Read an Excerpt
Natural Medicine for Weight Loss
By Deborah Mitchell
OPEN ROAD INTEGRATED MEDIACopyright © 2008 Deborah Mitchell
All rights reserved.
Weight Loss and Gain:? What's It All About
You want to lose weight. You're tired of playing games, feeling hungry, wasting your time and money, and regaining any weight you've lost. You don't want drugs or any more broken promises. You've heard and read the weight loss ads that sound too good to be true ... and they are. Now you want straight talk about weight loss. You want to feel good about the way you look. You want to be in control of your weight Before you can take back control—or perhaps have control for the first time in your life—you need to know where you stand.
Overweight in America: Where We Stand
Every year, millions of Americans make a tremendous investment. According to the National Academy of Sciences Institute of Medicine, Americans spend more than $33 billion annually on weight loss programs and diet aids, such as protein drinks or foods. For that investment, they reap dubious dividends: the vast majority of people will eventually gain back all the weight they lost, plus a few extra pounds
That's a good return if you're investing in the stock market; not so good if you are a dieter. The National Institutes of Health (NIH) report that of people who enroll in organized weight-loss programs, 95 percent will regain two-thirds of the pounds they lose within one to three years. So while the media saturates the public with the idea that they must be thin, the only things losing weight are consumers' wallets.
The paradox is that for all their efforts to lose weight, Americans are getting fatter. Between 1980 and 1994, the proportion of overweight adults increased 9 percent; among children and adolescents, the increase was 6 percent. The results of the third National Health and Nutrition Examination Survey (NHANES), conducted 1988-1994, show that the percentage of people who are overweight is approximately 14 percent among children aged 6 to 11; 12 percent of adolescents aged 12 to 17; and 35 percent of adults 20 years and older. Translation: One in three, or 58 million American adults aged 20 through 74 are overweight. A closer look reveals that minority populations edge out whites: approximately 50 percent of black or Hispanic women are overweight.
Millions of Americans say they are on a diet. The percentage of adult American women trying to lose weight at any given time is 33 to 40 percent; among men, 20 to 24 percent. Information about diets and weight loss programs abounds, yet most of it is wrapped up in so much hype and false promises that Americans are still misinformed and misled about dieting and weight loss. One result is that many individuals set unrealistic goals and become discouraged when their hoped-for weight loss does not occur. Another is that some people do not acknowledge their obesity or choose to deny that their overweight is a problem.
Are You Overweight?
Not all physicians and dietary experts agree on the exact definitions of overweight and obesity, but a general consensus has been reached. The word overweight means an excess amount of body weight, which includes bone, fat, water, and muscle. Obesity is the excess accumulation of body fat. Doctors and scientists generally agree that individuals are clinically obese if they are 20 percent or more above their desirable weight.
Measuring Body Mass and Body Fat
Scientists devised the Body Mass Index (BMI) as a tool to help classify individuals as overweight or obese. Physicians and obesity researchers prefer the BMI to other methods (which are described below). Body mass index is determined by dividing a person's weight in kilograms by height in meters squared. Men with a BMI greater than 27.8 and women with a BMI greater than 27.3 are considered obese. Or to put it another way, a man who is six feet tall and weighs 210 pounds and a woman who is five feet two inches and weighs 150 pounds are obese, according to this formula. Most Americans who are overweight have a BMI of 27 to 30, which is "mildly obese." These people are about 20 to 40 pounds heavier than their ideal weight. An estimated 41 percent of the population have a BMI of 25.1 or higher, and 8 percent have a BMI of 35 and greater, which is classified as severely obese.
You can determine your own BMI by using the following chart. It has already converted the centimeters and kilograms into inches and pounds for you. Find the intersection of your height and weight and you will have your BMI.
Physicians often depend on weight-for-height tables as a guideline to classify someone as obese. Unfortunately, there are many different versions of these tables. Some factor in characteristics such as age, sex, and frame size, but others do not. None of the charts make provisions for individuals who have excess muscle but not excess fat (e.g., weight lifters), yet they would be classified as obese according to these charts.
The most accurate way to determine body fat is to weigh people underwater. However, few people have access to the laboratories that have the special equipment for this approach. Therefore, most body fat measurements are done using the skinfold thickness measurement or the bioelectrical impedance analysis (BIA). Both are commonly used in health clubs and commercial weight-loss establishments. During a skinfold test, an examiner uses an instrument called a caliper to measure the thickness of skin and subcutaneous fat at specific sites, usually the back of the upper arm and the abdomen. The BIA sends a harmless electrical current through selected body sites to determine the total percentage of body water. This percentage is used to calculate estimated body fat and lean body mass figures.
