Obesity

• Obese individuals run up to 3 times increased the risk of death- compared to an individual who is in their normal weight range.
• The life span of an Obese individual is shortened by an average of 8 to 10 years. For every 15 extra kilo's, risk of early death increases by around 30%.
• Healthcare costs associated with obesity are exceeding those associated with smoking.
• Cost and possible side effects of prescription weight loss medication have influenced overweight patients to seek alternatives including nutraceuticals, see nutraceuticals below, to aid dramatic fat loss.

Obesity is generally diagnosed and defined by analysis of weight, body size and composition. Body mass index also is known as BMI, is the most commonly accepted metric for defining obesity. BMI is a surrogate measurement of adiposity, calculated as body mass (in kilogrammes) and divided by height squared (in meters). The World Health Organization (WHO) defines overweight and obese as BMI's of ≥ 25 and ≥ 30 kg/m2.

Although BMI is strongly correlated with total body fat, it is not without limitations;

• Important racial considerations can influence the BMI results (e.g. Asians typically carry more body fat and Africans less than Caucasians at any particular BMI).
• BMIcalculations are solely dependent on the net weight and height of an individual. It does not consider muscle or bone mass.
• BMI does not differentiate between body fat and muscle mass. This becomes misleading with regards to the amount of fat in an individual.
• BMI can be combined with waist circumference dimensions, which can estimate an individual's abdominal fat content (abdominal or visceral fat is a greater risk factor for obesity-related diseases than total body fat). Waist circumference dimensions of >102 cm (40 in.) for men and >88 cm (35 in.) for women carry a higher risk of obesity-related diseases such as type 2 diabetes, cardiovascular disease and hypertension.
• BMI is unable to provide an accurate determination of body fat percentage. A Body Stat analysis using a special machine is available at all Health Renewal clinics to give a more accurate determination of Body Renewal fat water and lean muscle percentages.
• BMI can underestimate the amount of body fat in the following individuals; Elderly people, individuals who have muscle wasting problems such as paraplegics who have wasting of lower limb muscles, individuals with Anorexia Nervosa and morbid obesity.

The complex system of appetite control can become perturbed in obesity, due to excess fat stores which contribute to constant elevated leptin levels. This leads to down-regulation of cellular sensitivity to the effects of leptin, a physiologic state known as, leptin resistance. Weight loss efforts put forth by obese individuals may be undermined by the failure of the leptin system to suppress their appetite, resulting in excessive hunger.

Adiponectin, another hormone derived from fat cells, is an anti-obesity signalling molecule; the signalling of adiponectin may be disrupted in obesity-related diseases as well as states of insulin resistance. Evidence suggests that leptin and adiponectin can work together to combat insulin resistance. Enhancing fat cell signalling consequently, represents an important aspect if any comprehensive weight-loss strategy.

Natural Aging-weight gain and progression to obesity may be caused by imbalances in energy input and expenditure in several ways. The natural ageing process associated with hormonal changes predominantly decreases in sex and thyroid hormones. These contribute to a decrease in metabolism and energy expenditure. Advancing age is associated with insulin sensitivity which interferes with appetite control as well as the physical activity which subsequently reduces energy expenditure. Decreased mobility and obesity in an ageing individual have reciprocal effects on one another (increase in weight and reduction in muscle mass leads to decreased mobility and energy expenditure.

Sex hormone and thyroid hormone insufficiencies/imbalances-Levels of sex hormones, such as testosterone and dehydroepiandrosterone (DHEA), weaken with age in both genders. This may lead to an increase in fat mass, reduction in lean body mass or central fat redistribution. Similarly, declining thyroid hormone levels are related to reduced metabolic rate and thus obesity. Obesity and low testosterone have a complex relationship; low testosterone can be considered both a cause and consequence of obesity.

The thyroid, which is a central regulator of metabolism, assimilates signals from the brain and secretes thyroid hormone (thyroxine or T4) to influence metabolism in a variety of tissue.

Body weight, composition, energy expenditure and body temperature may all be affected by thyroid dysfunction. A depressed thyroid function is associated with declining thermogenesis, which is the transformation of stored energy into heat, as well as weight gain and metabolic rate.

