Obesity is becoming a global problem. The majority of Australians are overweight, and 20% are obese. Professor Jeffrey Hamdorf talks about the problems caused by obesity and the possible treatments for obesity.
You would probably be aware that the health problems associated with excessive weight have been increasing in the Western world, particularly over the past two decades or so. The health problems we are talking about here include an increased risk of heart disease and high blood pressure (which can in turn cause stroke); also, there is a very high risk of developing diabetes and other problems with breathing such a sleep apnoea and asthma, and some digestive disorders as well. Overweight people have problems with mobility and they are at risk of developing diabetes affecting, especially, the weight bearing joints, like the ankles and knees. Fertility is affected, especially in women; this means that women which are overweight have a smaller chance of getting pregnant.
Obesity is regarded as morbid obesity when it reaches a point where there is a significant risk to health – and we can calculate and index for people. This is called the body mass index and it takes into account your weight and height. We are talking about morbid obesity, but this relates to people who have significant illnesses related to their weight, or who are in the order of 40 kilograms overweight. Obesity is a chronic illness and it does require significant treatment.
Now the reasons for obesity are many – it’s not simply a result of over eating. Once a patient becomes morbidly obese, a change in lifestyle – such a calorie-controlled diet – and increasing exercise is really important, but these have a limited effect on morbid obesity. Patients just can’t seem to lose enough weight using a diet approach alone to correct their health problems.
The principals for those that are overweight, but perhaps not obese, include a supervised diet and exercise program and this is entirely appropriate and there are many of these programs around. Unfortunately, these are not entirely suitable for obese patients, and particularly morbidly obese patients, because in over 90% of cases the weight lost in supervised programs is resumed within a couple of years. Once a patient’s weight is classified in the obese category then diet and lifestyle changes are not enough and medications may need to be added. There are two major medications in this area; they include Reductil, or Sebutramine, and Xenical, or Orlistat. These medications have to be offered under medical supervision.
Now another method which is successful in obese patients is cognitive behavioural therapy. This is group therapy supervised by a clinical psychologist and it looks at the reasons behind the peoples’ troublesome eating habits. This is available in Australia through general practitioner initiated care plans, so a GP needs to organise it.
For those patients that have morbid obesity (those people who are more than 40 kg overweight) or that have health problems created or made worse by their weight, then surgery is the mainstay treatment. Surgical procedures are based on reducing the amount of food one is able to eat before fullness occurs, or – and these are called reductive procedures – an old fashioned gastric stapling and more recently, a laparoscopic adjustable band or lap band. With the laparoscopic banding, a silicone band is placed around the top part of the stomach creating a small upper pouch. The band can be made tighter or looser depending on the weight loss, and this operation is one that is almost always done using the keyhole technique. The band can be adjusted and can be reversed if necessary. This is a method that helps people keep a sensible calorie-controlled diet and if it is reversed, more patients will resume their weight rather quickly. Another method which is gaining some popularity is called a sleeve or tube gastrectomy where a part of the stomach is surgically removed so that one is able to eat less. None of these methods tell a patient what to eat so we need to be fairly conscious about diet and for all surgical care of weight loss, a team approach is necessary with advice for the patient coming from a physician as well as a surgeon, a dietician, and sometimes a psychiatrist or a psychologist as well. Some teams use an exercise physiologist or a specialist physiotherapist to help design supervised exercise programs according to patients' needs.
More extensive surgery includes a procedure, which is particularly popular in the United States, called a Roux-en-Y gastric bypass. In this operation, the stomach is cut at the top portion leaving a small pouch and this is then connected to the intestine lower down; only small amounts of food may be eaten and these small amounts of food may take some time before they get to the digestive part of the bowel. That means that if the patient eats the wrong sorts of foods then they would experience significant indigestion symptoms. In addition to this, they will require daily nutritional supplements such as vitamins and minerals. Surgery for weight loss is very successful in a patient who is well prepared and well motivated to succeed, and most patients can expect to lose up to 60% of their excess weight. We find that this helps to correct the diabetes very quickly, patients sleep better and are much more mobile, improving their quality of life. Surgery is an important part in weight control and it should only be considered where a multidisciplinary team is used to help supervise patient care.
For more information on measures of weight and nutrition, including GI, GL, BMI, WC and WHR, as well as some useful tools, see Measures of Nutrition and Weight.
For more information on obesity, health and social issues, and methods of weight loss, as well as some useful tools, see Obesity and Weight Loss.
This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.
If your GORD is mild it is likely that you will respond satisfactorily with simple lifestyle changes and over-the-counter antacids. In many cases, people are able to control their own symptoms and do not necessarily need to see a doctor. It is quite common for people to go to the doctor only when their symptoms become so severe that they interfere with daily functioning. However, it is important that you realise that reflux symptoms may be a marker of more serious underlying conditions. GORD can cause nasty complications, including oesophageal cancer, which need to be monitored throughout your treatment. In general, the longer you have symptoms of reflux, the greater risk you have for additional complications. 
Depending on the severity of your symptoms, your doctor may prescribe medications or recommend over-the-counter (OTC) preparations. These may be needed for a short time while you have symptoms or on a long-term basis, depending on the features of your symptoms. 