Both approaches can give a wide margin of error. To get a general idea of whether you are obese, use this simple technique (you need a ruler and someone to take the measurement). Extend your arm out in front of you with the palm up. Using the forefinger and thumb of your other hand, gently grasp the skin on the underside of your upper arm and pull it away from your body. Ask your partner to measure the thickness of the skin that is between your fingers. If you are between ages 20 and 40, 5/8 inch is "good," 7/8 inch is "average," and 1 1/8 inches is "poor." If you are older than 40, ¾ inch is "good," 1 inch is "average," and 1 ¼ inches is "poor."
Apples and Pears
Are you an apple or a pear? Physicians often use these labels to identify people who carry their weight either around their waist and abdomen—an "apple"—or around their hips and buttocks—a "pear." Women typically, but not always, are pears, while men usually accumulate a fat buildup around their abdomens. Apples have a higher risk of developing the health problems associated with obesity. To find out whether you are an apple or a pear, determine your waist-to-hip ratio. To do so, you need a measuring tape.
Measure your waist at its narrowest point, then measure your hips at the widest point.
Divide the waist measurement by the hip measurement. For example, if your waist is 33 inches and your hips are 45 inches, 33 divided by 45 = 0.74.
A waist-to-hip ratio of more than 0.80 for women or 1.0 for men identifies an apple.
What Causes Overweight/Obesity?
From a scientific view, obesity occurs when people consume more calories than they burn. What causes this imbalance between the amount of calories consumed and used is unclear; however, it is likely a combination of genetics, environment, emotional-psychological considerations, and medical factors.
Some people seem to lack the internal programming that tells the body and mind that there is no danger of starvation. Such genetic misprogramming may be inherited. Researchers believe genes have about a 33 percent stake in determining people's weight. People who are biologically predisposed to being overweight can, and have, successfully lost weight or kept it off in the first place. Other genetic factors include the following:
In 1994, researchers discovered the obesity (ob) gene in mice. This gene produces the hormone leptin. Low levels of leptin may encourage the body to retain fat, but it is still unknown whether the hormone contributes to the regulation of body fat in humans. If it does, scientists believe leptin could prevent weight gain in people prone to obesity.
The metabolic rate of two people of the same sex, age, and body type may vary as much as 20 percent. The difference in resting metabolic expenditure, or RME, can have a significant effect on body weight because RME accounts for approximately 60 to 75 percent of a person's total daily energy use.
Black women expend less metabolic energy while at rest (RME) than do white women, and black women lose less weight and gain more weight than do white women when not treated. Overall, black women use 5 percent fewer calories while sitting than white women do, and similar findings have been reported between white men and black and Asian men.
One common misconception is that weight loss is about willpower; it is not. It's about understanding the factors that cause you to overeat or to continue with habits that contribute to being overweight. Once you understand your relationship with food, you can understand why you eat when you're not hungry. We look at these issues in Chapter 8.
Eating Habits. In today's stressful society, many people eat on the run, which often means buying high-fat, high-calorie fast food; snacking on candy, cookies, and other treats in the office during the day; tossing a prepackaged, chemical- laden dinner into the microwave; or grabbing a late meal and then falling asleep in front of the television.
Cultural, Familial, and Social Factors. For example, families for whom fried foods, heavy sauces, or sweets are routine fare are indoctrinating their children to food preferences they will likely find difficult to change. Being ordered as a child to clean off your plate may develop into overeating habits as an adult.
Medical and Drug-Related Factors
Experts estimate that 1 percent of people who are overweight can attribute it, at least partly, to a disease or to medication. Many health practitioners, however, believe there are medical factors other than the few diseases mentioned below that affect people's ability to lose weight. These conditions are usually overlooked by conventional physicians but are often part of the routine examination done by naturopaths. These factors, listed below, are key for many people who struggle between a healthy weight and being overweight.
Disease. Hypothyroidism is the most common in this category. If the thyroid gland malfunctions, the metabolism rate may slow down greatly. Less common medical conditions that can cause obesity include Cushing's syndrome and neurological problems that can lead to overeating.
Chronic Yeast Infection. This condition is caused by an imbalance in the body of a yeast fungus called Candida albicans. It contributes to weight gain by making the body store unwanted fat, especially among both young and postmenopausal women.
