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Monday, December 20, 2004
U.S. NIH’s Obesity Guidelines Part 34: Special weight loss groups
Age alone should not preclude weight loss treatment in older adults up to the age of 80-years-old, however, the longevity benefits of weight loss in older adults are less clear according to the U.S. NIH's Obesity Guidelines (p. xvii and 91).
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U.S. NIH’s Obesity Guidelines Part 33: Goals for maintaining weight loss
Weight loss is difficult to maintain over 3 to 5 years. A majority of people who lose weight regain it once they stop treatment according to the U.S. NIH's Obesity Guidelines (p. xxiv).
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U.S. NIH’s Obesity Guidelines Part 32: Advice for weight loss treatments
Weight loss surgery is an option for carefully selected patients with clinically severe obesity (BMI greater than 40 or BMI greater than 35 with comorbid conditions) when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity or mortality according to the U.S. NIH's Obesity Guidelines (p. xxiii).
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U.S. NIH’s Obesity Guidelines Part 31: Weight Loss Surgery
Weight loss surgery is an option for carefully selected patients with clinically severe obesity (BMI greater than 40 or BMI greater than 35 with comorbid conditions) when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity or mortality according to the U.S. NIH's Obesity Guidelines (p. xxiii).
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Friday, December 17, 2004
U.S. NIH’s Obesity Guidelines Part 30: Diet drugs for weight loss
Meridia (sibutramine) and and Xenical (orlistat) are the only diet drugs currently approved for long-term use according to the U.S. NIH's Obesity Guidelines (p. xvi).
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U.S. NIH’s Obesity Guidelines Part 29: Drug therapy for weight loss, when it is appropriate
Lifestyle changes including behavior modification, a low-calorie-diet, and increased physical activity should be tried for at least six months before weight loss drugs are tried according to the U.S. NIH's Obesity Guidelines (p. xvi). If after six months of diet and exercise a patient fails to lose the recommended 1 pound per week, then drug therapy can be tried. (p. 85)
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U.S. NIH’s Obesity Guidelines Part 28: Behavioral strategies for weight loss
The following behavioral strategies for losing weight are briefly discussed in the U.S. NIH's Obesity Guidelines (p. 81).
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Thursday, December 16, 2004
U.S. NIH’s Obesity Guidelines Part 27: Behavioral therapy for weight loss
Behavioral therapies to reinforce changes in diet and exercise cause roughly a 10 percent weight loss after four to twelve months according to the U.S. NIH's Obesity Guidelines (p. 50).
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U.S. NIH’s Obesity Guidelines Part 26: Weight lifting plus diet for weight loss
Patients who lifted weights in addition to dieting lost 4.9 pounds more after six months than a diet-only group, and 11 pounds more after eleven months. (p. 47) Patients who engaged in weight lifting-plus-aerobics-plus-diet lost 2 pounds more than those with only aerobics-plus-diet according to the U.S. NIH's Obesity Guidelines (p. 47).
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U.S. NIH’s Obesity Guidelines Part 25: Diet plus exercise for weight loss
Diet-plus-exercise causes an average weight loss of about 4 pounds more than diet alone, and modestly greater reductions in abdominal fat than either diet or exercise alone, however, this has not been found independent of weight loss according to the U.S. NIH's Obesity Guidelines (p. xxii and 47-8).
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U.S. NIH’s Obesity Guidelines Part 24: Exercise and weight loss
Exercise alone causes a modest weight loss of 2-3 percent according to the U.S. NIH's Obesity Guidelines (p. 77).
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Wednesday, December 15, 2004
U.S. NIH’s Obesity Guidelines Part 23: Dieting
The average weight loss on a low-calorie diet is 8 percent of body weight over three to twelve months according to the U.S. NIH's Obesity Guidelines (p. 42). The average long-term weight loss maintained after 3 to 4.5 years of follow-up is 4 percent of body weight.
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U.S. NIH’s Obesity Guidelines Part 22: Weight loss lowers insulin, blood sugar and diabetes
Weight loss lowers insulin levels, blood sugar levels and reduces the risk of diabetes according to the U.S. NIH's Obesity Guidelines.
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U.S. NIH’s Obesity Guidelines Part 21: Weight loss improves cholesterol
A weight loss of 5-13 percent from changes in lifestyle is associated with a 0-18 percent reduction in total cholesterol; 2-44 percent reduction in triglycerides; 3-22 percent reduction in LDL-cholesterol; and a 7-27 percent increase in HDL-cholesterol according to the U.S. NIH's Obesity Guidelines (p. 21). Changes are similar for those on diet-alone, exercise-alone, or diet-plus-exercise. (p. 34)
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U.S. NIH’s Obesity Guidelines Part 20: Weight loss lowers blood pressure
A weight loss of 22 pounds induced by lifestyle changes lowers systolic blood pressure an average of 7 points, and diastolic blood pressure 3 points according to a 1987 meta-analysis of five studies of hypertensive patients. (p. 29)
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Tuesday, December 14, 2004
U.S. NIH’s Obesity Guidelines Part 19: Risk of death
The risk of death increases modestly in people who are overweight (a BMI of 25 to 29.9), but increases substantially in someone obese (a BMI of 30 or more) according to the U.S. NIH's Obesity Guidelines (p. 21).
