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    Copy (2) of final obesity Copy (2) of final obesity Document Transcript

    • Biochemistry department Obesity By Ahmed El-Shaeer
    • Biochemistry department Obesityis a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. How to know your weight is good or not? The answer is very simplified by your weight and height only in the following law to calculate Body mass index BMI= Weight (Kgs)/Height (m2) The perfect body is not exceed 25% or low 20% of his/her bodyweight UNDERWEIGHT You are under optimum weight for your height. You could afford to gain a little weight. Less than 19 NORMAL You have a healthy weight for your height.20 - 25 OVERWEIGHT You are over optimum weight for your height. You may be facing health problems, so losing some weight would be a good idea. 26 - 30 OBESE You are over optimum weight for your height. You may be facing health risks, so see your doctor to help you achieve a healthier weight. 31 +
    • Biochemistry department The past table locates you in the classification of your weight if you exceed 30% you are obese and classified into Actually measuring a person's body fat percentage is not easy and is often inaccurate, so require special equipment such as hydrostatic weighing and Dual-energy X-ray absorptiometry (DEXA). Why morbid obesity is considered disease producing…… At this weight obesity starts to cause many diseases Hypertension (High blood pressure) Diabetes. Coronary artery disease. (Heart blood vessel occlusion) Respiratory problems ( anywhere between breathing difficulties, snoring, asthma, and up-to respiratory failure) Gall stones. Chronic back pain and disc prolapse. Knee, ankle pains and degenerative joint diseases. Fertility problems (anywhere between irregular period, infertility, to major problems during pregnancy for the mother and baby. Dyslipidemia (high blood cholesterol and triglycerides). Some types of cancer are seen much more frequently in the morbidly obese and depression and social withdraw. Severe class I obesity 30.0–34.9 Morbid class II obesity 35.0–39.9 Super class III obesity ≥ 40.0
    • Biochemistry department Causes - Diet: At an individual level, a combination of excessive food energy intake and a lack of physical activityare thought to explain most cases of obesityespecially if the diet is high in fat. For example, fast food, fried food, and sweets have high energy density (foods that have a lot of calories in a small amount of food). Epidemiologic studies have shown that diets high in fat contribute to weight gain. By mechanism high glucose not needed for energy convert into fatty acids then lipids and glucagon in the muscles and livers lead to high overweight rate ,so Some scientists believe that simple carbohydrates (sugars, fructose, desserts, soft drinks, beer, wine, etc.) contribute to weight gain because they are more rapidly absorbed into the bloodstream than complex carbohydrates (pasta, brown rice, grains, vegetables, raw fruits, etc.) and thus cause a more pronounced insulin release after meals than complex carbohydrates. This higher insulin release, some scientists believe, contributes to weight gain.
    • Biochemistry department - Frequency of eating: Scientists have observed that people who eat small meals four or five times daily, have lower cholesterol levels and lower and/or more stable blood sugar levels than people who eat less frequently (two or three large meals daily). One possible explanation is that small frequent meals produce stable insulin levels, whereas large meals cause large spikes of insulin after meals. - Genetics: A person is more likely to develop obesity if one or both parents are obese. Genetics also affect hormones involved in fat regulation. For example, one genetic cause of obesity is leptin deficiency. Leptin is a hormone produced by adipose fat cells and also in the placenta. Leptin controls weight by signaling the brain (C.N.S) to eat less when body fat stores are too high. If for some reason, the body cannot produce enough leptin or leptin cannot signal the brain to eat less, this control (sensation of feeding) is lost, and obesity occurs. The role of leptin replacement as a treatment for obesity is currently being explored there are another mediator called ghrelin shares in control of appetite.
    • Biochemistry department - Psychological factors: Some people, emotions influence eating habits. Many people eat excessively in response to emotions such as boredom, sadness, stress, or anger. While most overweight people have no more psychological disturbances than normal weight people. -Medications: Medications associated with weight gain include certain antidepressants, anticonvulsants such as carbamazepine and valproate, diabetes medications such as insulin, sulfonylureas, and thiazolidinedione), certain hormones such as oral contraceptives and most corticosteroids such as prednisone. Weight gain may also be seen with some high blood pressure medications and antihistamines. The reason for the weight gain with the medications differs for each medication. If this is a concern for you, you should discuss your medications with your physician rather than discontinuing the medication, as this could have serious effects.
