What you should know before you start a weight loss plan
What You Should Know Before You Start A Weight Loss Plan The measurements that count Know your Body Mass Index (BMI) Over the past twenty years, Americans have become more familiar with specific measurements related to health, such as cholesterol levels and blood pressure readings. When it comes to weight-related health risks, there are three important numbers that you should know. The first is your actual weight in pounds; the second is your Body Mass Index, or BMI; and the third is your waist measurement. Your BMI is based on your height and weight. Doctors consider BMI to be a better measure of health risk than your actual weight in pounds. In fact, the medical terms "overweight" and "obesity" are based on BMI values. A BMI of between 25 and 30 is defined as overweight, and a BMI of 30 or more is considered obese. The higher your BMI, the greater your risk of developing a weight-related illness, such as type 2 diabetes or heart disease. Physicians refer to certain measurements that provide valuable information about a patient’s condition as "vital signs." Standard vital signs include blood pressure, pulse rate, breathing rate and body temperature. The AAFP Panel on Overweight and Obesity recommends that the BMI become a new vital sign, to be recorded during routine visits to the doctors' office. That is because, like blood pressure, a BMI reading that is too high should be recognized and treated. What is your BMI? Are you overweight or obese?. The same BMI scale applies to both men and women. (see included chart) What is your waist circumference? Body fat that accumulates in the stomach area (described as "abdominal obesity") is more of a health risk than body fat that builds up in the buttocks and thigh areas. For this reason, your waistline provides valuable information about your risk for heart disease, high blood pressure, high cholesterol, and type 2 diabetes. Doctors consider a waist circumference too high if it is 40 inches or more in men, or 35 inches or more in women. Like the BMI, the AAFP Panel on Overweight and Obesity recommends that the waist circumference be measured during routine check-ups. The proper location to measure the waist is at the smallest spot under the rib cage and above the belly button.
Consulting your doctor about controlling your weight
Talk to your doctor about healthy eating and physical activities that can help you lose weight, improve your fitness and decrease the chances of developing heart disease, high blood pressure or type 2 diabetes. Be sure to set realistic goals. Small changes can make a surprising difference in your health. Your doctor can offer practical suggestions that do not require a complete overhaul of your current way of life. In some cases, your physician may refer you to a nutrition specialist, such as a registered dietitian, for in-depth counseling about food choices. You may want to start the conversation by asking a few questions of your own. For example:
Ask your doctor for any educational brochures on topics such as eating habits, counting calories or physical activity
Request to have your BMI measured and ask your doctor what it means with regard to your health status
Have your waist circumference measured and discuss the significance of the measurement with your doctor
Be prepared to describe your current diet and activity level and what changes might promote better health
Think about how much change you're willing to make before you visit your doctor
Ask if specialists are available on your health plan and in your area, such as dietitians or physical trainers
What is Metabolic Syndrome?
A high waist circumference can be one sign of a condition called Although most people have never heard of it, this syndrome is quite common; it affects about one out of every four adults in the United States. Metabolic Syndrome often progresses to type 2 diabetes—and treating the syndrome can help prevent this form of diabetes. A person has Metabolic Syndrome if they have at least 3 of the 5 conditions listed in the table below. If you think you may have Metabolic Syndrome, it is important to discuss the possibility with your doctor so that you can undergo the appropriate diagnostic tests. Treatments for Metabolic Syndrome involve basic lifestyle changes, such as losing weight, eating a healthier diet, and increasing your activity level. Your doctor can help you develop a specific plan for making the necessary changes.
More Information on Metabolic Syndrome Treatment: Lifestyle Condition Practical Suggestions
(measured by waist Increased physical activity
Men: less than 40 Increased physical activity
*(For example: replacing two 2-ounce cans of sugar sweetened soda with a beverage sweetened with a sugar substitute, such as sucralose (SPLENDA®) can cut over 350 calories per day.
How to get active
Regular physical activity has been shown to help prevent heart disease, type 2 diabetes, osteoporosis and other chronic conditions. It is important for maintaining good health in all adults and children, regardless of whether their weight is a problem or not. As the following suggestions make clear, lifestyle changes do not have to be drastic. Simple measures applied every day can make a significant difference over time. Here are a few examples:
Increase whatever physical activity you are currently doing by adding 10 minutes a day, or increase the intensity from low to moderate. (See the box below for an idea of different activity intensity levels.)
Limit time spent online, watching TV and playing video games to less than two hours total per day.
Take the stairs instead of the elevator.
Park at the far end of the parking lot and walk to your destination, rather than parking as close as possible. You can also get off the bus one stop earlier and walk the rest of the way.
Do more household chores (such as dusting, vacuuming or weeding).
Walk or run with the dog and/or the kids.
Use an exercise machine (such as a treadmill or bike) while watching TV.
Take "active" vacations—go hiking or ride bicycles.
Walk to do errands (such as to the grocery store or post office) instead of driving.
Buy a pedometer, which measures how many steps you take each day. Gradually increase your daily number of steps. (Pedometers can be purchased at sporting good stores.)
How Active Are You? Very hard physical Moderate physical activity Hard physical activity activity
Mowing lawn with hand Digging a ditch mower
Playing actively with children Weight lifting
Adapted with permission from Blair SN, Dunn AL, Marcus BH, et al. Active living every day: 20 Weeks to lifelong vitality. Champaign, Ill.: Human Kinetics; 2001.Conditions and medications that may prevent weight loss
In some people, overweight or obesity may be related to a medical condition, or a medication they are taking, which interferes with their weight loss efforts. If you have, or think you might have, any of the conditions on this list, or you are taking any of the medications listed, speak with your doctor about measures you should take to manage your weight. In some cases, specific treatments for your medical condition, or a switch in medications, can make a difference in your efforts to manage your weight. Some Medical Conditions that May Make it Difficult to Lose Weight Category Condition
Polycystic ovarian disease Cushing's disease Diabetes Hypothyroidism
Congestive heart failure Idiopathic hypertrophic cardiomyopathy Heart valve disorders
Obstructive sleep apnea Upper airway resistance syndrome
Medications that May Cause Weight Gain Condition Medication
Antihistamines (such as Claritin, Allegra)
Alpha blockers (such as Hytrin, Cardura)
Beta blockers (such as Betapace, Blocadren, Tenormin) Methyldopa (Aldoment)
Progestins (a component of certain oral contraceptives, such as Lo/Ovral and Ortho-Tri-Cylcen)
Tricyclic antidepressants (such as Norpramin and Sinequan)
Insulin Sulfonylureas (such as Diabinese and Glucotrol)
Neuroleptics (such as Zyprexa and Risperdal)
Can diet pills and supplements help with weight loss?
Although diet drugs may help you lose weight at first, they usually don't help you keep the weight off and may have damaging side effects. Most diet pills have not been tested by the Food and Drug Administration, which means you can't be sure if the drugs are safe. Taking drugs also does not help you learn how to change your eating and exercise habits. Making lasting changes in these habits is the way to lose weight and keep it off.
AAFP Physicians Panel on Obesity. Practical advice for family physicians to help overweight patients. An American Family Physician Monograph. 2003.
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The gastro-intestinal tract in systemic sclerosis Professor László Czirják Department of Immunology and Rheumatology, University of Pécs, Pécs, Hungary Systemic sclerosis (SSc) is a disease abnormality affecting the vessels and the connective tissue. Besides the skin, joints, muscles, several internal organs can also be involved in SSc including the gastrointestinal tract (GI).