Can Being Overweight Lead to Breast Cancer?

Can Being Overweight Lead to Breast Cancer?…

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The statistics surrounding breast cancer are staggering. One in eight women in the United States will develop invasive breast cancer in her lifetime. More than 315,000 women will receive a new breast cancer diagnosis this year alone. Breast cancer claims the lives of more women in the U.S. than any other cancer, except lung cancer. (Source:breastcancer.org) There are multiple factors that have been linked to an increased risk of breast cancer: gender , age, race, family history, genetic mutations and weight. While we have no control over most of these factors, one thing we can manage or control is our weight, and doing so is essential to preventing life-threatening diseases, such as cancer. It’s important to note that while breast cancer is most common in women, about 2,400 new cases of breast cancer will be diagnosed in men this year. About one  in 1,000 men will develop breast cancer in his lifetime. Many research studies have shown a link between a higher BMI (a measure of body fat percentage based on height and weight) and an increase in risk of breast cancer in postmenopausal women. According to the National Cancer Institute, women who are overweight or obese may be as much as 40 percent more likely to develop breast cancer compared with normal weight women. Why are postmenopausal women who are overweight or obese more likely to develop breast cancer? One word: estrogen. Fatty tissue is the largest source of estrogen production for postmenopausal women. Fat contains an enzyme called aromatase that converts hormones called androgens to estrogens. Carrying excess weight means higher estrogen levels, and women with higher estrogen levels are more likely to be diagnosed with breast cancer compared to women with lower estrogen levels. Are you at risk of breast cancer due to obesity? According to the National Institutes of Health, adults with a body mass index (BMI) 30.0 or higher are considered obese. Adults with a BMI between 25.0 and 29.9 are considered overweight. Use this BMI calculator from the National Heart, Lung, and Blood Institute to calculate your BMI. Women who are overweight or obese can reduce their risk of breast cancer by losing weight. Research from the Nurses’ Health Study found that women who lost weight and kept it off for at least four years after menopause were 40 percent less likely to develop breast cancer. Weight loss surgery has been proven an effective tool at helping women lose weight and reduce their cancer risk. Women who have undergone bariatric surgery may be 83 percent less likely to develop cancer. A reduced risk of cancer after weight loss surgery is due not only to a reduction in fatty tissue, but to changes in body chemistry that promote disease prevention and symptom control. If you are overweight or obese, contact us today to learn how weight loss surgery can help improve your health and reduce your risk of cancer.

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One of the most experienced weight loss surgeons in the country along with a full staff of surgeons, nurses and other experienced clinicians, help patients reverse obesity with LAP-BAND, Gastric Bypass, Sleeve Gastrectomy, Gastric Balloon and Revisions.

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Dance Moms’ Abby Lee Miller Has Lost 100 Pounds In Prison

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Things are looking up for Abby Lee Miller after gastric bypass Surgery.

A resource close to the previous Dance Moms celebrity informs ET that she will be released from the Federal Correctional Facility in Victorville, The Golden State, on Feb. 20. Miller was originally sentenced to one year and eventually in federal jail last July after pleading guilty to personal bankruptcy fraudulence in June 2016. When she is evetnually realeased, Miller will be required to report directly to a midway house in Van Nuys, The golden state, the resource states, due to the terms of her sentence. The length of time she is required to remain there is unknown at this time. According to our resource, followers could anticipate a much changed appearance in her looks for the 51-year-old reality celebrity, as she ‘s lost about 100 extra pounds and is really feeling “excellent ” because going into the penitentiary 6 months ago gave her the encouragement to follow a new health regime which she would have found difficult to follow otherwise. She has actually already requested multiple surgeries for when she ‘s released, including a tummy tuck, bust lift and excess skin removal. Last April, prior to her sentencing, the dance trainer underwent gastric bypass surgery, a procedure that decreased her stomach by 80 percent. “I believe this is the correct time, ” Miller specifically showed ET at the time. “People are claiming, ‘But your sentencing is turning up in a couple weeks! ‘ Which holds true, as well as I ‘m actually nervous regarding that– more compared to the surgical procedure– however there ‘s no appropriate time. “As ET previously reported, Miller was declared guilty of insolvency fraudulence in Pittsburgh, Pennsylvania. In addition to serving time, Principal Judge Joy Flowers Conti ordered the reality celebrity to pay a $40, 000 fine and offer 2 years probation after her time behind bars. A couple of weeks before she headed to prison, Miller informed ET that offering time would really be a possibility for her to concentrate solely on herself. “I ‘ve always placed everyone else ‘s kid first prior to my very own health, prior to my own outlook, prior to my very own timespan, ” she discussed. “Everybody else was clothed and out the door as well as looking perfect and I was running around attempting to find a clean towel to take a shower with, so I assume this will be a little ‘me ‘ time. We wish her well.

