Weight gain and treatment

This article is intended for patients and doctors alike, and is based on the latest studies and recommendations of the World in the diagnosis and treatment of weight gain, while avoiding all the threads and narratives is not scientifically established, which abound in entertainment magazines and non-specialist.



Evaluation of patient weight gain:



The assessment of the patient on the study of body mass index (Body Mass index = BMI) and waist circumference, and assessment of risk factors for disease.



Calculate body mass index (BMI)



This is calculated by applying the following equation hairy:

Body mass index = weight (kg) \ square of the height (m 2)



Classification of weight by body mass index number:



- Lack of weight less than 18.5

- Normal weight = 5.18 to 9.24

- Overweight = 25 - 29.9

- Obesity, first degree = 30 - 34.9

- The degree of obesity seconds = 35 - 39.9

- Obesity or severe = more than 40



Waist circumference:



The accumulation of fat in the abdominal area is a distinct risk factor for a number of diseases. Therefore, men who have to have a waist circumference of more than 100 cm, and women who have to have more than 90 cm are the most susceptible to infection with diabetes and blood lipid disorders and cardiovascular diseases.

The people who have an increase in waist circumference are more vulnerable to disease, even if the body mass index have a natural.

So, can a person be a natural indicator of where the block, but has the accumulation of fat in the abdomen only, with the increase in waist circumference. Such persons are also needed for treatment.



Assessment of disease risk factors:



The presence of other disease risk factors increase the likelihood of disease in people with excess weight, so do not need to address these factors in parallel for the treatment of weight gain. Most important of these factors:

- Smoking

- High blood pressure

- Blood cholesterol disorder

- Diabetes

- Glucose tolerance disorder

- The presence of cardiac or arterial injury early in the family.

- Age above 45 years for men and 55 years for women



Who should be reduced and weight?



People who have one of the following criteria, they must work to lose weight:

- Body mass index more than or equal to 30

- Body mass index between 25 - 29.9 with the seriousness of workers or more

- Waist circumference more than 88 cm for women and more than 102 cm for men with serious or more workers.

For people who have a body mass index between 25 - 29.9 without other risk factors, it is best to encourage them to lose weight, without being a medical necessity.



The goals of treatment:



The main objective of treatment is weight loss, and bringing it to the best number possible and maintain it without the return of the acquisition of a new increase.

Decision is to lose weight by mutual agreement between the physician and patient.

The initial goal should be weight loss rate of 10% during the first six months. After achieving the initial goal, and maintain it for another six months, you can set new goals.

Treatment consists of three pillars: diet, sports, and behavioral treatment. Following are the three pillars for a period of at least six months before thinking about adding medication.



Rapid weight loss:



Weight loss by 10% during the first six months is a logical and acceptable. Lose weight quickly a half to 1 kg per week is also acceptable and sufficient.



Contraindications weight loss:



Patients who are prevented from reducing their weight, they are:

- Pregnant women and nursing mothers

- People who have severe mental illness is controlled (such as severe depression)

- Patients with severe disease need to be effective nutrition



Diet:



Cornerstone in the diet is to reduce the calories entering the body. Must reduce calories consumed by 500 - 1000 calories for the normal rate of the patient. Are generally choose a diet containing 1000 - 1200 calories \ day for women, 1200 - 1600 calories \ day for men.

Have to rely on the basic diet of fruits and vegetables and proteins, with a large decrease in the amount of fat (fat and oils) and processed sugars and starches.

There are a large number of diets, published in many references, but the patient can be applied to the diet they want on the basis of diversity and preserve the previous recommendations in coordination with your physician.



Sports:



Sports are an integral part of weight loss program and maintain it. In the beginning, the sport can be mild for a period of 30-45 minutes from 0.3 to 5 times a week. But the real goal should be to reach at least 30 minutes, from medium voltage or higher every day.

As mentioned earlier, part sport can not do without it, and if it is itself not only reduce weight accompany her diet, but to prevent atrophy of muscle tissue, and contribute to maintain the weight that has been reached.

Must start slow and sport in gradually, and the patient chooses a sport that is pleased exercise more, after taking the doctor felt about the absence of other diseases to prevent this type of sport.







Behavioral treatment:



Are under the supervision of psychiatrists, and it aims to help the patient to overcome the psychological barriers to follow the diet or the exercise of Riyadh.

Some simple tips in this area can be:

- Not to eat any foods outside of meal times the main

- Develop a program to clear the timing and meals

- Clean your teeth well after every meal as this would help to refrain from eating between meals

- Do not eat in front of the TV



Medication:



Can be used as medicines for patients whose body mass index have more than 30, and those who do not have the disease prevents the use of these drugs. Can also be used in patients who followed the previous recommendations are good for at least 6 months, without access to the shortage desired weight. It also should not use medicines for slimming aesthetic, but also for medical weight loss.

Drugs used and currently permitted are:

-Sibutramine

- Orlistat

In vivo studies suggest these drugs, that patients who respond to medical treatment since the beginning, follow the response during the treatment period, while those who do not seem to get an initial response will not have any response, even if later was increased doses.

If, in the event of a lack of weight during the first six months as a result of the use of medications, can continue to use, and not only benefit from it.

Also, we draw attention to the important point is that medicine is not a substitute for dieting and sports, it is an aide to two and participant.

Medicine should be used for very long periods, so get the results you want and keeping it, knowing that the side effects that may produce a few useless and dangerous and irreversible, and that the use of the drug for short periods is useless.

Sibutramine contraindications are:

- High blood pressure

- Heart disease, all

- Cerebrovascular accidents

The side effects is the rise in blood pressure only.

For the drug Orlistat side effects is the lack of basic vitamins and diarrhea. Therefore advised the use of various vitamins while taking this medicine.









Surgical treatment:



Surgical therapy is a good solution for patients whose body mass index had a higher or equal to 40, or who have a hairy top of the 35 with other diseases accompany.

Not be used for this treatment only after failure of all previous processors.

There are two types of surgery have shown the effectiveness of the good:

- Surgery to reduce the size of the stomach (such as enclosure) and are the most widely used. The best way to reduce the stomach is the way loop adjustable from the outside. This process is undoubtedly one of the successful operations that have provided for people with a great solution to obesity disease without subjecting them to major surgical work. Since this process is carried out laparoscopic through four or five holes in the abdomen. This ring placed around the upper stomach to form a small enclave higher stomach fullness only in very small amounts of food gives people a feeling of fullness will last a long time. And thus help to take down the fat and excess weight in a balanced and constant weight and then permanently. And not to any effects of this process
Negative if the loop has been installed properly, however, and the expert patient and follow the instructions given to him accurately, especially in the first weeks after installation.

- Surgery reduce absorption of food (gastric bypass in the form of Y) and are less widely used because of side effects



Tips to prevent the return of weight gain:



After obtaining the ideal weight, it becomes the main objective is to maintain it. Therefore it is necessary for the patient to follow the diet food and sports on a permanent basis, and not to stop for a lifetime, because the return to former habits will expose him to gain weight again. Follow-up can also take medication for two years after reaching the desired weight, and to help the patient to maintain it.