards of repeated weight loss and regain are cardiovascular disease, stroke, diabetes and altered immune function, said Dr Mann and colleagues. They said more research is needed on the effects of weight loss and regain on health, and say scientists do not fully understand the underlying factors involved in this complex relationship.

Dr Mann quoted her mother, who herself has tried to diet many times, without success. Dr Mann’s mother said her daughter’s findings were “obvious”.

Although this study reviewed 31 long term dieting projects, they did not look into specific diets. The researchers are of the opinion that weight loss programs are not good value for money in the treatment of obesity. “The benefits of dieting are too small and the potential harm is too large for dieting to be recommended as a safe, effective treatment for obesity,” said Dr Mann.

Between 1980 and 2000, the proportion of obese Americans has doubled, from 15 to 31 per cent of the population.

Prof. Martínez de Victoria (Head of the Institute of Nutrition and Food Technology at the University of Granada in Spain)

insists that the best way to control body weight is to combine a limited food intake with regular physical exercise. In this sense, he states that with a 500 to 700 calorie deficit, depending on body weight, age and physical exercise, a person can gradually lose 6.5 lbs a month, with the guarantee of not recovering double the weight they lost in half the time they lost it. In the same way, this researcher stresses the fact that a high-fibre diet helps control obesity, as fibre-rich foods facilitate a lower intake because their mastication time is longer and, due to their volume, produce the filling sensation more quickly. Furthermore, fibre speeds intestinal transit time while slowing food absorption.



 

Artificial Sweetener Avoidance

It would be logical to think that the use of no-calorie artificial sweeteners would reduce weight gain, since less calories would be consumed. Right? It turns out that just the opposite is true. Don’t mess with what God has created!

This failed attempt to satisfy the sweet tooth while bypassing the negative consequences seems to work by:



 

Fructose Avoidance/reduction

Research from the University of California at San Francisco indicates that fructose can trick our brains into craving more food, even when we’re full. It works by impeding the body’s ability to use leptin, the “satiation hormone” that tells us when we’ve had enough to eat.

“Our data indicate that chronic fructose consumption induces leptin resistance prior to body weight, adiposity, serum leptin, insulin, or glucose increases, and this fructose-induced leptin resistance accelerates high-fat induced obesity.” [Am J Physiol Regul Integr Comp Physiol. 2008 Nov;295(5):R1370-5. Epub 2008 Aug 13]

In plain English this means: Regular use of a lot of fructose produces leptin resistance. Leptim resistance results in weight gain.



 

Raw Food Diet

In a study of 28 overweight patients whose diets were changed to include 62% of calories from raw foods, the mean weight loss was 8lbs (3.8kg), which is very statistically significant. This study was conducted over a period of 6 months, where the percentage of raw food was changed back and forth with each patient. Weight loss took place with greater raw food consumption and weight gain with less raw food consumption [South Med J 1985 Jul;78(7): pp.841-4]. It is expected that a higher percentage of raw food consumed consistently would result in greater weight loss, as shown in the following study.

572 participants (60% women, 40% men) with an average age of 44 years spent an average of 2.3 years adhering to a raw food diet (RFD). Afterwards, according to their BMI, 25% of the women and 30% of the men were underweight, 70% of the women and 68% of the men were classified normal while 5% of the women and 2% of the men were overweight. This stands in stark contrast to the general situation in Germany where less than 6% of the population is underweight and more than 35% is overweight.

For the majority of the participants health factors were the most important reason for changing to a RFD; 55% giving disease as their main reason for changing. Most were highly content with their diet and almost 98% stated their intention to follow it as a long-term regimen. The extreme forms of diet were followed more often by younger participants and by males. Women adhering to the stricter forms stated that their menstruation became infrequent or stopped altogether. This latter group is further typified by younger participants and those with a lower BMI. [Presented at the Third International Congress on Vegetarian Nutrition, Loma Linda, California USA, March 24-26, 1997]



 

Therapeutic Fasting

There is an excellent article by Dr. Mercola describing the benefits of exercising while fasting. There are ways to make this very doable. If done on a regular basis, extra weight will be lost without any more exertion than you would have expended anyway. The article is worth reading!