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, End Obesity Management Market Worldwide by Surgery, Prescription Weight-Loss Medication

Prescription Medications to Treat Over-weight and Obesity for people from Ashburn

weight loss surgery france HandbookHow do you define:- “over weight” and “obesity”?

Health care providers use the Body Mass Index (BMI), which is a measure of your weight in relation to your height, to define overweight and obesity. People who have a BMI between 25 and 30 are considered overweight. Obesity is defined as having a BMI of 30 or greater. You can calculate your BMI to learn if you are overweight or obese. Being overweight or obese may increase the risk of health problems. Your health care provider can assess your individual risk due to your weight. Obesity is a chronic condition that affects more than one in three adults in the United States. Another one in three adults is overweight. If you are struggling with your weight, you may find that a healthy eating plan and regular physical activity help you lose weight and keep it off over the long term. If these lifestyle changes are not enough to help you lose weight or maintain your weight loss, your doctor may prescribe medications as part of your weight-control program.

How do weight-loss medications work?

Prescription medications to treat overweight and obesity work in different ways. For example, some medications may help you feel less hungry or full sooner. Other medications may make it harder for your body to absorb fat from the foods you eat.

Who might benefit from weight-loss medications?

Weight-loss medications are meant to help people who may have health problems related to overweight or obesity. Before prescribing a weight-loss medication, your doctor also will consider the likely benefits of weight loss the medication’s possible side effects your current health issues and other medications your family’s medical history cost Health care professionals often use BMI to help decide who might benefit from weight-loss medications. Your doctor may prescribe a medication to treat your overweight or obesity if you are an adult with a BMI of 30 or more or a BMI of 27 or more and you have weight-related health problems, such as high blood pressure or type 2 diabetes. Weight-loss medications aren’t for everyone with a high BMI. Some people who are overweight or obese may lose weight with a lifestyle program that helps them change their behaviors and improve their eating and physical activity habits. A lifestyle program may also address other factors that affect weight gain, such as eating triggers and not getting enough sleep.

Can children or teenagers take weight-loss medications?

The U.S. Food and Drug Administration (FDA) has approved most weight-loss medications only for adults. The prescription medication orlistat (Xenical) is FDA-approved for children ages 12 and older.

Can medications replace physical activity and healthy eating habits as a way to lose weight?

Medications don’t replace physical activity or healthy eating habits as a way to lose weight. Studies show that weight-loss medications work best when combined with a lifestyle program. Ask your doctor or other health care professional about lifestyle treatment programs for weight management that will work for you. Weight-loss medications don’t replace physical activity and healthy eating habits.

What are the benefits of using prescription medications to lose weight?

When combined with changes to behavior, including eating and physical activity habits, prescription medications may help some people lose weight. On average, people who take prescription medications as part of a lifestyle program lose between 3 and 9 percent more of their starting body weight than people in a lifestyle program who do not take medication. Research shows that some people taking prescription weight-loss medications lose 10 percent or more of their starting weight.1 Results vary by medication and by person. Weight loss of 5 to 10 percent of your starting body weight may help improve your health by lowering blood sugar, blood pressure, and triglycerides. Losing weight also can improve some other health problems related to overweight and obesity, such as joint pain or sleep apnea. Most weight loss takes place within the first 6 months of starting the medication.  