Underactive thyroid activity is most common as individuals' age; hypothyroidism is 3.7% of the general population, however, is five times more common in individuals that are 80 and older as opposed to 12 to 49 year olds'.

In addition to a result of being obese, increased levels of leptin and insulin in obese people may be symptomatic of a resistance to activities. Insulin is a hormone that assists cellular uptake of glucose, mainly in the muscles, liver and adipose tissue. Once insulin resistance develops, glucose levels are no longer controlled by insulin and blood levels become elevated. Additionally, when higher levels of insulin and leptin subdue the desire to eat and stimulate energy expenditure, they become unable to perform this function in resistant individuals.

Body Renewal's Leptin Facilitator: Rhodiola Rosea, Red Korean Ginseng and Resveratrol are combined to improve leptin resistance.

Insulin resistance is a result of sustained hyperinsulinemia (high insulin levels) and becomes complicated by obesity and chronic inflammation. In order to improve insulin sensitivity, one must follow the approaches that are an essential part of successful weight loss. These include the use of a low-cost prescription drug called metformin, which is approved for the maintenance of type 2 diabetes and may help reduce body fat as well as natural compounds which assist by promoting insulin signalling.

Contact between leptin and the inflammatory biomarker C-reactive protein(CRP) in cell culture suggests a role of chronic inflammation in leptin resistance as well as appetite loss. Based on findings, mediators that ease inflammation such as Curcumin which is a plant compound & Omega-3 fatty acids in fish oil may assist in combatting the harmful effects of leptin resistance as well as lower CRP levels.

The increase in daily food intake contributes to weight gain and eating out may encourage overeating. Supplementing with green coffee extract before meals and CLA which can slow down carbohydrate absorption will help reduce after-meal spikes in glucose levels.

Chronic stress, appetite low levels and changed Serotonin signalling of the neurotransmitter serotonin (usually associated with depression), may be associated with weight gain. Chronic stress can compromise the function of gastrointestinal, hormonal and immune systems. Chronic stress is associated with obesity and metabolic syndrome. Stress raises the production of the hormone cortisol which when combined with excessive food intake, promotes the development of visceral obesity.

In order to obtain an appropriate weight loss strategy, we need to understand the overall risks. Adequate levels of thyroid hormone are needed in order to minimalise obesity risk; thyroid deficiency may be improved with hormone replacement. Weight gain in both women and men are generally associated with low levels of oestrogen and testosterone, therefore sufficient DHEA is vital for sex hormone production. Risk factors for obesity-related diseases include high blood pressure (Hypertension), chronic inflammation as well as high cholesterol.

In addition, The RID medical weight loss program is offered at Body Renewal. This program uses hCG together with a low calorie, low glycemic eating program to improve Leptin resistance and facilitate dramatic weight/ fat loss. Read more on Sleep Renewal about Obesity

RID Medical Weight loss program: Insulin resistance and diabetes can be dramatically improved if one can lose between 5 to 10 % of body weight. If the program is strictly followed; patients can lose between 8 and 15 kilogrammes of fat over 4 weeks, generally find it quite easy, and feel good with high energy levels. In fact, depressed patients have mood elevation 10 days into the program. Many of our patients have tried numerous other well-known diets but find this to be the magic one that actually works.

i-lipo laser lipolysis is a low-level laser therapy and is available at Body Renewal which helps with centimeters  reduction and weight loss. Low-level laser therapy (LLLT) such as i-lipo has been proven to restore a lean state of adipocyte without inducing cell apoptosis/ death. It is hypothesised that i-Lipo LLLT could serve as an adjunct to other dietary therapies to promote insulin sensitivity and reduce the risk of diabetes because a lean state is produced in the fat cell. Leen state means improved insulin sensitivity, resulting in less insulin needed for glucose metabolism. Less insulin equates to less fat being deposited.

• Health Renewal encourages anyone striving to lose weight to consider adopting a CALORIE RESTRICTED DIET but nutrition-dense diet.
• Increase Physical Activity is one of the most effective means of attaining a negative energy balance, which facilitates weight loss. Physical exercise should be undertaken regularly in accordance with one's overall health and mobility. Anyone with a physical impairment, such as extreme obesity or severe osteoarthritis, should consult a healthcare provider prior to embarking on an exercise regimen.

