Obesity:

Obesity is a term used to describe
body weight that is much greater than
what is considered healthy. If you are
obese, you have a much higher
amount of body fat than is healthy or
desirable.

Adults with a body mass index (BMI,
calculated as weight in kilograms
divided by height in meters squared)
greater than 25 kg/m2 but less than 30
kg/m2 are considered overweight.

Adults with a BMI greater than 30
kg/m2 are considered obese.

Anyone who is more than 100 pounds
overweight or who has a BMI greater
than 40 kg/m2 is considered morbidly
obese.

Obesity is associated with a myriad of
diseases and disabilities which include:
metabolic syndrome, type-II diabetes,
hypertension, cardiovascular disease,
dyslipidemias, arthritis, cancer, sleep
apnea, stroke, steatohepatitis, PCOS,
infertility, depression, and premature
death.




OBESITY DRUG BELVIQ APPROVED
In June 2012 the FDA approved Belviq
(lorcaserin hydrochloride), made by
Arena  as an addition to a reduced-
calorie diet and exercise, for chronic
weight  management.

The drug is approved for use in adults
with a body mass index (BMI) of 30 or
greater (obese), or adults with a BMI of
27 or greater (overweight) and who
have at least one weight-related
condition such as high blood pressure
(hypertension), type 2 diabetes, or
high cholesterol (dyslipidemia).
BMI, which measures body fat based
on an individual's weight and height, is
used to define the obesity and
overweight categories. According to
the Centers for Disease Control and
Prevention, more than one-third of
adults in the United States are obese.

Belviq works by activating the
serotonin 2C receptor in the brain.
Activation of this receptor may help a
person eat less and feel full after
eating smaller amounts of food.

In 1997, the weight-loss drugs
fenfluramine and dexfenfluramine were
withdrawn from the market after
evidence emerged that they caused
heart valve damage. This effect is
assumed to be related to activation of
the serotonin 2B receptor on heart
tissue. When used at the approved
dose of 10 milligrams twice a day,
Belviq does not appear to activate the
serotonin 2B receptor.

Belviq is made by Arena
Pharmaceuticals GmbH of Zofingen,
Switzerland, and distributed by Eisai
Inc. of Woodcliff Lake, N.J.


Vivus's Qnexa and Orexigen
Therapeutics Inc.'s (OREX) weight-loss
drug Contrave were also previously
rejected by the FDA. While Orexigen
suspended development of Contrave,
Vivus resubmitted its application in
October 2011.

The development of obesity
compounds has been a tough area for
companies since 1997, when a fen-
phen drug combination was taken off
the U.S. market after being linked to
heart-valve damage. The FDA has set
a high bar for approving any weight-
loss drugs that would be taken by
millions of people, potentially over long
periods of time.





CHINESE FOOD MAY BE MORE
FATTENING THAN MCDONALDS
Many items on a typical Chinese food
restaurant menu are over 1000
calories. That's half your caloric intake
per day, in just one meal.

According to a recently published
study, MSG (monosodium glutamate),
a flavor enhancer most often
associated with Chinese food, may
also contribute to weight gain. The
study measured the dietary MSG
intake of 10,095 Chinese adults in
order to determine if there was an
association between MSG intake and
obesity. The study found that
participants who consumed the most
MSG were 28% more likely to be
overweight compared to those who
consumed the least amount of MSG.

It is not entirely clear why higher
consumption of MSG is associated with
weight gain. However, the authors
suspect that over time MSG intake
prevents brain cells from responding to
leptin. Leptin is a hormone that
suppresses appetite and when brain
cells no longer respond to it, this may
lead to excess energy intake and
weight gain.

Highest Calorie Chinese Foods That
May Surprise You:

EGGPLANT IN GARLIC SAUCE
Calories: 1,000 Sat Fat: 13 grams
Sodium: 2,000 mg

TOFU & MIXED VEGETABLES
Calories: 900  Sat Fat: 9 grams  
Sodium: 2,200 mg

LEMON CHICKEN Calories: 1,400 Sat
Fat: 13 grams Sodium: 700 mg

KUNG PAO CHICKEN Calories: 1,400
Sat Fat: 13 grams Sodium: 2,600 mg

GENERAL TSO'S CHICKEN Calories:
1,300 Sat Fat: 11 grams Sodium:
3,200 mg








WEIGHT- LOSS  SURGERY CURES
MANY OBESE PEOPLE OF THEIR
DIABETES
Weight-loss surgery can cure many
obese people -- perhaps more than
60% of them -- of their diabetes, at
least in the short term, suggests a new
analysis of several studies.

Though previous research had
suggested that weight-loss surgery
could reverse diabetes, researchers
from the Netherlands have formalized
the evidence a bit through a review of
nine studies published in the June
Archives of Surgery.

Among the studies included in the
analysis, 424 people with Type 2
diabetes underwent Roux-en-Y gastric
bypass surgery, in which the surgeon
creates a small pouch in the stomach
that restricts food intake and bypasses
part of the small intestines to cut down
on absorption. Within days of the
surgery, 83% of the subjects could
stop taking diabetes medications.

And among 211 patients who had
adjustable gastric banding, in which a
silicon band is fitted around the
stomach to restrict food intake, 62%
could stop taking their diabetes
medications in the months after
surgery.

The effect continued after one and two
years, the researchers found, but
appeared to wane after 10 years.


TWO NEW FAT REDUCING DEVICES
APPROVED BY THE FDA
Two new devices—one that deflates
fat cells, one that destroys them—
have  been cleared in 2011 for "body
contouring" in doctors' offices by the
Food and Drug Administration.