What are the concerns with using prescription medications to lose weight?

Experts are concerned that, in some cases, the side effects of prescription medications to treat overweight and obesity may outweigh the benefits. For this reason, you should never take a weight-loss medication only to improve the way you look. In the past, some weight-loss medications were linked to serious health problems. For example, the FDA recalled fenfluramine and dexfenfluramine (part of the “fen-phen” combination) in 1997 because of concerns related to heart valve problems. Possible side effects vary by medication and how it acts on your body. Most side effects are mild and most often improve if you continue to take the medication. Rarely, serious side effects can occur.

Tips for Taking Weight-loss Medication

Follow your doctor’s instructions about weight-loss medications. Buy your medication from a pharmacy or web distributor approved by your doctor. Take weight-loss medication to support your healthy eating and physical activity program. Know the side effects and warnings for taking any medication. Ask your doctor if you should stop taking your medication if you are not losing weight after 12 weeks. Discuss other medications, including supplements and vitamins, you are taking with your doctor when considering weight-loss medications. Avoid taking weight-loss medications during pregnancy or if you are planning a pregnancy.  

Which weight-loss medication might work for me?

Choosing a medication to treat overweight or obesity is a decision between you and your doctor. Important factors to consider include the likely benefits of weight loss the medication’s possible side effects your current health issues and other medications your family’s medical history cost Talk with your doctor about which weight-loss medication might be right for you.

How long will I need to take weight-loss medication?

How long you will need to take weight-loss medication depends on whether the drug helps you lose and maintain weight and whether you have any side effects. If you have lost enough weight to improve your health and are not having serious side effects, your doctor may advise that you stay on the medication indefinitely. If you do not lose at least 5 percent of your starting weight after 12 weeks on the full dose of your medication, your doctor will probably advise you to stop taking it. He or she may change your treatment plan or consider using a different weight-loss medication. Your doctor also may have you try different lifestyle, physical activity, or eating programs; change your other medications that cause weight gain; or refer you to a bariatric surgeon to see if weight-loss surgery might be an option for you. Because obesity is a chronic condition, you may need to continue changes to your eating and physical activity habits and other behaviors for years—or even a lifetime—to improve your health and maintain a healthy weight.

Will I regain some weight after I stop taking weight-loss medication?

You will probably regain some weight after you stop taking weight-loss medication. Developing and maintaining healthy eating habits and increasing physical activity may help you regain less weight or keep it off. Federal physical activity guidelines recommend at least 150 minutes of physical activity per week for adults—that’s about 30 minutes a day most days of the week. You may need to do more to reach or maintain your weight-loss goal.    

What medications are available to treat overweight and obesity?

The table below lists FDA-approved prescription medications for weight loss. The FDA has approved five of these drugs—orlistat (Xenical, Alli), lorcaserin (Belviq), phentermine-topiramate (Qsymia), naltrexone-bupropion (Contrave), and liraglutide (Saxenda)—for long-term use. You can keep taking these drugs as long as you are benefiting from treatment and not having unpleasant side-effects. Some weight-loss medications that curb appetite are approved by the FDA only for short-term use, or up to 12 weeks. Although some doctors prescribe them for longer periods of time, not many research studies have looked at how safe and effective they are for long-term use. Pregnant women should never take weight-loss medications. Women who are planning to get pregnant also should avoid these medications, as some of them may harm a fetus.

