Obesity and Xenical

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What is obesity?

Obesity is defined as a medical condition where there is excess body fat. Obesity is an imbalance disorder where the energy (food calories) intake is greater than the energy output (calories used by metabolism during physical activity and given out as body heat). Persons who are obese weigh at least 20% heavier than the ideal weight for their height. If one is obese and wants to lose fat and weight, the calories burned through daily regular physical exercise and activities should be greater than the calories (food) taken in. In simple terms, it is a matter of intake and output of calories, one that could be regulated by you.

How do we measure obesity?

The most commonly used formula is called BMI (Body Mass Index): Weight in kilograms divided by the square of the height in meters (Kg/m2). This is independent of sex or age. Example: If a person weighs 60 Kg and the height is 2 meters, then divide 60 by the square root of 2 (same as multiplying 2 by itself) which is 4. So, 60 divided by 4 equals 15. The BMI of this person is 15. The accepted international BMI cut-off points are as follows: Underweight (under 20); Normal weight (20-24.9); Overweight (25-229.9); Obese (30-39.9); and Severely obese (40 and over).

Is obesity more prevalent in the USA? Statistics from around the globe shows a rapid increase in the prevalence of obesity the past 10 to 15 years. Obesity is more common in Germany and the United Kingdom compared to the United States. In general, the males are more likely to be overweight than the females, but women comprise the majority of the obese and severely obese. Compared to other countries, Italy has the greatest number of obese and severely obese, followed by Germany. The prevalence of obesity in the United Kingdom is 14.5% and in France, 7%. The Netherlands and Australia have the least obese and severely obese people, but they have about the same (28-32% of population) overweight people as in the United States. About 8.4 million Filipinos are obese. Of these 22% (about 1.85 million) are in Cebu, Bacolod and Iloilo, and 19% (about 1.6 million) in Manila. Unfortunately, with the western influence on our lifestyle and behavior, there seems to be a trend among Asians towards the U.S. statistics. What is the problem with obesity?

Besides the aesthetic social consideration, overweight and obesity pose higher health risks, like heart attack, stroke, gout, tiredness and shortness of breath, hypertension, breath holding during sleep, diabetes, hypercholesterolemia, infertility, pregnancy complications, menstrual problems, varicose veins, hemorrhoids, gallstones, diverticular disease of the colon, back pains, anxiety, constipation, some cancers, etc. The mortality and complications of any serious illness or surgery among overweight or obese patients are generally higher than those with normal weight. The medical risk is therefore a more major concern here than the physical or cosmetic aspect of obesity.

Could obesity be hormonal?

Yes, but these conditions (under active thyroid gland, or, overactive adrenal glands, or Prader-Wili or Lawrence-Moon-Biedl syndromes, etc) are uncommon or even rare as the latter two conditions. Most of these are easily diagnosed and proper treatment helps correct the problem, including the obesity.

Is obesity hereditary?

We tend to blame our parents for almost anything as a convenient cop out, but what majority of us do after we are born make us what we are, not necessarily because of our genes. If both parents are obese, it is true that their children will have about 70% to be obese, if the children live the same lifestyle as the parents. If the siblings have healthier life style than the parents, the odds are much less for them to be overweight or obese. If both parents are lean, their offspring have about 20% chance of being overweight or obese, but, again, if these youngsters live a healthy lifestyle with good regular exercises and healthy dieting, they could beat the odds. Environment (what we do or not do) plays a very major role in our body weight management.

What is this latest anti-obesity pill ?

The popular anti-obesity pill in the market that was approved by the FDA (Food and Drug Administration of the United States) a couple of years ago is called Xenical (Chemical name: Orlistat). This is the only oral medication that acts in the gastrointestinal tract and not systemically absorbed (into the blood stream). The mode of action is preferred because acts locally and not circulated all through out the body. The drug acts as a lipase (pancreatic enzyme needed to digest and absorb fats) inhibitor. With the lipase is inhibited, fat absorption in the gut is blocked and significantly reduced by one third. The remaining two thirds are eliminated through the feces. Xenical, produced by Roche (Basel, Switzerland), is the only prescription lipase inhibitor approved by the FDA for its efficacy and safety.

Why is this non-systemically absorbed medication better?

Many diet pills are absorbed into the blood stream and work in the brain as appetite suppressants. Xenical works locally in the gut and also does not have the side effects on the heart as most diet pills have. Millions of persons have been treated with Xenical todate in 20 countries, including Europe, with encouraging success. Some of the possible side effects include nausea, stomach cramps, bloated sensation, very oily stools, oil stains on underwears, diarrhea, etc.

What is the safest way to lose weight?

The safest way is to cut your food intake, without using diet pills, and doing daily exercises to burn off calories until you lose weight. The first thing to do is to find out how much you weigh, using an accurate scale. If you are, in fact, overweight, make a list of reasons why you want to lose. This should include the cosmetic, medical and other personal or social reasons to really inspire you to lose weight, because you must first convince your brain. Then, calculate how much weight you have to lose to attain the "normal" weight for your height (based on our BMI formula above). At this point, you have to make a firm decision that you will do "anything and everything necessary," like cutting down on your food intake as you weigh yourself weekly, doing daily exercise (walking, ballroom dancing, tai-chi, tai-bo, aerobics, etc), quitting cigarettes, snacks and pop drinks, or even seeking the aid of your doctor. Drinking a tall glass of ice cold filtered water BEFORE each meal (to pre-fill your stomach) will help too. Having overweight friends join you in this "project" is a good motivating factor. If this full strategy has been done honestly and faithfully for four weeks, without success in tipping down your scale, then this new anti-obesity pill, Xenical, may be resorted to, BUT only under a physician's supervision.

©2003Raoul R. Diez, M.A.O.D.