- \n
- Obesity occurs when an individual has an increased amount of body fat. It is usually defined as being 20-30% above the normal body weight for someone of the same age, gender, and height.<\/li>\n\n\n\n
- Morbid obesity is usually defined as being 50-100% above the normal body weight for someone of the same age, gender, and height.<\/li>\n\n\n\n
- Many factors, including an individual\u2019s age, gender, and height, are considered to determine if he\/she is overweight. People increase in weight until they are fully grown. On average, females tend to gain about 16 pounds of body weight from age 25-54. In contrast, males tend to gain about 10 pounds of body weight from age 25-45. By around age 55, both men and women start to decline in weight. Females naturally have more body fat and less muscle mass than men. It is also normal for taller individuals to weigh more than shorter individuals.<\/li>\n\n\n\n
- Obesity is typically considered a long-term condition that often persists for many years. Researchers believe that many factors, including poor diet, overeating, pregnancy, medications, medical conditions, genetics, gender, and age, may contribute to a person becoming obese.<\/li>\n\n\n\n
- Obesity can have serious long-term effects on health. Individuals who are overweight have an increased risk of developing many life-threatening illnesses including heart disease, high blood pressure, stroke, obesity, diabetes, osteoporosis, and cancer. According to the American Heart Association, obesity was associated with nearly 112,000 deaths in 2005.<\/li>\n\n\n\n
- In the United States, obesity is considered an epidemic. More than half of all Americans are considered overweight, and about 20% of children are overweight. In 2005, 140 million Americans were considered overweight or obese, according to the American Heart Association. Nearly 33% of Americans are considered obese, and these numbers continue to grow.<\/li>\n<\/ul>\n\n\n\n
Causes<\/h2>\n\n\n\n
- \n
- General<\/strong>: There are many potential causes of obesity. Some patients may be obese for multiple reasons.<\/li>\n\n\n\n
- Poor diet<\/strong>: Individuals who regularly consume foods that are high in calories and saturated fats have an increased risk of becoming obese. Examples of foods and beverages that may lead to obesity include fast food, fried food, sodas, candy, and desserts.<\/li>\n\n\n\n
- Overeating<\/strong>: Consistently eating too much food also increases the risk of becoming obese. Individuals who regularly eat extra-large portions of food, eat until they are full, or eat many times throughout the day are more likely to become obese.<\/li>\n\n\n\n
- Inactivity<\/strong>: Individuals who do not exercise regularly are more likely to become obese. Physical activity is needed to burn the calories that are consumed in the diet. If these calories are not burned, they will be stored as fat in the body. Most experts recommend at least 30 minutes of moderate exercise three or more times per week to help maintain a healthy weight.<\/li>\n\n\n\n
- Pregnancy<\/strong>: During pregnancy, the female\u2019s body weight increases, not only because she is carrying a baby, but also because the mother\u2019s body needs to support the growing fetus. The average weight gain after pregnancy is typically 25-35 pounds. Researchers believe that this weight gain may contribute to the development of obesity.<\/li>\n\n\n\n
- Medications<\/strong>: Some medications, including corticosteroids and tricyclic antidepressants, may cause weight gain as a side effect.<\/li>\n\n\n\n
- Medical conditions<\/strong>: Although it is uncommon, sometimes obesity is caused by medical conditions. For instance, if the thyroid does not produce enough thyroid hormone, the metabolism slows down and it may lead to mild weight gain and difficulty losing extra weight.<\/li>\n\n\n\n
- In addition, some long-term conditions, such as emphysema or arthritis, may limit an individual\u2019s ability to exercise. As a result, individuals may become overweight or obese.<\/li>\n\n\n\n
- Stress<\/strong>: Stress may also contribute to obesity. When an individual becomes stressed, it signals the adrenal glands to release a hormone called cortisol. Research suggests that an increase in cortisol levels may lead to increased fat around the midsection.<\/li>\n\n\n\n
- Genetics<\/strong>: Genetics may also contribute to obesity. For instance, a patient\u2019s genetics may affect how much fat is stored and where it is distributed in the body. Genetics may also affect how quickly the body can convert food into energy and how efficiently the body can burn calories during physical activity. Although genetics can increase an individual\u2019s risk of becoming obese, it is not the only factor for the condition. In other words, individuals who are genetically predisposed to become obese will not always become obese, especially if they make the right lifestyle choices.<\/li>\n\n\n\n
