What You Should Know Before You Start A Weight Loss Plan

"What You Should Know Before You Start A Weight Loss Plan"

The measurements that count :

Know your Body Mass Index (BMI)Over the past twenty years, Americans have become more familiar with specific measurements related to health, such as cholesterol levels and blood pressure readings. When it comes to weight-related health risks, there are three important numbers that you should know. The first is your actual weight in pounds; the second is your Body Mass Index, or BMI; and the third is your waist measurement.

Your BMI is based on your height and weight. Doctors consider BMI to be a better measure of health risk than your actual weight in pounds. In fact, the medical terms "overweight" and "obesity" are based on BMI values. A BMI of between 25 and 30 is defined as overweight, and a BMI of 30 or more is considered obese. The higher your BMI, the greater your risk of developing a weight-related illness, such as type 2 diabetes or heart disease.

Physicians refer to certain measurements that provide valuable information about a patient’s condition as "vital signs." Standard vital signs include blood pressure, pulse rate, breathing rate and body temperature. The AAFP Panel on Overweight and Obesity recommends that the BMI become a new vital sign, to be recorded during routine visits to the doctors' office. That is because, like blood pressure, a BMI reading that is too high should be recognized and treated.

What is your BMI? Are you overweight or obese?

You can find out by using the BMI Calculator or BMI Chart . The same BMI scale applies to both men and women.

What is your waist circumference?

Body fat that accumulates in the stomach area (described as "abdominal obesity") is more of a health risk than body fat that builds up in the buttocks and thigh areas. For this reason, your waistline provides valuable information about your risk for heart disease, high blood pressure, high cholesterol, and type 2 diabetes. Doctors consider a waist circumference too high if it is 40 inches or more in men, or 35 inches or more in women.

Like the BMI, the AAFP Panel on Overweight and Obesity recommends that the waist circumference be measured during routine check-ups. The proper location to measure the waist is at the smallest spot under the rib cage and above the belly button.

Consulting your doctor about controlling your weight:

Talk to your doctor about healthy eating and physical activities that can help you lose weight, improve your fitness and decrease the chances of developing heart disease, high blood pressure or type 2 diabetes. Be sure to set realistic goals. Small changes can make a surprising difference in your health. Your doctor can offer practical suggestions that do not require a complete overhaul of your current way of life. In some cases, your physician may refer you to a nutrition specialist, such as a registered dietitian, for in-depth counseling about food choices. You may want to start the conversation by asking a few questions of your own. For example:

*Ask your doctor for any educational brochures on topics such as eating habits, counting calories or physical activity.
*Request to have your BMI measured and ask your doctor what it means with regard to your health status .
*Have your waist circumference measured and discuss the significance of the measurement with your doctor .
*Be prepared to describe your current diet and activity level and what changes might promote better health .
*Think about how much change you're willing to make before you visit your doctor .
*Ask if specialists are available on your health plan and in your area, such as dietitians or physical trainers .

What is Metabolic Syndrome?
A high waist circumference can be one sign of a condition called Metabolic Syndrome. Although most people have never heard of it, this syndrome is quite common; it affects about one out of every four adults in the United States. Metabolic Syndrome often progresses to type 2 diabetes—and treating the syndrome can help prevent this form of diabetes.

A person has Metabolic Syndrome if they have at least 3 of the 5 conditions listed in the table below. If you think you may have Metabolic Syndrome, it is important to discuss the possibility with your doctor so that you can undergo the appropriate diagnostic tests. Treatments for Metabolic Syndrome involve basic lifestyle changes, such as losing weight, eating a healthier diet, and increasing your activity level. Your doctor can help you develop a specific plan for making the necessary changes.

