Weight Loss

Submitted by Colleen Brown PA on Thu, 10/06/2011 – 22:31

Obesity is a chronic condition defined by an excess amount of body fat. The calculation of body mass index (BMI) has also been used in the definition of obesity. The BMI equals a person’s weight in kilograms divided by their height in meters squared. Since BMI describes body weight relative to height, it is strongly correlated with total body fat content in adults. A BMI of =25.0 is defined as overweight, a BMI of 30.0-39.9 is obese, and a BMI of = 40 is morbid obesity. As well as an increased BMI, a waist circumference greater than 102 cm (40 in) for men and 88 cm (35 in) for women are associated with an increased risk of morbidity and mortality.

Causes

Most cases of obesity are related to non-medical disorders such as a sedentary lifestyle and increased caloric intake. To determine etiology and plan future management strategies, additional medical history should be obtained to include age at onset of weight gain, previous weight loss attempts, change in dietary patterns, history of exercise, current and past medications, and history of smoking cessation. Medications are a common cause of weight gain and obesity, in particular insulin, sulfonylureas, and antipsychotics. Smoking cessation is also associated with weight gain. Although uncommon, some obese patients have an endocrine disorder such as Cushing’s syndrome and hypothyroidism.

Risk Assessment

In patients with a BMI = 25 kg/m2 or a waist circumference greater than 88 cm (women) or 102 cm (men), we suggest further evaluation of risk. Assessment of an individual’s overall risk status includes determining the degree of overweight (BMI), the presence of abdominal obesity (waist circumference), and the presence of cardiovascular risk factors or comorbidities.

Comorbidities:

Obesity is associated with a significant increase in mortality and risk of many disorders, including diabetes mellitus, hypertension, dyslipidemia, heart disease, stroke, sleep apnea, cancer, and many others. Conversely, weight loss is associated with a reduction in obesity-associated morbidity.

Weight Loss Treatment

Based on your measurements and your medical history, we can determine what combination of weight loss treatments would work best for you. Treatments may include changes in lifestyle, exercise, dieting, and, in some cases, weight loss medicines or weight loss surgery. Here’s an overview of what we need to discuss in order to make your weight loss become a reality:

Set a weight loss goal
Lifestyle changes
Determine triggers that make you eat
Change eating habits
Reward yourself for good eating behaviors
Have a buddy system, support system, and positive thinking
Reduce stress
Choose a diet right for you
Weight loss medications
Weight loss Surgery