- Gender<\/strong>: Women are more likely to become obese than men. This is because women naturally have more body fat and less muscle mass than men. In addition, women burn fewer calories at rest than men do. As a result, women are more likely to experience an increase in body fat than males.<\/li>\n\n\n\n
- Age<\/strong>: Age may also contribute to obesity. Muscle mass tends to decrease with age, which decreases the body\u2019s metabolism, or rate at which the body can process fats. In addition, most patients become less active as they age. All of these changes lead to a decrease in the amount of calories that the body needs. If individuals do not decrease the amount of calories they consume, they will start to gain weight.<\/li>\n<\/ul>\n\n\n\n
Signs & Symptoms<\/h2>\n\n\n\n
- \n
- Patients who are obese have more fat than normal, healthy individuals of the same age, gender, and height. They may have difficulty walking, experience shortness of breath, and become tired after very little physical exertion.<\/li>\n<\/ul>\n\n\n\n
Diagnosis<\/h2>\n\n\n\n
- \n
- A healthcare provider diagnoses obesity after measuring the patient\u2019s body mass index (BMI) and hip-to-waist ratio.<\/li>\n\n\n\n
- The BMI is a measurement of weight (in pounds) for height (in inches) in adults who are older than 20 years of age. BMI falls into one of these categories: below 18.5 units is underweight, 18.5-24.9 is normal, 25.0-29.9 is overweight, and 30.0 and above is obese. For adults, the accepted formula for BMI is: BMI=703 x [Weight in pounds\/(Height in inches)2].<\/li>\n\n\n\n
- Waist-to-hip ratio (WHR) is the circumference of the waist divided by the circumference of the hips. For women, a healthy ratio is 0.8 or lower. For men, a healthy ratio is 1.0 or lower. A high ratio means that the patient is overweight or obese. A low ratio means that the patient is underweight.<\/li>\n<\/ul>\n\n\n\n
Complications<\/strong><\/h2>\n\n\n\n
- \n
- Depression<\/strong>: Individuals who are obese often suffer from depression. This may occur if the patient\u2019s weight limits his\/her ability to perform certain activities. Depression may also occur if the patient has poor self-esteem as a result of his\/her weight.<\/li>\n\n\n\n
- Heart disease<\/strong>: Obese individuals have an increased risk of developing high blood pressure. This is because the extra fat tissue, like other tissues in the body, requires oxygen from the blood. Therefore, the circulatory system is strained and the heart rate increases as it tries to supply a larger-than-normal body with enough oxygenated blood.<\/li>\n\n\n\n
- Sleep apnea<\/strong>: Obese patients have an increased risk of developing sleep apnea, a serious condition that occurs when the individual stops breathing for short periods of time during sleep. In obese patients, sleep apnea typically occurs when excess fat in the upper airway obstructs breathing. Because sleep apnea causes individuals to wake up frequently throughout the night, patients are often drowsy during the day.<\/li>\n\n\n\n
- Diabetes<\/strong>: Obese patients are more likely to develop type 2 diabetes. This condition occurs when the body becomes resistant to a hormone called insulin. As a result, patients with type 2 diabetes have too much sugar in their bloodstream.<\/li>\n\n\n\n
- Cancer<\/strong>: Many types of cancer, including colon cancer, rectal colon, esophageal cancer, kidney cancer, breast cancer, and prostate cancer, are associated with being overweight.<\/li>\n\n\n\n
- Physical discomfort<\/strong>: Obese patients may suffer from chronic pain in various parts of the body. This is because fat eventually starts to crowd the space near the internal organs, impairs blood circulation, and puts extra strain and pressure on the body\u2019s joints. Sometimes the fat in the abdomen prevents patients from sitting comfortably. Pain is most likely to develop in the feet, joints, back, and muscles. It may be difficult for obese patients to breathe when they are sitting up.<\/li>\n\n\n\n
- Fertility problems and sexual dysfunction<\/strong>: Men and women who are obese may suffer from fertility problems. In general, being obese decreases an individual\u2019s sex drive (libido). It may also make it difficult for males to achieve or maintain an erection.<\/li>\n\n\n\n