 

Juices / Juicing

Vegetable juicing increases not only the quantity of vegetables that you will eat, but also the absorption of their nutrients. Nutrient deficiency, a common problem with dieting, is thereby overcome. Fresh vegetable juice also helps lower calorie consumption because it reduces or replaces other foods that you might have eaten instead. Juicing helps normalize weight, sometimes without a forced reduction in calorie consumption. Juicing also promotes a feeling of being energized. It is as though energy would rather be burned than converted to fat.



 

Vegetarian/Vegan Diet

Obesity is a major contributor to many serious illnesses, and is much less common among vegetarians, compared to the general population. Vegetarians are, on average, about 10% leaner then omnivores.



 

High/Increased Fiber Diet

Good results in weight loss studies have been achieved with guar gum, a water-soluble fiber obtained from the Indian cluster bean (cyamopsis tetragonoloba). In one study, nine women weighing between 160 and 242 pounds (73 to 110kg) were given 10gm of guar gum immediately before lunch and dinner. They were told not to consciously alter their eating habits. After two months, the women reported an average weight loss of 9.4 pounds (4.3kg) – over 1 pound per week.

An increasing number of studies suggest that any water-soluble fiber may help people lose weight. It is thought to work by decreasing appetite: it bulks up in the stomach and causes a “full” feeling, resulting in fewer calories being consumed.



 

High/Increased Protein Diet

An excellent book to read on the benefits gained from an adequate (not high) protein diet is “Protein Power The High-Protein/Low Carbohydrate Way to Lose Weight, Feel Fit, and Boost Your Health-in Just Weeks!” by Michael and Mary Eades. Their more recent book Protein Power LifePlan, is good, also outlining an effective program to achieve weight loss.

More and more researchers are citing insulin as the main culprit in weight gain and expound the benefits of a diet low in carbohydrates. Carbohydrates – especially rapidly-absorbed simple carbohydrates (sugars) – stimulate the body to store fat, thus making weight loss difficult. Researchers have found that eating larger portions of protein in conjunction with severely reduced portions of carbohydrates causes people to burn the excess fat stored in their bodies. High glycemic index foods are linked to overeating and obesity. A sample list of these foods can be found on our web site.

A University of Illinois study indicates that exercise is more effective when coupled with a high-protein diet. A diet higher in carbohydrates based on the USDA food guide pyramid, on the other hand, reduced the effectiveness of exercise.

Forty-eight women, divided into two groups, participated in this four-month study. One group substituted protein-rich foods, like meats, dairy, eggs, and nuts, for carbohydrate-laden foods like as breads, rice, cereal, pasta, and potatoes.

Both groups were required to exercise at various levels of exertion. The protein-rich, high-exercise group lost the most weight, and nearly 100% of the weight loss was fat. In the high-carbohydrate, high-exercise group, 25 to 30% of the weight lost was muscle.

This protein-rich diet seems very effective for people who have Metabolic Syndrome (Syndrome X), a combination of high triglyceride levels and excess weight in their midsections. The protein-rich diet works well because it contains high levels of the amino acid leucine, which works with insulin to helps stimulate protein synthesis in muscle. [Journal of Nutrition August 2005; 135 (8): 1903-1910]



 

Grain-free / Low Starch Diet

The majority of Americans who are currently obese or overweight would benefit from a radical reduction in their grain intake and replacing those grains with fresh vegetables. High glycemic index foods are linked to overeating and obesity. A sample list of these foods can be found on our web site.



 

Coconut

Studies in coconut eating countries have shown a higher metabolic rate in both men and women than in the general US population.



 

Nut and Seed Consumption

A study examining the effect of nuts on insulin resistance and in patients with type 2 diabetes found that nuts may also increase weight. Twenty people participated in the study by eating about 3 ounces of almonds a day for four weeks. Though the nuts did not substantially influence insulin sensitivity, body weight increased significantly, which may have affected changes in insulin sensitivity. Cholesterol, both good (HDL) and bad (LDL), decreased significantly after the four-week period.

In patients with diabetes, the increase in almonds did not alter blood sugar control. The study suggests that in order to avoid weight gain, nuts must be replaced by other sources of energy in the diet. [American J Clinical Nutrition November 2002;76(5): pp.1000-6]

Others have reported that the continued consumption of nuts commonly prevents people from losing weight.

