Through Thick & Thin

Resolved to lose weight in 2007? Tallahassee Magazine wants to help you, with a 26-page special health section on obesity. We examine all angles – from weight loss strategies to understanding the latest surgeries available to helping kids eat smart.

Take It OffA Tallahassee Magazine Special Report On Weight Loss & Maintainence

By Triston V. Sanders

If you’re like most Americans, your New Year’s resolution sounds something like these:

“I hope to lose weight.”

“I’ll go on a diet.”

“I’ll exercise more.”

“I resolve to get back into shape.”

“I’ll work off my love handles, stomach, thighs, (or pick a flabby part and fill in the blank).”

And if you’re like most Americans, by April you’ll give up. Tallahassee Magazine wants to inspire you to stick with it and see it through. We’re going to help you “lighten your load” over the next 27 pages by loading you up with facts, tips, tools and inspiration to start 2007 with resolve . . . and finish it with success.

Let’s start by waking you up with the facts. It is estimated that about two-thirds of American adults are overweight or obese. Approximately 127 million adults in the United States are overweight, 60 million are obese, and t9 million are severely obese. In a recent article in the Journal of the American Medical Association, it was found that, taken together, poor diet and physical inactivity was the second-leading cause of death in the United States in the year 2000. The number of overweight and obese Americans has continued to increase since 1960 – and the trend is not slowing down. Each year, obesity causes at least 300,000 deaths in the United States, and health-care costs of obese American adults amounts to approximately $100 billion.

Florida residents are just about keeping pace with the national average. According to the Florida Department of Health, a total of 60.7 percent of Florida adults were either overweight (37.9 percent) or obese (22.8 percent) in 2005.

People gain weight when the body takes in more calories than it burns off. Those extra calories are stored as fat. The amount of weight gain that leads to obesity doesn’t happen in a few weeks or months. Because being obese is more than just being a few pounds overweight, people who are obese usually have been getting more calories than they need for years.

Few people have more experience with obesity in Tallahassee than Dr. Eliot Sieloff, medical director of The Bariatric and Weight Management Center at Tallahassee Memorial Hospital. Over the past 14 years, he has performed more than 750 weight-loss operations. He has done 150 vertical banded gastroplasties, 200 open gastric bypasses and 400 laparoscopic gastric bypasses.

“Three generations ago, when the majority of Americans lived on farms and raised their own food, it took a significant amount of energy to grow, harvest and process 3,000 calories of food,” Sieloff said. “Now, Americans can get 3,000 calories of food three times a day without getting out of their car. Our diets are higher in fat and carbohydrates, and the amount of exercise we do on a daily basis has decreased.”

If you look at every decade, the number of obese and morbidly obese people has continued to grow. Although one of the national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15 percent, current data indicate that the situation is worsening rather than improving.

Obesity is considered a chronic disease and is a major risk factor for hypertension, cardiovascular disease, diabetes, obstructive sleep apnea, degenerative joint disease, infertility and certain cancers in both men and women. As the weight goes up, so does the risk.

Obesity is a major contributor to heart disease, and the best way to combat it is by making lifestyle changes, according to Dr. Harry Rosenblum, a cardiovascular surgeon at Capital Regional Medical Center.

“This is a multi-factor thing that involves diet, it does involve exercise, and it involves keeping your weight under good control,” he said.

To treat it, you need to acknowledge your condition and make a conscious decision to do something about your weight. Some causes of obesity are beyond a person’s control, such as an underlying health condition or genetics. But most people can fight it. Here are some different approaches that are best used together:

 

Control your intake

For those who have tried diets and failed, try focusing on eating for good health. Gradually increase your fruit and vegetable intake, choose whole-grain foods, limit fatty and fried foods, choose lower-fat dairy products, consume sweets sparingly, and get moving. The weight loss will follow.

The 2005 Dietary Guidelines for Americans says it is helpful to reduce calorie intake in order to lose weight.

“Since many adults gain weight slowly over time, even small decreases in calorie intake can help avoid weight gain, especially if accompanied by increased physical activity,” the government panel wrote. “For example, for most adults, a reduction of 50 to 100 calories per day may prevent gradual weight gain, whereas a reduction of 500 calories or more per day is a common initial goal in weight-loss programs.”

Some proposed calorie-lowering strategies include eating foods that are low in calories for a given measure of food (for example, many kinds of vegetables and fruits and some soups). However, when making changes to improve nutrient intake, you will need to make substitutions to avoid excessive calorie intake. The healthiest way to reduce calories is to reduce the intake of added sugars, fats and alcohol, which all provide calories but few or no essential nutrients.

Special attention should be given to portion sizes, which have increased significantly over the past two decades. (Check out an interesting Web site that illustrates this point at http://hin.nhlbi.nih.gov/portion/index.htm.)

When using packaged foods with nutrient labels, pay attention to the units for serving sizes and how they compare to the serving sizes in the USDA Food Guide. (See health.gov/dietaryguidelines/dga2005/document for more information on serving sizes.)

Two main drugs have been approved for weight loss by the Food and Drug Administration – orlistat and sibutramine. Orlistat is sold under the brand name Xenical, while sibutramine is sold as Meridia. Sibutramine is an appetite suppressant, while orlistat is known as a lipase inhibitor, which means it interferes with the body’s ability to absorb fat. Both drugs are approved for long-term use.

 

Exercise those muscles

In 2005, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture released guidelines recommending a minimum of at least 30 minutes of moderate exercise – brisk walking or gardening – on most days. But the government also says many adults need to exercise for 60 minutes or more each day to prevent weight gain, and people who have lost weight may need to exercise for 60 to 90 minutes to keep it off.

Dr. Sieloff says exercise has three major benefits:
1.    Exercise helps to burn up more calories and will help patients maximize their weight loss and prevent them from regaining weight.

2.    Exercise preserves muscle mass, causing patients to lose weight by burning up excess calories that are stored as fat rather than using muscle tissue as fuel.

3.    Exercise helps to improve stamina and endurance.

 

Surgery a growing treatment

The two most common types of surgery to treat obesity – called bariatric surgery – are gastric bypass, which diverts food from the stomach, and gastric banding, which uses an adjustable band to restrict the stomach’s size. Bariatric surgery may work by limiting food intake, slowing digestion and/or hindering absorption.

Whatever route you choose, it’s wise to consult a doctor before trying to lose weight. Write down your current weight, BMI and waist circumference.  If you have a bad day, don’t be deterred. Every day is a new day. Grab an exercise buddy. Join a weight-loss program. Enroll in a gym. Play an organized sport. Throw away the junk food. Plan your meals. Take your meals and snacks to work with you to avoid the snack machines and birthday parties. Take your entire family for an evening walk. Turn off the TV. Whatever you do, don’t give up! Tallahassee Magazine wants to take you through thick and thin and help make 2007 your best year ever.

Categories: Special Section