Prescription Medications Approved for Overweight and Obesity Treatment

Weight-loss medication Approved for How it works Common side effects Warnings Orlistat (Xenical) Available in lower dose without prescription (Alli) Adults and children ages 12 and older Works in your gut to reduce the amount of fat your body absorbs from the food you eat diarrhea gas leakage of oily stools stomach pain Rare cases of severe liver injury have been reported. Avoid taking with cyclosporine. Take a multivitamin pill daily to make sure you get enough of certain vitamins that your body may not absorb from the food you eat. Lorcaserin (Belviq) Adults Acts on the serotonin receptors in your brain. May help you feel full after eating smaller amounts of food. constipation cough dizziness dry mouth feeling tired headaches nausea Tell your doctor if you take antidepressants or migraine medications, since some of these can cause problems when taken together. Phentermine-topiramate (Qsymia) Adults A mix of two medications: phentermine, which lessens your appetite, and topiramate, which is used to treat seizures or migraine headaches. May make you less hungry or feel full sooner. constipation dizziness dry mouth taste changes, especially with carbonated beverages tingling of your hands and feet trouble sleeping Don’t use if you have glaucoma or hyperthyroidism. Tell your doctor if you have had a heart attack or stroke, abnormal heart rhythm, kidney disease, or mood problems. MAY LEAD TO BIRTH DEFECTS. DO NOT TAKE QSYMIA IF YOU ARE PREGNANT OR PLANNING A PREGNANCY. Do not take if you are breastfeeding. Naltrexone-bupropion (Contrave) Adults A mix of two medications: naltrexone, which is used to treat alcohol and drug dependence, and bupropion, which is used to treat depression or help people quit smoking. May make you feel less hungry or full sooner. constipation diarrhea dizziness dry mouth headache increased blood pressure increased heart rate insomnia liver damage nausea vomiting Do not use if you have uncontrolled high blood pressure, seizures or a history of anorexia or bulimia nervosa. Do not use if you are dependent on opioid pain medications or withdrawing from drugs or alcohol. Do not use if you are taking bupropion (Wellbutrin, Zyban).

How do doctors use prescription medications “off-label” to treat overweight and obesity?

Sometimes doctors use medications in a way that’s different from what the FDA has approved, known as “off-label” use. By choosing an off-label medication to treat overweight and obesity, your doctor may prescribe a drug approved for treating a different medical problem two or more drugs at the same time a drug for a longer period of time than approved by the FDA You should feel comfortable asking your doctor if he or she is prescribing a medication that is not approved just for treating overweight and obesity. Before using a medication, learn all you need to know about it.

What other medications for weight loss may be available in the future?

Researchers are currently studying several new medications and combinations of medications in animals and people. Researchers are working to identify safer and more effective medications to help people who are overweight or obese lose weight and maintain a healthy weight for a long time. Future drugs may use new strategies, such as to combine drugs that affect appetite and those that affect addiction (or craving) stimulate gut hormones that reduce appetite shrink the blood vessels that feed fat cells in the body, thereby preventing them from growing target genes that affect body weight change bacteria in the gut to control weight

References

[1] Yanovski SZ, Yanovski JA. JAMA. Long-term drug treatment for obesity: A systematic and clinical review. 2014; 311(1):74–86.

July 2016 Share

Additional Information sources

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts. The NIDDK would like to thank: Kishore Gadde, M.D., Pennington Biomedical Research Center

The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center

   

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Wendy Williams brags weight loss, plastic surgery boob job after beach body diss

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Poor #Wendy Williams can’t win for losing. She’s still dealing with shade over her bikini body. The radio host shared pictures of herself in a string bikini on Instagram and that set off a barrage of body-shaming toward her “transgender” look, boob job, saggy skin and plastic surgery. The celebrity shut down the Twitter diss storm saying she’s “got in goin’ on” with a tight tummy after weight loss. But all followfolks saw was a beach body fail.

Wendy Williams dissed on breast implant, skinny body

After a boasted 50-lb weight loss not long ago, Wendy Williams braved to beach to show off her slimmed down bikini body. But since the TV celebrity has had had extensive breast implant procedures, the effect is top-heavy. That’s putting it mildly according to many social media commenters. One said “The Wendy Williams Show” host looked like an improper fraction. Others were horrified by saggy skin and cellulite. At first Williams laughed it off saying that as a celebrity commenter herself she couldn’t live in a glass house.

