Obesity and Diet

If your weight is quite a bit above what is healthy for a person with your body type, you may be considered obese. Obesity is a more serious condition than being just a little overweight because of the increased risk of:

• heart disease
• stroke
• high blood pressure
• diabetes
• arthritis
• cancer
• other medical problems.

Your health care provider can tell you if your weight puts you in the category of being obese.

It is important to consider body composition. If you are muscular and athletic, you may weigh more than a sedentary person of the same height and frame size, yet you may be trim, while your sedentary counterpart may be overweight. If your weight comes from muscle, you may fall technically into the overweight category yet not be fat. However, in general, as you approach 20% or more above your ideal weight, your excess weight usually comes from fat.

Body fat percentage can be determined by several methods, such as skinfold thickness, underwater weighing, total body water (hydrometry), and whole body potassium.

Losing weight

Diets for losing weight involve controlling the amount and types of food you eat. This most often means eating fewer calories and avoiding fatty foods or empty-calorie foods.

Losing weight requires a change in behavior that almost always involves:

• a better understanding of your own health
• healthy eating habits
• a plan for rewards for following your program
• an increase in regular physical activity.

A weight reduction diet needs to provide adequate nutrition, a good variety of foods, and a reduction in calories. This is usually best done by limiting fat, especially saturated fat, in the diet.

What is most effective is a gradual change in eating and physical activity habits that you can continue for the rest of your life. The best diet is one that helps you lose weight slowly but steadily, so you can maintain your ideal weight after you have reached your goal. Ask your health care provider for a safe, healthy, effective weight reduction program.

Selecting foods to lose weight

Keep a food diary. As soon as you eat or drink, write it down. It may be helpful to use a small pocket diary. Seeing what you eat and drink will help you examine your eating patterns and food habits.

To lose weight in a healthy manner, follow these guidelines:

• Drink at least six 8-ounce glasses of water each day.
• Choose unlimited amounts of vegetables and salads.
• Choose:
  • lean meats, poultry, and fish
  • baked or broiled meat, fish, and poultry
  • salad dressing containing little or no oil.
• Choose regular but limited amounts of:
  • low-fat or skim milk, cheeses, and yogurts
  • legumes (lentils, peas, and beans)
  • unrefined carbohydrates (whole wheat bread, whole grain cereals without sugar)
  • raw fruits.
• Significantly limit how much you eat of the following:
  • refined carbohydrates (sugar) and foods containing sugar
  • refined grain products such as white rice and white flour.
• Avoid:
  • saturated fats such as butter, margarine, and fat on meats
  • other foods that contain fats, such as pastries, cakes, and cheese
  • fried foods
  • processed meats
  • alcoholic beverages.

To have a balanced diet, be sure to choose a variety of foods from the basic food groups:

• dairy
• meat and other protein
• vegetables
• fruit
• bread and cereal.

Counting calories

A calorie is a unit of measurement used to express the energy value of food. Your body burns calories to use for basic body functions. Proteins, carbohydrates, and fats contain calories and produce energy. To lose weight, reduce the calories in the food you eat (without giving up nutrition) and increase the number of calories you use in physical activity.

Eating 500 calories less a day can result in losing 1 pound a week. One to one and a half pounds (2 pounds maximum) is the ideal amount to lose in a week. If you lose more than that each week, you begin to lose muscle rather than fat.

Most weight reduction diets suggest 1200 to 1500 calories a day for women and 1500 to 1800 calories a day for men. Ask your health care provider or dietitian to help you determine how many calories you need a day.

The rate at which you can lose weight depends on your body's metabolism. This is the rate at which your body uses the energy from food for basic body functions. Metabolism can be increased by increasing physical activity.

Weight loss may occur more quickly at the beginning of a diet because the body releases extra water that was retained.

Sit down and relax while you eat your meals. Avoid distractions such as the phone and TV. Chewing your food thoroughly helps digestion. Eating small, frequent meals instead of three full meals a day is also helpful. You should eat every 4 to 5 hours. This keeps your blood sugar at a constant level and helps keep you from feeling hungry. Finish your meals with a piece of fruit instead of a sweet dessert.