However, this may not be the case with almonds. In this study, women were instructed to eat 344 calories worth of almonds (around 56 grammes) every day for one 10-week period, and then eat their customary diet for another 10 weeks. The women did not gain weight during the period they consumed almonds.

The researchers determined that the study participants felt satisfied, so they naturally compensated for most of the calories in almonds by reducing their intake of other foods in their normal daily diet. They also noted a decrease in total carbohydrate intake, suggesting almonds may have replaced carbohydrate-rich foods.

Additionally, the researchers found that the fibre in almonds appears to block some of the fat they contain from being digested and absorbed. This means that almonds may provide fewer calories than would be expected. [British Journal of Nutrition Sept. 2007]



 

Increased Fruit/Vegetable Consumption

Large amounts of fruit high in fructose should be avoided. Fructose induces insulin resistance, promoting weight gain. Reduced fruit and increased vegetable intake is advised.



 

Spicy Foods

You can increase your metabolism a little by using hot and spicy foods such as hot peppers (of all varieties) and mustards. Research shows that these foods increase your metabolism. Try substituting mustard for mayonnaise and add hot peppers to your food for greater flavor and increased metabolism. Cayenne may promote weight loss in those with a low basal temperature.



 

Low Fat Diet

Reducing fat in the diet may reduce cancer risk and, in helping weight control, may reduce the risk of heart attacks and strokes. [The National Cancer Institute booklet, “Diet, Nutrition, & Cancer Prevention: A Guide to Food Choices”]

Mice that ate a high-fat diet gained weight and experienced a disruption in their circadian clocks, which regulate metabolic functions such as when they go to sleep, wake up and become hungry.

The disruption threw off the timing of the animals’ internal signals, including appetite control. As a result, the mice ate extra calories during the time when they would have otherwise been asleep or resting. For humans, this would be the equivalent of raiding the refrigerator in the middle of the night.

The high-fat diet and resulting weight gain also triggered diminished expression of genes that encode the clock in the brain and in peripheral tissues.

The findings suggest that changes in metabolic state that occur with obesity and diabetes affect not only circadian rhythms of behavior but also physiology.

Past studies have found that a misaligned body clock can throw off your metabolism, and increase your risk of obesity and diabetes.

This represents a “vicious loop,” according to researchers, because once weight is gained, your internal clock is disrupted, and a disrupted clock makes the original problem worse.

“Timing and metabolism evolved together and are almost a conjoined system,” said one of the study’s authors Joe Bass, M.D., assistant professor of medicine and neurobiology and physiology at Northwestern and head of the division of endocrinology and metabolism at ENH. “If we perturb the delicate balance between the two, we see deleterious effects.” [Cell Metabolism Nov. 2007, Vol 6, pp.414-421, 07]

However, the consumption of high glycemic index foods are more strongly linked to overeating and obesity.



Habits  

Aerobic Exercise

Increased physical activity lowers the risk of obesity, favorably influences the distribution of body weight and has a variety of health-related benefits, even in the absence of weight loss. Exercise is the natural partner to weight loss. You will discover improvement in balance, energy level, immune function, muscular strength, reflexes, and self-esteem.

One of the biggest challenges for dieters is keeping the weight off. Previous research has shown that the hormone leptin decreases food consumption while increasing fat metabolism and energy expenditure. Researchers delivered leptin into the brains of obese rats to determine whether an increase in energy expenditure alone would maintain, over an extended period of time, weight loss achieved through an initial food reduction. They concluded that a reduction in food intake mediated the initial loss of body weight, however, only an increase in energy expenditure was necessary to maintain the reduced weight, even after food consumption returned to normal. The findings suggest that a continuation of reduced food consumption is not critical to maintain a reduced body weight as long as there is a sustained increase in energy expenditure.[Endocrinology August 2002 143: p.3183]

Products like Leptoprin and Anorex SF refer to a study [Current Therapeutic Research 60; 4; April 1999] which demonstrates weight loss with the use of “the active compounds” from their product. These appear to be conventional metabolic stimulants, and the name Leptoprin being merely a play on words with the hormone Leptin. Caution is advised when listening to any ‘sales pitch’ by promoters of these expensive products. It remains to be seen if a Leptin based product promotes weight loss and becomes commercially available.