Wendy Williams called transgender in bikini pic

Comparisons were made to Michael Jackson. Another Twitter user saw Roger from American Dad in one of his female impersonator disguises. Reality TV [VIDEO] star Mama June Shannon can be thankful that Honey Boo Boo and Pumpkin talked her out of the size F boob job. Shannon posed in the Baywatch suit both in obesity and after bariatric surgery and weight loss. But June says she’ll never wear a bikini due to tummy tuck, skin removal and gastric bypass surgery scars

Wendy Show host loves her “tight” body

The talk show host had to start her new season off talking down bikini body dissing. Much of the body-shaming focused on the loose skin. Folks said Williams needed some skin removal surgery herself. Wendy says her skin is taut and the tummy is tight and free of belly fat. She claims that it’s from weight loss but most folks said it looked more like a tummy tuck taken to extremes. Her boob job and nose job, implants, and facelift stood out like sore thumbs.

What’s body-shaming and what’s truth-saying?

Usually when there’s online body-trolling, it’s of the fat-shaming kind. Oprah Winfrey has dealt with this for some time, but seems to have mastered her obesity without weight loss surgery. And folks have thin-shamed too. This often involves very slender #Celebrities being “accused” of having an eating disorder (like it’s a fault and something to be ashamed of). Sometimes it turns out to be anorexia, but often, as with Sarah Hyland, it’s a health condition. The big issue seems to be the boob job. When done with a tummy tuck it can make weight loss appear greater. In Wendy Williams’ case, it seems to have been exaggerated, howeve See all stories on this topic Read more…

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Weight Loss Surgeries May Make You Anemic Later in Life: Study

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Weight Loss Surgeries May Make You Anemic Later in Life:

An American based study indicates that the risk of long-term loss of healthy red blood cells, otherwise known as anemia, may be associated with weight loss surgeries.

Have you been considering a weight reduction surgery? Here’s a piece of information that you might be interested in. An American based study indicates that the risk of long-term loss of healthy red blood cells, otherwise known as anemia, may be associated with weight loss surgeries. In the study, published in the journal JAMA Surgery, people who got a common form of weight-loss (bariatric) surgery, faced symptoms of anemia later. Anemia rates were found to be on a higher side 10 years after the surgery, noted the researchers. Scientists who reviewed the study explained that anemia is a common problem in patients who have undergone gastric bypass, and the severity of problem may increase in patients who don’t receive adequate treatment, adding to certain side effects of the surgery such as vitamin and mineral deficiency. For the study, the team tracked outcomes for 74 older male veterans, with the average age of 51, who underwent a common type of weight-loss surgery called Roux-en-Y gastric bypass. The findings revealed that the overall rate of anemia before the surgery was 20 percent. The team further noted that 10 years after surgery that number had risen to 47 percent. The study also finds that anemia was much more common among patients who did not have close follow-up care with a weight-loss surgeon. For such patients, who discontinued their follow up care, anemia rates rose from 22 percent before surgery to 57 percent a decade later. The scientists noted that while bariatric surgery may help curb obesity, but patients should not believe that they are cured and must continue to follow medical direction for the duration of their life. Obesity is a disorder involving excessive body fat that increases the risk of health problems. Obesity is often tied to health problems such as heart disease and diabetes. Here are some suggestions to control excess weight gain. 1.Eat more whole grains: Whole grains provide energy and are also full of essential nutrients. Stock up on whole grains like Bajra, Ragi, Maize and Jowar and use them often. Try red, black and brown rice instead of refined white rice. 2.Keep trans fats away: Industrial trans fats may be present in fast foods, snack foods, cookies, margarine and spreads. Read the labels and find better substitutes. 3.Do not skip meals: Yes, as counter-intutive as it may sound, but it is essential to keep your diet in place to maintain healthy weight. Eat three balanced meals. Take a standard dinner plate, fill with vegetables, 1/3rd with cereal, 1/3rd with the protein and add 150 ml of milk or dahi. 4. Apples can help: Apples contain pectin, a type of fiber that keeps you feeling fuller for longer. Apples can be great mid-meal snacks. 5. Load up on strawberries: Strawberries are extremely low in calories and pack heaps of antioxidants and Vitamin C. An entire cup of strawberries barely contains 50 calories! These simple diet tweaks will not only help you lose weight but also maintain it Read more…

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Weight Loss – Four Tips To Prevent A Stall

