OBESITY: Obesity is the biggest Malnutrition problem in USA. About one third of the U.S. population are obese, with increased risk of hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease, osteoarthritis, and some cancers.
What is over weight: Obesity is a chronic condition characterized by an excess of body fat. It is most often defined by the body mass index (BMI), a mathematical formula that is highly correlated with body fat. BMI is weight in kilograms divided by height in meters squared (kg per m2).
Energy balance is modulated by many factors, including metabolic rate, appetite, diet, and physical activity. Although these factors are influenced by genetic traits, the increase in obesity prevalence in the past few decades cannot be explained by changes in the human gene pool, and it is more often attributed to environmental changes that promote excessive food intake and discourage physical activity.
overweight: adults with a BMI of 25 to 30 kg per m2 are categorized as overweight
obese: those with a BMI greater than 30 kg per m2 are categorized as obese.
What is my normal weight: look below to find your goal weight base on your gender and hieght
How you become over weight: If you eat more energy=calorie = food than your body needs, your body turn it to fat to keep for later to use. fat will be deposited base on your genetic either in your abdomen, face, neck, foot or waist area.
each one gram carbs (like bread, sugar, rice, cake): have 4 Kilo-calorie
each one gram protein(like meat-fish or chicken): have 4 Kilo-calorie
each one gram FAT(like butter,oil, fat in meat and ): have 9 Kilo-calorie
WEIGHT CONTROL BY DR SEP:
- Develop new eating habit:
- What you eat: Is THE MOST important part of your program. you have to develop habit to buy healthy food. follow the food pyramid: eat less sugar, less fat, less salt and more fiber.
- Eat less fat: since they have more calorie, buy lean meat, chicken
- Use organic meat and fish and chicken look at label of food: no hormone,no antibiotic add is important. what animal was eating is very important. ie grass fed cow meat from Australia or Newzeland is much superior to animal who raised by china imported food, wild Atlantic fish is better than china farm raised fish or American raised farm fish fed by china imported food. chicken is most problematic protein since chicken grow fast farm raiser can feed them hormone, antibiotic and china imported food which can contribute to more problem for eater.
- Eat less sugar: sugar is called white poison since it kills slowly. is worse than fat since its absorb fast and your body make it fat by injection insulin. the rise of insulin and fast absorption will prevent your brain to order you to stop eating so in small amount of time you take in lot of calorie transfer it to fat and you still feel hungry. other name of sugar that they put on food label and don’t want you to notice it is fructose, corn syrup, Malta, fructose syrup, honey, honey syrup and ……….. these are all sugar they absorb and metabolize the same way
- Less diet label item: we don’t know how aspartame or splenda or will affect our body it may take 20-25yr from now till we find out they could cause cancer
- Less fat milk and cheese is better, buy organic no hormone
- organic food: is better but you should know different organic food exist read label . some of them say no growth hormone but have antibiotic some say no hormone but fed by china imported food that have hormone and antibiotic.
- Why you eat:Many people eat to be polite. Ask yourself the real reason you’re eating,and don’t be afraid to say “no
- Where you eat:Sometimes you may eat because of where you are-not because you’re hungry.So try a new rule:you’ll only eat at the dining table or you won’t eat after 8:00pm
- When you eat: some people starve all day then eat at night this is wrong since you raid the fridge and food at night. if you eat three meal a day you’re less likely to over do it
- How you eat: when your on run its easy to overeat. it take 20 minutes for your stomach to tell your brain your full so slow down on eating.
- Keep record of what you eat: every day record how many gram fat-protein and carbohydrate you eat and then at end of each day see how many calorie you take in each
- one gram carbs (like bread, sugar, rice, cake): have 4 Kilo-calorie each
- one gram protein(like meat-fish or chicken): have 4 Kilo-calorie
- each one gram FAT(like butter,oil, fat in meat and ): have 9 Kilo-calorie
- Balance your calorie IN & OUT: your body needs energy to do its regular function and it burn it to do that like move, absorb food, talking and …. if you get less calorie in per day and you spend more calorie you lose weight ie 1500 k-cal IN but 2000 k-cal out = 500 k-cal loss if you loose 500 k-cal per day in one week you loose 0.5-1 pound per week a simple math is try to take 250 k-cal less and exercise 250 k-cal per day = 500 k-cal/day then u loose 1 lb per week
- Start Exercising: 4-5 times a week do exercise that you like for 30 minutes at least. it not only help you loose the calorie but decrease your appetite.
