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Weight, Obesity, and BMI


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Obesity is a worldwide epidemic. Approximately one out of every three Americans is obese, according to the National Institutes of Health. Particularly disturbing is the increase of obesity in children. According to the Nemours Foundation, 10 percent of 2- to 5-yearolds and more than 15 percent of children between the ages of 6 and 19 are overweight.1 In response to this trend and in consideration of the health risks of being overweight, weight-loss drugs are in great demand. Weight-loss drugs refer to any over-the-counter or prescription drug used for weight loss. Like any drug, these weight-loss aids present varying degrees of risk. Many doctors advise patients to assume the risks of these drugs even to experience the average 5- to 10-percent weight loss. This risk was grossly miscalculated, however, with drugs such as Redux and Fen-phen, which caused some consumers permanent heart and lung damage. This book will describe the health and emotional implications of being overweight, the biological mechanisms of weight-loss drugs, and the benefits and side effects of these drugs. Weight-Loss Drugs: Pills and Supplements Weight-loss drugs are intended to enable patients to lose weight more effectively than diet or exercise alone by suppressing appetite, inhibiting the absorption of fat, or in some cases, increasing the metabolism slightly. Maximum weight loss as a direct result of the drugs will generally show results within the first six months. A patient could also lose weight due to the drugs after the first six months, but it be a moderate weight loss. The length of time during which a person will continue to lose weight as a direct result of the weight-loss drug depends on how long it takes his or her body to adjust to the medication. Despite the efficacy of weight-loss drugs, the likelihood of losing significant weight without also increasing exercise or making dietary changes is unlikely. For this reason, patients should always incorporate at least some form of exercise and dieting as part of their weight-loss plan. Even if a patient’s weight loss has leveled and he or she has reached a target weight, the individual must continue to take the medication to maintain the weight loss; this is controversial because some doctors believe the safety of taking many of these drugs for decades is not yet well known. We know that many weight-loss drugs cannot be taken long term, and therefore the patient must switch to another weight-loss drug, further increase exercise, or adjust his or her diet. Weight-loss drugs are generally prescribed for people who are obese, not those who are slightly overweight or those looking to get ultra-slim. The most common guideline used to determine who is underweight, normal weight, overweight, or obese, is the body mass index (BMI). The body mass index is a guideline of how appropriate a person’s weight is given his or her height. BMI is a number that represents weight divided by height squared. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) define the weight status categories with BMI ranges for adults in the following table:


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