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Weight Loss – Four Tips To Prevent you from stopping your weight loss programme

Worried about what could be stalling your weight loss progress? Have you been following your diet without missing a beat, seeing good results for the first few weeks and then suddenly, all improvements in your weight loss readings stopped? You might have been frustrated – ready to toss in the towel. But don’t be so quick to do that just yet! The fact is, you can overcome a weight loss stall with a few smart strategies. Let us look at what you need to know to get this handled… 1. Triple Check Your Counting. One of the main reasons people stop seeing results is they become lazy with their calorie counting. Remember, you must count calories accurately if you hope to see ongoing success. If you mistakenly miscount your calories, this could easily cost you your results. If you are 200 to 300 calories over each day, this will wipe out the progress you should be seeing. 2. Increase Your Macronutrients. Another thing to try is to raise your number of macros: your carbohydrates, protein, and fats. Or, if you have been using a higher carb diet, try a lower carb one instead as this might jump-start your progress. Likewise, if you have been on a low-carb diet, try a higher carb one instead. Sometimes a simple switch is all you need. 3. Try A Refeed. If the above fails, you might want to try a refeed. If you have been dieting for weeks on end, a higher calorie day or two could help restart your stalled metabolism, giving you faster progress again. Try eating 500 to 1000 calories more for one or two days, making most of those calories from carbohydrate foods. Then see if that doesn’t restart fat burning when you move back onto your fat loss plan. 4. Reconsider Your Approach. Finally, if this all fails, you may need to review your calorie intake entirely. Perhaps you need to adjust it down since you have lost weight? Remember weight loss requires continual adjustments, so do not be afraid to make changes as you go about your weight loss plans. Keep these tips in mind, and you can ensure you continually see progress on your weight loss plan. Anyone who starts making changes to their diet reaps tremendous health benefits almost immediately. One study revealed people who ate a low-fat, high-fiber diet, and who also added forty minutes of physical activity to their day, found…
  • they lowered their blood pressure,
  • improved their cholesterol levels, and
  • reduced their insulin levels
in just three weeks. Just ensure you keep your weight on the downward slope.
Although managing Type 2 diabetes can be very challenging, it is not a condition you must just live with. Make simple changes to your daily routine – include exercise to help lower both your blood sugar levels and your weight. For nearly 25 years, Beverleigh Piepers has searched for and found a number of secrets to help you build a healthy body. Go to http://DrugFreeType2Diabetes.com to learn about some of those secrets
Article Source: http://EzineArticles.com/9774969
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Healthy Living – Four Tips For Maintaining A Healthy Body Weight

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Healthy Living – Four Tips For Maintaining A Healthy Body Weight

get gastric sleeve surgeryLooking to maintain a healthy body weight in Ashburn?
Looking to maintain a healthy body weight? Whether you have been dieting in the last little while and have finally reached your goal weight or you simply are looking to ensure you do not gain weight going forward, there are a few tips that can assist in ensuring you stay on track. Let us look at four different strategies you can use to keep your weight in check. Four strategies not requiring intricate calorie counting… 1. Add More Protein. If you hate counting calories but want to do your best to prevent weight gain, consider adding more protein to your diet plan. Protein is the nutrient tending to be the most satisfying, so is what you are least likely to overeat. As a result, you will feel more satisfied after every meal. Thus your chances of eating more than you should go down. Aim to take in at least 15 grams of protein with each snack and 20 to 30 grams with each meal to achieve this effect. 2. Sip Water Throughout The Day. Dehydration can cause food cravings in many people, leading you to eat when you just needed to have a drink. To avoid this, sip water throughout the day. Carry a jug of water with you wherever you go and make a concentrated effort to drink it between meals. It can help to get a gallon jug of water and fill it up once in the morning and then make sure by dinner time you have drunk it all. A gallon jug of water will provide a little extra over what you need but will be beneficial if you are also leading an active lifestyle. 3. Set Fitness Focused Goals. Do not fall into the trap of thinking once you have reached your body weight goal that is it. Set a new goal. Focus on something fitness related. Train for a 10km race or focus on adding 20 pounds to your squat or bench press exercise. By having a new goal to work towards, you will help sustain better overall focus on your fitness plan, and this can lead to healthier eating efforts as well. 4. Allow For Indulgence. Finally, do not be too strict on yourself. Make sure you are allowing for overeating every so often. Remember your diet should make room for fun foods as well. Otherwise, it is not a diet you will want to be on for the long-term. If you keep these tips in mind, you should have no problem sustaining a healthy body weight well into the months ahead.
Although managing Type 2 diabetes can be very challenging, it is not a condition you must just live with. Make simple changes to your daily routine – include exercise to help lower both your blood sugar levels and your weight. For nearly 25 years, Beverleigh Piepers has searched for and found a number of secrets to help you build a healthy body.
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Bariatric surgery could help solve Ireland’s obesity crisis and save the country billions