Weight loss and exercise gyms are available in just about any city. For example, Curves for Women, now the largest fitness franchise in the world, seeks to provide women affordable, one stop fitness and nutritional guidance.

If swimming is what you would like to do, this study is of interest. Researchers compared the energy exhausted by 11 students, ages 21-31, who rode a stationary bike in warm-water (91 degrees Fahrenheit) and cold-water (68 degrees Fahrenheit) pools for 45 minutes. The amount of calories students expended in both water temperatures was virtually the same.

After a rest period, students were brought into a room to have their blood pressure and heart rates measured. They were asked to remain in that same room, where they had free access to a standard assortment of food, for an hour. Researchers found:

1. Significantly more calories were eaten after exercise in cold water, compared to exercise in warm water or at rest.

2. Caloric intake after exercise in cold water was 44 percent higher than after exercise in warm water and 41 percent higher than after periods of rest.

3. Students consumed a mean of 877 calories after exercise in cold water, 608 after exercise in warm water and 618 after resting.

The practical implication is that cold water temperature minht impair weight loss by increasing your caloric intake after the exercise. [International Journal of Sport Nutrition and Exercise Metabolism February 2005 ] Something to keep in mind…

Please also review the link between being Overweight and a High Protein Diet.

Exercise may well be the key factor leading to sustained weight loss. Studies consistently find that people who reported the most exercise also had the most weight loss. When time is short, a program called Sprint 8 could be considered. Twenty minutes, twice a week is all it takes.Here is an introduction to Phil Campbell’s book [Ready, Set, GO! Synergy Fitness] with recommendations.



Hormone  

DHEA

7-Keto DHEA supplements, at a dose of 200mg per day in adults 25 to 55 years of age has been shown in a double-blind trial to enhance weight loss, aid in the reduction of body fat and effect thyroid hormone levels. This two-month study also demonstrated that 7-Keto does not significantly affect blood sugar, testosterone, estradiol, liver or kidney function.

How much DHEA we maintain may be involved in determining how fat is actually stored in the body. In another study, DHEA was given to five male, normal weight subjects at a dose of 1600mg per day, divided into 4 doses. After 28 days, with diet and physical activity remaining normal, 4 of the 5 exhibited a mean body fat decrease of 31% with no overall weight change. This meant that their fat loss was balanced by a gain in muscle mass characteristic of youth. At the same time, their LDL levels fell by 7.5% to confer protection against cardiovascular disease.

7-Keto DHEA does not become converted to sex hormones as does DHEA. The choice of whether to use DHEA or 7-Keto DHEA will be influenced by your sex and adrenal hormone status. Laboratory testing is required to determine this.



Lab Tests/Rule-Outs  

Test for Food Allergies

Masked food allergy can be a factor in the development and persistence of obesity. [Abstract. J Lab Clin Med 32: 1547, 1947]



Mineral  

Calcium

In a study of obese people consuming a low-calorie diet for 24 weeks, those receiving a calcium supplement (800 mg per day) lost significantly more weight than those given a placebo [Obes Res. 2004 Apr;12(4): pp.582-90.]. Calcium was effective when provided either as a supplement, or in the form of dairy products. Fat loss from the trunk area increased as the level of calcium supplementation increased.

In a second study, however, the amount of weight loss resulting from calcium supplementation (1,000 mg per day) was small and not statistically significant. In that study, participants’ typical diet contained more calcium than in the study in which calcium supplementation was more effective. Thus, it is possible that calcium supplementation enhances weight loss only when the diet is low in calcium.



 

Chromium

A 3-month double-blind study of 122 moderately overweight people found that 400mcg of chromium daily resulted in an average loss of 6.2 pounds (2.8kg) of body fat, as opposed to 3.4 pounds (1.5kg) in the placebo group. There was no loss of lean body mass. These results suggest that chromium can help you lose fat without losing muscle.

However, six smaller double-blind placebo-controlled studies found chromium picolinate supplements produced no weight loss or change in lean body mass. These conflicting results may be due to differences in study size, the dosage of chromium, and the individuals enrolled. Overall, chromium does appear to be promising.



Miscellaneous  

Reading List

There are so many books written about dieting that a person could probably read for hours each day and never read them all. If leptin resistance is suspected, the high fat, moderate protein and low carbohydrate approach of the Rosedale Diet may help those who are metabolically negative (need a high fat and protein diet).

