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It appears that almost everybody in America—regardless of race, ethnic background, class, or income—wants to be slim. When this desire becomes an overriding obsession with achieving bone thinness, it can translate into the distorted eating patterns of anorexia or bulimia. Estimates of the scope of these disorders necessarily involve guesswork, but some say that more than 35 percent of American women and over 75 percent of American teenage girls have at least flirted with either bulimia or anorexia. The incidence among males has not been adequately studied, but it appears to be rising.Anorexia nervosa is a condition of self-induced starvation tied in to a fear of becoming fat, poor body image, mental stress, and biochemical imbalances. A person loses a minimum of 20 percent of her or his body weight and still perceives her- or himself as fat. Every pound lost is seen as a victory and gives the person a feeling of greater control over his or her life.The effects of anorexia go far beyond a person’s looking emaciated. Starvation, whether involuntary or self-inflicted, affects mental function, so what the person can no longer think clearly. This does not help the person deal with or comprehend the seriousness of the physical problems that develop. These include fatigue, loss of menstruation, constipation, and hormonal changes, including increased levels of cortisol, the stress hormone. One of the many problems of this progressive condition is that when the person’s electrolyte balance, particularly in relation to sodium and potassium, becomes disturbed, it can lead to life-threatening complications, including kidney failure, heart rhythm abnormalities, and cardiac arrest.Bulimia nervosa, which describes a binge-purge cycle, is not as obvious a disorder as anorexia. Here a person eats uncontrollably and then purges the food in one of several ways. She or he may vomit; take laxatives, purgatives, diuretics, or enemas; sit in a sauna; or even cover her-or himself in plastic wrap. Whatever the method, the goal is the same: to avoid the consequence of eating too many calories. After a person takes several laxatives a day—and in rare instances as many as 100—over a period of time, the body loses its ability to eliminate on its own. Other serious medical consequences of bulimia include loss of tooth enamel and tooth decay, rupturing of the esophagus and stomach, throat muscle enlargement, dehydration, low blood sugar, and personality changes. As with anorexia, bulimia can result in severe chemical imbalances, leading to abnormal heart rhythms and even death.*60\233\8*



Just as we see in literature a pattern of a hero or heroine opposed by an antagonist, we find in our own lives the existence of the True Hero and His antagonist. God’s role is to give us truth, while Satan’s role is to keep our minds confused and unfocused on God’s ways. One way that Satan accomplishes this feat is through lies.
People who are especially vulnerable to these deceitful lies could be people who have not died to their own wills. When we do not die to our own will, we usually do not diagnose ourselves properly. We start blaming anything and everything around us as the sources of our unhappiness, or we become very depressed and even more deeply engrossed in self and filled with self-pity. This leads to more earthly comforts, such as overeating to soothe ourselves. People call this “just a cycle.” I call it a “downward spiral,” and we cannot even feel or see it.
Satan can lie to us, and if he stays around long enough, he can become our master without our even knowing it. He is very discreet. He does not want us to know that he is our lord. Look at this curious dialogue between Jesus and the preacher-teachers of the day in the Gospel of John. Jesus starts by telling them that neither God nor Abraham was their father. The Bible records their reply:
“We are not illegitimate children,” they protested. “The only Father we have is God himself.” Jesus said to them, “If God were your Father, you would love me, for I came from God and now am here. I have not come on my own; but he sent me. Why is my language not clear to you? Because you are unable to hear what I say. You belong to your father, the devil, and you want to carry out your father’s desire. He was a murderer from the beginning, not holding to the truth, for there is no truth in him. When he lies, he speaks his native language, for he is a liar and the father of lies. Yet because I tell the truth, you do not believe me! Can any of you prove me guilty of sin? If I am telling the truth, why don’t you believe me? He who belongs to God hears what God says. The reason you do not hear is that you do not belong to God.” (John 8:41b-47)
The Pharisees (the preachers of Jesus’ day) knew Scripture. They went to the temple constantly. However, their wills had not submitted to the will of the Heavenly Father. They were quickly adopted by the father of the dark world. If your will is to love God with all of your heart, your soul, and your mind, then you can hear His voice. But, if your will is to halfway serve Him when it is convenient, you will not hear His voice. You cannot hear His voice. Once again, you cannot have two masters.
We are all recovering Pharisees, or we have all known people who are like the Pharisees. Pharisees are uncomfortable in the presence
of someone who has submitted his will. They avoid spiritual conversations, and the lifestyle and behavior of spiritual people often seem stupid to them. Pharisees might be the type who, when they go to worship, criticize the        sermon, the song leaders, the people in the choir, the elders, the ministries, and the number of contributions. They have forgotten that  the whole idea behind the Sunday morning gathering is self-examination. As I spend more and more time examining myself, I feel better and happier. My job description is not to help God fix other people, but to work on myself with the help of God.
All of us have our times when we resist having things go God’s way. Even the beloved Apostle Peter, in Matthew 16:22-23, voiced the ways of Satan and not God when he said:
“Never, Lord!” he said. “This shall never happen to you!” Jesus turned and said to Peter, “Get behind me, Satan! You are a stumbling block to me; you do not have in mind the things of God, but the things of men.” At all times, we must keep the right mental attitude to win victory in the battles we face. If we have a heart for it, it will be easy.
Satan is the ruler of this world, we are told. That is why he was able to offer to Jesus the kingdoms of the world and their splendor, if Jesus would, as Satan put it, “bow down and worship me.” Notice the way Jesus fought the spiritual battle and won victory over temptation and the way He eventually got rid of the tempter for a time. He did it by quoting God’s truths or telling the truth. You can read this in the fourth chapter of Matthew.
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Unusually for drugs developed to tackle chronic illness, both orlistat and sibutramine have strict limitations imposed by their SPA licenses on their length of use:



  • Orlistat is licensed for use up to 24 months. NICE recommends that it is used for up to a maximum of 12 months normally and up to 24 months in exceptional circumstances.

