In summary, initial treatment for unexplained weight loss should be targeted at addressing identified risk factors, although evidence of benefit is limited. Medications that are not clearly required and that may be contributing to the weight loss should be discontinued or appropriate alternatives considered. The role for specific nutritional interventions targeted at increasing caloric intake and improving weight is unclear. There is also minimal evidence to support use of pharmacologic agents. Megestrol acetate may be effective for older adults living in care facilities when used in conjunction with feeding assistance, but further study is required.
Data Sources: A PubMed search was completed in Clinical Queries. Key terms: unintentional, involuntary, weight loss, geriatric, elderly, appetite stimulants, cachexia/drug therapy, and nutrition. The search included meta-analyses, randomized controlled trials, clinical trials, and reviews. Also searched were Essential Evidence Plus, the Agency for Healthcare Research and Quality evidence reports, Clinical Evidence, Google Scholar, and the Cochrane database. References from those sources were also searched. Search dates: January 2012 and March 2014.
Dr. Ryan Masters and Dr. Bruce Link at Columbia University’s Mailman School of Public Health, in collaboration with Dr. Daniel Powers at the University of Texas, published the results of the study online this week in the American Journal of Epidemiology.
For example, obesity is associated with increased risks of treatment-related lymphedema in breast cancer survivors (39) and incontinence in prostate cancer survivors treated with radical prostatectomy (40). In a large clinical trial of patients with stage II and stage III rectal cancer, those with a higher baseline BMI (particularly men) had an increased risk of local recurrence (41). Death from multiple myeloma is 50% more likely for people at the highest levels of obesity compared with people at normal weight (42).
Also, our busy lives make it harder to plan and cook healthy meals. For many of us, it’s easier to reach for prepared foods, go out to eat, or go to the drive-through. But these foods are often high in saturated fat and calories. Portions are often too large. Work schedules, long commutes, and other commitments also cut into the time we have for physical activity.
Obesity is best defined by using the body mass index. The body mass index is calculated using a person’s height and weight. The body mass index (BMI) equals a person’s weight in kilograms (kg) divided by their height in meters (m) squared. Since BMI describes body weight relative to height, it is strongly correlated with total body fat content in adults. An adult who has a BMI of 25-29.9 is considered overweight, and an adult who has a BMI over 30 is considered obese. A BMI of 18.5-24.9 is considered normal weight.
Adults: A healthy weight for adults is usually when your BMI is 18.5 to less than 25. To figure out your BMI, use the National Heart, Lung, and Blood Institute’s online BMI calculator and compare it with the table below. You can also download the BMI calculator app for iPhone and Android.
Adapted with permission from The clinical and cost-effectiveness of medical nutrition therapies: evidence and estimates of potential medical savings from the use of selected nutritional intervention. June 1996. Summary report prepared for the Nutrition Screening Initiative, a project of the American Academy of Family Physicians, the American Dietetic Association, and the National Council on Aging, Inc.
A condition in women characterized by irregular or no menstrual periods, acne, obesity, and excess hair growth. PCOS is a disorder of chronically abnormal ovarian function and hyperandrogenism (abnormally elevated androgen levels).
Hi Susan, thank you for bringing this up! There are many drug-nutrient interactions that are not mentioned here. It’s a good practice to ask your doctor or pharmacist about any interactions with medications you are taking. There are also some good resources out there on the topic. Here is one: Food Medication Interactions 18th Edition.
Waist circumference is a less-common method used to measure obesity in an individual. This simple measurement indicates obesity and morbid obesity in adults by measuring your waist. To find your waist circumference, wrap a tape measure around the area above your hip bone and below your rib cage.
