Can we change our weight for the better and for good?
Can we change the body weight for the better and for good? Or can we accept it and still be healthy and happy? Can we tell when it is best to change and when to accept? 
From Article's Sponsor:
Current medical trends are finding that unhealthy lifestyle scan result in being overweight as well as contributing to many other health problems. This is contrary to the popular belief that being overweight was actually the cause of these problems. Diseases previously blamed on excessive weight are now seen as rooted in an unhealthy lifestyle with overweight being one of the results, not causes. In 1998, the New England Journal of Medicine published an editorial titled:
"Losing Weight -- An ill-fated New Year's Resolution" that caused fierce debates among medical professionals, health educators, and in the mass media.
Now, that new year is beginning once again, can we tell that any significant changes have occurred in this field?
Yes, we can!
First, what was the editorial all about?
The article began with an aggressive outline of the methods that up to 35 % of all Americans are using"...to reach the elusive American ideal -- to be slim, fit, and forever young."
These weight loss methods are widely known:
All these attempts are costly: an estimated annual spending on weight loss is $30 billion to $50 billion yearly, and it is wasted to say the least, stated the NEJM: Olestra causes a loss of essential nutrients, dexfenfluramine is associated with potentially fatal pulmonary hypertension, and fen-phen may be associated with serious valvular disease of the heart.So what should one do to fight the harmful consequences of being overweight? Not so harmful if you look at it strictly scientifically, said the NEJM: |
For example, amount of obese people may be misleadingly high because overweight people are more likely to be sedentary and of low socioeconomic status.
Thus, although some claim that every year 300,000 deaths un the United States are caused by obesity, that figure is by no means well established.
But how about weight loss as a heavily propagandized method to reach better health? The editorial stated that a few well established facts linking obesity to increased health risks could never really prove that the benefits of weight loss are equal to the benefits of being initially and permanently lean:
"It does not follow that losing weight will reduce the risk. We simply do not know...
...whether a person who loses 20 lb. will thereby acquire the same reduced risk as a person who started out 20 lb. lighter."The conclusion? Avoiding weight gain in the first place:
Undoubtedly, the best public health approach is to concentrate on measures to prevent obesity.
A progressive fattening of the population is not inevitable. We need to doa better job of educating people about healthful diets, including the calorie content of common foods, without promoting fetishes. Encouraging lifelong, regular exercise in children may well have the greatest effect in terms of preventing obesity, as well as numerous other benefits.
But what should those who are already overweight do? Well, said the authors of the editorial, it depends: the obese are not created equal:
Many overweight persons are happy and in reasonably good health...
...some overeat because they are depressed, and still others are depressed because they are overweight. In our view, doctors should recommend weight loss if a patient is suffering from health problems that can be ameliorated by weight loss, such as hypertension, diabetes, or osteoarthritis. Finally, doctors should do their part to help end discrimination against overweight people in schools and workplaces. We should also speak out against the public's excessive infatuation with being thin and the extreme, expensive, and potentially dangerous measures taken to attain that goal.
This concluded the editorial and ignited the year-long debates that were generally uniform in repeating the much heard logic: being overweight is bad and losing weight is good. However, not much more factual fortification of the benefits of losing weight followed. Quite to the contrary, one of the correspondents, Dr. Glenn A. Gaesser, from the University of Virginia, Charlottesville, contributed the data on the prominent health benefits of positive life style changes with little if any mention at all of weight loss:
When 72 obese men and women consumed a low fat diet high in complex carbohydrates and fiber and exercised daily for three weeks, significant reductions were observed in most vital blood readings (Am J Cardiol 1992;69:440-4).The average weight loss in these subjects was less than 5 % of initial body weight.
The results of the Dietary Approaches to Stop Hypertension trial, published in the Journal last year, (N Engl J Med1997;336:1117-24) demonstratedthat subjects could reduce their blood pressure within two weeks by consuming a healthier diet, without losing weight.
What's more, the editors were even reprimanded for not emphasizing the dangers of being underweight ( NEJM, 1998, v. 338, No.16):
In addition to remembering that" Above all else, do no harm," we would be wise to heed one of Hippocrates' more insightful, if less well known, aphorisms:
"Do not allow the body to attain extreme thinness, for that, too, is treacherous, but bring it only to a condition that will naturally continue unchanged, whatever that may be."
0 Comments:
Post a Comment
<< Home