The U.S. National Institutes of Health is launching a systematic campaign to fight obesity, which now affects close to two-thirds of the U.S. population and threatens to overtake smoking as the leading cause of death.
An estimated 65 percent of Americans are overweight and 31 percent are obese, meaning they are at serious risk of disease from their fat.
“Levels of childhood overweight have nearly tripled since 1970: approximately 16 percent of children and teens ages 6 through 19 are now overweight,” adds the report, found on the Internet at http://obesityresearch.nih.gov. “The levels of pediatric overweight have ominous implications for the development of serious diseases, both during youth and later in adulthood,” it adds.
“Left unabated, the escalating rates of obesity in the U.S. population will place a severe burden on the nation’s health and its healthcare system.” Obesity costs an estimated $117 billion a year in indirect costs such as lost wages and direct medical cost due to:
- High blood pressure
- Type 2 diabetes
- Coronary artery disease
- Gallbladder disease
- Certain cancers
- Sleep apnea
Why is there a weight problem?
Carbohydrates have become a huge problem with weight gain in recent years. If you look at the trends in diet composition in more detail from the National Health and Nutrition Examination Survey (NHANES) data, you can see, when comparing the period of 1971 to 1974 with the period of 1999 to 2000, that the protein percentage has not increased. In fact, it has changed very little. The fat amount in the diet has not changed much, if anything, it has gone down from 37% to 33% and the saturated fat amount in the diet has gone down, from 14% to 11%. And the main issue is that the carbohydrate intake has increased over time for men and women from 45% to 52% and 42% to 49%. Most importantly, is that there was an increase in energy intake or calorie intake and this, for women, was from 1542 calories per day to 1877 calories per day; and for men, 2450 calories per day increased to 2618 calories per day. So over the past 30 years, there has been an increase in the calorie consumption and this increase in calories is predominantly from carbohydrate.
The standard American Diet is 80% carbohydrate. Per capita, soft drink consumption has increased by 500 % over the last 50 years. Half of all Americans, 65 % of girls and 74% of boys consume soft drinks daily! Sugar has many effects on the body, one of which is an increase in insulin which ultimately leads to energy conservation and fat production. The food industry uses large amounts of carbohydrates in processed fast foods because they are a cheaper compared to other food groups. In addition, dieters turned to higher carbohydrate foods in an attempt to avoid the the calories associated with a high fat diet. There are high amounts of carbohydrates in processed and fast foods that many Americans quickly grab because they are convenient in our face paced lifestyle.
Carbohydrates trigger insulin production and Insulin can be easily related to weight gain. Insulin’s peripheral actions are involved in blood sugar regulation and insulin is increased in the presence of increased carbohydrates. Insulin allows the body to conserve energy and decreases metabolic processes that would increase serum glucose.
A rise in insulin suppresses hormone-sensitive lipase, inhibiting fat breakdown, and promotes uptake of free fatty acids into adipose tissue for fat synthesis. Insulin also blocks the use of stored fat as a fuel source. Injected insulin has been shown to result in lowered energy production and increased appetite and food intake. High amounts of insulin increase serum triglycerides as well as increase the activity of the enzyme HMG CoA Reductase, which is the rate-limiting enzyme in cholesterol synthesis. Insulin increases the activity of a second enzyme, delta 5 desaturase, which results in an increased amount of arachidonic acid in the system. This inflated amount of arachidonic acid can lead to inflammatory eicosenoids which have the potential over time to lead to arteriosclerosis and cardiovascular disease.
Historically our bodies cycled with the seasons and in times when the supply of food was plentiful, our bodies increased insulin production in response to food intake in order to stimulate fat storage for later times when food became scarce. In our society today, having increased amounts of insulin on a regular basis due to our diet of excess carbohydrates and refined foods, is detrimental to weight loss and leads to other health problems.
A prolonged increase in insulin can eventually lead to hyperinsulinemia and what is termed insulin resistance. It is postulated that insulin resistance is the body’s need for higher and higher amounts of insulin to maintain blood sugar regulation. Insulin resistance can be a result of decreased receptor sensitivity due to prolonged over stimulation of the receptors with high amounts of insulin. Long term hyperglycemia due to many sugars in the diet, genetic susceptibility, and other lifestyle factors along with increased insulin response and eventually insulin resistance often leads to the development of type II diabetes.
Too Little Activity
In addition to excess carbohydrate consumption our society as a whole has adopted a lifestyle lacking physical activity. Television has played a major role in our adaptation to inactive lifestyles. In a study done by Fung et al in the American Journal of Epidemiology in 2000, results indicated that the average number of hours of television watching in 1994 was significantly positively associated with obesity and LDL cholesterol (the bad cholesterol) and significantly inversely proportional to HDL cholesterol (the good cholesterol) and apolipoprotein A1 (a cardiovascular risk factor).
Food intake, or energy consumption, must be balanced by energy expenditure. The way our bodies are made, we were meant to be involved in some sort of physical activity to balance our energy equation, so to say. The energy we take in needs to equal the energy we put out to maintain a steady weight. To lose weight, we can increase our energy output with physical activity while decreasing our energy intake. Foods that account for a lot of energy are simple sugars, such as simple carbohydrates.
Health Benefits of Weight Loss
- Decreased cardiovascular risk, i.e. heart attack and stroke
- Decreased blood sugar and insulin levels.
- Decreased blood pressure
- Decreased LDL cholesterol and triglycerides, increased HDL
- Decreased severity of sleep apnea
- Reduced pain from degenerative joint disease
- Decreased cancer risk
- Decrease in body fat content and improvement in physical function
- Possible slowing and/or reversal of some aspects of the aging process
What is the Solution
The key to all weight loss programs is the desire and motivation of the patient to lose weight and regain health. Patients must be involved and satisfied with their treatment plan in order to ensure patient compliance. The strategies that have been most successful over time include alterations in diet, physical activity, and behavior therapy. More important than reducing the weight is maintaining the weight loss for life, again stressing the importance of long term care for patients desiring to lose weight.
Dr. Dickson’s program
- Honest and accurate assessment: Where are you and where to you want to be with your weight and health?
- Clear vision: What is possible for you? How healthy can you be? What will improve when you lose weight?
- Specific goals: These are stepping stones that provide direction and feedback of how you are doing on your path to health.
- Plan of action: How are you going to reach your specific goals?
- Easy and effective tools: Your weight loss program must be easy to understand, simple to follow, easy to execute.
- Willingness to take action: We encourage and coach you to be proactive in managing your weight and health.
- Teamwork: Working together regularly in a supervised setting increases success.
- 3-5 lb weight loss per week
- 4-7 lb weight loss the first week
- decreased body size measured in inches
- increased energy
- improved mood
- deceased body aches
- reduction in diabetic and blood pressure medication
- increased feeling of control over one’s health
- decreased anxiety about health
The management of weight loss should include medical evaluations, regular physical examinations, and close monitoring via labs and encouragement follow up appointments. Lipid screening, thyroid panels, and other tests such as glycosylated hemoglobin should be considered as screening tools for diabetes, hypothyroidism, and any other underlying metabolic disorders.
As you have read, the rise in obese and overweight individuals within our society is largely due to the current lifestyle that is lived by so many of us. Highly processed and refined carbohydrate foods in the diet, excess sugar consumption, lack of exercise, high stress work and family situations, and lack of specific nutrients in the diet has carried 50 % of our population on the road to obesity beginning with being overweight. However, you have the power to change your weight and your risk for chronic disease. If you are ready to take that step, I urge you to call me. I have a program that will help you to simply, easily, and effective lose weight and regain your health as these case studies demonstrate.