    • Biochemistry department -Diseases: Hypothyroidism This is a condition where the thyroid glandproduces too little thyroid hormone. Thyroid hormone regulates our metabolism, so too little hormone slows the metabolism and often causes weight gain.The most common causesare Hashimoto's thyroiditis (autoimmune disease) and may due to Viral and bacterial infections.The most accompanied symptoms are dry skin, weakness, heavy and irregular menstrual period, etc. Doctors usually prescribe thyroid hormone pills to treat hypothyroidism or surgical removal of tumors if are found. Cushing's syndrome This condition results when the adrenal glands which produce an excess amount of a steroid hormone called cortisol. This leads to a build-up of fat in characteristic sites such as the face, upper back, and abdomen. If corticosteroid medicine is the cause of Cushing's syndrome, your doctor will help you lower your dose or gradually stop taking it.If you are well enough to have surgery, surgical removal of the pituitary tumor or benign adrenal tumors offers the best chance for recovery.
    • Biochemistry department Depression Some people with depression overeat or neural disorder e.g. neurotransmitters disorders, which can lead to obesity. There are other diseases can cause excess weight gain for example growth hormone deficiency , the eating disorders , insulin resistance and infectious agents (GIT flora) mainly study of the effect of infectious agents on metabolism is still in its early stages. IS a sex type male or female share in rate of weight gain or loss? The Answer depends on the ability of body metabolism.Women have less muscle than men. Muscle burns (metabolizes) more calories than other tissue (which includes fat). As a result, women have a slower metabolism than men, and hence, have a tendency to put on more weight than men, and weight loss is more difficult for women. As we age, we tend to lose muscle and our metabolism slows; therefore, we tend to gain weight as we get older particularly if we do not reduce our daily caloric intake. Not onlythis cause, but hormones share in weight gain. Women tend to gain weight especially during certain events such as pregnancy, menopause, and in some cases, with the use of oral contraceptives. However, with the availability of the lower- dose estrogen pills, weight gain has not been as great a risk.
    • Biochemistry department
    • Biochemistry department Management Before anything in control or loss your weight, you must put in your mind by faith that you can do it and bears all difficult that you will face to get new easily life free from diseases. There are many examples of lose their weight and they said *I spent my life trying to lose weight. I tried everything, even an operation of the stomach. Nothing worked except for OA: Overeaters Anonymous. I have lost all my weight, and it's not coming back. For me, food is an addiction, and I need to work through a 12-step group. It's an incredible program that changed my life. There are meetings all over the world. Good luck. *The best thing that has worked for me is to write everything I have eaten or drank in the day. It would help me control what I ate because I would think twice about eating certain things. *I lost 100 pounds by drinking large amounts of water during meal time, which helped me cut back my food intake. When I went off the diet after reaching my goal, I started slowly gaining. I didn't have a plan for post-diet. Now, 108 pounds later at 308 pounds I'm looking at losing again. *7 years ago I went from 230 pounds to 175 in a matter of days. I had high volumn liposuction done, then Tummy tuck. I went from a size 24 to a size 12. Today 7 years latter I am a size 8 and weigh 165 pounds. Since the surgeries I exercise mostly walking once a week for 30 minutes. I watch what I eat. I eat small portions of food and an apple before each meal. I eat meat 3 times a week. From past success, experience and advises we get strategy based on guidelines before and till after loss weight because more than95% of the people who lose weight regain the weight within five years.
    • Biochemistry department Firstphysical activity and exercise: Physical activity and exercise help burn calories. The amount of calories burned depends on the type, duration, and intensity of the activity. It also depends on the weight of the person. A 200- pound person will burn more calories running 1 mile than a 120-pound person, because the work of carrying those extra 80 pounds must be factored in. But exercise as a treatment for obesity is most effective when combined with a diet. Another advantage of regular exercise as part of a weight-loss program is a greater loss of body fat versus lean muscle compared to those who diet alone. The National Health and Examination Survey (NHANES I) showed that people who engage in limited recreational activity were more likely to gain weight than more active people. Other studies have shown that people who engage in regular strenuous activity gain less weight than sedentary people. Other benefits of exercise include improved blood sugar control and increased insulin sensitivity (decreased insulin resistance), reduced triglyceride levels and increased "good" HDL cholesterol levels, lowered blood pressure, A reduction in abdominal fat and reduced risk of heart disease.
