Obesity

A sedentary lifestyle was associated with a rised factor which causes principal metabolic and endocrine affections: obesity and diabets. Although, not even one of these diseases took separately doesn't represent a principal cause of death, both are in connection with other diseases which cause death, like: high blood pressure, cancer.

Terms like overweight and fatness are frequently used one in place of the other, but, in fact they have different meanings.

Beeing overweight means that the corporal weight exceeds the standard weight for a person, based on height and body size.

Fatness refers to the condition in which a person has an excessive amount of fat tissue.

The exact standards for a fat precentage allowed weren't established, however it considers that men with more than 25 %corporal fat and women with more than 35% should be considered obeses. Men with relatives values of fat between 20-25% and for women 30-35% should be cousidered at fatness limit.

Doctors and scientists use a formula known as body mass index, which is calculated from measurements of height and weight. Body mass index is a method, frequently used to estimate fatness.

The body mass index of one person is calculated by dividing the body mass ( in kilograms )to the height ( in metres ).

B.M.I = weight (kg) / height (m)

The body mass index is correlated with the body fat to give a better appreciation of the fatness than the relative weight measure.

For better understanding how a person becomes obese we must understand how the body weight is controlled.

The human body needs usually 2500 kcal a day or 1 milion kcal per year. It wins 0,7 kg every year which represent a disharmony of 5250 kcal per year between the energy income and consume (3500 kcal is the equivalent of 0,45 fat tissue). This translates in 15 kcal surplus per day. Even with a win of 0,75 kg per year, our body can compensate the disharmony. The ability of our body to equilibrate the caloric incomeing and it's use, made the scientist to say that the body weight is fixed around a point like the body temperature.

The total amount of energy which can be consumed is expressed three categories:

1. Basal metabolism
2. Food intaking effect
3. Activity thermic effect

The basal metabolism means the level of the metabolism in the morning, after a night of 8 hours of sleep. Most of nowadays researches use basal metabolism. This value represents the minimum amount of energy necessary to endure the basic physiological processes. It consumes between 60 - 75% of the total daily energy.

The effect of food swallowing

This term is refering at the increase of the metabolism rate which is asociated with digestion, absorption, transport and store up the swallowed food. This effect consumes approximately 10% of total energy consumed each day. This value includes also the energy wasted, because the body can increase the level of metabolism above the necessary for processing and the store up of food.

The thermic effect of the activity represents the energy consumed over the basal metabolism necessary to achieve your purpose or activity, and it consumes 15 -30% of total energy. The organism adapts to the main increases and decreases of the contribution of energy by each of this components.

In a hipocalorical food diet, all these components decrease. It seems that the organism is trying to conserv its energy reserves. Is possible to observ by the increase of basal metabolism rate with 20% or even more, established after more weeks by when the pacient starts the hypocaloric diet.

On the ofter hand, all these components show a considerable growth in hyper -caloric diets. In this case the body tries to prevent the deposits which aren't necessary to the caloric surplus. All these adjustments are under the control of nervous system and play a leading role in keeping weight around a limit point.

Obesity cause

Obesity was thought to be caused by some fundament hormonal imbalances, as a result of the dysfunction of one or more endocrine glands in adequately controlling body weight. Other time it has been considered that the main cause of obesity would be the gluttonous or desirous nature of the person. In the first case it was considered that the person does't have control over the situation while in the second case, the person is directly responsible.

Fatness was also connected with psychological and physiological trauma. Hormonal malfunctions , emational traumas and damage to homeostasy mechanisms have been founded beeing in direct or indirect connection with fatness.

Envioroment factors as inadequate physical effort, unhealthy diet of eating contribute also to obesity. Obesity has a complex origin and it's specific causes vary from a person to another.

Health problems associated with excessive weight and fatness

During many years the scientists thought that the main risk related to the excess of weight could be the excess of fat. Beeing overbalance without having a surplus of fat was not considerated as beeing a significant concern for health.

The persons with or without obesity was classified in 3 groups:

1. The group considered 15% underweight
2. The group with a medium weight between 15 -86%.
3. The obese group by more than 86%.

Underweight and overweight were also divided in 3 groups on the base of the corpulence index. It has been arrived at the conclusion that some persons are overweight, but not obese and others are obese but they aren't overwight. Both groups were founded as having a bigger risk for some diseases.

There are some risks who will affect the health , in the first place the high blood pressure associated with the overbalance, even in the absence of obesity.