Reflux is a very common condition in children but the symptoms are often non-specific. To date there is no ideal method of diagnosing or treating the problem in infants and children. However, you may gain some comfort from knowing that the symptoms of reflux are extremely common and that the condition is not due to any fault on your part. Often simple reassurance from a medical practitioner is helpful in improving both your and your child's quality of life. 
Spinal cord stimulation (SCS) is an emerging, minimally invasive procedure used to treat chronic, refractory, neuropathic pain. Neuropathic pain is one of the most difficult medical conditions to treat; it is not the "normal" pain we associate with stubbing a toe or getting a paper cut – this is nocioceptive pain. Neuropathic pain is caused by abnormal nerve signalling in the nervous system and, as a result, commonly does not respond to most pain relief strategies. It is for this reason that SCS is a very exciting area of development and is becoming widely accepted for use in many areas of neuropathic pain management. SCS does not eliminate pain but creates a numbness called paraesthesia in the area. This results in a masking of the pain.
For more information on menopause, including symptoms and management of menopause, as well as some useful animations and videos, see Menopause.
Article Date: 11/4/2013 
Focus on your friends, not the food, and you'll enjoy eating out on a diet even more.© [2009] Jupiterimages Corporation Eating out on a diet doesn't have to be cause for panic. Sure, you hear about oversize restaurant portions and the plethora of fattening menu choices available all the time, but that doesn't mean dining out will doom your dieting efforts! Just use these 10 simple tips for eating out on a diet: Cram for tonight's dinner. Many eateries post their entire menu online so you can print it out for reference. If you often eat at "mom and pop" type restaurants that aren't online, call and ask for the menu to be faxed to you, or pick up a takeout menu on your next visit. Highlight the healthiest options for each menu and store them all in a central location. Then, when you are planning your next night out, take the time to decide on your dishes at home before you've been tempted by the sight of other choices. Order your main dish from the appetizer menu. Not only are appetizers more reasonably-portioned, they will save you some money as well. (This is a great way to save enough calories and cash to split dessert with someone!) Too peckish to be satisfied with just a starter? Order a side salad, too -- the fiber-rich veggies will round out your meal. Soup is super-filling, so it's an awesome appetizer add-on, too (just steer clear of cream-based ones).Beware these high-fat menu buzz words: Cream sauce, butter, oil, au gratin, breaded, Alfredo, battered or batter-dipped, "with gravy," or smothered. Unless you've spared yourself treats for several days and snacked on salad greens all day, these little "extras" aren't worth the extra calories.Modify the menu. In my neck of the woods, anything and everything can be batter-dipped and fried, so I make special requests all the time. Many restaurants will take your dietary needs into account so you'll be a happy customer and return. Don't hesitate to request anything on the menu to be prepared in a more diet-friendly and for sauces or dressings to be served on the side. It's not likely that you will be denied.The meat is on. As tempting as that bucket of fried chicken looked on the commercial before you left home, order poultry steamed, poached, roasted, broiled, boiled, grilled or baked. Ask for skinless chicken whenever possible or remove it yourself. If you do treat yourself to fried chicken, choose white meat as it has fewer calories than dark. Of course, chicken, chicken and more chicken gets old after a while, so if you're asking, "Where's the beef?" allow yourself red meat a few times a week -- just be sure to choose leaner cuts of meat like loin or flank.Keep tabs on that tubini. Endless pasta at your favorite Italian restaurant may be carb-lovers' heaven (Darn near nirvana for yours truly!), but it's a waist-widening trap for those of us who tend to overeat (How are you supposed to know when to say "when" if they keep bringing more?). As tempting as the great "value" for your money that infinitely-refilling pasta bowl seems, it's certainly not a bargain for your calorie budget. Order a portion-controlled main dish instead. "Ixnay" on the endless breadsticks, too! "Wrap it up, I'll take it!" You know you're at a nice restaurant when the server takes your plate away and wraps up your leftover food for you at the end of the meal. (And if you're in a really nice restaurant, you'll get the eating out equivalent of a balloon animal -- the tin foil swan!) To ensure you don't leave sans swan, keep temptation at bay and ask the server to wrap up half of your as soon as it is served.Take control of takeout. You don't have to swear off takeout when you're dieting -- there are many healthy options at ethnic restaurants. Portion control is key, though: Take out half of your takeout before dishing up your dinner, put the food in microwave containers and tuck it away in the fridge before you even start eating. (Instant will power and instant next-day lunch!)Banish buffets. Portion control can become a foreign concept for even the most determined dieter at an all-you-can-eat buffet. (Who can practice moderation when there are new, clean plates just beckoning to be filled?) The sheer variety of foods available at buffets is also daunting -- studies have shown that when we're given more choices, we tend to eat more without realizing it. Simply avoid buffet restaurants and you won't have to face this temptation.Mini meals are a must. It's smart to eat smaller meals during the day when you're planning to dine out. Just don't eat too sparingly, though -- you don't want to be so famished by the evening that you overeat. (It was a dark day when I ate too-mini mini meals and -- clearly ignoring my own tip number 9! -- visited a buffet in a ravenous state with a fellow waist-watcher ... the look of sheer horror on her face as I went for round number four is not something I will soon forget!) If mini meals don't tide you over, have a small, healthful snack in the afternoon to curb your appetite and you'll be much more in control come dinner time.