- Birth defects<\/strong>: Obese females have an increased risk of having children with gestational diabetes or other complications during pregnancy that may lead to birth defects.<\/li>\n\n\n\n
- Osteoarthritis<\/strong>: Obese individuals are more likely to develop a degenerative joint disease called osteoarthritis. This is because being overweight increases the strain put on the weight-bearing joints, such as the knees and ankles.<\/li>\n\n\n\n
- Osteoporosis<\/strong>: Obese individuals have an increased risk of developing osteoporosis, which causes the bones to become weak and brittle. The bones become porous and less dense. As a result, individuals are more likely to fracture their bones if they slip, fall, or injure themselves. Some evidence suggests that osteoporosis may develop in obese patients because fat cells infiltrate the bone marrow. In addition, it has been shown that individuals who live sedentary lifestyles have an increased risk of developing osteoporosis.<\/li>\n<\/ul>\n\n\n\n
Treatment<\/strong><\/h2>\n\n\n\n
- \n
- General<\/strong>: Most doctors believe that overweight individuals should try to lose weight gradually. This reduces the risk of nutritional deficiencies and increases the likelihood of long-term success. Individuals who are overweight should aim to lose about one-half to two pounds per week. The safest and most effective way to lose weight is to reduce the amount of calories in the diet and increase physical activity. Individuals should eat sensible portions of foods that are well-balanced.<\/li>\n\n\n\n
- In serious<\/strong>\u00a0cases when obesity is causing life-threatening conditions or when all other options have failed, surgical weight-loss procedures (called bariatric surgeries) may be considered. However, individuals must meet specific criteria to qualify for weight-loss surgery. In addition, bariatric surgeries, like all surgeries, have potential health risks. Patients should discuss the potential risks and benefits with their healthcare providers before making any decisions about medical treatments.<\/li>\n\n\n\n
- Exercise programs<\/strong>: Patients who are overweight or obese are encouraged to exercise. Research shows that regular exercise can help individuals live longer, healthier lives. Exercise can help prevent illnesses, such as heart disease, stroke, diabetes, and cancer.<\/li>\n\n\n\n
- In general,<\/strong>\u00a0overweight patients should participate in 45-60 minutes of moderate exercise (e.g. brisk walking or jogging) each day in order to prevent becoming obese. Patients who were formerly obese are encouraged to participate in 60-90 minutes of moderate exercise each day along with a healthy, well-balanced diet, in order to prevent gaining the weight back.<\/li>\n\n\n\n
- Not everyone\u00a0<\/strong>can perform intense types of exercise, such as tennis or running. The American Academy of Family Physicians recommends that individuals who are pregnant or have bone disease or nerve injuries participate in low-impact forms of exercise, such as walking or swimming. Individuals who are overweight or obese may have serious health conditions that limit the type or amount of exercise they can perform. Therefore, patients should talk to their healthcare providers before starting a new exercise plan, especially if they are pregnant, elderly, or have a critical illness or injury. A healthcare provider can work with a patient to design an individualized and safe exercise program.<\/li>\n\n\n\n
- Healthy diet<\/strong>: In addition to regular exercise, a healthy diet is also important. Individuals should eat well-balanced meals that are sensible portions. The U.S. government issued a revised food pyramid in 2005 to help Americans choose healthier eating habits. The new, updated food pyramid provides 12 different models based on daily calorie needs, ranging from 1,000-calorie diets for toddlers to 3,200-calorie diets for teenage boys..<\/li>\n\n\n\n
- Appetite suppressants<\/strong>: Appetite suppressants are medications, herbs, or supplements that decrease appetite or make the individual feel full.<\/li>\n\n\n\n
- Some doctors prescribe appetite-suppressant medications to help treat obese individuals. Most individuals who take these medications initially lose between five and 22 pounds. Weight loss is usually greatest during the first few weeks or months of treatment. After about six months, the patient\u2019s weight usually levels off. However, most people gain the weight back once they stop taking the medications.<\/li>\n\n\n\n
- Appetite suppressants can be taken short-term (a few weeks to a few months) or long-term (one year or more), depending on the specific medication prescribed. Diethylpropion (Tenuate\u00ae), a short-term medication, may increase blood pressure. Phentermine (Fastin\u00ae), another short-term medication, has been taken off the market due to increased risk for heart valve disease.<\/li>\n\n\n\n