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U.S. NIH’s Obesity Guidelines Part 18: Binge Eating
Binge Eating Disorder, that is eating large amounts of food in short period of time, occurs in 20-50 percent of people seeking weight loss treatment compared to only 2 percent in the general population according to according to the U.S. NIH's Obesity Guidelines (p. 21).
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U.S. NIH’s Obesity Guidelines Part 17: Emotional Problems
Obesity may be associated with increased emotional problems according to some recent studies. One study found 62 percent of patients showed signs of depression and 37 percent were clinically depressed. (p. 21)
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Monday, December 13, 2004
U.S. NIH’s Obesity Guidelines Part 16: Pregnancy
Black and white women retain an average of 4.4 to 6.6 pounds with their first pregnancy, however, 42 percent of women retain at least 9 pounds, and 34 percent retain at least 14 pounds according to the U.S. NIH's Obesity Guidelines (p. 19).
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U.S. NIH’s Obesity Guidelines Part 15: Menstrual Function and Fertility
Obesity is associated with menstrual irregularity, amenorrhea (lack of a menstruation), and infertility according to the U.S. NIH's Obesity Guidelines (p. 19).
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U.S. NIH’s Obesity Guidelines Part 13: Endometrial cancer
Obesity triples the risk of endometrial cancer according to the U.S. NIH's Obesity Guidelines (p. 18).
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U.S. NIH’s Obesity Guidelines Part 14: Gallbladder cancer
Obesity increases the risk of gallbladder cancer 16 to 53 percent according to the U.S. NIH's Obesity Guidelines (p. 19).
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U.S. NIH’s Obesity Guidelines Part 12: Breast Cancer
An adult weight gain of 20 pounds doubles a woman's risk of breast cancer according to the U.S. NIH's Obesity Guidelines (p. 18).
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U.S. NIH’s Obesity Guidelines Part 11: Colon cancer
Obesity doubles the risk of colon cancer according to the U.S. NIH's Obesity Guidelines (p. 18).
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Friday, December 10, 2004
U.S. NIH’s Obesity Guidelines Part 10: Sleep Apnea
Obesity, particularly upper body obesity, is a risk factor for sleep apnea. Most people with sleep apnea have a BMI of 30 or more.
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U.S. NIH’s Obesity Guidelines Part 9: Osteoarthritis
Being overweight increases the risk of osteoarthritis more so in women than men. For every 2.2 pound increase in weight, the risk of osteoarthritis increases by an estimated 9 to 13 percent.
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U.S. NIH’s Obesity Guidelines Part 8: Gallstones
The risk of gallstones increases with adult weight. According to NHANES III data, the prevalence of gallstone disease among women increased 2.7 fold, from 9.4 percent in the first quartile of BMI to 25.5 percent in the fourth quartile of BMI.
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U.S. NIH’s Obesity Guidelines Part 7: Stroke
Being overweight appears to be related to stroke -- ischemic stroke, but not hemorrhagic stroke -- although this has been less well studied that coronary heart disease.
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U.S. NIH’s Obesity Guidelines Part 6: Heart disease
The risk of coronary heart disease increases with BMI. In women, the risk of coronary heart disease is twice as great for overweight women (BMI 25-28.9) as lean women (BMI of 21 or less), and three times as great for obese women (BMI 29 or more) according to the Nurse's Health Study. (p. 16)
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Thursday, December 09, 2004
U.S. NIH’s Obesity Guidelines Part 5: Diabetes
The risk of developing type 2 diabetes increases by approximately 25 percent for each one unit increase in BMI over 22 according to the U.S. NIH's Obesity Guidelines (p. 15).
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U.S. NIH’s Obesity Guidelines Part 4: Cholesterol
The prevalence of high total cholesterol (greater than 240 mg/dL) increases with BMI above 25, although at each BMI level, the prevalence is greater in women than in men according to the U.S. NIH's Obesity Guidelines (p. 14).
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U.S. NIH’s Obesity Guidelines Part 3: Hypertension
Hypertension is 2.1 more common in men and 1.9 times more common in women with a BMI of 30 or more compared to those with a BMI of 25 or less according to the U.S. NIH's Obesity Guidelines (p. 12).
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U.S. NIH’s Obesity Guidelines Part 2: Health Risks of being Overweight
Above a Body Mass Index (BMI) of 20 there is an increased incidence of hypertension, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and some types of cancer including endometrial, breast, prostate, and colon according to the U.S. NIH's Obesity Guidelines.
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U.S. NIH’s Obesity Guidelines Part 1: Overview
In 1998, the U.S. National Institutes of Health's pubished the first federal guidelines for identifying and treating overweight and obese adults. Here is an overview of that excellent report.
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