can be given to adults with a body mass index (BMI) of 30 kg/m2 or greater (obese), or adults with a BMI of 27 kg/m2 or greater (overweight) with at least one weight-related medical problem such as high blood pressure, high cholesterol, or type 2 diabetes, lose weight and keep the weight off. Medication should be used with a reduced-calorie diet and increased physical activity
NAME OF DRUG, Class and How it work
Approved for short term use
1-Benzophetamine(Dirdex) Sympathomimetic Suppress appetite schedule III
2-Diethylpropion (tenuate) Sympathomimetic Suppress appetite schedule IV
3-Phendimetrazine (bontril) Sympathomimetic Suppress appetite schedule III
4-Phentermine (adipex- Suprenza) Sympathomimetic Suppress appetite schedule IV
Approved for long term use
1-Lorcaserin (Belviq) Serotonin 2C agonist Suppress appetite/ promote satiety IV
2-Orlistate (Xenical, Alli) GI Lipase inhibitor Reduce fat absorption from gastrointestinal track –
3-Phentermin/topiramate(Qsymia) Sympathomimetic/ gamma-amino butyrate agonist Suppress appetite/ promote satiety IV
4- Saxenda is an FDA-approved, prescription injectable medicine that, when used with a low-calorie meal plan and increased physical activity, may help some adults with excess weighta who also have weight-related medical problems (such as high blood pressure, high cholesterol, or type 2 diabetes), or obesity,b to lose weight and keep it off.
What is the most important information I should know about Saxenda®?
Serious side effects may happen in people who take Saxenda®, including:
Possible thyroid tumors, including cancer. Tell your health care professional if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid cancer. In studies with rats and mice, Saxenda® and medicines that work like Saxenda® caused thyroid tumors, including thyroid cancer. It is not known if Saxenda® will cause thyroid tumors or a type of thyroid cancer called medullary thyroid carcinoma (MTC) in people.
Do not use Saxenda® if you or any of your family have ever had MTC, or if you have an endocrine system condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Who should not use Saxenda®?
Do not use Saxenda® if:
- you or any of your family have a history of MTC
- you have MEN 2. This is a disease where people have tumors in more than one gland in their body
- you are allergic to liraglutide or any of the ingredients in Saxenda®. Symptoms of a serious allergic reaction may include: swelling of your face, lips, tongue, or throat, fainting or feeling dizzy, very rapid heartbeat, problems breathing or swallowing, and severe rash or itching
Talk with your health care provider if you are not sure if you are pregnant or planning to become pregnant. Saxenda® may harm your unborn baby
Before taking Saxenda®, tell your health care provider about all of your medical conditions, including if you:
- have any of the conditions listed in the section “What is the most important information I should know about Saxenda®?”
- are taking certain medications called GLP-1 receptor agonists
- are allergic to liraglutide or any of the other ingredients in Saxenda®
- have severe problems with your stomach, such as slowed emptying of your stomach (gastroparesis) or problems with digesting food
- have or have had problems with your pancreas, kidneys or liver
- have or have had depression or suicidal thoughts
- are pregnant or plan to become pregnant. Saxenda® may harm your unborn baby. Tell your health care provider if you become pregnant while taking Saxenda®. If you are pregnant you should stop using Saxenda®
- are breastfeeding or plan to breastfeed. It is not known if Saxenda® passes into your breast milk. You and your health care provider should decide if you will take Saxenda® or breastfeed. You should not do both without talking with your health care provider first
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Saxenda® slows stomach emptying and can affect medicines that need to pass through the stomach quickly. Saxenda® may affect the way some medicines work and some other medicines may affect the way Saxenda® works. Tell your health care provider if you take diabetes medicines, especially sulfonylurea medicines or insulin.
How should I use Saxenda®?
- Inject your dose of Saxenda® under the skin (subcutaneous injection) in your stomach area (abdomen), upper leg (thigh), or upper arm, as instructed by your health care provider. Do not inject into a vein or muscle
- Never share your Saxenda® pen or needles with another person. You may give an infection to them, or get an infection from them
What are the possible side effects of Saxenda®?