    • Biochemistry department Recommendations and Precautions: 1- Perform 20-30 minutes of moderate exercise five to seven days a week. Types of exercise include walking, stationary bicycling, walking or jogging on a treadmill, stair climbing machines, jogging, and swimming. 2- Start slowly and progress gradually to avoid injury, excessive soreness, or fatigue. Over time, build up to 30 to 60 minutes of moderate to vigorous exercise every day. 3- People are never too old to start exercising. Even frail, elderly individuals (70-90 years of age) can improve their strength and balance. 4- After any exercises, you can compensate your minerals by fresh vegetables not preferred fruits due to its high calories and low fibers. The following people should consult a doctor before vigorous exercise: Men over age 40 or women over age 50. Individuals with heart or lung disease, asthma, arthritis, or osteoporosis. Individuals who experience chest pressure or pain with exertion, or who develop fatigue or shortness of breath easily. Individuals with conditions or lifestyle factors that increase their risk of developing coronary heart disease, such as high blood pressure, diabetes, cigarette smoking, high blood cholesterol, or having family members with early onset heart attacks and coronary heart disease.
    • Biochemistry department Second dietand healthy food: The goal is to establish realistic weight-loss goals. While the ideal weight corresponds to a BMI of 20-25, this is difficult to achieve for many people. Thus, success is higher when a goal is set to lose 10%-15% of baseline weight as opposed to 20%-30% or greater. The higher the initial weight of a person, the more quickly he/she will achieve weight loss. This is because for every 1 kilogram (2.2 pounds) of body weight, approximately 22 calories are required to maintain that weight. So for a woman weighing 100 kilograms (220 pounds), he or she would require about 2,200 calories a day to maintain his or her weight, while a person weighing 60 kilograms (132 pounds) would require only about 1,320 calories. If both ate a calorie-restricted diet of 1,200 calories per day, the heavier person would lose weight faster. Age also is a factor in calorie expenditure. Metabolic rate tends to slow as we age, so the older a person is, the harder it is to lose weight. When carbohydrates are restricted, people often experience rapid initial weight loss within the first two weeks. This weight loss is due mainly to fluid loss. When carbohydrates are added back to the diet, weight gain often occurs, simply due to a regain of the fluid and excess CHO convert into fats accumulated in the body.
    • Biochemistry department Diet guidelines: Take To Avoid Balanced nutritious foods Vitamins deficiencies andother diseases of malnutrition. Eating low energy dense foods include vegetables, fruits, lean meat, fish, grains, beans and diet soft drinks. excesscaloriesnotneeded A healthy diet should have less than 30% fat. Fat contains twice as many calories per unit weight than protein or carbohydrates. Artificial sweeteners: Saccharin and aspartame are sugar substitutes that provide little or no calories. They may be used as a substitute for table sugar. Fructose, sorbitol, and xylitol may be used as alternatives to sugar, but they provide more calories than saccharin and aspartame. "Take complex Carbohydrates causesimple carbohydrates cause excessive insulin release by the pancreas, and insulin promotes growth of fat tissue" People with phenylketonuria (a serious genetic disease in which an individual is unable to break down and eliminate an amino acid, phenylalanine) should not use aspartame because it contains phenylalanine. Excessive use of sorbitol also may cause diarrhea.
