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.

simple math:

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:

1. 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.

MEDICATION:
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 weight^a 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.

https://www.saxenda.com/?campaign=000870391&modal=isi&utm_source=google&utm_medium=cpc&utm_term=saxenda&utm_campaign=Saxenda+Brand+Expanded&utm_group=Misspellings+Exact_-mkwid-s8aCjWVzl_dc-pcrid-150820604810-pkw-saxenda-pmt-e-&gclid=CI6PieOy_NECFQctaQodFyoCPQ

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

contrave.com