Obesity has become a focus of national concern and the nation’s No. 1 public-health problem. Health experts from the National Institutes of Health, Centers for Disease Control, and Prevention and the American Heart Association, have warned the publics of the dangers associated with being overweight.
Statistically, over two-thirds of U.S. adults are overweight, and about half of those are fully obese. [1, 2] If this trend continues, most of America will become unhealthily and frighteningly overweight and/or obese within the next couple of decades. The most alarming trend is the steadily rising number of obese children, where one out of every six children are now considered overweight.
Obesity is defined as being more than twenty percent above the average weight for a person’s age, sex, and height; or having a Body Mass Index (BMI) of over 30. The BMI is a height-weight calculation that correlates body fat with risk for disease. Obesity is more than an aesthetic problem. It is the second leading cause of preventable death in the U.S. (tobacco being first), and may soon overtake tobacco as the leading cause of preventable death. Being overweight and/or obese are major risk factors for many chronic diseases including:
- heart disease
- high blood pressure and stroke
- some cancers (uterine, breast, colorectal, kidney, prostate, pancreatic, and gallbladder)
- gall bladder disease
- sleep apnea
- sexual dysfunction
The primary cause of obesity is dietary and lifestyle practices, such as overeating and lack of exercise. Many Americans are overweight because they have sedentary lifestyles and eat too much processed, high-fat, high-sugar junk foods. However, emerging physiological theories of obesity are suggesting that obesity may not be just a matter of inactivity and eating too much. Obesity may also be associated with certain physiological factors, including; low brain serotonin levels (causing carbohydrate cravings), diet-induced thermogenesis and insulin insensitivity (causing decreased metabolic rate), impaired sympathetic nervous system activity (causing decreased metabolism), and a low percentage of brown fat cells (causing decreased metabolic rate).
Obesity has a profound effect not only on physical health, but also on emotional well-being. Most conventional weight loss programs have a high failure rate, although some research indicates success of long-term weight management with regular exercise. One of the most difficult emotional impacts of obesity and dieting may be the disappointment of regaining some or all of the lost weight, and/or ending up weighing more than dieting began.
According to National Center for Health Statistics (3):
- 64 percent of adults age 20 years and over are overweight or obese
- 30 percent of adults age 20 years and over are obese
- 15 percent of adolescents age 12-19 years are overweight
- 15 percent of children age 6-11 years are overweight
The main symptoms of obesity include:
- Weighing more than twenty percent above the average weight for a person’s age, sex and height
- A Body Mass Index (BMI) over 30
- A BMI between 20 and 25 is considered a healthy number for men and women. Any number over 25 is considered overweight
- To figure out the BMI, multiply the weight in pounds by 700. Then divide this number by the square of the height in inches:
BMI = weight in pounds x 700 divided by (height in inches) 2
Obesity treatment includes dietary and lifestyle modifications, such as eating a balanced, healthful diet, regular exercise, nutritional supplements, and prescription drug therapy. The most basic equation for losing weight is by monitoring energy expenditure. Caloric intake (energy) must be less than calories burned/used (energy expenditure). An individual needs to expend 3,500 calories to lose one pound. For example, if 500 calories are reduced each day for seven days, then at the end of the week one pound will be lost. This can be done by increasing the amount of exercise and by decreasing the amount of calories consumed.
Weight loss drugs such as stimulants (amphetamines), sibutramine (appetite-suppressants), and orlistat (blocks fat absorption), are often prescribed for the morbidly obese persons, but are associated with dangeroud side effects.
5-Hydroxytryptophan (5-HTP) 5-Hydroxytryptophan (5-HTP), an amino acid precursor to serotonin, may be beneficial in obese patients. Low levels of serotonin (an important neurotransmitter) have been linked to carbohydrate craving and may play a major role in the development of obesity. Studies have shown that 5-HTP supplementation promotes weight loss and decreases carbohydrate intake by promoting post-meal satiety (sensation of fullness) and reduced appetite, thereby leading to reduced food intake. [4, 5] One study shows that 5-HTP may help diabetics control food intake and lose weight. 