  • Sibutramine is licensed for 12 months of treatment.


Available data suggest that many patients receive only 2 or 3 months of treatment. The probable explanation for this is likely to be unmet and unrealistic expectations – on the part of the patient or clinician. The rate of weight loss in the first few weeks is often too slow to satisfy a patient who has been struggling to lose weight for months, and possibly years. Other reasons might include poor pretreatment counselling – in the case of orlistat leading to perceived unacceptable GI side-effects, in the case of sibutramine to unpleasant but often transient dry mouth, headache or constipation.


The important thing is to use the drugs for as long as it takes, within the licensing regulations, to achieve the purpose for which they were started. After the initial weight-loss phase, drugs can play a crucial role in preventing weight regain, both prolonging the beneficial effects of weight loss and allowing more time for the patient to reinforce newly learned dietary and exercise habits.


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New research on the effects of ageing on body fat suggest that there are a number of components of ageing which mean that gaining fat stores with age is a ‘natural’ process and that losing fat becomes more difficult. Changes with age that promote fat gain are:

• a decrease in lean body mass: and therefore a reduction in metabolic rate. This may be compensated for by such activities as resistance training, although the extent to which this can occur is not dear at this stage. Metabolic rate is thought to decrease naturally by about 2 per cent per decade after the age of 20.

• changes in fat oxidation. The rate at which the body bums fat as an energy source in contrast to blood sugars, decreases with age, possibly as a result of the increase in body fat mass. This means fat is stored more readily and used less easily as a fuel source in the elderly.

changes in the influences of stimuli which ‘break down’ fat (lipolytic stimuli). Hormones such as growth hormone and testosterone all decrease with age and catecholamines from the adrenal glands appear less effective with age. Hence, the normal status of older people promotes fat gain

• decreases in spontaneous physical activity (SPA). As well as a decrease in physical activity (through sport and games) it now appears that even if older people consciously exercise vigorously to lose fat, they may unconsciously decrease their rate of physical activity at other times during the day: they simply get more tired than young people as a result of exercise, and unless an effort is made to maintain SPA, the net effect may be no real gain in overall physical activity.

• increased associated health conditions: heart disease, arthritis and other muscular-skeletal problems.

• a decrease in intra-muscular fat as an energy source. There are significant stores of fat in muscle tissue. The storage of fat in the muscle tissue decreases with age as the binding protein decreases. This means fat from the muscle is less readily available as an energy source during exercise and a greater reliance is placed on other energy stores.

• increased eating. Although this is often under-reported, there is evidence to suggest that eating and drinking may actually increase with age, rather than decrease or remain stable, as would be necessary to stabilise body fat. Accurate monitoring of food intake in the elderly will be necessary before this can be verified.

On the positive side, it appears that moderate fat gains with ageing do not appear to be as dangerous as those in the young and a BM up to 27kg/m2 is considered within the normal range for older people. However, this point is still hotly debated and in the meantime caution is still advised.

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When dealing with the area of managing body fat levels we must have a basic understanding of how energy is balanced in the body. We consume on average anywhere from 1500kcal-2500kcal per day. This adds up to an energy intake of about 555 000-1 million kcal (2.33-4.17 kj) per year. But what about expenditure? How does the body balance energy intake with expenditure? Why can some individuals seemingly consume relatively greater quantities of food than others, and at the same time end up with lower stores of body fat? Dr Klaas Westerterp and his group from the University of Limberg in the Netherlands, have estimated that over the course of a lifetime, there is an actual discrepancy between energy intake and energy expenditure of only around 1 per cent, making the system an extremely well balanced one.2 What this implies, of course, is that body weight is not just equal to the amount of energy intake minus energy expenditure, but that energy intake + expenditure must change, as a function of a number of factors, to help balance the system. To understand this, we need to understand the components of energy expenditure. There are three main components of energy expenditure.

1. Resting metabolic rate (RMR) or basal metabolic rate (BMR), which equals sleeping metabolic rate (SMR) and arousal.

2. The thermogenic effect of food.

3. Exercise, or daily physical activity and spontaneous physical activity (SPA).

The vast majority (i.e. around 70 per cent) of daily energy expenditure (EE) in the average person is accounted for by RMR. Thermogenesis contributes about 15 per cent and daily physical activity is the most variable being around 10-25 per cent in sedentary individuals.

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Ask Lisa Gardiner about her favorite weight-loss weapon, and she’s likely to show you her toothbrush. After all, it helped her take off 25 pounds in just 6 months.

After two pregnancies, Lisa, of Ballston Spa, New York, was eager to slim down. But caring for her newborn twin daughters and 3-year-old son didn’t leave her much time to plan nutritious meals or stick with an exercise routine.

Lisa believed that if she could just control her after-dinner noshing, she’d take a significant bite out of her fat and calorie intake. So she fell back on a little trick that she had used to lose 20 pounds in college.

Instead of heading to the kitchen right after dinner, Lisa would head to the bathroom and brush her teeth. “It was my signal that my time to eat was over for the day” she says. “If I felt the urge to snack, I just reminded myself that I had already brushed my teeth.”

This simple strategy helped Lisa, age 35, slim down for the second—and, she’s determined—last time in her life.

WINNING ACTION

Try the toothbrush trick. After dinner, brush your teeth. This simple task sends a message to your brain that you’re done eating for the day. What’s more, the toothpaste alters the flavor of food. If you were to eat something after brushing, it wouldn’t taste very good. What’s more, your teeth and your smile will thank you!

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