More Information on Metabolic Syndrome
Condition:

• Condition-Abdominal obesity(measured by waist circumference)
  Men: greater than 40 inches
  Women: greater than 35 inches

Treatment: Lifestyle Changes-

Weight loss
Increased physical activity

Practical Suggestions-

Cut 250 calories a day*; lose 1/2 pound a week; aim for losing 20 pounds in a year
30 minutes of moderate activity 5 days a week

• Condition-High blood pressure
  130/85 mm Hg or greater

Treatment: Lifestyle Change-Weight lossReduced salt intake
More fruits and vegetablesLow-fat dairy products

Practical Suggestions-Aim for 20-pound loss/yearSalt shaker off the table; no salt when cookingGet at least 5 servings/dayGet 3 glasses of skim milk, low-fat yogurt, cheese/day.

• Condition-High blood sugar after fasting
  110 mg/dL or greater

Treatment: Lifestyle Changes-Weight lossIncrease soluble fiber

Practical Suggestions-Aim for 20-pound loss/year*Replace white bread with brown bread, whole grains, cereals

*(For example: replacing two 2-ounce cans of sugar sweetened soda with a beverage sweetened with a sugar substitute, such as sucralose (SPLENDA®) can cut over 350 calories per day.)

How to get active?
Regular physical activity has been shown to help prevent heart disease, type 2 diabetes, osteoporosis and other chronic conditions. It is important for maintaining good health in all adults and children, regardless of whether their weight is a problem or not. As the following suggestions make clear, lifestyle changes do not have to be drastic. Simple measures applied every day can make a significant difference over time. Here are a few examples:

1. Increase whatever physical activity you are currently doing by adding 10 minutes a day, or increase the intensity from low to moderate. (See the box below for an idea of different activity intensity levels.)


2. Limit time spent online, watching TV and playing video games to less than two hours total per day.


3. Take the stairs instead of the elevator.


4. Park at the far end of the parking lot and walk to your destination, rather than parking as close as possible. You can also get off the bus one stop earlier and walk the rest of the way.


5. Do more household chores (such as dusting, vacuuming or weeding).


6. Walk or run with the dog and/or the kids.


7. Use an exercise machine (such as a treadmill or bike) while watching TV.


8. Take "active" vacations—go hiking or ride bicycles.


9. Walk to do errands (such as to the grocery store or post office) instead of driving.


10. Buy a pedometer, which measures how many steps you take each day. Gradually increase your daily number of steps. (Pedometers can be purchased at sporting good stores.)


11. Don't be embarrassed about exercising!

How Active Are You?

"Moderate physical activity"

1. Walking a mile in 15-20 min (3-4 mph)


2. Treading water


3. Bicycling (10 mph)


4. Dancing or tai chi


5. Yard work/gardening


6. Hiking


7. Vacuuming


8. Playing actively with children

"Hard physical activity"

1. Walking or jogging (12 min/mile)


2. Swimming laps (light effort)


3. Bicycling (12 mph)


4. High impact aerobics


5. Mowing lawn with hand mower


6. Playing doubles tennis


7. Moving furniture


8. Weight lifting

"Very hard physical activity"

1. Jogging (<10>
   
2. Swimming laps (vigorous effort)


3. Bicycling (> 14 mph)


4. Step aerobics (6- to 8-in steps)


5. Digging a ditch


6. Playing singles tennis


7. Playing basketball or soccer


8. In-line skating

Some Medical Conditions that May Make it Difficult to

Lose Weight:

condition**

1.Hormonal disorders, Polycystic ovarian disease, Cushing's disease, Diabetes, Hypothyroidism
2.Congestive heart failure, Idiopathic hypertrophic cardiomyopathy, Heart valve disorders

3.Obstructive sleep apnea, Upper airway resistance syndrome,

4.Eating Disorders, Bulimia, Carbohydrate craving syndrome.

Medications that May Cause Weight Gain:

• Allergies:
  Antihistamines (such as Claritin, Allegra)


• High blood pressure:
  Alpha blockers (such as Hytrin, Cardura)Beta blockers (such as Betapace, Blocadren, Tenormin)Methyldopa (Aldoment).


