Sunday, 20 September 2015

Doctor, why I'm fat?

On numerous occasions we have heard that that "as little and gain weight and, instead, others eat more and not gain weight." For what is this?
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Why am I fat?

No magic: the weight is a matter of energy balance. Moreover, the balance between energy consumption and energy expenditure. Your energy consumption is essentially your caloric intake, ie, it depends on your diet. Your energy expenditure, however, depends on:
  • Your age / stage of growth.
  • Your height.
  • Your weight.
  • Physical activity you do.
  • The thermogenic effect of food or calorie consumption involved in the process of digestion. Thus, if different foods or food outlets throughout the day are made, the more power used.
So, if you do not suffer any metabolic problem, your overweight because your calorie intake exceeds your energy expenditure.

Why I've gained at menopause?

At peak times, but for various reasons the energy balance is fattening. It is the case of menopause weight gain and changes in the shape at this stage are a reality and affect one in three women between 55 and 60 years.
The causes are many and varied:
  1. Decreases resting energy expenditure (the body is now less efficient burning fat).
  2. A progressive reduction of physical activity occurs.
  3. Estrogen levels fall, contributing to this condition less satiety.
  4. Increases abdominal fat level (increased fat and decreased lean tissue).

Why my child is overweight?

Although "but do not take things that fatten and exercise" is one of the most heard phrases in consultations pediatric endocrinology, most cases of childhood and adolescent obesity are due to caloric intake is higher than expenditure energy. And, in general, have a poor perception of caloric intake of many foods frequently consumed, they bring us many calories in not very large quantities. We speak of so-called "food trap":
  • chocolates (just a bit after eating all the vegetables)
  • refreshments (only weekends and celebrations, they are children!)
  • ketchup type sauce (because otherwise no food is eaten)
  • ready meals (when I have no time to cook)
  • sweet (as a reward for good behavior).
This, coupled with sedentary lifestyles that lead our children (school sport is not enough), usually ends in overweight and childhood obesity more or less severe.

What to do?

Forget fad diets that promise you much: they do not lose weight, but fluid and muscle mass, and is likely to quickly recover the lost kilos. It is also important to have in mind that when there is a shortage of food intake, the body tends to save or spend less energy. So, if you hardly move and eat little and badly, these calories accumulate in the body as fat and tend to not be consumed. This may be the case of people with a sedentary lifestyle and no complete or balanced diet, skip breakfast and then do a more copious lunch and dinner, etc.
It is possible to maintain a healthy weight and be healthy; a simple solution is based on an active life, made ​​between 4 or 5 light day and the food is varied and balanced diet (consisting of carbohydrates, vegetables, fruits, dairy, protein and fat in perspective-in adecuados- type and quantity).
WHEN THE WEIGHT IS MORE THAN A PROBLEM
If your BMI is over 40 (or over 35 but associated as diabetes, hypertension or heart disease, respiratory and / or joint disease), you can consider obesity surgery beyond diet and exercise.
At present, there are many techniques for intervention, allowing tailor treatment to each case and not vice versa. The simplest techniques such as adjustable gastric band, seeking to reduce the capacity of the stomach for a prolonged feeling of satiety after ingestion of food, thus reducing the amount of food that can be taken. More complex, such as gastric bypass, associated reduction of the stomach and intestinal bypass and are most effective in losing weight and, particularly, to solve the associated problems (diabetes, hypertension). All are safe, effective and with very low complication rates, are performed in less than 45 minutes and are minimally invasive.
In all these cases, candidates are carefully selected after evaluation by a multidisciplinary team with medical, nutritional, surgical and psychological expertise.
You have doubts? Plantéalas in the comments and we will respond with pleasure.
This information was drawn from the reflections of the doctors: Alberto Aliaga (endocrinologist • Sacred Heart Hospital Chiron - OBEMETS), Eugenio J. Fernandez Hernandez (endocrine pediatrician • Sacred Heart Hospital Chiron - IHP), Fernando Garcia (Unit coordinator • Hospital Chiron obesity Vitoria) and Jorge Solano (department head of the Advanced Laparoscopic Surgery Unit • Hospital Chiron Zaragoza).
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