| Médecine | rencontres.bizland.com/ christian.htm
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| Weight control |  |
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| My intent is not to analyse the social
phenomenon behind this behaviour, but to give a medicaly-oriented view of the problem. So,
what is the ideal weight? The ideal weight is not medically defined. As strange as it seems, the first persons really interested in such an 'ideal weight' were the insurers. They knew that weight excess was positively correlated with death, and consecutively with life insurance wages. For a given sex and height a corresponding weight is appropriate. A good rule of thumb is to use the Body Mass Index (BMI), defined by Quetelet as the following ratio: weight (kg)/ height squared (m). Between 19 and 25 is considered as healthy. The fact that sudden weight change is a sign of disease is probably known from ancient agesTo be overweighted is a bad thing, but to be too meagre is a bad sign as well. The ideal weight is only defined in statistical terms. However, the number of diseases associated with weight loss (Diabetes, hyperthyroidism, chronic infection, urinary tract infection, abscess, Addison's disease, AIDS...) or weight gain (Diabetes, Cushing's disease...) is awesome. Reciprocally, inappropriate weight could trigger a series of diseases (heart diseases for instance). But before going further, one has to understand how weight is related to energy and energy to nutrients, namely glucids, lipids and proteins. |
Weight control, a twentieth century quest |
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 Carbohydrates (sugar, starch...) are the main fuel used by the body to produce energy. By "circulating" in this cycle, a glucose molecule generates the production of 34 ATP molecules. This represents many kilocalories.The Krebs cycle is also called "cellular respiration" cycle, for reasons that go beyond the scope of this short text. For those who want to know more, this is site worth a click: |
Proteins are composed of aminoacids. There are composed by 21 different aminoacids. With these 21 aminoacids, it is possible to build all the proteins constitutive of the body. However, only 10 aminoacids are able to enter the Krebs cycle to produce energy. Fats are "fatty acids". Cholesterol and triglycerides are the main representatives of this category. | |
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acid cycle From this, one could easily understand the algebra behind weight control: to lose weight, you have to decrease your intake or to increase your expenses, preferably both. Nobody is obese if he or she has no access to food, even if he or she is"genetically predisposed" to be obese. Genetics and weight control Well, many times people who are overweighted attribute their weight problem to heredity. "I am obese, because my parents were obese". At first sight, it seems logical. However, recent advances in molecular biology explain only a part of the obesity mechanisms. Most probable, cultural habits are more responsible than genes. The chances to be obese when educated in a family where people have bad eating habits are very high. There is a continuous increase of the percentage of obese persons in western countries. In US, this is a public health issue. A recent article in the JAMA (Journal of the American Medical Association), described that people who declare that they want to lose weight, do not exercise at all. Even a healthy person should exercise at least 30 minutes per day. People with a weight problem should consider exercise not only as a treatment, but also as "normalisation" of their life style. Modern life explains why young children are overweighted. They are watching TV while eating junk food. Cars and other devices (just count how many electric motors are dissimulated in your house appliances) facilitate everyday life at the expense of our health. The human metabolism was very well adapted in times where food was rare and not assured, but nowadays, food is abundant and it seems that the human body is not well prepared for this regime. Several theories suggest that obesity may be an expression of bad environmental factors and genetic determinants. Adipocytes are the fat cells. They literally contain fat. They play a role in energy homeostasis (energy control). It has been demonstrated that children, who are fed with large quantities of food, develop more adipocytes, leading to obesity when they are grown ups. Many hormones (insulin, glucorticoids) and cellular factors are playing a role too. Psychology and weight control Beauty is more and more a matter of weight. Top model and actors are fascinating for young people. Teenagers' role model are thin, almost bi-dimensional. Syndromes like anorexia-bulimia, are more and more frequent. There is a kind of distortion of the body image. Vitamins and other add-ons (L-carnitine, ginseng...) are mystifying people. But now, you know the basic equation: to lose weight, you have to limit your consumption and/or to increase your activity level. Tips to control your weightEat less: You don't need to be a doctor to know that one. Don't be fooled by "light food", do not compensate quality for quantity. You must feel hungry...and not eat. This is difficult, but after all, half a steak is as good as a complete portion. Starving is also an opportunity to "burn" your calories in excess, and to rediscover the pleasure of eating. Increase your activity level: no more lifts or escalators, don't use your car for short trips, use your legs. Thirty minutes of exercise are a minimum, so try to use your body. Fitness is good, provided that you do not compensate with snack bars or other "complementary" nutrients. And remember, do not exceed your capacity. It's far more clever to exercise slightly, but on a regular basis, rather than trying to be a champion. Eat differently: Try to discover new flavours. Do not eat meat at each meal. Green vegetables and fish are good for your health. Cuisine is an art, try to be creative. There is probably something healthy and appealing for you. Drink water: Do you know that you don't need to drink anything but water? This is trivial, but it seems that many people are using water only for cleaning purposes. Soft drinks are calories, and there is no need to have so many calories in a so poorly nutritive nutrient. A glass of Coke contains as much as 16 sugar cubes. Think: yes, thinking is an activity that burns calories. The brain can only use glucose for its functioning. When the blood glucose (sugar) is over, the liver compensates. In fact, some intellectual activities are consuming as much as a tennis match...this is something to consider. Do not eat without any reason: eating should always be linked to a physical need. To eat something, just for the pleasure of having something in the mouth has nothing to do with nutrition. It's more or less a return to what Freud used to call the oral stage. This behaviour has more to do with a kind of affective disorder. Food is a kind of a reward for the ego. So, be proud, do not eat over and over again. Just try to control your impulses. Be rigorous: Limit your food intake to predefined periods. Eat reasonable quantities. Limit your alcohol consumption. We tend to under-evaluate our alcohol dependence. Try this test: No alcohol during two weeks...and gauge your resistance. Try to analyse your eating pattern: obesity is becoming an epidemic disease, and the first step for a cure is to know your food habits. There is an alimentary culture, and some behaviours are so 'natural' that we don't pay attention anymore. Consult a doctor: if your obesity is very important, try to consult a physician. Some diets could help. The famous Slimfast could be useful, as well as the Weight Watcher (behavioural therapy) regime. Drugs are not very useful, although some drugs currently being tested (sibutramine ,Knoll Pharmaceuticals Co), could be interesting. Last but not least: do not be obsessive, otherwise your weight will change too fast and you could possibly gain weight afterwards. It's very bad to have an unstable weight. This is a long-term issue, do not expect immediate results. Molière, a classic French writer said: "you should eat to live, not live to eat!"...something to consider.
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