- Many appetite suppressants are available over-the-counter. These products can be purchased at health food stores, local pharmacies, or nutrition stores. For instance, an herb called hoodia may cause individuals to feel full. As a result, patients may eat less food. However, no studies have been performed in humans to determine if hoodia is safe and effective in humans.<\/li>\n\n\n\n
- Dietrine Carb Blocker with Phase 2\u00ae is also available over-the-counter. This product is made with an ingredient from white kidney beans that may prevent the body from storing sugar as fat in the body.<\/li>\n\n\n\n
- While some side effects of U.S. Food and Drug Administration (FDA) approved medications are mild, and may usually go away as treatment is continued, some side effects may be severe and long-lasting. Symptoms may include sleeplessness and\/or nervousness. There have also been reports of serious and deadly reactions to appetite suppressants, including primary pulmonary hypertension. Several previously approved drugs, such as phentermine (Fastin\u00ae), have caused heart valve disease in patients, and are no longer available.<\/li>\n\n\n\n
- Other medications<\/strong>: Orlistat (Xenical\u00ae) is a lipase inhibitor, which reduces the amount of fat the body can absorb, and is used as long-term medication. About 30% of the fat from foods is excreted instead of being absorbed. Alli\u00ae is a reduced-strength form of orlistat (Xenical\u00ae) currently available, thus it also functions in weight loss by decreasing fat absorption. Sibutramine (Meridia\u00ae), also a long-term medication, aids in weight loss by blocking the reuptake of the neurotransmitters serotonin and norepinephrine. These long-term medications may be taken for several months or years. Some individuals may need to take them their entire lives.<\/li>\n\n\n\n
- Gastric bypass surgery<\/strong>: Gastric bypass surgery, which uses bands or staples to create food intake restriction, is the most common weight loss surgery. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and the patient also feels full for a longer time. Next, a section of the small intestine is attached to the pouch. This allows food to bypass part of the intestine, resulting in fewer calories being absorbed.<\/li>\n\n\n\n
- This surgery is often performed in those who have a BMI =40 (extremely obese) or in patients that have BMIs that are 35-39.9 along with weight-related health problems such as diabetes or high blood pressure.<\/li>\n\n\n\n
- Surgical candidates go through an extensive screening process. Not everyone who meets the criteria for the surgery is psychologically or medically ready for the surgical procedure. A team of professionals, including a physician, dietitian, psychologist, and surgeon, evaluate whether the surgery is appropriate. Following surgery, physical, nutritional and metabolic counseling are given to prevent nutritional deficiencies. Lifelong use of nutritional supplements such as multivitamins, vitamin B12, vitamin D, and calcium is recommended.<\/li>\n\n\n\n
- Over two years, gastric bypass surgery patients have been shown to lose two-thirds of excess weight. The improvements observed in type 2 diabetes, high blood pressure, and high blood cholesterol may significantly decrease the risk of heart disease in individuals who have undergone gastric bypass surgery compared to those treated through other means. Gastric bypass surgery has also been shown to improve mobility and quality of life for people who are severely overweight.<\/li>\n\n\n\n
- However, individuals who continue to overeat after undergoing the surgery may stretch out the pouch. As a result, the stomach may become as large as it was before surgery, and the patient may gain back weight.<\/li>\n\n\n\n
- There is a risk of death during gastric bypass surgery. The risk varies depending on age, general health, and other medical conditions.<\/li>\n\n\n\n
- If the contents of the stomach leak out of one of the staple lines, the patient will receive antibiotics to prevent an infection. Most cases heal with time. Sometimes, the leak can be serious enough to require emergency surgery.<\/li>\n\n\n\n
- Excess weight places extra stress on the chest cavity and lungs. As a result, there is a higher risk of developing pneumonia during post-operative recovery when the patient is lying down.<\/li>\n\n\n\n
