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Jebb S. and Wells J. Measuring body composition in adults and children In:Peter G. Kopelman; Ian D. Caterson; Michael J. Stock; William H. Dietz (2005). Clinical obesity in adults and children: In Adults and Children. Blackwell Publishing. pp. 12–28. ISBN 1-4051-1672-2.
Modugno says she is sympathetic to the government’s concerns about widespread fraud — that just about everyone in the weight loss and fitness world wanted to be able to bill Medicare for obesity counseling. But she says doctors should be allowed to refer their patients to registered dieticians like her. “Unless we change the nature of how this occurs, how the counseling occurs, I don’t see it being available to people in a meaningful way,” says Modugno.
It doesn’t guarantee that you’ll lose all of your excess weight or that you’ll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.
Inflammatory cytokines, including tumour necrosis factor-α (TNF-α), interleukin-1 β and interleukin-6 have been implicated in cachexia and weight loss.1 Historically termed cachectin, TNF-α is considered one of the more prominent cytokines and is thought to be a primary mediator of the muscle wasting of cachexia; it is also believed to act synergistically with interleukin-1 β to promote cachexia.1 Cytokines may act both centrally, by inhibiting feeding behaviour, and peripherally, by decreasing gastric motility, gastric emptying and intestinal motility and by modifying gastric secretion.1 Tumour necrosis factor-α levels are elevated in several human disease states associated with cachexia and weight loss, including malignancy, acquired immunodeficiency syndrome, heart failure, rheumatoid arthritis and chronic obstructive pulmonary disease.1
Obese people often have increased blood levels of insulin and insulin-like growth factor-1 (IGF-1). (This condition, known as hyperinsulinemia or insulin resistance, precedes the development of type 2 diabetes.) High levels of insulin and IGF-1 may promote the development of colon, kidney, prostate, and endometrial cancers (29).
[7] Institute of Medicine and National Research Council. Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, D.C.: The National Academies Press; 2009. http://www.ncbi.nlm.nih.gov/books/NBK32813.
While weight management may be complex, its solution is basic: Keep it simple. As director of preventive cardiology at the University of Chicago Medical Center Michael Davidson told US News and World Report, the best eating and exercise plans prioritize the question, “What can be a lifelong change instead of just a short-term fix for the patient?” Whether you’ve tried and failed in the past or are setting out on your first weight loss journey, letting this question be your guide may make all the difference in 2017.
Market researchers define the boomer generation as the “have it all” generation. The Boomer Generation Diet explains, in their terms, how they can lose weight, have fun and live more+. Here’s what Jen Boynton,  editor in chief of TriplePundit, says about the book:
In an attempt to address her risk factors, you advise her to have her dentures adjusted. Suspecting that the NSAIDS may be contributing to her nausea, you advise her to use acetaminophen for her knee pains instead. At your encouragement, she starts attending grief counselling becomes involved in social activities, including a supper club, at her local seniors centre.
Generally speaking, obesity occurs when a person consumes more calories than her or she burns. While we need food to provide us with sustenance to live and to provide us with the energy to remain active, when the balance between what we ingest and the amount of energy we expend is disrupted and we are taking in much more calories than we use, weight gain occurs. This can be especially difficult for older adults because they may not be able to get enough physical activity. Also, many adults age 65 and older experience hormonal changes, such as decreased growth hormone secretions and reduced responsiveness to thyroid hormone, which may cause the accumulation of fat. Other factors that may play a role in the development of obesity also include genetics, environmental influences, and other risk factors, which are listed below:
Obesity is diagnosed by calculating your BMI. BMI is based on your height and weight. A BMI of 30 or more defines obesity. In general, this means your body weight is 35% to 40% more than your ideal body weight.
The NCI Cohort Consortium is an extramural–intramural partnership within NCI’s Division of Cancer Control and Population Sciences that combines more than 50 prospective cohort studies from around the world with more than seven million participants. The studies are gathering information on energy balance–related factors from each cohort. The large size of the study will allow researchers to get a better sense of how obesity-related factors relate to less common cancers, such as cancers of the thyroid, gallbladder, head and neck, and kidney.
Adding to the problem is the fact that baby boomers weren’t raised with deprivation. To the contrary, an abundance of food – frozen food, canned food, soft drinks and snack food – filled many boomers’ childhood kitchens. The generation embraced fast food culture in their teens and 20s. The question for many of them now, in their 50s and 60s, is why they’re still eating like kids.
