Weight loss

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Weight loss, deals with the process of losing weight within the context of medicine, health, or physical fitness, with the aim of improving wellness and involves reduction of the total body mass index.This can be due to loss of body fat or adipose tissue and/or lean mass, excess body fluid loss, loss of muscle, and other connective tissue. Weight loss can occur unintentionally due to an underlying disease or can arise from a conscious effort to improve an actual or perceived overweight or obese state. Losing weight intentionally involves many steps including motivational steps for behavior change, Very low calorie diet (VLCD), Low calorie diet (LCD), appetite suppressant medications, and other measures to lose weight.

Unintentional

Characteristics

Unintentional weight loss may be a result of loss of fat, muscle atrophy, fluid loss or a combination of these.[1][2] It is generally regarded as a medical problem when at least 10% of a person's body weight has been lost in six months[3][1] or 5% in the last month.[4] Another criterion used for assessing weight that is too low is the body mass index (BMI).[5] However, even lesser amounts of weight loss can be a cause for serious concern in a frail elderly person.[6]

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Unintentional weight loss can occur because of an inadequately nutritious diet relative to a person's energy needs (generally called malnutrition). Disease processes, changes in metabolism, hormonal changes, medications or other treatments, disease- or treatment-related dietary changes, or reduced appetite associated with a disease or treatment can also cause unintentional weight loss.[1][3][2][7][8][9] Poor nutrient utilization can lead to weight loss, and can be caused by fistulae in the gastrointestinal tract, diarrhea, drug-nutrient interaction, enzyme depletion and muscle atrophy.[3]

Continuing weight loss may deteriorate into wasting, a vaguely defined condition called cachexia.[6] Cachexia differs from starvation in part because it involves a systemic inflammatory response.[6] It is associated with poorer outcomes.[1][6][7] In the advanced stages of progressive disease, metabolism can change so that they lose weight even when they are getting what is normally regarded as adequate nutrition and the body cannot compensate. This leads to a condition called anorexia cachexia syndrome (ACS) and additional nutrition or supplementation is unlikely to help.[3] Symptoms of weight loss from ACS include severe weight loss from muscle rather than body fat, loss of appetite and feeling full after eating small amounts, nausea, anemia, weakness and fatigue.[3]

Serious weight loss may reduce quality of life, impair treatment effectiveness or recovery, worsen disease processes and be a risk factor for earlier mortality.[1][6] Malnutrition can affect every function of the human body, from the cells to the most complex functions, including:[5]

  • immune response;
  • wound healing;
  • muscle strength (including respiratory muscles);
  • renal capacity and depletion leading to water and electrolyte disturbances;
  • thermoregulation; and
  • menstruation.

In addition, malnutrition can lead to vitamin and other deficiencies and to inactivity, which in turn may pre-dispose to other problems, such as pressure sores.[5]

Unintentional weight loss can be the characteristic leading to diagnosis of diseases such as cancer[1] and type 1 diabetes.[10]

In the UK, up to 5% of the general population is underweight, but more than 10% of those with lung or gastrointestinal diseases and who have recently had surgery.[5] According to data in the UK using the Malnutrition Universal Screening Tool ('MUST'), which incorporates unintentional weight loss, more than 10% of the population over the age of 65 is at risk of malnutrition.[5] A high proportion (10-60%) of hospital patients are also at risk, along with a similar proportion in care homes.[5]

Causes

Disease-related

Disease-related malnutrition can be considered in four categories:[5]

Problem Cause
Impaired intake Poor appetite can be a direct symptom of an illness, or an illness could make eating painful or induce nausea. Illness can also cause food aversion.

Inability to eat can result from: diminished consciousness or confusion, or physical problems affecting the arm or hands, swallowing or chewing. Eating restrictions may also be imposed as part of treatment or investigations. Lack of food can result from: poverty, difficulty in shopping or cooking, and poor quality meals.

Impaired digestion &/or absorption This can result from conditions that affect the digestive system.
Altered requirements Changes to metabolic demands can be caused by illness, surgery and organ dysfunction.
Excess nutrient losses Losses from the gastrointestinal can occur because of symptoms such as vomiting or diarrhea, as well as fistulae and stomas. There can also be losses from drains, including nasogastric tubes.

Other losses: Conditions such as burns can be associated with losses such as skin exudates.