You must eat a minimum quantity of appropriate food or your body will shut down its metabolism in an effort to survive the lean time. This happens when people go on "starvation diets." The body's survival response prevents them from losing weight.

Popular diets

Popular or fad diets may be dangerous. They can be divided into several groups:

• high-protein diets
• specific food diets
• calorie-conscious commercial programs.

High-protein diets result in a quick initial loss of weight. These diets allow unlimited amounts of high-protein foods, but little or no carbohydrates. Examples include the Atkins Diet, Cambridge Diet (The University Diet), Herbalife Diet Plan, Stillman Diet, and Scarsdale Diet. The Federal Drug Administration has reported cases of acute illness from the Cambridge Diet requiring hospitalization, and a warning has been added to the product label. The Herbalife Diet Plan may cause diarrhea, nausea, heavy sweating, headaches, and cramps. The Stillman Diet does not include the five basic food groups and provides only small amounts of vitamins A and C, thiamine, and iron. In the Scarsdale Diet there is little iron, vitamin A, calcium, and riboflavin because the diet limits milk, bread, and cereals. It can lead to dehydration because fluids are limited to coffee, tea, and water.

Specific food diets are based on food combinations. These diets don't count calories, are monotonous, and encourage unrealistic eating habits. You may develop vitamin and mineral deficiencies can after a few days on one of these diets. Examples of these diets are the Mayo (or grapefruit) Diet, the Beverly Hills Diet, and high-carbohydrate diets.

• The Mayo diet is based on the belief that grapefruit causes weight loss by causing fat to be burned off faster. One of the problems is that the diet is high in saturated fats and cholesterol.
• The Beverly Hills Diet is low in protein, vitamins, and minerals such as iron, zinc, calcium, and magnesium.
• High-carbohydrate diets (for example, Jane Fonda, Pritikin, Bloomingdale's Eat to Succeed) are based on high-carbohydrate, high-fiber foods. Some are balanced, others are not.

Calorie-conscious commercial programs and weight loss clinics offer group support and motivation for the dieter, a wide variety of foods, and a calorie intake between 500 and 1500 a day. These programs are often expensive and should not be used without medical supervision. Some programs can provide excellent support in changing bad eating habits and maintaining a program over time.

Very low calorie diets and total fasting (eating less than 500 calories a day) are potentially fatal and require medical supervision.

Protein-sparing modified fasting

Protein-sparing modified fasting is used for people who are more than 30% to 40% over their ideal weight. Before recommending this diet, your health care provider will evaluate your cardiovascular system. You remain under your provider's care while you are on this diet.

This diet is not recommended for children, adolescents, pregnant women, nursing mothers, the elderly, those who are moderately overweight, and those who have problems with their health, such as high blood pressure or cardiovascular disease.

A program that combines a very low calorie diet (to achieve a large initial weight loss) with medical supervision, counseling, an exercise program, and behavior modification can provide some initial motivation for a person trying to deal with obesity. However, the disadvantages of losing muscle may outweigh any quick success benefit.

For those who compulsively overeat, Overeaters Anonymous may help. The program is free. Write or call:

Overeaters Anonymous
World Service Office
4025 Spencer Street #203
Torrance, CA 90503

Phone: 1-310-542-8363

Another program that can help you lose weight is Weight Watchers. To learn about Weight Watchers meetings and programs in your region, call 1-800-651-6000.

Increasing physical activity to lose weight

In addition to diet, adding daily walking to your routine can help you manage your weight. Start with a comfortable goal: 5, 10, or 15 minutes a day. Walk this amount at least 4 to 7 times a week. Each week add 5 minutes to your time until after several weeks you have worked up to 30 to 40 minutes per day. Invite someone to walk with you, for example, your spouse or a child you've been meaning to spend more time with.

In addition to the calories you are burning as you walk, regular physical activity increases your metabolic rate. Therefore, you will be using more calories 24 hours a day, even as you sleep. If you are unable to walk, ask your health care provider to recommend a different type of exercise.

In addition to helping you lose or maintain your weight, regular physical activity lowers your pulse, blood pressure, cholesterol, and blood sugar. It also increases your energy level.