Weight Loss surgery could help solve Ireland’s obesity crisis and save the country billions

A group of doctors say that, for many people, prevention methods are already too late and other interventions are needed.

lowest price for gastric sleeve surgery in FranceBLifestyle factors only get you so far. To prevent the children who are obese today from becoming adults who are obese in the next 10 years, you have to offer treatment. It’s the only way. ACCORDING TO THE latest estimates, only one in every 10 Irish men will not be overweight or obese by 2030. By 2025, we’re set to be one of the most overweight nations in Europe. Already, six in every 10 people in Ireland are overweight. The HSE says that the cost of adult obesity in Ireland is estimated to be €1.3 billion per annum, €400 million of which is direct healthcare costs. That figure could rise even further in the future, as the population’s weight increases. While a number of prevention strategies are essential, some doctors say that for people who are already obese, it is already too late. As a result, a disparate group of health organisations, including Diabetes Ireland, the Irish Society for Clinical Nutrition and Metabolism and Irish Nutrition and Dietetic Institute, are calling on the government and HSE to introduce a variety of health interventions for overweight or obese people, with surgery one of the main options put forth. They say that, from a public health and economic point of view, their case is compelling. “No way of avoiding it” Dr Grace O’Malley lectures at the Royal College of Surgeons in Ireland and also works at Temple Street Children’s University Hospital. She told TheJournal.ie that there is a cost-effectiveness in providing surgery for obese people, particularly those with type-2 diabetes, that hasn’t yet been fully explored in Ireland. O’Malley said that a coordinated approach of GP care, dietitians, chartered physios and clinical psychologists could all play a role, as could surgical interventions. “The idea of willpower and individual responsibility works to a point, ” she said. “When a disease like obesity has ingrained itself in the body to an extreme level, reversing it through lifestyle approaches becomes harder and harder. Look to the evidence, currently it suggests that bariatric procedures are effective at reducing morbidity and reducing mortality. It’s actually saving money in the long run because you’re not spending on medication. So what is bariatric surgery? It can take several different forms. The gold standard surgery comes in two forms – a gastric bypass or gastresctomy – and both are minimally invasive. Within a year of treatment,  a patient’s excess body weight can be cut in half. Helen Heneghan, bariatric surgeon at St Vincent’s Hospital and St Columcille’s Hospital in Dublin, told TheJournal.ie that the results for obese patients with type-2 diabetes can be drastic. She said: “Within 24 hours of a gastric bypass for example, we routinely see patients achieve normal blood sugars by the following morning. At least 80% of patients can achieve that a year after surgery. We know five years after that a patient may need medication, but they don’t go back on insulin. There’s a strong health and economic argument. If you can reduce the cost of treating a type-2 diabetic overnight, it’s quite clear what we need to do.