- Narrowing of the opening between the stomach and small intestine has occurred. This rare complication may require either an outpatient procedure to pass a tube through the mouth to widen the narrowed opening or corrective surgery.<\/li>\n\n\n\n
- Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness, and sweating.<\/li>\n\n\n\n
- Other common complications include dehydration, gallstones, bleeding stomach ulcers, hernia at the incision site, and intolerance to certain foods.<\/li>\n\n\n\n
- Liposuction<\/strong>: Liposuction is the most frequent cosmetic operation in the United States in which fat tissue is removed. Relatively small amounts of total body fat can be removed safely. However, little weight is lost. Unless the patient makes lifestyle changes, that include regular exercise and a healthy diet, the weight will return. Therefore, liposuction is categorized as a cosmetic surgery rather than a weight loss surgery.<\/li>\n\n\n\n
- Adjustable gastric banding<\/strong>: A surgical procedure called gastric banding may also be performed. This surgery is designed to make the patient feel full quicker so he\/she will eat less and lose weight. During the procedure, the surgeon uses an inflatable band to partition the stomach into two parts. The surgeon then wraps the band around the upper part of the stomach and pulls it tight, like a belt, creating a tiny channel between the two pouches. The band keeps the opening from expanding and is designed to stay in place indefinitely. However, it can be adjusted or surgically removed if necessary. Most surgeons perform this operation using a laparoscope.<\/li>\n\n\n\n
- Biliopancreatic diversion<\/strong>: During a surgical procedure, called biliopancreatic diversion, a portion of the stomach is removed. The remaining pouch is connected directly to the small intestine but completely bypasses the small intestine, where most nutrient absorption takes place. This weight-loss surgery offers sustained weight loss, but it presents a greater risk of malnutrition and vitamin deficiencies that require close monitoring.<\/li>\n\n\n\n
- Some patients may require vitamin and\/or nutritional supplements after the surgery. Other possible complications include infection, blood clots in the lung (called pulmonary embolism), as well as stomach contents leaking into the abdominal cavity.<\/li>\n\n\n\n
- Vertical banded gastroplasty<\/strong>: This operation divides the stomach into two parts, limiting space for food and forcing the patient to eat less. There is no bypass. Using a surgical stapler, the surgeon divides the stomach into upper and lower sections. The upper pouch is small and empties into the lower pouch, the rest of the stomach. Surgeons use this procedure less frequently than gastric bypass partly because it does not lead to adequate long-term weight loss.<\/li>\n\n\n\n
- Jaw wiring<\/strong>: Jaw wiring is another option, although it is used infrequently. This is a form of food intake restriction for temporary use in patients who do not have breathing problems. During the procedure, the patient\u2019s jaw is wired shut. While the jaw is wired, the patient is only able to consume liquid nutrition through a straw. The wires are typically removed every four to six weeks to allow the patient to exercise the jaw. Treatment may last anywhere from three to six months. Individuals regularly rinse their mouths with mouthwash and use antiseptic wipes on the front of their teeth. When the wires are removed, the patient can brush his\/her teeth.<\/li>\n\n\n\n
- It is recommended that individuals carry wire cutters with them at all times in case of an emergency such as the need to vomit. In general, breathing is not inhibited while the jaw is wired. However, activities that cause deep breathing, such as aerobic exercise, should be avoided.<\/li>\n\n\n\n
- Although jaw wiring can be effective for short-term weight loss, weight regain occurs soon after the wires are removed. Therefore, it is not considered a conventional weight-loss procedure.<\/li>\n\n\n\n
- Antidepressants<\/strong>: Depression is commonly associated with obesity. Antidepressants may be prescribed to treat depression in some patients. Drugs called selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressant used. Commonly prescribed SSRIs include fluoxetine (Prozac\u00ae), fluvoxamine (Luvox\u00ae), sertraline (Zoloft\u00ae), and paroxetine (Paxil\u00ae). Less commonly prescribed antidepressants include clomipramine (Anafranil\u00ae), mirtazapine (Remeron\u00ae), amitriptyline (Elavil\u00ae), and bupropion (Wellbutrin\u00ae). Side effects may include nausea, nervousness, insomnia, diarrhea, rash, agitation, or problems with sexual arousal or orgasm.<\/li>\n<\/ul>\n\n\n\n
Prevention<\/strong><\/h2>\n\n\n\n