Enzyme Imbalance. Enzymes help convert foods into nutrients the body can use in order to digest food and initiate metabolic activity. Enzyme deficiencies can cause insufficient absorption of food and food cravings.
Sluggish Lymphatic System. The lymphatic system eliminates cellular waste and environmental poisons from the body and plays a major role in fat metabolism. If you eat too much fat, the system can become congested and cause cellulite, tissue swelling, and a slowdown in your metabolic rate.
Toxic Liver. The liver detoxifies the blood, manages nutrients and hormones, and metabolizes fats, all of which make it a vital part of weight management and maintenance. Many people overburden the liver with a poor diet and high stress, which often leaves the liver in a toxic state.
Food Allergies and Intolerances. Food allergies and intolerance are overlooked contributors to overweight, binge eating, compulsive eating, and food cravings. It is estimated that 2 percent of the population have food allergies and that at least 40 percent have food intolerance. Chronic symptoms such as weight gain, arthritis, and gastritis are common among people with food intolerance.
Insulin Resistance. Some people's cells resist the effort of insulin to penetrate them, so the extra insulin builds up in the bloodstream and causes the insulin level to increase. Insulin resistance may stimulate the appetite and increase the amount of fat the body stores. Researchers believe about 25 percent of people are insulin resistant.
Certain drugs can cause weight gain by increasing appetite, promoting fluid retention, and stimulating hormones that cause weight gain, or by unknown mechanisms (see the table below). Most drugs associated with weight gain fall into the latter category. Although these drugs are not the primary reason for weight gain, they can play a significant contributing role and so deserve mention.
DRUG-INDUCED WEIGHT GAIN
Drugs that Stimulate the Appetite: corticosteroids (e.g., beclomethasone, betamethasone, prednisone), estrogens, and antidepressants (e.g., amitriptyline, desipramine, doxepin, nortriptyline, and venlafaxine)
Drugs that Cause Water Retention: Antihypertensive drugs, including certain calcium channel blockers and beta-blockers; also estrogens and corticosteroids
Drugs that Cause Weight Gain Indirectly: Ironically, oral hypoglycemic agents, which are used to treat adult-onset diabetes, stimulate weight gain in the very population that usually needs to lose weight.
Drugs that Cause Weight Gain by Unknown Mechanisms: antihistamines (including methyldopa, clonidine, guanadrel sulfate, lithium, thioridazine, and alprazolam)
Obesity: How Unhealthy Is It?
Why do you want to lose weight? If you are like most people who are overweight, it's because you want to look better and feel better about yourself, and/or you want to improve your health. Both reasons go hand in hand: when your health improves, you feel better physically, emotionally, and spiritually. Conversely, bonuses come with weight loss: a significantly decreased risk of troublesome and sometimes fatal diseases; and increased energy, better mood, and improved self-esteem.
Obesity carries high health and economic price tags. For example, if you are obese:
You have a 3.8 greater risk of developing NIDDM (also known as Type II diabetes).
Your chances of developing high blood pressure are double that of normal-weight individuals. Hypertension affects about 26 percent of people who are obese.
You have an increased risk of developing breast cancer and colon cancer.
You have a 2.1 times greater risk of getting hypercholesterolemia (high cholesterol levels), a significant factor in stroke, heart disease, and circulatory problems, if you are aged 20 to 44.
Some researchers question the validity of these statistics, and research into the role of exercise, genetics, and environmental factors in obesity continues. In most cases, however, it appears that being overweight carries certain health risks, and that being 30 percent or more over ideal body weight is a definite health hazard.
Are You at Risk for Health Complications?
Doctors generally agree that people who are 20 percent or more overweight can gain significant health benefits (i.e., lower blood pressure and cholesterol levels) from as little as a 10- to 20-pound weight loss. Individuals who are more than 20 percent overweight run an especially high risk of health problems if any of the following factors are true for them:
A family history of diabetes or heart disease. People with close relatives who have had these medical conditions are more likely also to develop these problems if they are obese.
Presence of high blood pressure, high cholesterol levels, and high blood sugar levels, which are all warning signs of some obesity-associated diseases.
"Apple" shape. People who carry their extra weight in the abdominal area may be at greater risk of heart disease, diabetes, or cancer than people of the same weight who carry their extra weight in the hip and buttocks (pear-shaped).
Excerpted from Natural Medicine for Weight Loss by Deborah Mitchell. Copyright © 2008 Deborah Mitchell. Excerpted by permission of OPEN ROAD INTEGRATED MEDIA.
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