Phil Campbell has written a book called [Ready, Set, GO! Synergy Fitness.] In it he describes how to lose weight with a program called Sprint 8. This is a form of intense aerobic exercise, but only takes 20 minutes and should only be done twice a week.



Oriental Medicine  

Emotional Freedom Technique (EFT)

It is common for people to turn to food, especially carbohydrates, for satisfaction when they are emotionally unsatisfied. Addressing and overcoming underlying issues with EFT should reduce this tendency to overeat the wrong foods.



Physical Medicine  

Cold Applications

There is an excellent article by Dr. Mercola describing the benefits of exercising when you are colder. Bringing your temperature down, or exercising in a colder environment may contribute to a greater percentage of brown fat, which, unlike white fat, burns calories more like muscle does! This means that for the same amount of exertion, more calories are burned and more weight is lost.



Psychological  

Hypnosis

109 people were divided into two groups for a 9 week study. The first group were treated with changes in diet and exercise habits (the only way to lose weight) without the addition of hypnosis. The second group was given the same diet and exercise treatment and was also given hypnosis for reinforcement.

After 9 weeks, not surprisingly, both groups lost weight due to the changes in diet and exercise while under supervision.

What happened after the 8 month and 2-year follow-ups might surprise you. The group that did not have hypnosis did not lose anymore weight and in fact most gained most of their weight back.

The hypnosis group, however, continued to lose weight during both intervals and the studies showed that far more people in the hypnosis group met their long term weight loss goals.

The take home is that the hypnosis group continued the eating and exercise habits learned in the experiment while the non hypnosis group did not.

There is no magic pill for weight loss and you simply have to follow a healthy eating and exercise plan — from this study, I believe it is clear that hypnosis supports diet and exercise adherence. [Journal of Clinical Psychology, 41 (1),1985:pp. 35-41]

This study investigated the effects of hypnosis in weight loss for 60 females at least 20% overweight and not involved in other treatment. The researchers interviewed each participant this time about their family background, educational background, and their belief as to their hypnotizability.

The group was split into hypnosis and non hypnosis groups with both groups being given weight loss behavioral treatments and counseling. The results were very interesting. The group using hypnosis lost an average of 17 pounds at the 6 month follow up. The group that did not receive hypnosis only lost a half of a pound. They also found that “hypnotizability” and social and educational backgrounds had nothing to do with the results. [Journal of Consulting and Clinical Psychology, 54,1986:pp. 489-492]

Here is a link to an audio resource for sessions you can do at home at achieve these benefits.Hypnosis Network.



Surgery/Invasive  

Surgery

Two 2005 studies indicate that gastric bypass surgery could have severely dangerous side effects, including severe hypoglycemia (low blood glucose level) and even death.

The first study demonstrated that gastric bypass surgery can result in a potentially dangerous hypoglycemia (low blood glucose) complication that may require quick treatment. It examined the history of three patients who suffered such severe hypoglycemia following meals, as a result of high insulin levels, that they became confused and sometimes blacked out. In two cases, this caused automobile collisions. None of the patients responded to medication, and they all eventually needed partial or complete removal of the pancreas, the major source of insulin, in order to prevent them from undergoing dangerous declines in blood glucose.

A possible reason for the postprandial (after-meal) hypoglycemia they experienced is “dumping syndrome,” which occurs when the small intestine fills too quickly with undigested food from the stomach. This can happen following gastric bypass surgery.

However, the failure of the symptoms to respond to treatment suggests there are other mechanisms at work as well, such as increased insulin sensitivity following the surgery, and abnormal hormone secretion patterns resulting from alteration of the intestinal tract.

At the same time, other research has uncovered a higher-than-expected risk of death following surgery for obesity, even among younger patients. In a study of more than 16,000 subjects, more than 5 percent of men and nearly 3 percent of women aged 35 to 44 were dead within a year of the surgery. The rates increased with older people.

The potentially deadly complications can include malnutrition, infection, and bowel and gallbladder problems. The surgery itself can be a dangerous shock to the system, particularly for older patients.