Chromium The trace mineral, chromium, is often low in obese patients. Chromium can be depleted by eating a diet high in refined sugar and white flour products, and also by a lack of exercise. Chromium regulates blood glucose levels, decreases insulin resistance, aids in weight loss, and stabilizes the body’s metabolism. [7, 8] Preliminary studies have shown that chromium picolinate supplementation results in a reduction of body fat and weight, and an increase in lean body and muscle mass. [9, 10]
Ephedra (ma huang) The herb, ma huang (ephedra) has a long tradition of medical use in China. Ephedra and the alkaloids, ephedrine and pseudoephedrine, are sympathetic nervous system stimulants that can cause rapid heartbeat and high blood pressure side effects. [11-14] Ephedrine is contraindicated in patients with heart disease, high blood pressure, thyroid disease, diabetes, or difficulty in urination caused by prostate disease. It is also contraindicated for patients taking antihypertensive or antidepressant drugs. 
Despite these precautions, there have been many studies of this herb’s effect on weight loss. Preliminary findings report that ephedra increases the metabolism, reduces body fat, and promotes weight loss. [16-17] Other studies have shown that the metabolic effects of ephedra are enhanced by combining with caffeine compounds (methylxanthines). [18-21] However, ephedra-containing products have been irresponsibly abused and this abuse has lead to an impending action against their sale. [22, 23] ndividuals who choose to take ephedra-containing products should do so under the supervision of a health care professional.
Coenzyme Q10 (CoQ10) Coenzyme Q10 (CoQ10) is an antioxidant that boosts cellular energy production in the mitochondria, the cell’s energy powerhouse. Supplementation with CoQ10 has been reported to help promote weight loss. 
Fiber Supplements (Psyllium, Pectin, Guar Gum, Chitosan) A high-fiber diet including the use of soluble and insoluble fiber such as pectin (fruit fiber), psyllium (natural plant fiber), guar gum (Indian cluster bea plant fiber), and chitosan (derived from shellfish chitin) may be effective for weight loss. Numerous studies suggest that fiber supplements may reduce the number of calories and fat absorbed by the body, help to control glucose and insulin effects, increase post-meal satiety (sensation of fullness), and decrease appetite. [25-29] Since chitin may prevent fat absorption, it should not be taken together with other fat-soluble nutrients.
Guggulipid (Commiphora mukul) Guggulipid, an extract of the mukul myrrh tree (Commiphora mukul) of India, has been used for centuries to treat various ailments including obesity and infections. Supplementation with guggulipid effectively lowers blood cholesterol levels and stimulates thyroid function, which may help promote weight loss. 
Garcinia (hydroxycitrate) Garcinia (hydroxycitrate), an extract from the fruit of the Garcinia cambogia tree of India, has been found to help prevent fat production and to suppress appetite. [31-32] Garcinia’s effects have been studied in animals, but human studies are still preliminary to validate these claims.
Conjugated linoleic acid (CLA) Conjugated linoleic acid (CLA) helps transport dietary fat into cells, where it is used to produce energy. Supplementation with CLA has been reported to help reduce body fat and promote weight loss. [33-35]
Bladderwrack (fucus vesiculosus) Bladderwrack (fucus vesiculosus), a source of iodine from seaweed, may be beneficial in obese patients. Bladderwrack supplementation stimulates thyroid function, which may help promote weight loss.  Since iodine toxicity problems are possible, use bladderwrack products which include the iodine content on the label. 
Medium-chain triglycerides (MCTs) Medium-chain triglycerides (MCTs), a special type of fat derived from coconut oil, may be beneficial in obese patients. Studies have shown that the substitution of MCT products for long-chain fats may increase metabolism and help promote weight loss. [38-39] Due to the possibility of ketoacidosis, diabetics and patients with liver disease and should take MCTs under the supervision of a health care professional.
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