Bahamas Anti-Aging Medical Institute

It’s no longer news that America is in the midst of an epidemic of overweight and obesity, but debate remains over the causes and treatments. There’s no argument at all about the consequences – people who are overweight or obese are at significantly increased risk for a host of chronic diseases, including type 2 diabetes, atherosclerosis and resulting cardiovascular disease, osteoporosis, bone and joint conditions, and many more. It appears that it’s not simply the excessive weight itself that’s the culprit; rather, fat (adipose) tissue itself is biologically active, and may contribute to higher than normal degrees of inflammation, which in turn are associated with the long list of chronic diseases. Even the risk of certain cancers is increased in people who are overweight or obese. What’s to be done?

First it’s important to understand the definitions. Risks are established using a measure called body mass index (BMI), which is based on both weight and height. This is obviously important because a short person may be obese at a body weight that’s entirely normal for a taller person. According to the US Centers for Disease Control (CDC), a BMI of 18.5 – 24.9 is considered normal; a BMI of 25.0 – 29.9 falls into the category known as overweight, and people with BMI of 30.0 and above are defined as being obese. These definitions matter because different health risks are associated with BMI in each of the different ranges (for a very few conditions, BMI in the overweight, but not obese category is actually protective). You can find a BMI calculator at the CDC’s website at http://www.cdc.gov/nccdphp/dnpa/healthyweight/assessing/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm.

So once a person has determined that s/he is overweight or obese, what are the options? Any physician (or sensible person) will tell you that careful attention to diet and a regular exercise program are the most important first steps; they’ll also acknowledge, if they are both realistic and compassionate, that strict adherence to those programs is very, very difficult indeed. A first step is always a thorough physical examination by a physician, with appropriate blood testing to rule out or identify genuine abnormalities that might be contributing factors. This information should then be used to carefully map out a long-term plan that focuses on gradual increase in physical activity plus gradual elimination from the diet of foods known to induce obesity.

There are a few prescription weight loss drugs available today ^1-3, and countless over-the-counter drugs and supplements that target people desperate to lose weight ^4,5; studies have shown, however, that only a minority of people using these approaches actually lose weight, and that few of them adhere to the diet and lifestyle changes so vital to improving overall health³. Similarly, weight loss, or bariatric, surgery, while often dramatically effective in the short run, rarely contributes to important life habit changes ⁶.

A large number of dietary supplements is now emerging; some of these show genuine promise as means to enhance energy utilization and increase the metabolism (burning) of excessive fat tissue. Perhaps the most effective of these is fucoxanthin, an extract from brown seaweed that appears to stimulate enzyme systems in adult fatty tissue that are normally found only in infants ^7,8. These enzymes allow fat to expend calories in heat production, rather than requiring physical energy expenditure. But it’s still unknown whether these supplements can produce the lasting changes required to maximize health. Of course, good attention to overall nutrition, and supplementation with essential vitamins, minerals, antioxidants and natural anti-inflammatory agents is always necessary, and may be even more important for people who are engaged in a serious weight loss effort.

A wealth of important information on obesity and its prevention can be found at Life Extension Foundation’s on-line Health Concerns Textbook: http://www.lef.org/protocols/metabolic_health/obesity_01.htm.

References

(1) Khan LK, Serdula MK, Bowman BA, Williamson DF. Use of prescription weight loss pills among U.S. adults in 1996-1998. Ann Intern Med. 2001;134:282-286.

(2) Blanck HM, Khan LK, Serdula MK. Prescription weight loss pill use among Americans: patterns of pill use and lessons learned from the fen-phen market withdrawal. Prev Med. 2004;39:1243-1248.

(3) Blanck HM, Khan LK, Serdula MK. Diet and physical activity behavior among users of prescription weight loss medications. Int J Behav Nutr Phys Act. 2004;1:17.

(4) Egger G, Cameron-Smith D, Stanton R. The effectiveness of popular, non-prescription weight loss supplements. Med J Aust. 1999;171:604-608.

(5) Blanck HM, Khan LK, Serdula MK. Use of nonprescription weight loss products: results from a multistate survey. JAMA. 2001;286:930-935.

(6) Encinosa WE, Bernard DM, Steiner CA, Chen CC. Use and costs of bariatric surgery and prescription weight-loss medications. Health Aff (Millwood ). 2005;24:1039-1046.

(7) Maeda H, Hosokawa M, Sashima T, Funayama K, Miyashita K. Fucoxanthin from edible seaweed, Undaria pinnatifida, shows antiobesity effect through UCP1 expression in white adipose tissues. Biochem Biophys Res Commun. 2005;332:392-397.

(8) Maeda H, Hosokawa M, Sashima T, Funayama K, Miyashita K. Effect of medium-chain triacylglycerols on anti-obesity effect of fucoxanthin. J Oleo Sci. 2007;56:615-621.