    • Biochemistry department Thirdpointmedication in the management of obesity: Medication that used in treatment of obesity should be used only in patients who have health risks related to obesity. Medications should be used in patients with a BMI greater than 30 who have other medical conditions that put them at risk for developing heart disease. They should not be used for cosmetic reasons. Medications should only be used as an adjunct to diet modifications and an exercise program and they are classified into synthetic and Natural. Syntheticmedications in this category divide into two classes: First class Second class Mechanism of action Increasing the levels of neurotransmitters at the junction called (synapse) between nerve endings in the brain. Inhibiting the action of lipase enzymes. Mode of action These medications decrease appetite and create a sensation of Hunger and fullness (satiety) are regulated by brain chemicals called neurotransmitters. Preventing the intestinal absorption of fat by 30%. Side effect They cause symptoms that mimic the sympathetic nervous system, so the major side effects high blood pressure, headache, insomnia, nervousness, heart attack and stroke. They have minimal or no systemic side effects. A long-term decrease in fat absorptioncan cause deficiency of fat-soluble vitamins (such as vitamins A, D, E, K). Examples -Sibutramine,Fenfluramine (the fen of fen/phen) and dexfenfluramine -Orlistat (Xenical, alli)
    • Biochemistry department The first class of medications was taken off the market since 2010 due to its bad side effects. Thereare new drugs were produced in the market: -Qsymia Which is a combination of phentermine and topiramate extended release, butit is important to note that "Qsymia"canlead to birth defects,other possible serious side effects include increased heart rate, eye problems (glaucoma), and suicidal thoughts. In patients with diabetes, low blood sugar was also a concern when taking "Qsymia".Ask the doctor before starting any synthetic medication. -Belviq In June 2012, the FDA approved Belviq (lorcaserin hydrochloride) as a weight loss medication. The medication works by controlling appetite (via serotonin activation) from its receptor C2. The predominant side effects were headache and dizziness, as well as fatigue. In patients with diabetes, low blood sugar was also a concern when taking Belviq. It is first new drug that approved from about 13 years by FDA and there is a report by American channel "C.N.N" about the story of approval this drug that was dismissed for approval in 2010 after the clinical trials on the animals showed that drug haveside effects tumor in breast and problems in heart valves, - -but nowadays showed that tumors not reach to the upper limit of the danger that may cause bad cases which can prevent the approval of the drug and the same to the another side effect of problems in heart valves.
    • Biochemistry department Natural medications: Herbal weight loss products or preparations are even more misleading. These products may contain a combination of: Fat burners Weight-loss teas These agents are stimulants, which theoretically increase the metabolism and help thebodybreak downfat.E.g: Ma huang (a botanical source of ephedrine), White willow (a source of salicin), Hoodia gordonii, and/or Guarana or kola nut (a source of caffeine), Ginger, Cinnamon, Fennel, Kiwi, Green apple pineapple, Celery. Contain strong botanical laxatives (Senna, cascara sagrada) and diuretics (Rhamnuspurshiana) that cause diarrhea and loss of water from the body. Minerals Others Chromium also is a popular ingredient in weight-loss products, but there is no evidence that chromium has any effect on weight loss(may be to its effect on insulin regulation). Guar gum preparations have also been promoted as a weight-loss agent. Guar gum is thought to work by leading to a feeling of fullness early in the meal. It has not been scientifically proven and has been associated with abdominal pain, gas, and diarrhea. Red grapesis thought to decrease fats in blood Any food rich in fibers due to the thermic effect will be greater than any normal foods and easily loss excess lipids and not easily get other fats For example Mango which is 40% containing fibers. All of the products discussed above are not considered drugs and are therefore not regulated by the Food and Drug Administration. As a result, there is little information on their effectiveness or safety. You should discuss any weight loss products you are planning on taking or are taking with your health care.
    • Biochemistry department The last choice is a role of surgery in the treatment of obesity: The National Institute of Health consensus has suggested the following guidelines for surgery in obese patients: Patients with a BMI of greater than 40 Patients with a BMI of greater than 35 who have serious medical problems such as sleep apnea, that would improve with weight loss. Before anysurgery is necessary to preview the patient comprehensively to include this preview performance evaluation and examination of hormonal accurately, and a careful analysis of the nature of life and eating habits of the patient, and must be verified and documented previous attempts at weight loss. We must know the risks of surgery before starting any type of surgery to put it in the last choice. The risks of surgery include: Complications of infection Blood clots in the lower extremities (deep vein thrombosis) and in the lungs (pulmonary embolism). Anesthesiarisk. Specific long-term risks related to obesity surgery include lack of iron absorption and iron deficiencyanemia. Vitamin B12 deficiency can also develop and could lead to nerve damage (neuropathies). Rapid weight loss may also be associated with gallstones.