With Zeltiq's CoolSculpting device, you
sit in a chair while a technician places
a specifically designed cooling
applicator over the area desired for fat
reduction, which then extracts energy
from the underlying fat cells (i.e: cools
them) without damaging skin or
surrounding tissue.
The procedure is designed to deliver
controlled and precise cooling
conditions to the targeted area,
causing the cooled fat cells begin a
process called apoptosis (natural cell
death), reduce in size, and then be
naturally removed through the body’s
normal metabolic processes.

The area goes cold, then numb while
you read, sleep or relax for about an
hour while your fat cells receive a fatal,
freezing dose. It isn't painful—just
slightly uncomfortable—and the area
may feel stiff, with mild bruising or
redness for several days.

The procedure lasts between one to
two hours and on average will reduce
fat cells by 20 percent. There is no
required recovery time after the
procedure, so patients can resume
normal activities immediately and
should start to see results after three
weeks.

Coolsculpting procedures are now
available through a network of medical
centers throughout the United States.


The freezing technology causes the fat
inside fat cells to crystallize, and then
the cells die an early, natural death,
and wait to be reabsorbed into the
body. It takes three to four months to
see results. Once gone, the fat cells
don't grow back—or grow back very
slowly. Some patients have been
followed for three years now without
seeing fat deposits return. To date,
more than 7,000 patients have had the
Coolsculpting Procedure worldwide
safely.

Each Zeltiq treatment costs between
$1,500 and $3,000.

Rival technique is Erchonia's  Zerona
doesn't kill fat cells. The low-energy
laser device creates tiny pores in the
cell membranes that cause the fatty
contents to seep out and the cells to
deflate, like squishing a grape. The
cell is still viable and can still secrete
beneficial hormones.

Patients lie on a table while the device
rotates around the waist, hips and
thighs. The procedure takes 40
minutes—20 minutes on each side—
and is repeated three times a week for
two weeks, for a total of $1,800 to
$3,000. There's no pain, skin irritation
or blistering. Results are visible in
about two weeks.

In a placebo-controlled double-blind
trial with 67 patients, those who had
Zerona lost an average of 3.65 inches
from their waist, hips and thighs (that
is, about an inch per area), compared
with only a half-inch in the placebo
group. It's not going to give you ripped,
defined abs, but it will create an
obvious slimming.



SURGERY MAY REDUCE DIABETICS'
NEED FOR DRUGS
The majority of people with diabetes
who had bariatric surgery (gastric
banding) to lose weight were able to
stop taking their diabetes medications,
which led to a significant decline in
health-care costs, according to a study.

Researchers at Johns Hopkins in
Baltimore, looked at 2,235 adults who
had the stomach-reducing surgery and
who also had Type 2 diabetes, a
common form of the disease often
associated with weight gain. Six
months after surgery, nearly 75% of
patients had eliminated their diabetes
medications and after two years 84.5%
of patients were off medicine.

The study, published in this month's
Archives of Surgery, a Journal of the
American Medical Association
publication, was funded by the
Department of Health and Human
Services.




GASTRIC BANDING
In gastric banding an adjustable band
is inserted in a small incision and
wrapped around the top of the
stomach, giving the patient the illusion
of fullness with small meals;

Gastric bypass surgery known as Roux-
en-Y the stomach is closed off near
the top, creating a small pouch, it
is done laparoscopically;

Both Johnson & Johnson and Allergan
Inc make bands for weight-loss surgery



OTHER DEVELOPMENTS
A DOCTOR'S ADVICE
From an  Interview with Denise Bruner,
M.D., a  past president of the American
Society of Bariatric Physicians:

Against obesity the  nutrients I find
most useful in my practice are as
follows: L-carnitine, CLA, chromium,
CoQ10, OmegaPro 3 Fatty Acids,
vanadium, alpha lipoic acid, zinc,
calcium magnesium, multivitamin, B
complex especially pyridoxine,
pyridoxal-5-phosphate, B12, folic acid,
niacinamide, vitamin C, taurine, 5-HTP,
tyrosine, phenylalanine and Rhodiola
Rosea. In terms of pharmaceutical
agents, phentermine is a
Norepinephrine re-uptake inhibitor
which helps to decrease appetite.
Reductil [Ed.- Sibutramine] is both a
norepinephrine and selective serotonin
re-uptake inhibitor- therefore it should
help with both appetite and cravings. I
prefer using phentermine in my
practice as there is a great deal of
flexibility with dosing and has a rapid
onset of action as compared with at
times a 4 week period before the effect
of Reductil is noted. Phentermine is
affordable as contrasted with the
expense of Reductil and works well in
people who have issues with their
overactive appetite. In my experience
and discussion with my colleagues,
Reductil seems to work in only about
20% of those for whom it is prescribed.
Bupropion has been helpful with
decreasing appetite and cravings.
Topiramate is useful in those with
binge eating disorders and has been
involved in a clinical trial in
combination with phentermine. The
results look promising. Xenical blocks
fat absorption when the food
consumed has a fat percentage
greater than 30%. It is analogous to
using the drug, antabuse, in
alcoholics…definitely aversive
conditioning. I use it primarily in the
maintenance phase, because it helps
to keep patients on their food plan
especially when in social gatherings.
Many of my patients have metabolic
syndrome, so I use metformin to help
improve their insulin resistance.
The Omron HBF-306C Body Fat
Analyzer measures your body fat with
a gentle, micro electrical current --
don't worry, you won't feel it.












EatSmart "Step-On" technology allows
you to simply step on the scale and get
your weights.