Saxenda® may cause serious side effects, including:
- possible thyroid tumors, including cancer
- inflammation of the pancreas (pancreatitis). Stop using Saxenda® and call your healthcare provider right away if you have severe pain in your stomach area (abdomen) that will not go away, with or without vomiting. You may feel the pain from your abdomen to your back
- gallbladder problems. Saxenda® may cause gallbladder problems, including gallstones. Some gallbladder problems need surgery. Call your health care provider if you have any of the following symptoms: pain in your upper stomach (abdomen), fever, yellowing of your skin or eyes (jaundice), and clay-colored stools
- low blood sugar (hypoglycemia) in people with type 2 diabetes who also take medicines to treat type 2 diabetes. Saxenda® can cause low blood sugar in people with type 2 diabetes who also take medicines used to treat type 2 diabetes (such as sulfonylureas). In some people, the blood sugar may get so low that they need another person to help them. If you take a sulfonylurea medicine, the dose may need to be lowered while you use Saxenda®. Signs and symptoms of low blood sugar may include: shakiness, sweating, headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, and feeling jittery. You should check your blood sugar before you start taking Saxenda® and while you take Saxenda®
- increased heart rate. Saxenda® can increase your heart rate while you are at rest. Your health care provider should check your heart rate while you take Saxenda®. Tell your health care professional if you feel your heart racing or pounding in your chest and it lasts for several minutes when taking Saxenda®
- kidney problems (kidney failure). Saxenda® may cause nausea, vomiting, or diarrhea leading to loss of fluids (dehydration). Dehydration may cause kidney failure, which can lead to the need for dialysis. This can happen in people who have never had kidney problems before. Drinking plenty of fluids may reduce your chance of dehydration. Call your health care provider right away if you have nausea, vomiting, or diarrhea that does not go away, or if you cannot drink liquids by mouth
- serious allergic reactions. Serious allergic reactions can happen with Saxenda®. Stop using Saxenda® and get medical help right away if you have any symptoms of a serious allergic reaction
- depression or thoughts of suicide. You should pay attention to any mental changes, especially sudden changes, in your mood, behaviors, thoughts, or feelings. Call your health care provider right away if you have any mental changes that are new, worse, or worry you
Common side effects of Saxenda® include nausea, diarrhea, constipation, headache, vomiting, low blood sugar (hypoglycemia), decreased appetite, upset stomach, tiredness, dizziness, stomach pain, and changes in enzyme (lipase) levels in your blood. Nausea is most common when first starting Saxenda®, but decreases over time in most people as their body gets used to the medicine. Tell your health care professional if you have any side effect that bothers you or that does not go away.
Please see full Prescribing Information and Medication Guide for Saxenda®.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
5- CONTRAVE(naltrexone HCl/bupropion HCl): increased the firing rate of pomc neurons which regulate appetite/ act on mesolimbic dopamin circuit (reward system)promote satiety not schedule yet
What should I avoid while taking CONTRAVE?
- Do not drink a lot of alcohol while taking CONTRAVE. If you drink a lot of alcohol, talk with your healthcare provider before suddenly stopping. If you suddenly stop drinking alcohol, you may increase your chance of having a seizure.
Who should not take CONTRAVE
Do not take CONTRAVE if you:
- have uncontrolled high blood pressure
- have or have had seizures
- use other medicines that contain bupropion such as WELLBUTRIN, WELLBUTRIN SR, WELLBUTRIN XL, and APLENZIN
- have or have had an eating disorder called anorexia or bulimia
- are dependent on opioid pain medicines or use medicines to help stop taking opioids such as methadone or buprenorphine, or are in opiate withdrawal
- drink a lot of alcohol and abruptly stop drinking, as this may increase your chance of having a seizure; or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines and you stop using them all of a sudden
- have taken medicines called monoamine oxidase inhibitors (MAOIs), including linezolid, within the last 14 days
- are allergic to any of the ingredients in CONTRAVE
- are pregnant or planning to become pregnant. Tell your healthcare provider right away if you become pregnant while taking CONTRAVE