Obesity & Health

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There are a number of reasons why people choose to lose weight.  Some of the most powerful motivators are often very personal, such as wanting to look more attractive to one’s spouse and put the zing back in their relationship.  Beyond these, there are definite health benefits to lowering your BMI into the normal range.  So if you are on the fence about whether to lose weight, the following might help you make up your mind.

Being overweight or obese increases the risk of developing many diseases and conditions including high blood pressure, coronary heart disease, stroke, type 2 diabetes, sleep apnea, high cholesterol levels, high triglyceride levels, osteoarthritis and gallbladder disease. It even increases the risk for endometrial cancer, breast cancer and colon cancer.

During pregnancy, obesity increases the risk of death for both the baby and the mother and raises the maternal risk of high blood pressure by a factor of ten. The woman who is obese during pregnancy has an increased risk of gestational diabetes and problems with labor and delivery. The infants of these obese women have a higher birthweight which leads to a higher rate of cesarean section with its higher rate of complications. These infants often have low blood sugar which can lead to brain damage and seizures. In addition, these infants have a higher risk of birth defects.

The attainment of a normal weight can lower these risks. A report from the Surgeon General stated that an overweight individual can reduce their risk of heart disease even by just losing 5-15% of their body weight. So there is definitely hope to improve your health risk.

A Simple Formula

Being overweight or obese is due to an energy imbalance. More calories are eaten or consumed than are used in the activities of the body. To lose weight you must do the opposite:

Formula For Weight Loss: Calories Out (Activity) > Calories In (Food Eaten)

Body weight is the result of heredity, environmental factors and individual behaviors. While you can’t change your heredity, you can alter your environment and your individual behaviors. That is where your power lies. You’ll lose the most the fastest when you eat less and burn more. So, an exercise regimen is an important part of the formula. After being cleared by your doctor, you will need to build up your routine, but it will be worth it!  In addition to helping you lose weight, exercise provides other health benefits including improving your cardiovascular fitness.

For Your Health – Dr. Bob

How Is Obesity Defined?

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Body Mass Index (BMI) is a measure calculated from a person’s weight and height. It provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. BMI is calculated by dividing your weight in kilograms by your height in meters squared. That number should be between 18.5 and 24.9. The National Institutes of Health has defined certain classifications of weight based upon the BMI:

Classification

BMI Range

Underweight

Less than 18.5

Normal

18.5 – 24.9

Overweight

25.0 – 29.9

Obese

30.0 – 39.9

Extreme Obesity

Greater than 39.9

According to a report released on July 7, 2011 by the Trust for America’s Health and the Robert Wood Johnson Foundation, two-thirds of all adults and about a third of all children and teenagers in the United States are overweight or obese.  In fact 16 states have obesity rates over 30%.  Colorado has the lowest rate at 19.8%.  Twenty years ago no state’s obesity rate exceeded 15%.  Indeed we have an epidemic!

You should discuss with your physician whether your goal should be to attain a normal BMI. For people with a lot of muscle mass, such as trained athletes, a healthy BMI may actually be somewhat higher than what the table would indicate. For most people, however, these categories are a useful guide.

Another body measurement that is related to health risk is the waist circumference. It seems that the location of fat makes a difference as far as health risk. Fat in the waist carries a greater health risk than fat in hips or thighs. Scientific studies have shown that people whose waists exceed the targets in the table below have a higher risk of health problems.

Gender

Healthy Waist Circumference

Men

Less than or equal to 40

Women

Less than or equal to 35

In my next post I’ll talk about the health risks from being overweight.

For Your Health – Dr. Bob

Describing Your Symptoms

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Whenever you have a doctor’s appointment, it’s a good idea to plan what you would like to talk about including questions for your physician. Making notes beforehand helps to make sure you won’t forget anything.

Since time with the doctor is often limited, it also makes sense to understand the best way to describe your symptoms so you’re prepared for the questions the doctor will ask. Here’s a list of 10 things to include:

  1. When did the symptom first start to occur?
  2. What were you doing when it first started?
  3. Where do you feel it?
  4. How long does it last?
  5. If it’s a pain, how would you describe it? Sharp, dull, burning, stabbing?
  6. If it’s a pain, does it seem to spread or move (radiate) to other locations?
  7. Is the symptom accompanied by any other symptom?
  8. What seems to make it get better or worse?
  9. Is it occurring more frequently since it started?
  10. Is it growing in intensity since it started?

These 10 questions give you a sense of what the doctor will be looking for when you tell him about your symptom. Knowing how to describe it in these terms will help him identify the cause and prescribe an effective treatment.

For Your Health – Dr. Bob

Challenges Along The Way

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It’s important to set expectations early in your behavior change plan.  Whether you are trying to quit smoking, start an exercise program or lose weight, be prepared for some challenges along the way.  It is very common to make some progress and then go backwards from time to time.  It’s what you do when that happens that will determine whether you will ultimately reach your goal.

These challenges should be viewed as learning opportunities.  When they occur, accept them for what they are, situations that caused you to deviate from your plan temporarily. They don’t mean that all is lost.  You need to step back, look at the situation and understand why there was a lapse.  Once you understand that, you can devise a plan to use when those circumstances occur again.  For instance, three weeks into your healthier eating plan, you go to an all you can eat buffet and can’t resist the temptation.  You wind up gaining 2 pounds after that.  Instead of giving up your eating plan entirely, you should learn from this.  Next time, avoid those buffets or, if you must go, fill up on water, fruits and vegetables beforehand so you won’t be able to overeat.

So, remember that it is common that the path to success is not straight or smooth when changing your behaviors.  When you get stuck or move backward, learn from the challenge and, above all, don’t use it as an excuse to give up.  Keep moving forward!  Remember two steps forward and one step back is still one step forward.

For Your Health – Dr. Bob

First PCP Visit – Eight Things to Check Out While Waiting to See the Doctor

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On my last post I listed some questions to ask your new PCP. Today I’ll mention some of the things I would look for at the doctor’s office even before I meet with the physician.

The doctor relies upon his office staff, and the caliber of that staff dictates the service you will receive and some aspects of the quality of medical care as well. After all, it is the receptionist who will set up your appointment when you call in, and you will rely on her judgment. So rather than thumbing through magazines or checking your e-mails in the waiting room, I suggest you pay attention to a few things:

  1. Is the waiting area clean and orderly? While the magazines may not be the most recent issues, does it look as though someone takes pride in maintaining a professional appearance?
  2. How courteous is the staff on and off the phone with other patients?
  3. Do they gossip about patients?
  4. Do they seem to be interested in helping the patients?
  5. Are they purely business-like or do are they more personable?
  6. Do they talk about other patients who aren’t present so the patients waiting can overhear? If they use identifying information and discuss personal health information this is a breach of confidentiality.  They may be talking about you someday in front of one of your neighbors.
  7. Do they keep to the schedule or at least inform the waiting patients when the doctor is running late?
  8. When you are brought into the exam room, does the nurse take the time to listen to you and answer your questions?

Now that I have you thinking along these lines, I’d be interested in some other things you look for in a doctor’s office. Please send me your thoughts so I can add to this list. Next time I’ll talk about how to prepare for a visit to your doctor including how to describe your symptoms.

For Your Health – Dr. Bob