- \n
- Awareness<\/strong>: Individuals should regularly visit their healthcare providers and know what their healthy weight should be. Individuals should also regularly weigh themselves so they can make lifestyle changes if they start to gain weight.<\/li>\n\n\n\n
- Individuals who are overweight or obese should be aware of the health risks associated with these conditions, including high blood pressure, high cholesterol, diabetes, heart disease, stroke, and diabetes. To prevent these complications, overweight individuals should make lifestyle changes to promote weight loss.<\/li>\n\n\n\n
- Exercise<\/strong>: Regular exercise can help individuals maintain a healthy weight. It has also been shown to control diabetes, reduce stress, and reduce the risk of heart disease and stroke. Thirty minutes daily of exercise is normally recommended. Patients should talk to their healthcare providers before starting new exercise programs.<\/li>\n\n\n\n
- Diet<\/strong>: Eating a healthy and well-balanced diet is essential to maintaining a healthy weight. A healthy diet should include five or more daily servings of fruits and vegetables, foods rich in soluble fiber (such as oatmeal and beans), foods rich in calcium (such as dairy products, spinach), soy products (such as tempeh, miso, tofu, and soy milk), and foods rich in omega-3 fatty acids, including cold-water fish (such as salmon, mackerel, and tuna).<\/li>\n\n\n\n
- Stress management<\/strong>: Because stress may increase the risk of becoming obese, stress management is recommended.<\/li>\n<\/ul>\n\n\n\n
Food and Metabolism<\/h2>\n\n\n\n
The amount of energy that is needed or ingested per day is measured in calories. The nutritional\u00a0Calorie (C)\u00a0is the amount of heat it takes to raise 1 kg (1000 g) of water by 1 \u00b0C. This is different from the calorie (c) used in the physical sciences, which is the amount of heat it takes to raise 1 g of water by 1 \u00b0C. When we refer to \u201ccalorie,\u201d we are referring to the nutritional Calorie.<\/p>\n\n\n\n
On average, a person needs 1500 to 2000 calories per day to sustain (or carry out) daily activities. The total number of calories needed by one person is dependent on their body mass, age, height, gender, activity level, and the amount of exercise per day. If exercise is a regular part of one\u2019s day, more calories are required. As a rule, people underestimate the number of calories ingested and overestimate the amount they burn through exercise. This can lead to ingestion of too many calories per day. The accumulation of an extra 3500 calories adds one pound of weight. If an excess of 200 calories per day is ingested, one extra pound of body weight will be gained every 18 days. At that rate, an extra 20 pounds can be gained over a year. Of course, this increase in calories could be offset by increased exercise. Running or jogging one mile burns almost 100 calories.<\/p>\n\n\n\n
The type of food ingested also affects the body\u2019s metabolic rate. The processing of carbohydrates requires less energy than the processing of proteins. The breakdown of carbohydrates requires the least amount of energy, whereas the processing of proteins demands the most energy. In general, the amount of calories ingested and the amount of calories burned determines the overall weight. To lose weight, the number of calories burned per day must exceed the number ingested. Calories are in almost everything you ingest, so when considering calorie intake, beverages must also be considered.<\/p>\n\n\n\n
To help provide guidelines regarding the types and quantities of food that should be eaten every day, the USDA has updated its food guidelines from MyPyramid to MyPlate. They have put the recommended elements of a healthy meal into the context of a place setting of food. MyPlate categorizes food into the standard six food groups: fruits, vegetables, grains, protein foods, dairy, and oils. The accompanying website gives clear recommendations regarding the quantity and type of each food that you should consume each day, as well as identifying which foods belong in each category. The accompanying graphic (Figure 1) gives a clear visual with general recommendations for a healthy and balanced meal. The guidelines recommend \u201cMake half your plate fruits and vegetables.\u201d The other half is grains and protein, with a slightly higher quantity of grains than protein. Dairy products are represented by a drink, but the quantity can be applied to other dairy products as well.<\/p>\n\n\n
\n<\/figure>\n<\/div>\n\n\n
Figure 1. MyPlate<\/strong><\/p>\n\n\n\n