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
With the onset of the Industrial Revolution it was realized that the military and economic might of nations were dependent on both the body size and strength of their soldiers and workers. Increasing the average body mass index from what is now considered underweight to what is now the normal range played a significant role in the development of industrialized societies. Height and weight thus both increased through the 19th century in the developed world. During the 20th century, as populations reached their genetic potential for height, weight began increasing much more than height, resulting in obesity. In the 1950s increasing wealth in the developed world decreased child mortality, but as body weight increased heart and kidney disease became more common. During this time period, insurance companies realized the connection between weight and life expectancy and increased premiums for the obese.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
Through its growing sway over health-conscious consumers and policy makers, the wholesome-food movement is impeding the progress of the one segment of the food world that is actually positioned to take effective, near-term steps to reverse the obesity trend: the processed-food industry. Popular food producers, fast-food chains among them, are already applying various tricks and technologies to create less caloric and more satiating versions of their junky fare that nonetheless retain much of the appeal of the originals, and could be induced to go much further. In fact, these roundly demonized companies could do far more for the public’s health in five years than the wholesome-food movement is likely to accomplish in the next 50. But will the wholesome-food advocates let them?
Diabetes disproportionately affects older adults; a staggering 25 percent of adults age 60 and older have the disease. Without a significant strategy change in the public or private sectors, population growth on top of skyrocketing medical costs and an aging population will add an unbearable strain to an already overburdened healthcare system. These grim numbers accentuate the growing need for new strategies that will not simply react to the disease and manage symptoms, but prevent the disease from happening.
Gordon’s team then repeated the experiment with one small twist: after giving the baby mice microbes from their respective twins, they moved the animals into a shared cage. This time both groups remained lean. Studies showed that the mice carrying microbes from the obese human had picked up some of their lean roommates’ gut bacteria—especially varieties of Bacteroidetes—probably by consuming their feces, a typical, if unappealing, mouse behavior. To further prove the point, the researchers transferred 54 varieties of bacteria from some lean mice to those with the obese-type community of germs and found that the animals that had been destined to become obese developed a healthy weight instead. Transferring just 39 strains did not do the trick. “Taken together, these experiments provide pretty compelling proof that there is a cause-and-effect relationship and that it was possible to prevent the development of obesity,” Gordon says.
The high rates of obesity and depression, and their individual links with cardiovascular disease, have prompted many investigators to explore the relationship between weight and mood. An analysis of 17 cross-sectional studies found that people who were obese were more likely to have depression than people with healthy weights. (17) Since the studies included in the analysis assessed weight and mood only at one point in time, the investigators could not say whether obesity increases the risk of depression or depression increases the risk of obesity. New evidence confirms that the relationship between obesity and depression may be a two-way street: A meta-analysis of 15 long-term studies that followed 58,000 participants for up to 28 years found that people who were obese at the start of the study had a 55 percent higher risk of developing depression by the end of the follow-up period, and people who had depression at the start of the study had a 58 percent higher risk of becoming obese. (18)
To begin with the second part, I suggest that you look for a physician in your community that addresses weight and diet issues. Your father cannot see his weight as a problem because he cannot consider the possibility of living without whatever need the food is meeting. He shold be checked medically for conditions, such as diabetes and body chemistry imbalances. You can hire an ambulance service that transports wheelchair patients to take him to the doctor.
Anna Medaris Miller is a Health & Wellness editor at U.S. News, where she writes consumer advice stories on fitness, nutrition, reproductive health, medical conditions, mental health and more. She also manages the Eat+Run blog and frequently appears as a health expert on local and national radio and TV shows. Prior to joining U.S. News, Anna wrote for The Washington Post, The Muse and Monitor on Psychology magazine, where she served as associate editor. Anna is a graduate of the University of Michigan and American University, where she earned her master’s degree in interactive journalism in 2014. Follow her on Twitter or email her at firstname.lastname@example.org.
Being significantly overweight places extra strain on all of the systems of the body, affecting them in different ways. Examples of the effects of obesity on some body systems are listed in the table below.
Jump up ^ Hunskaar S (2008). “A systematic review of overweight and obesity as risk factors and targets for clinical intervention for urinary incontinence in women”. Neurourol. Urodyn. (Review). 27 (8): 749–57. doi:10.1002/nau.20635. PMID 18951445.
Keeping a record. Keep a food and activity log. This record can help you remain accountable for your eating and exercise habits. You can discover behavior that may be holding you back and, conversely, what works well for you. You can also use your log to track other important health parameters such as blood pressure and cholesterol levels and overall fitness.