• Contraception:
  Progestins (a component of certain oral contraceptives, such as Lo/Ovral and Ortho-Tri-Cylcen).


• Depression:
  Tricyclic antidepressants (such as Norpramin and Sinequan)


• Diabetes:
  InsulinSulfonylureas (such as Diabinese and Glucotrol).


• Epilepsy:
  Valproate (such as Depakene)


• Manic-depressive illness:
  Lithium (such as Eskalith and Lithobid)


• Schizophrenia:
  Neuroleptics (such as Zyprexa and Risperdal).

Can diet pills and supplements help with weight loss?

Although diet drugs may help you lose weight at first, they usually don't help you keep the weight off and may have damaging side effects. Most diet pills have not been tested by the Food and Drug Administration, which means you can't be sure if the drugs are safe. Taking drugs also does not help you learn how to change your eating and exercise habits. Making lasting changes in these habits is the way to lose weight and keep it off.

Perimenopausal Women and the Use of Very-Low-Dose Birth Control Pills

What is perimenopause?

Menopause is when your periods stop completely. Perimenopause is the term for the period "around the time of menopause." The perimenopausal years are the 3 to 5 years before your final period. The timing of actual menopause is different for each woman. Although some women stop having periods in their 30s, the average age is the early 50s. So, perimenopausal women are usually in their 40s or early 50s.

What are very-low-dose birth control pills?

Very-low-dose birth control pills (brand names: LoEstrin 1/20, Alesse) have less estrogen than regular birth control pills. These pills typically have 20 micrograms of estrogen, compared with 30 to 50 micrograms of estrogen in regular birth control pills.

Why would I use very-low-dose birth control pills during perimenopause?
If you're still having periods, very-low-dose birth control pills prevent pregnancy and may also have some health benefits. They can reduce hot flashes and vaginal dryness (which are symptoms of perimenopause and menopause). Very-low-dose birth control pills can also help regulate your periods if they are heavy or irregular. They may also prevent bone loss (which occurs during menopause), and helps protect you from osteoporosis. Another potential benefit is protection from cancer of the ovary and uterus. The lower dose of estrogen in these pills (compared to regular birth control pills) is believed to be safer for women who are perimenopausal.

Who should not take very-low-dose birth control pills?
Perimenopausal women who have a history of deep blood clots, breast cancer or heart disease should not take very-low-dose birth control pills. Perimenopausal women who smoke also should not take them.

How are very-low-dose birth control pills taken?
Very-low-dose birth control pills are taken the same way as other birth control pills, which is orally. They are usually started on the first Sunday after your period starts. If you're perimenopausal but you aren't having regular periods, you can probably take a hormone called medroxyprogesterone acetate (one brand name: Provera) to start your period. (Your doctor will check you for pregnancy first.)These pills are taken for 21 days in a row and then not taken for 7 days. During the 7 days without medicine, your period will start. Seven days later, you will start taking the very-low-dose birth control pills for another cycle.

Do very-low-dose birth control pills have any side effects?
The hormone doses in these pills are so low that most women do not experience side effects. You might have breast tenderness, nausea, higher blood pressure or headaches. It's also possible that these very-low-dose birth control pills may not regulate your periods. If you're having any abnormal bleeding, it might get worse. There is also evidence that estrogen slightly increases your risk of breast cancer, so you should talk with your doctor if you have questions or concerns.

If I'm taking birth control pills, how will I know when menopause starts?
You and your doctor will decide together how long you should take this medicine. You can stop taking very-low-dose birth control pills any time. The decision to change from the low-dose birth control pills to estrogen replacement therapy or another type of treatment for menopause is usually made around the age of 49 to 52. Your doctor can also measure a hormone called FSH (follicle-stimulating hormone) to see if you're in menopause.Talk to your doctor to see if very-low-dose birth control pills might be a good idea for you during your perimenopausal years.