Obesity affects 33.8 percent of U.S. adults; 68.0 percent are either overweight or obese.
An estimated 40 percent of endometrial cancers, 25 percent of renal cancers, and 10 percent of breast and colon cancers could be prevented by maintaining a body mass index (BMI) of less than 25 kg per m
According to the guidelines, the most successful strategies for weight loss include calorie
reduction, increased physical activity, high carbohydrate and fiber content in
diet, palatable food choices, decreased fat consumption and behavior therapy designed to improve eating and physical activity habits. Other recommendations include:
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Engage in moderate physical activity, progressing to
30 minutes or more on most or preferably all days of the week. Choose
a low impact exercise such as walking, swimming or cycling, avoid
high-impact aerobics. Besides, begin at low intensity just enough to get
your muscles accustomed to moving. Once regular slowly build up on duration
by 5-10 min per session. Try to exercise for a longer duration rather than
increasing the pace to burn fat. Don't count the scale to tell you the
whole story, for muscle weigh more than fat, you may be getting fitter and
thinner without corresponding loss of pound.
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Reducing dietary fat alone--without reducing
calories--will not
produce weight loss. Cutting back on dietary fat can help reduce calories and is heart-healthy. Foods
high in fat and sugar such as cakes, puddings, cream, chips, pies,
mayonnaise and butter need not be banned, but should not become a part of
your daily diet. Instead eat more vegetables, fruits, wholegrain, and
pulses which are filling nutritious but not fattening.
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Resistance
training has been found to significantly increase the Resting
Metabolic Rate (RMR) and Fat-Free Mass (FFM) in sedentary elderly women.
Therefore a personalised Strength
Training Program is essential component of a weightloss program.
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The initial goal of treatment should be to reduce body weight by about 10 percent from baseline, an amount that reduces obesity-related risk factors. With success, and if warranted, further weight loss can be attempted.
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A reasonable time line for a 10 percent reduction in body weight is six months of treatment, with a weight loss of 1 to 2 pounds per week.
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Weight-maintenance should be a priority after the first 6 months of weight-loss therapy.
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Physicians should have their patients try lifestyle therapy for at least 6 months before embarking on physician-prescribed drug therapy. Weight loss drugs approved by the FDA for long-term use may be tried as part of a comprehensive weight loss program that includes dietary therapy and physical activity in carefully selected patients (BMI >30 without additional risk factors, BMI >27 with two or more risk factors) who have been unable to lose weight or maintain weight loss with conventional
non-drug therapies. Drug therapy may also be used during the weight maintenance phase of treatment. However, drug safety and effectiveness beyond one year of total treatment have not been established.
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Weight loss surgery is an option for carefully selected patients with clinically severe obesity -- BMI of > 40 or BMI of >35 with coexisting conditions when less invasive methods have failed and the patient is at high risk for obesity-associated illness. Lifelong medical surveillance after surgery is a necessity.
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Overweight and obese patients who do not wish to lose weight, or are otherwise not candidates for weight loss treatment, should be counseled on strategies to avoid further weight gain.
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Age alone should not preclude weight loss treatment in older adults. A careful evaluation of potential risks and benefits in the individual patient should guide management.
The guidelines have been reviewed by 115 health experts at major medical and professional societies. They have been endorsed by the coordinating committees of the National Cholesterol Education Program and the National High Blood Pressure Education Program, the North American Association for the Study of Obesity, the NIDDK Task force on the Prevention and Treatment of Obesity, and the American Heart Association.
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