(b) Weight control: general considerations

Obesity is due to ingestion of excessive calories:  Obesity is due to eating more calories than normally necessary to keep the body functions. In most cases, this is a habit, an acquired tendency to do something automatically, practically unconsciously and reinforced by repetition.

Normal people can get used to eat more and more until they become obese.  The stimulus for overeating is stress in some people. The stress may be physical, emotional or mental. A response for dealing with this stress is by eating. Over time, the bond may become so strong that the automatic response to stress is to eat.

Some environmental factors promote high energy intake and sedentary behavior. Takeaway and fast-food services (clustered on urban areas) are usually nutrient poor and energy dense.  They often cost less than healthier fruits and vegetables.  Sites such as school cafeterias and movie theaters are other examples.  Mechanization of labor, mobilization by car rather than walking and use of elevators rather than stairs reduces the energy expended. Sitting for long time in front of a computer at the office, the TV at home and the cell phone anywhere are also worth mentioning.

Cultural and familiar (who is cooking!) factors also influential.

There are medical conditions that induce obesity. Examples are hypothyroidism (an endocrine disease) and compulsory eating (a mental disease).

There are also complex changes of many hormones in obesity, from insulin (for instance insulin increase and resistance) to changes in more recently identified hormones such as leptin (that decreases appetite and is produced mainly by fat cells) and ghrelin (that increases appetite and is produced mainly by the stomach).

One impressive finding at autopsies of fatty individuals is the extreme large size of their digestive organs like stomach and pancreas. As weight lifters develop large muscles, obese people develop huge digestive organs. Of course, the multiple neural, endocrine and mental changes in obesity are not visible in the autopsy.

Treatment of obesity needs to address both the chronic physical and neuroendocrine changes as well as the acquired wrong mental habits.

Calories have to be controlled:  Obese people have to reduce their ingestion of calories (dieting) and increase their consumption (exercise).  Both have to be performed in an organized way (life style change). You probably already explored and even expend some money in diets. You may have also attempted to increase your exercise, perhaps by joining a gym. These are fine but not easy endeavors.

The problem with usual diets is that they require great effort and their results are not durable. The objective in our clinic is mainly to reeducate how to eat rather than to count calories or eating unpleasant food.  The ideal is to help you to eat what you want but the right way.

Life style plan:  We will help you to make a life time commitment to combine the right dietary changes (decreasing food servings and eating the right foods at the right times) with exercise (from walking at different paces to more demanding routines).  This will maintain the localized fat loss initially obtained with the contour shaping machines.

In summary, we are offering you a great opportunity to achieve a healthier and happier life.

NEXT: Dieting: General concepts (Click).

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