    • Biochemistry department There are different types of surgery to get loss of morbid or super obesity for examples: Adjustable gastric banding: This surgery is carried out in general by laparoscopy technique (laparoscopy) and which is the mode of ring made of soft silicon, 2 cm below the point of the corner of the stomach with the esophagus. There is a flexible tube is connected between the ring and Blower (PORT), which is implanted in the abdominal wall under a layer of fat under the skin, whereby it is possible inflatable this episode and how tight control of this part of the stomach. This method is based on a simple principle of reducing the size of the stomach, leading to a feeling of fullness even after eating a small meal. Gastric bypass: The stomach is divided into the upper part of the stomach and which is smaller than the lower section of the stomachThis upper section are connected to the small intestine and so that we can overcome the proximal section and who has a greater capacity to absorption. This surgery is more complex than its predecessor and requires to be held a high degree of experience and skill. Laparoscopic surgery is a process or surgeon open and require, in most cases, longer recovered. Liposuction Surgery: Aims liposuction to remove excess fat in certain areas of the body, in order to improve the appearance of the body in terms of aesthetic and reduce waist circumference as well as other areas in the oceans of the body. In the surgical process is the use of a special device, which is pumping off small parts of excess fat tissue and accumulated by vacuum pump.
    • Biochemistry department Obesity surgery needs a professional health care especially in the role of anesthesia of patient as in the case of surgical liposuction, so they found different techniques to destroy fat cells for examples: Normal waves That developed to concentrated waves and the last technology is reached to low-level lasers (also known as “cold lasers”). Cold laser Does not have to be emitted at high temperatures, so it can penetrate the epidermis without burning it or causing any damage to the tissue and travel through the skin and puncture fat cells. The normal fatty cells takes the lipids from outer membrane through its pores as single units and converts it to triple units for trapping it then prevents it from go out again, so here rays works on widening the pores of the cells to be able the fat cells leak and the fatty waste is expelled from the system through normal bodily functions. There is another theory that rays can destroy the covalent bonds between the triple units then single units can leak directly out by easy way. Ultrasonic We can use it in getting loss of excess fat that cannot be removed by the normal surgery. It depends on destroying fat cells Finally the more developed techniques the lowest side effects.
    • Biochemistry department Conclusion: Obesity is a chronic condition. Too often it is viewed as a temporary problem that can be treated for a few months with a strenuous diet. However, as most overweight people know, weight control must be considered a lifelong effort to be safe, effective and obesity not mean starvation. The best and the safest ways to lose fats and keep it off are through a commitment to a lifelong process of proper diet and regular exercise. Medications should be considered helpful adjuncts to diet and exercise for patients whose health risk from obesity clearly outweigh the potential side effects of the medications. Medications should be prescribed by doctors familiar with the patients' conditions and with the use of the medications. Medication(s) and other "herbal" preparations with unproven effectiveness and safety should be avoided, but the major doctors supplied their patients with approved herbal supplement that improve body case. The loss weight plan must be put without any effect on immunity improvement.
    • Biochemistry department The increment in thermogenesis is regulated by catechol amines such as norepinephrine. Researchers are also investigating the possibility of increasing the amount of brown adipose tissue in the body, a site of thermogenesis (Thermogenesis is the process of heat production in organisms and is regulated mainly by thyroid hormone, the sympathetic nervous system and by movement of the muscles). The surgery role to get loss of obesity is easy way, but its risks are very high and patient cannot change his life style after surgery easily, but Bariatric surgery results in durable weight loss and amelioration of obesity-associated co-morbidities, particularly type 2 diabetes mellitus and reduced mortality results showed a 65% cure rate, but actually still have danger rate. Doctor must tell his patient the best food to increase his body with good immune system, balanced minerals and low fats gain exactly with this sequence immunity treatment first before obesity itself. Patient must have knowledge about a health food i.e. when he takes excess calories he must know what he will do in these situations by his experience in weight loss plan to be able to get loss the excess gained calories. Patient must continue with his/her different past doctors without stopping and have ability to continue his loss weight program before and after the loss required weight.
    • Biochemistry department Reference: http://www.medicinenet.com "National Health and Nutrition Examination Survey." http://www.cdc.gov/nchs/nhanes.htm. www.wikipedia.org http://www.webmd.com/diet/medical-reasons-obesity http://thechart.blogs.cnn.com/2012/06/27/fda-approves-drug-to- treat-some-obese-overweight-adults/