The Size of the Problem
There is little doubt that increasing body weight
is linked to increasing diabetes 2. Fat stored in the abdomen is the most
problematic fat. Strategies that reduce fat stores in the body reduce the
effects of DB2. Dieters have proven that weight-loss attempts by following a
"weight-loss diet" may succeed for a short time but ultimately fail, about 90%
of the time. Hundreds of weight loss schemes have been marketed, some are
sincere but flawed, and others are frankly fraudulent. This constant barrage of
weight loss fantasy and fraud has become an integral part of the overweight
problem. The right approach is to adopt realistic goals and practice reasonable
strategies of self-management. Research has shown several important features of
body weight management. There are powerful biological controllers of eating
behaviors, appetite and weight regulation.
There are genetic tendencies
toward excess weight and obesity-causing gene mutations have been discovered.
European and North American diets are flawed. There is too much fat and sugar in
all the foods and food is too abundant. Eating has become entertainment. The
modern lifestyle is flawed. There is too much sitting, too much convenience and
too little physical work. One of the first challenges you face is to abandon
recreational eating in favor of recreational exercise
According to Gibbs,
staff writer, for Scientific American: “Throughout human history, a wide girth
has been viewed as a sign of health and prosperity. It seems both ironic and
fitting, then, that corpulence now poses a growing threat to the health of many
inhabitants of the richest nations… The measure of the hazard in the U.S. is
well known: 59 percent of the adult population meets the current definition of
obesity, according to a 1995 report by the Institute of Medicine, easily
qualifying the disease for epidemic status. Epidemiologists at Harvard
University conservatively estimate that treating obesity and the diabetes, heart
disease, high blood pressure and gall stones caused by it rang up $45.8 billion
in health care costs in 1990. Indirect costs because of missed work pitched
another $23 billion onto the pile. That year, a congressional committee
calculated that Americans spent about $33 billion on weight-loss products and
services. Yet, roughly 300,000 men and women were sent early to their graves by
the damaging effects of eating too much and moving too little...Polls that show
gasoline consumption and hours spent watching television rise as quickly as the
rate of obesity in some countries.”Fat storage has a purpose and offers
benefits. Everyone stores some white fat to provide insulation and body shape.
Our facial contours are constructed from fat. The shape of women’s bodies
differs from men’s bodies because of carefully designed fat deposits in the
breast, abdomen and buttocks. Extra fat is a good insulator and keeps you warm.
Extra fat is buoyant and helps you float in water. Marine mammals are all fat
because they swim in cold water. Eskimos are fat so that they can survive cold
winters when food is scarce. Brown fat is a source of heat; calories are burned
in brown fat to warm the body.
In simple terms, there is a built in tendency to binge eat and gain weight
when food is abundant. If you accept that the overweight condition is caused by
the lack of famine, absence of hibernation and/or the failure to schedule
sustained athletic training, you are better prepared to lose weight.
overweight people would become slimmer people if they ate less food. All
overweight people would become slimmer if they hibernated over the winter and
did not eat food for 4 months. All overweight people would become lean people if
they as trained hard and long as an endurance cyclist. Long-distance athletes
are the leanest people in town because sustained exertion causes muscle cells to
use fat as fuel. If you train long enough and hard enough, most of your stored
body fat is burned as fuel. Extra food may be ingested slowly and gradually,
although people gain weight in spurts, because of binge-eating or periodic
indulgences in extra high-calorie foods, sugar beverages, desserts and snacks.
Rapid weight gain may be associated with hormonal changes, as in pregnancy or
low thyroid states, or whenever life-style changes, injury, or illness reduce
physical activity. Without a balanced reduction in food intake or change in food
selection, reduced physical activity produces weight gain. Bursts of weight gain
represent maladaptive responses to a variety of stressors.
Leibel et al,
have shown that the human body maintains a stable weight by increasing the
number of calories burned when weight is gained, and slowing the rate of energy
consumption when weight is lost. The investigators studied 41 women and men at
the Rockefeller Hospital, a component of the National Institutes of Health's New
York Obesity Research Center. Their findings suggest a few basic principles:
1. Energy expenditure is adjusted spontaneously to compensate
for weight change.
2. Most of the change was observed in
non-resting energy expenditure through physical activity, the only aspect of
metabolism that you can control directly.
efficiency of muscle contraction changes as weight varies. These findings may
account, in part, for the poor long-term success of treatments for obesity.
Leibel suggested: "Our data indicate that the maintenance of reduced body weight
is not impossible… only that the formerly obese will require long term adherence
to regimens of reduced calorie intake and increased physical activity…
decreasing food intake or increasing energy output for a short period is not
going to control weight. Good nutrition and increased physical activity over the
long term are necessary to lose weight and keep it off."
Weight Loss Surgery
Obese patients often fail to lose weight or lose and then quickly regain
their weight. Surgical interventions have many benefits and have become
increasingly popular to rescue obese patients. A number of bariatric
surgical procedures have been used to decrease stomach size. The surgeries
usually reserved for obese patients (BMI ≥40), are sleeve gastrectomy and
gastric bypass. Two randomized trials of bariatric surgery have reported 5-year
outcomes — both in obese patients with type 2 diabetes — most recently the
Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently
(STAMPEDE) trial. In these studies, sleeve gastrectomy, RYGB, and BPD reduced
the burden of glucose-lowering medication and produced diabetes remission in up
to 50% of patients.
About 65% to 70% of bariatric-surgery procedures
today in the United States are sleeve gastrectomies, It is a safe operation. A
statement issued at the meeting, the American Society for Metabolic and
Bariatric Surgery explained that last year sleeve gastrectomy, where
surgeons remove about 80% of the stomach, emerged as the most popular method of
weight-loss surgery in America, surpassing laparoscopic gastric bypass, which
had been the most common procedure for decades. In 2013 in the United States,
sleeve gastrectomy accounted for 42.1% of the 179 000 bariatric procedures
performed, followed by gastric bypass (34.2%), gastric band (14%), and
biliopancreatic diversion with duodenal switch (1%). (Miriam E Tucker.
Laparoscopic Sleeve Gastrectomy: Good Operation, With Limits Medscape
November 09, 2017)
- You are visiting the Diabetes Center at Alpha Online, and educational
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Managing Diabetes by
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self-help book explains how to manage diabetes.
The book offers the good news that the impending disasters are optional if
eating and living conditions are changed correctly. Newly diagnosed diabetics
should act to design a new diet with increased physical activity. 2018
Edition 170 Pages
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