Gastric bypass is the most common U.S. obesity surgery. About 160,000 people undergo gastric bypass surgery every year. [Journal of the American Medical Association October 19, 2005; 294(15): pp.1903-1908]



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Weakly counter-indicative
Strongly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences

Glossary

Metabolism

The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Sodium

An essential mineral that our bodies regulate and conserve. Excess sodium retention increases the fluid volume (edema) and low sodium leads to less fluid and relative dehydration. The adult body averages a total content of over 100 grams of sodium, of which a surprising one-third is in bone. A small amount of sodium does get into cell interiors, but this represents only about ten percent of the body content. The remaining 57 percent or so of the body sodium content is in the fluid immediately surrounding the cells, where it is the major cation (positive ion). The role of sodium in the extracellular fluid is maintaining osmotic equilibrium (the proper difference in ions dissolved in the fluids inside and outside the cell) and extracellular fluid volume. Sodium is also involved in nerve impulse transmission, muscle tone and nutrient transport. All of these functions are interrelated with potassium.

Allergy

Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Anxiety

Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.

Diabetes Mellitus

A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Hypothalamus

An important supervisory center in the brain regulating many body functions. Despite its importance in maintaining homeostasis, the hypothalamus in humans accounts for only 1/300 of total brain weight, and is about the size of an almond.

Hypothyroidism

Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.

Hyperlipidemia

Increased cholesterol level.

Insulin

A hormone secreted by the pancreas in response to elevated blood glucose levels. Insulin stimulates the liver, muscles, and fat cells to remove glucose from the blood for use or storage.

Hormones

Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Stomach

A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Postmenopause

The postmenopausal phase of a woman's life begins when 12 full months have passed since the last menstrual period and any menopausal symptoms have become milder and/or less frequent.

Gout

A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.

Hypertension

High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.

Gallstone

(Biliary Calculus): Stone-like objects in either the gallbladder or bile ducts, composed mainly of cholesterol and occasionally mixed with calcium. Most gallstones do not cause problems until they become larger or they begin obstructing bile ducts, at which point gallbladder "attacks" begin to occur. Symptoms usually occur after a fatty meal and at night. The following are the most common ones: steady, severe pain in the middle-upper abdomen or below the ribs on the right; pain in the back between the shoulder blades; pain under the right shoulder; nausea; vomiting; fever; chills; jaundice; abdominal bloating; intolerance of fatty foods; belching or gas; indigestion.

Bile

A bitter, yellow-green secretion of the liver. Bile is stored in the gallbladder and is released when fat enters the first part of the small intestine (duodenum) in order to aid digestion.

Cholesterol

A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.

Asthma

A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.

Apnea

Cessation of breathing.

Cardiovascular

Pertaining to the heart and blood vessels.

Atherosclerosis

Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.

Cardiac

Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.

Chronic

Usually Chronic illness: Illness extending over a long period of time.

Menorrhagia

Abnormally heavy menstrual period.

Premenstrual Syndrome

PMS consists of various physical and/or emotional symptoms that occur in the second half of the menstrual cycle, after ovulation. The symptoms begin about midcycle, are generally the most intense during the last seven days before menstruation and include: acne; backache; bloating; fatigue; headache; sore breasts; changes in sexual desire; depression; difficulty concentrating; difficulty handling stress; irritability; tearfulness.

Androgen

Any steroid hormone that increases male characteristics.

Carbohydrates

The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.

Serotonin

A phenolic amine neurotransmitter (C10H12N2O) that is a powerful vasoconstrictor and is found especially in the brain, blood serum and gastric membranes of mammals. Considered essential for relaxation, sleep, and concentration.

CRP

C-reactive protein. A sensitive measure of inflammation in the body.

Dementia

An acquired progressive impairment of intellectual function. Marked compromise exists in at least three of the following mental activity spheres: memory, language, personality, visuospatial skills, and cognition (i.e., abstraction and calculation).

Catecholamine

Any of various amines (as epinephrine, norepinephrine, and dopamine) that function as hormones and/or neurotransmitters.

Stroke

A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.

Prostate

The prostate gland in men that surrounds the neck of the bladder and the urethra and produces a secretion that liquefies coagulated semen.

Cancer

Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.

Epidemiology

The study of the causes and distribution of disease in human populations.

Estrogen

One of the female sex hormones produced by the ovaries.

Colon

The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.

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