Over balance and the obesity are associated with a grown instalment of demise. A growth of risk will be when the index of stautness will outrun 30 kg/mp. The effects of obesity are serious; causes of demise associated with obesity and over balance include:

• cardiac sickness
• the high blood pressure
• different tipes of cancer
• diabetes

Obesity was directly tied with:

1. Changes in the normaly working of organism.
2. Grown risk for certain sickneses.
3. Different psychological reactions.
4. Negative effects of fixed sickness.

1.The changes in the working of organism vary from person to person and with the degree of obesity. The respiratory problems are almost common among the persons with obesity. This brings to other following of obesity like the lethargy, the slath owing to the grown level of CO2 in blood and to polyglobulia reply to a weak oxygenation of arterial blood. These can lead to appearance of thrombosis, the growth of heart.

The persons with typical obesity have a low tolerance to exercises owing to the respiratory problems and to the bodily weight which is grown when have to be out of place in the time of exercises. The supplementary gain in weight reduce the level of activities and the tolerance to exercises decrease very much.

2. A grown risk for the development of certain chronic sickneses degenerate is also associated with obesity. High blood pressure and atherosclerosis were associate with obesity. So, we have variate metabolic and endocrine disturbes like diabetes, the weak metabolism of carbohydrase. Obesity is in particular, a problem associated with the type 2 of diabets, which is not dependent on insulin.

Many investigations made possible to us to understand better the obesity role like a risk factor for diseases. Were fixed the principal differences between the sexs regarding the way that the grease is stored. Men tend to have a fat distribution in the superior part of the body, while women tend to store fat in the inferior part of the trunk, especially on thighs, posteriors and on hips.

The predominat obesity of the superior train is a risk factor for:

• artery diseases
• high blood pressure
• brain attack
• grown level of cholesterol
• diabetes

Most of the times obesity of superior train seems to be for these diseases a more important factor that the overweight of whole body. The measure of the waist circumference and of hips it can be used to indentify the people with a grown risk. In the superior train's obesity the raised risk can result from the visceral deposit of greases, from approach the portal circular system.

The obesity effect of the existing diseases are not clear until now. The obesity could contribuate to an additional development at some diseases and the weight lost is usually prescribed like a part of the treatment.

The complications that usually benefit by reduction of the weight are:

• Angina Pectoris
• High blood pressure
• Cardiacs diseases
• Myocardium infarct
• Varix
• Orthopedical problems

3.Psychological and emotional problems could be considered a cause of obesity at a rised number of people. In our society obesity brings a social brand which contributes substantially to the problems of the persons in question .

Even the average shows only those people who have an almost perfect body. So, some obese people need a psychologist or a special conseling in their efforts to lose weight.

The general treatment for obesity

Weight control seems to be a simple mather. Energy ingested by the body as food must be equal with the energetic consumption which is the sum: the basal metabolism, of the effect of eating food and the thermal effect of activity. Usually, the body maintains a balance between eaten food and the calorical consumption, but when this balance becomes unstable you will lose or gain weight. Both, losing and gaining weight seems to depend on two factors :calorical contribution and physical activity.

But not everybody respond in the same way to this intervention. This difference must be taken into consideration when we make treatment programs for individual trying to lose weight; persons who are trying to lose weight must understand this difference in order to not be discouraged.

Generally, the lose of weight mustn't outrun 1 kg /week. Losing a larger amount of weight than this, must be supervised by doctors. Losing only 0,45 kg of fat / week will lead to a 24 kg /year. Also, losing weight should be considered a long term project.

A quick lose of weight is short term and the weight lost is fast gain because quick lose of weight is usually the result of a massive lose in water. The body has security mechanisms to prevent a body fluid imbalance, so the amount of water lost will be replaced.

In general, the malicious eating habits are responsible for most weight problemes. People should try to learn make permanent changes in their eating habits mostly by reduceing fat and simple sugar.

For many people, a low fat diet will lead to a gradual weight lose and the person will reach the desired level without having to worry about how much they eat. Also, the reduction of the calories quantity ingested by 250 to500 kcal per day will be sufficient to reach the desired weight.

Hormones and drugs have also been used to help patients lose weight by increasing the basal metabolism. A change in behavior and manners has also been suggested as being one of the most effective techniques for helping people with weight problems.

The most important results in weight losing have been reached by changing the eating habits. Most of the time, these weight loses seem to be more lasting. This approach attracts many people because these techniques seem to have sense and are often easy to imput into the daily routine.