Huge savings

Up to now, these surgeries have been performed rarely in Ireland. We do just one of these surgeries per 100, 000 population here. It’s 20 times that in the UK. It’s around 80 times that in Sweden. These doctors, in citing evidence to support their case, mainly draw on international examples but also say that research on the surgeries performed last year in Ireland support their case too. Taking 15 patients, with hard-to-treat type-2 diabetes, who received bariatric surgery in 2016, a comparison was made between how much they spent on insulin before and how they spent after. O’Malley said: “Beforehand, they were spending an estimated €8 per day for insulin. After the surgery they were, on average, spending 23 cent a day. And that’s an immediate reduction of 97%. That’s a huge amount.” Both O’Malley and Heneghan said they wished they could provide more data but, despite hundreds of people on waiting lists, the number of bariatric procedures performed last year was extremely low. Heneghan said that only being able to provide data from 15 patients was “dismal” while O’Malley said “it’s a shame but that’s all we’ve done”. Heneghan went on: “No drug treatment can put diabetes into remission like that. It’s a chronic, relentless disease that often leads to damaging, and quite costly, complications. Things like cardiovascular disease, stroke. It’s hugely costly to our health service.

Weight Loss Surgery Funding

The main barrier to more surgeries being done in Ireland at the moment is funding. The HSE launched a 10-year plan last year to fight obesity in Ireland, and recently appointed the first national clinical lead in this area,  Professor Donal O’Shea. “But the new clinical lead is going to need support, ” O’Malley said. “This condition has only really developed over the last 20 years. Financial support is needed to do what needs to be done.” According to estimates based on figures from the World Health Organisation, the World Bank and an in-depth study of when the surgeries began to be routinely performed in Australia, it would cost about €400 million of investment into providing these surgeries on a wider level nationwide. “There’s a lot of evidence to show investment will make a difference, ” O’Malley said. Medication savings alone are a really good argument. And that’s not counting the savings from people not requiring treatment for obesity-related conditions. We’ve kicked our heels for too long. For a lot of people, it may already too late.

How many would benefit from bariatric Surgery?

According to figures provided by Diabetes Ireland, there are around 26, 000 people in the country with type-2 diabetes who are obese. “The vast majority of these people would benefit from surgery in the near future, ” Heneghan said. “We want to get to a point of 100 cases a year, ” she said. “But we could easily justify 400 cases a year in Ireland.” Only two publicly-funded hospitals offer such surgeries – in Galway and Dublin – but of the relatively small number of people on the waiting list, some have been waiting a long time for treatment. “There around 400 people on waiting lists for bariatric surgery in the country right now, ” Heneghan said. “And some of those would have been waiting for five or six years.”

“They Did it to themselves?”

If the most cost-effective treatment solution is so apparent, then why don’t we offer it routinely in Ireland? According to the doctors, there are a number of reasons for this and it is partly related to the way society views people with obesity. Routinely, according to scientific literature cited by the doctors, people who are overweight are told to simply change lifestyle factors and there may be a perception that they “did it to themselves”. Not so, according to O’Malley. She said: “There are ingrained judgemental attitudes and negative stigma towards people of larger size. For those of us working in the area, anyone who’s honest would say that when they began working in this field, they’d be quite judgemental too. She said that it is important to treat obesity as a disease, and approach treatment options to it as such. “Obesity is now linked with deprivation, ” O’Malley said. “Where there is lower socio-economic status, children are twice as likely to be obese. That can’t be ignored. If we were talking about the management of cancer, or other chronic disease, thankfully we’ve got to a stage where depending on the stage of that cancer, we have different treatments to offer that person. We don’t – and shouldn’t – withhold treatment based on their disease. Heneghan added that, for these surgical interventions to be the most effective, action must be taken now. “There may be tens of thousands who could benefit, ” she said. “We know that if you delay surgery, not only do the costs of treating patients medically accumulate, the likely benefit of the surgery reduced.” For its part, the HSE said it is committed to following through on its 10-year action plan. Taking his new role as the HSE’s clinical lead in obesity, Professor O’Shea cited lifestyle factors as important but said that there was “no magic bullet” to fixing the problems. He said: “Somehow we have to get this whole of government, whole of industry and whole of society approach to come alive – and take obesity on.” Heneghan added that, with current trends only going upwards in terms of the number of people in Ireland who are overweight or obese, the time to act is now: We have a window of opportunity over the next few years. We need to seize it before it’s too late. y Sean Murray Thursday 5 Oct 2017, 12:15 AM Oct 5th 2017

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