Weight loss issues related to specific diseases include:

  • As chronic obstructive pulmonary disease (COPD) advances, about 35% of patients experience severe weight loss called pulmonary cachexia, including diminished muscle mass.[7] Around 25% experience moderate to severe weight loss, and most others have some weight loss.[7] Greater weight loss is associated with poorer prognosis.[7] Theories about contributing factors include appetite loss related to reduced activity, additional energy required for breathing, and the difficulty of eating with dyspnea (labored breathing).[7]
  • Cancer, a very common and sometimes fatal cause of unexplained (idiopathic) weight loss. About one-third of unintentional weight loss cases are secondary to malignancy. Cancers to suspect in patients with unexplained weight loss include gastrointestinal, prostate, hepatobillary (hepatocellular carcinoma, pancreatic cancer), ovarian, hematologic or lung malignancies.
  • People with HIV often experience weight loss, and it is associated with poorer outcomes.[11] Wasting syndrome is an AIDS-defining condition.[11]
  • Gastrointestinal disorders are another common cause of unexplained weight loss – in fact they are the most common non-cancerous cause of idiopathic weight loss. Possible gastrointestinal etiologies of unexplained weight loss include: celiac disease, peptic ulcer disease, inflammatory bowel disease (crohn's disease and ulcerative colitis), pancreatitis, gastritis, diarrhea and many other GI conditions.
  • Infection. Some infectious diseases can cause weight loss. Fungal illnesses, endocarditis, many parasitic diseases, AIDS, and some other subacute or occult infections may cause weight loss.
  • Renal disease. Patients who have uremia often have poor or absent appetite, vomiting and nausea. This can cause weight loss.
  • Cardiac disease. Cardiovascular disease, especially congestive heart failure, may cause unexplained weight loss.
  • Connective tissue disease
  • Neurologic disease, including dementia[12]
  • Oral, taste or dental problems (including infections) can reduce nutrient intake leading to weight loss.[3]

Therapy-related

Medical treatment can directly or indirectly cause weight loss, impairing treatment effectiveness and recovery that can lead to further weight loss in a vicious cycle.[1]

Many patients will be in pain and have a loss of appetite after surgery.[1] Part of the body's response to surgery is to direct energy to wound healing, which increases the body's overall energy requirements.[1] Surgery affects nutritional status indirectly, particularly during the recovery period, as it can interfere with wound healing and other aspects of recovery.[1][5] Surgery directly affects nutritional status if a procedure permanently alters the digestive system.[1] Enteral nutrition (tube feeding) is often needed.[1] However a policy of 'nil by mouth' for all gastrointestinal surgery has not been shown to benefit, with some suggestion it might hinder recovery.[13]

Early post-operative nutrition is a part of Enhanced Recovery After Surgery protocols.[14] These protocols also include carbohydrate loading in the 24 hours before surgery, but earlier nutritional interventions have not been shown to have a significant impact.[14]

Some medications can cause weight loss,[15] while others can cause weight gain.[16][17]

Social conditions

Social conditions such as poverty, social isolation and inability to get or prepare preferred foods can cause unintentional weight loss, and this may be particularly common in older people.[18] Nutrient intake can also be affected by culture, family and belief systems.[3] Ill-fitting dentures and other dental or oral health problems can also affect adequacy of nutrition.[3]

Loss of hope, status or social contact and spiritual distress can cause depression, which may be associated with reduced nutrition, as can fatigue.[3]

Intentional

Intentional weight loss refers to the loss of total body mass as a result of efforts to improve fitness and health, and/or to change appearance.

Weight loss in individuals who are overweight or obese can reduce health risks,[19] increase fitness,[20] and may delay the onset of diabetes.[19] It could reduce pain and increase movement in people with osteoarthritis of the knee.[20] Weight loss can lead to a reduction in hypertension (high blood pressure), however whether this reduces hypertension-related harm is unclear.[19]

Weight loss occurs when an individual is in a state of negative thermodynamic flux: when the body is expending more energy (i.e. in work and metabolism) than it is consuming (i.e., from food or other nutritional supplements), it will use stored reserves from fat or muscle, gradually leading to weight loss.

It is not uncommon for some people who are at their ideal body weight to seek additional weight loss in order to improve athletic performance or meet required weight classification for participation in a sport. Others may be driven to lose weight to achieve a more attractive appearance. Being underweight is associated with health risks such as difficulty fighting off infection, osteoporosis, decreased muscle strength, trouble regulating body temperature and even increased risk of death.[21]

According to the U.S. Food and Drug Administration (FDA), healthy individuals seeking to maintain their weight should consume 2,000 calories per day.[22]

According to the Dietary Guidelines for Americans those who achieve and manage a healthy weight do so most successfully by being careful to consume just enough calories to meet their needs, and being physically active.[23]