Physical activity in controlling weight

Inactivity is the main cause of obesity. In fact, inactivity can be a factor by far more significant in the development of obesity than the extra alimentation as an essential component in any weight reduceing program.

Physical effort can substantially modify the body composition. Many people belived that physical activity has a limited role in modifying the body composition and that only high intensity exercises burn calories and substantially reduce body fat.

How will we explain this so called conflict?

A person that runs 3 days a week for 30 minutes a day with 11 km/h (jogging) will burn approximately 14,5 kcal/min or 435 kcal for every 30 minutes of running, every day. This adds up to a total of 1305 kcal per week, the equivalent of 0,14 kg of fat lost for every week of exercise. This should establish people to belive that physical effort is a slow and painful way of sigrificantly reduceing body weight and there are better way of burning fat .

Still, in 52 weeks, if the energy contribution remains constant, this person will lose 8 kg.

When we estimate the energetic cost of a physical activity, the medium energy lose is multiplied by number of minutes for which we sustain the activity.

But by only examining the amount of energy consumed during the exercise we will not see the whole picture. The metabolism stays at high rates even after the end of the exercises. This phenomenon leads to the excess consumption after exercise. The returning to the installment level of metabolism before the exercise may necessity more minutes as following of easy exercises like: walking, several hours after intense exercises and even 12 - 24 hours or more after complete, sustained exercises like running or marathon. Physical activity is important in maintaining as much as in the lost of weight. Near the consumed calories while the exercises, a substantial consume of calories is produced in the period after exercises.

The studies have shown the main changes in weight and in the corporal composition once with physical exercises. Other studies have investigated changes in the corporal composition with: alimentary diet, physical effort, the combination of diet with physical effort.

Most of the studies are having the same tendency:

• The diminution of corporal weight
• The fat mass and the relative grease of the body is decreasing
• The mass of the free grease is or maintaining or grown

The evidence are showing that exercise are an important part in any program of reduceing weight, but for maximize the lose of grease and corporal weight, is necessary the combination of exercise and a decreasing of caloric contribution.

When we try to explain how exercise determine such changes in the corporal weight and composition, we must consider both parts of the energy balance ecuation. The evaluation of the energy consumption requires that we take in consideration each one of the three components of the energetic consumption: the basal metabolism, the effect of the food supply and the activity thermic effect.

Some persons think that exercises stimulate the appetite, so that the food supply is unconsciously increased finally at least equalble with the consumption the exercises.

More studies leades us to the theory according to which a minimal level of physical activity is necessary for the organism to regulate precisely the food supply in establishing the balance of the energetic consumption. A sedentary likestyle can reduce this relative ability, the result concretising by gaining weight.

Exercises seems to be a gentle limitary factor of the appetite at least in the first few hours as result of some intense physical exercises. Most of studies have shown that the whole number of the consumed calorie a day doesn't change when a person begins a training program.

Although some people interpret this fact as a clear evidence that exercises do not effect appetite, a more exact conclusion would be that the appetite was affected, actually it was limited because the caloric supply didn't increase proportionately with the extra caloric consumption after the physical effort.

The high body temperature which accompanies activity at high intensity or almost any activity made in heat or humidity conditions can reduce the appetite.

We all know, by experience, that we need less food when the weather is hot or when our body temperature is high as result of ilnesses. This should esplain why long distance runners need less food while swimmers have a powerful desire of eating. In the pool, the water temperature is inferior, so the heat generated during exercises is actually lost. Periodic physical activity could so determine a better appetite control and through this the balance of the caloric consumption.

Recent researches suggest that the exercises even localized mobilisate the fat from almost all the body places, not just from the main places.

A study like that was performed over some tennis players: they could be considered ideal subjects: one arm is used predominantly during the training for several hours a day, meanwhile the other arm is " sedentary ".Researchers supposed that the inactive arm should have a more substantial quantity of fat than the other arm. The active arm have a bigger size thank to the exercise determing the muscle hypertrophy. But it is not right that.

Decreases of the dimension can take place in the same time with the training, but this result from a raised muscular tonus and not after the lost in fat.

In the aerobic exercises with high intensity, the carbohydrates can replace 65 % or more from the energetic necessary of the organism.

Different groups have promoted the aerobic exercise with low intensity to raise the lose of fat. These groups affirm that aerobic exercise with low intensity will determine the organism to consume more fat as an energetic source, quickening the lose of fat into the organism.

Really, the body is using a higher percentage of energy for the low intensity exercises, yet the total consumption of calories won't change necessarely.