Weight Management: Healthy Weight and Physical Activity

WEIGHT MANAGEMENT: HEALTHY WEIGHT AND PHYSICAL ACTIVITY

healthy eating, physical activity, optimal sleep, and stress reduction. There are many factors that contribute to a person’s weight, including diet, physical activity, genetics, environmental factors, health care support, medications, and illnesses. Each of these factors affect weight in different ways and to varying degree.

WEIGHT ASSESSMENT

A high amount of body fat can lead to weight-related diseases and other health issues. Being underweight is also a health risk.
Body Mass Index (BMI)and Waist Circumference are screening tools to estimate weight status in relation to potential disease risk but is not diagnostic of the body fatness or health of an individual.

Body Mass Index

BMI is a person’s Weight (Wt.) in kilograms divided by the square of Height (Ht )in meters. (Wt. in kg/Ht in m²)

BMI	WEIGHT RANGE
< 18.5	Under weight
18.5 – 24.9	Healthy weight
25 – 29.9	Overweight
30 / Higher	Obese

WAIST CIRCUMFERENCE Another way to estimate your potential disease risk is to measure your waist circumference. Excessive abdominal fat may be serious because it places you at greater risk for developing obesity-related conditions, such as Type 2 Diabetes, High blood pressure, and coronary artery disease etc.

A man whose waist circumference is more than 40 inches.
A non-pregnant woman whose waist circumference is more than 35 inches.
These are the indicators of excessive abdominal fat.

MANAGEMENT: OBESITY

As people age, their body composition gradually shifts — the proportion of muscle decreases and the proportion of fat increases. This shift slows their metabolism, making it easier to gain weight. In addition, some people become less physically active as they get older, increasing the risk of weight gain. When you’re trying to lose weight, it’s natural to want it to happen very quickly. But people with gradual and steady weight loss (about 1 to 2 pounds per week) are more likely to keep the weight off. If your goal is to prevent weight gain, choose foods that supply the appropriate number of calories to maintain your weight. It depends on many factors, including your height, weight, age, sex, and activity level. Management should include Dietary modification, Physical Activity, Behavioral interventions, Medications, and Surgical intervention if needed.

Dietary Modification

Healthy eating features a variety of healthy foods. Fad diets may promise fast results, but such diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run. The dietary modification should be individualized with close monitoring of regular weight loss. Low-calorie diets are recommended. Low calories could be carbohydrate or fat-restricted. A low-carbohydrate diet can produce greater weight loss in the first months compared to a low-fat diet. To help children develop healthy eating habits: Provide plenty of vegetables, fruits, and whole-grain products.

Include low-fat or non-fat milk or dairy products, including cheese and yogurt.
Choose lean meats, poultry, fish, lentils, and beans for protein.
Encourage your family to drink lots of water.
Limit sugary drinks.
Limit consumption of sugar and saturated fat.

Physical activity

Regular physical activity is important for good health, and it’s especially important if you’re trying to lose weight or to maintain a healthy weight When losing weight, more physical activity increases the number of calories your body uses for energy or “burns off.” The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a “calorie deficit” that results in weight loss.
Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintainweight loss is to be engaged in regular physical activity.

Physical activity also helps to:

Maintain weight.
Reduce high blood pressure.
Reduce risk for type 2 diabetes, heart attack, stroke, and several forms of cancer.
Reduce arthritis pain and associated disability.
Reduce risk for osteoporosis and falls.
Children ages 3 through 5 years should be active throughout the day. Children and adolescents ages 6 through 17 years should be physically active for at least 60 minutes each day. Include aerobic activity, which is anything that makes their hearts beat faster.
Also includes bone-strengthening activities such as running or jumping and muscle-strengthening activities such as climbing or push-ups.

Behavior Interventions: Several psychotherapeutic interventions are available which include motivational interviewing, cognitive behavior therapy, dialectical behavior therapy, and interpersonal psychotherapy. Behavior interventions are more effective when they are combined with diet and exercise. Medications: Anti-obesity medications can be used for a BMI greater than or equal to 30 or a BMI greater than or equal to 27 with comorbidities. Medications can be combined with diet, exercise, and behavior interventions. Surgery: Indications for surgery are a BMI greater or equal to 40 or a BMI of 35 or greater with severe comorbid conditions. The patient should be compliant with post-surgery lifestyle changes, office visits, and exercise programs. Patients should have an extensive preoperative evaluation of surgical risks. Commonly performed bariatric surgeries include adjustable gastric banding, Rou-en-Y gastric bypass, and sleeve gastrectomy. Rapid weight loss can be achieved with a gastric bypass, and it is the most performed procedure. Early postoperative complications include leak, infection, postoperative bleeding, thrombosis, and cardiac events. Late complications include malabsorption, vitamin, and mineral deficiency, refeeding syndrome, and dumping syndrome.

OUTLOOK

healthy eating and physical activity to help maintain health over the long term. Attaining a healthy weight involves recognition of general techniques such as portion sizing, self-monitoring, and daily diet consistency. If you are concerned about your weight or have questions about your medications, talk with your healthcare provider.