The U.S. Department of Agriculture developed food guidelines called MyPlate to help demonstrate how to maintain a healthy lifestyle.<\/p>\n\n\n\n
Self Care<\/h2>\n\n\n\n
We could all use a little self-care right now.\u00a0Unfortunately, many people\u2019s usual coping strategies are simply unavailable\u00a0at the moment, whether that\u2019s socializing with friends or family, playing or watching sports,\u00a0going to the gym,\u00a0or enjoying a little retail therapy.\u00a0\u00a0<\/p>\n\n\n\n
On the upside, there are still plenty of ways that you and your clients can practice self-care during these troubling times, even if you\u2019re under orders to stay at home as much as possible.\u00a0\u00a0<\/p>\n\n\n\n
Practice\u00a0Mindfulness<\/strong>\u00a0<\/p>\n\n\n\n
Mindfulness practices have been shown to offer a host of physical, psychological, and social benefits that can lead to decreases in perceived stress, improved self-efficacy, enhanced emotional regulation, and a greater sense of meaning and purpose in life.\u00a0<\/p>\n\n\n\n
Relaxation counters the short-term effects of stress by decreasing blood pressure, heart rate, respiration rate, and muscle tension. Over the long term, relaxation can mitigate certain health issues, including hypertension, anxiety, and even cancer (Esch,\u00a0Fricchione\u00a0& Stefano, 2003; Keefer & Blanchard, 2002),\u00a0in addition to\u00a0improving\u00a0overall health and healing.\u00a0\u00a0<\/p>\n\n\n\n
Here are some mindful practices that you and your clients might want to try:\u00a0<\/p>\n\n\n\n
- \n
- Mindful movement, such as yoga, tai chi, qigong, walking, or cycling:<\/em>\u00a0Your clients might be surprised to learn that one of the two common aspects of practices that elicit relaxation is repetition (Benson &\u00a0Klipper, 1975), as is experienced during\u00a0exercises like\u00a0walking and cycling.\u00a0<\/li>\n\n\n\n
- Meditation:<\/em>\u00a0This can include any of\u00a0several\u00a0types of meditation, which you should encourage your clients to research. While some people thrive with an ongoing transcendental meditation practice, others may simply want\u00a0a way to get\u00a010 or 15 minutes of quiet\u00a0time or prayer\u00a0during a stressful period. This is where the second aspect of practices that elicit relaxation comes in\u2014a passive disregard of thoughts as they arise (Benson &\u00a0Klipper, 1975).\u00a0\u00a0<\/li>\n\n\n\n
- Breathing exercises:<\/em>\u00a0Again, there are\u00a0several\u00a0breathing exercises that clients can explore, including diaphragmatic breathing and pursed-lip breathing.\u00a0<\/li>\n<\/ul>\n\n\n\n
- Meditation:<\/em>\u00a0This can include any of\u00a0several\u00a0types of meditation, which you should encourage your clients to research. While some people thrive with an ongoing transcendental meditation practice, others may simply want\u00a0a way to get\u00a010 or 15 minutes of quiet\u00a0time or prayer\u00a0during a stressful period. This is where the second aspect of practices that elicit relaxation comes in\u2014a passive disregard of thoughts as they arise (Benson &\u00a0Klipper, 1975).\u00a0\u00a0<\/li>\n\n\n\n
- In serious<\/strong>\u00a0cases when obesity is causing life-threatening conditions or when all other options have failed, surgical weight-loss procedures (called bariatric surgeries) may be considered. However, individuals must meet specific criteria to qualify for weight-loss surgery. In addition, bariatric surgeries, like all surgeries, have potential health risks. Patients should discuss the potential risks and benefits with their healthcare providers before making any decisions about medical treatments.<\/li>\n\n\n\n
- Heart disease<\/strong>: Obese individuals have an increased risk of developing high blood pressure. This is because the extra fat tissue, like other tissues in the body, requires oxygen from the blood. Therefore, the circulatory system is strained and the heart rate increases as it tries to supply a larger-than-normal body with enough oxygenated blood.<\/li>\n\n\n\n
- Depression<\/strong>: Individuals who are obese often suffer from depression. This may occur if the patient\u2019s weight limits his\/her ability to perform certain activities. Depression may also occur if the patient has poor self-esteem as a result of his\/her weight.<\/li>\n\n\n\n
- Poor diet<\/strong>: Individuals who regularly consume foods that are high in calories and saturated fats have an increased risk of becoming obese. Examples of foods and beverages that may lead to obesity include fast food, fried food, sodas, candy, and desserts.<\/li>\n\n\n\n
- General<\/strong>: There are many potential causes of obesity. Some patients may be obese for multiple reasons.<\/li>\n\n\n\n