A prospective study evaluated 101 patients (inpatient and outpatient) with an average age of 64 years and unintentional weight loss of at least 5% within six to 12 months.12 Baseline evaluation included a comprehensive history and physical examination, the laboratory studies mentioned in the previous paragraph except for fecal occult blood testing, and abdominal ultrasonography and ferritin measurement. After baseline evaluation, the etiology of unintentional weight loss was established in 73 patients (72%). Organic disease was identified in 57 patients, and 16 patients had a psychiatric diagnosis. More importantly, all of the 22 patients with malignant disease had abnormal results in the baseline assessment. Tests with the highest yield (i.e., typically abnormal in the setting of organic disease) were C-reactive protein, hemoglobin, lactate dehydrogenase, and albumin measurements. None of the 25 patients with negative findings on baseline evaluation had a malignancy on additional workup, such as computed tomography, endoscopy, colonoscopy, magnetic resonance imaging, or radionuclide examinations. Therefore, the authors concluded that if baseline test results are normal, further workup is not necessary, and close observation for three to six months is justified.11,12
While there are other measures of obesity, including abdominal fat and waist circumference, researchers generally define it according to body mass index, or BMI. The BMI formula divides an individual’s weight by the square of height, then multiplies the result by 703. The math is not without controversy: Some health experts charge that for people with large muscle mass, the calculations may unfairly skew them into overweight or obese categories.
We know perfectly well who within our society has developed an extraordinary facility for nudging the masses to eat certain foods, and for making those foods widely available in cheap and convenient forms. The Pollanites have led us to conflate the industrial processing of food with the adding of fat and sugar in order to hook customers, even while pushing many faux-healthy foods of their own. But why couldn’t Big Food’s processing and marketing genius be put to use on genuinely healthier foods, like grilled fish? Putting aside the standard objection that the industry has no interest in doing so—we’ll see later that in fact the industry has plenty of motivation for taking on this challenge—wouldn’t that present a more plausible answer to America’s junk-food problem than ordering up 50,000 new farmers’ markets featuring locally grown organic squash blossoms?
There are many possible pathophysiological mechanisms involved in the development and maintenance of obesity.[148] This field of research had been almost unapproached until the leptin gene was discovered in 1994 by J. M. Friedman’s laboratory.[149] While leptin and ghrelin are produced peripherally, they control appetite through their actions on the central nervous system. In particular, they and other appetite-related hormones act on the hypothalamus, a region of the brain central to the regulation of food intake and energy expenditure. There are several circuits within the hypothalamus that contribute to its role in integrating appetite, the melanocortin pathway being the most well understood.[148] The circuit begins with an area of the hypothalamus, the arcuate nucleus, that has outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brain’s feeding and satiety centers, respectively.[150]
Jump up ^ Sweeting HN (2007). “Measurement and Definitions of Obesity In Childhood and Adolescence: A field guide for the uninitiated”. Nutr J. 6 (1): 32. doi:10.1186/1475-2891-6-32. PMC 2164947 . PMID 17963490.
A chart review of 290 medical records from many centres in the United States that included long-term care residents and home care clients found six factors to be associated with unexplained weight loss.3 These factors included reduced functional ability, taking in 50% or less of the food served in three consecutive days, refusal of 50% or more of food replacement offered over a seven-day period, chewing problems, a serum albumin level less than 35 g/L with normal hydration status and a cholesterol level less than 4.1 mmol/L.
During your appointment, your doctor or other health care provider is likely to ask you a number of questions about your weight, eating, activity, mood and thoughts, and any symptoms you might have. You may be asked such questions as:
Phentermine (Fastin, Adipex P) — the other half of fen/phen — suppresses appetite by causing a release of norepinephrine in the body. Phentermine alone is still available for treatment of obesity but only on a short-term basis (a few weeks). The common side effects of phentermine include headache, insomnia, irritability, and nervousness. Fenfluramine (the fen of fen/phen) and dexfenfluramine (Redux) suppress appetite mainly by increasing release of serotonin by the cells. Both fenfluramine and dexfenfluramine were withdrawn from the market in September 1997 because of association of these two medications with pulmonary hypertension (a rare but serious disease of the arteries in the lungs) and association of fen/phen with damage to the heart valves. Since the withdrawal of fenfluramine, some have suggested combining phentermine with fluoxetine (Prozac), a combination that has been referred to as phen/pro. However, no clinical trials have been conducted to confirm the safety and effectiveness of this combination. Therefore, this combination is not an accepted treatment for obesity.

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