He kind of rolls off the bed into a wheelchair and she has to push him to the bathroom where he walks the one step from the wheelchair to the toilet to use it. I have tried talking to his doctor numerous times and his doctor just tells him to take more pain medication for his problems. Hello? Pain medication is not going to help him lose weight, or move better. My father refuses to believe that his weight is a problem. He won’t listen to my mother, myself, or my brother.
Jump up ^ Goodman E, Adler NE, Daniels SR, Morrison JA, Slap GB, Dolan LM (2003). “Impact of objective and subjective social status on obesity in a biracial cohort of adolescents”. Obesity Reviews (Research Support). 11 (8): 1018–26. doi:10.1038/oby.2003.140. PMID 12917508.
There are many risk factors for overweight and obesity. Some risk factors can be changed, such as unhealthy lifestyle habits and environments. Other risk factors, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed. Heathy lifestyle changes can decrease your risk for developing overweight and obesity.
Obesity is a major public health problem and the leading nutritional disorder in the U.S. It is responsible for more than 280,000 deaths annually in this country. A widely accepted definition of obesity is body weight that is 20% or more in excess of ideal weight:height ratio according to actuarial tables. By this definition, 34% of adults in the U.S. are obese. The National Institutes of Health have defined obesity as a BMI of 30 kg/m2 or more, and overweight as a BMI between 25 and 30 kg/m2. By these criteria, two thirds of adults are either overweight or obese. There is strong evidence that the prevalence of obesity is increasing in both children and adults. Increases are particularly striking among African-Americans and Mexican-Americans. More than 80% of black women over the age of 40 are overweight, and 50% are obese. Among factors blamed for the steady increase in the prevalence of obesity are unhealthful eating practices (high-fat diet, overlarge portions) and the decline in physical activity associated with use of automobiles and public transportation instead of walking, labor-saving devices including computers, and passive forms of entertainment and recreation (television, computer games). Despite efforts of public health authorities to educate the public about the dangers of obesity, it is widely viewed as a cosmetic rather than a medical problem. Obesity is an independent risk factor for hypertension, hypercholesterolemia, Type 2 diabetes mellitus, myocardial infarction, certain malignancies (cancer of the colon, rectum, and prostate in men and of the breast, cervix, endometrium, and ovary in women), obstructive sleep apnea, hypoventilation syndrome, osteoarthritis and other orthopedic disorders, infertility, lower extremity venous stasis disease, gastroesophageal reflux disease, and urinary stress incontinence. Lesser degrees of obesity can constitute a significant health hazard in the presence of diabetes mellitus, hypertension, heart disease, or their associated risk factors. Body fat distribution in central (abdominal or male pattern, with an increased waist:hip ratio) versus peripheral (gluteal or female pattern) adipose tissue depots is associated with higher risks of many of these disorders. Obese people are more liable to injury, more difficult to examine by palpation and imaging techniques, and more likely to have unsuccessful outcomes and complications from surgical operations. Not least among the adverse effects of obesity are social stigmatization, poor self-image, and psychological stress. Weight reduction is associated with improvement in most of the health risks of obesity. All treatments for obesity (other than cosmetic surgical procedures in which subcutaneous fat is mechanically removed) require creation of an energy deficit by reducing caloric intake, increasing physical exercise, or both. Basic weight reduction programs involve consumption of a restricted-calorie, low-fat diet and performance of at least 30 minutes of endurance-type physical activity of at least moderate intensity on most and preferably all days of the week. Behavior modification therapy, hypnosis, anorexiant drugs (sympathomimetic agents, sibutramine), the lipase inhibitor orlistat, and surgical procedures to reduce gastric capacity or intestinal absorption of nutrients are useful in selected cases, but the emphasis should be on establishing permanent changes in lifestyle. Weight reduction is not recommended during pregnancy or in patients with osteoporosis, cholelithiasis, severe mental illness including anorexia nervosa, or terminal illness.
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The initial goal of weight-loss therapy should be to reduce body weight by about 10 percent from baseline. For the first six months, weight loss should be approximately one to two pounds per week. If necessary, the patient can continue to lose more weight.