Restore Resting Energy Expenditure(REE);

• Green tea extract
• Omega 3 Fish oil

Restore Healthy ADIPOCYTE (Fat Cell) signaling with;

• Irvingia gabonensis

Restore Brain SEROTONIN/Suppress Hunger Signals;

• L-tryptophan
• Pharmaceutical support

Control Rate of CARBOHYDRATE ABSORPTION and Glucose Synthesis;

• Propolmannan (before meal)
• Green Coffee bean extract

Restore Youthful HORMONE Balance;

• Dehydroepiandrosterone(DHEA):depending on blood test results
• 7-Keto® DHEA
• Bio-identical (natural) hormone replacement therapy (if needed): as directed by an experienced physician
• Thyroid hormone replacement therapy (if needed): as directed
• Aromatase inhibitor (if needed; men only)

Restore INSULIN Sensitivity;

• Chromium
• Magnesium
• Pharmaceutical support: Metformin

Inhibit the LIPASE Enzyme;

• Green tea extract (std. to 98% polyphenols)

An individual who is overweight or obese increases the risk of diseases such as;

• Cardiovascular disease
• Arthritis
• High blood pressure
• Malignancies such as breast, prostate, pancreatic and colon cancer
• Excess body weight also affects mobility and interferes with restful sleep,
• Contributes to digestive disorders
• Can contribute to an overall lower quality of life than that enjoyed by lean individuals.

Make an appointment to consult with your Health Renewal Doctor and they will assist you in measuring your blood levels and advising you of further preventative measures and supplements to reduce weight.

Depending on blood tests; investigations to rule out medical conditions that need treatment, one could expect to follow up with your physician from anything between every 2 weeks to once every 3 months.

• Limit your total fructose intake to less than 25g per day (which is equivalent to 2 low fructose fruits) as Fructose can increase your hunger and lead to overeating by triggering changes in your brain. Effective treatment of obesity requires turning off your fat switch (limiting fructose) and improving the function of your cells' mitochondria.
• Limit fructose from fruit to 15 grammes a day. For example, 1 cup berries contain between 3 to 4 g of fructose, an orange=6.1 g, a banana=7.1g, an apple=9.5 g, 1 cup grapes 12.4 g & 1/2 mango=16.2g. Fructose is also metabolised to fat in your body far more rapidly than any other sugar, and the metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which drives up blood pressure and can cause gout.
• High fructose diets will lead to obesity, insulin resistance, fatty liver and high triglycerides, signs of inflammation, vascular disease and high blood pressure. Fruit juices are high in Fructose, so strict avoidance is recommended. Likewise, honey is very high in fructose. A far safer alternative is to use pure glucose (dextrose) or Stevia or Xylitol.
• Replace sweetened drinks(whether they're sweetened with sugar, HFCS [high corn fructose sugar] or artificial sweeteners) with plenty of pure, clean water. Fructose/ fruit juice turns your fat switch on.
• Eat Healthily
• Consume healthy fats, like butter, eggs, avocados and nuts especially macadamia nuts which are higher in fat and lower in protein. Unheated oils such as 1T coconut oil, palm oil and olive oil are beneficial to the body.
• Eat plenty of raw food.
• Avoid all genetically engineered foods and processed foods.
• Avoid any product containing aspartame, which is derived from a GE organism.
• Walk regularly
• Make sure to incorporate high intensity, interval training at least once or twice a week once you are closer to your ideal weight.
• Get an appropriate amount of SUNLIGHT (6 to 10 mins per day) on your skin (not face) to optimise your vitamin D 3 levels.
• Get plenty of SLEEP in terms of its effect on your metabolism and weight, lack of sleep has been shown to affect levels of leptin and ghrelin–two of the hormones linked with appetite and eating behaviour. When you are sleep deprived, your body decreases production, of leptin, the hormone that tells your brain there is no need for more food, while increasing levels of ghrelin, a hormone that triggers hunger (these are the same hormones detrimentally affected by a high-fructose diet, as discussed above).
• Manage your STRESS with exercise, meditation, yoga, prayer etc. see Adrenal burnout.