Low-calorie regimen diets are also referred to as balanced percentage diets. Due to their minimal detrimental effects, these types of diets are most commonly recommended by nutritionists. In addition to restricting calorie intake, a balanced diet also regulates macronutrient consumption. From the total number of allotted daily calories, it is recommended that 55% should come from carbohydrates, 15% from protein, and 30% from fats with no more than 10% of total fat coming from saturated forms.[24] For instance, a recommended 1,200 calorie diet would supply about 660 calories from carbohydrates, 180 from protein, and 360 from fat. Some studies suggest that increased consumption of protein can help ease hunger pangs associated with reduced caloric intake by increasing the feeling of satiety.[25] Calorie restriction in this way has many long-term benefits. After reaching the desired body weight, the calories consumed per day may be increased gradually, without exceeding 2,000 net (i.e. derived by subtracting calories burned by physical activity from calories consumed). Combined with increased physical activity, long-term low-calorie diets are thought to be most effective long term, unlike crash diets which can achieve short term results, at best. Physical activity could greatly enhance the efficiency of a diet. The healthiest weight loss regimen, therefore, is one that consists of a balanced diet and moderate physical activity.

Weight gain has been associated with excessive consumption of fats, sugars, carbohydrates in general, and alcohol. Depression, stress or boredom may also contribute to weight increase, and in these cases, individuals are advised to seek medical help. A 2010 study found that dieters who got a full night's sleep lost more than twice as much fat as sleep-deprived dieters.[26][27]

The majority of dieters regain weight over the long term.[28]

There is some research that suggests that all calories are not created equal (in other words, a calorie is not necessarily a calorie). Thus the human body might not gain the same amount of weight from 500 calories of certain foods than it would from 500 calories of other foods.[29][30]

Therapeutic weight loss techniques

The least intrusive weight loss methods, and those most often recommended, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. The World Health Organization recommended that people combine a reduction of processed foods high in saturated fats, sugar and salt[31] and caloric content of the diet with an increase in physical activity.[32]

An increase in fiber intake is also recommended for regulating bowel movements.

Other methods of weight loss include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume.

Bariatric surgery may be indicated in cases of severe obesity. Two common bariatric surgical procedures are gastric bypass and gastric banding.[33] Both can be effective at limiting the intake of food energy by reducing the size of the stomach, but as with any surgical procedure both come with their own risks[34] that should be considered in consultation with a physician.

Dietary supplements, though widely used, are not considered a healthy option for weight loss.[35] Even though a many are available, very few are effective long term.[36]

Virtual gastric band uses hypnosis to make the brain think the stomach is smaller than it really is and hence lower the amount of food ingested. This brings as a consequence weight reduction. This method is complemented with psychological treatment for anxiety management and with hypnopedia. Research has been conducted into the use of hypnosis as a weight management alternative.[37][38][39][40] In 1996 a study found that cognitive-behavioral therapy (CBT) was more effective for weight reduction if reinforced with hypnosis.[38] Acceptance and Commitment Therapy ACT, a mindfulness approach to weight loss, has also in the last few years been demonstrating its usefulness.[41]

Crash dieting

A crash diet refers to willful nutritional restriction (except water) for more than 12 waking hours. The desired result is to have the body burn fat for energy with the goal of losing a significant amount of weight in a short time. Crash dieting can be dangerous to health and this method of weight loss is not recommended by physicians.[42]

According to the Academy of Nutrition and Dietetics,[43] "If the diet or product sounds too good to be true, it probably is. There are no foods or pills that magically burn fat. No super foods will alter your genetic code. No products will miraculously melt fat while you watch TV or sleep." Certain ingredients in supplements and herbal productsTemplate:Vague can be dangerous and even deadly for some people.

Weight loss industry

Template:Globalise-section There is a substantial market for products which promise to make weight loss easier, quicker, cheaper, more reliable, or less painful. These include books, DVDs, CDs, cremes, lotions, pills, rings and earrings, body wraps, body belts and other materials, fitness centers, personal coaches, weight loss groups, and food products and supplements.[44]

In 2008 between US$33 billion and $55 billion was spent annually in the US on weight-loss products and services, including medical procedures and pharmaceuticals, with weight-loss centers taking between 6 and 12 percent of total annual expenditure. Over $1.6 billion a year was spent on weight-loss supplements. About 70 percent of Americans' dieting attempts are of a self-help nature. Although often short-lived, these diet fads are a positive trend for this sector as Americans ultimately turn to professionals to help them meet their weight loss goals.[45][46]

In Western Europe, sales of weight-loss products, excluding prescription medications, topped £900 million ($1.4 billion) in 2009.[46]

How to lose weight | causes of weight gain | VLCD diet | LCD diet | Diet pills | Top 200 weight loss searches | Dietary supplements | Herbal supplements


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Sleep medicine program uses state of the art technology including the convenient home sleep studies or in lab sleep diagnostic studies to diagnose and treat over 80 different sleep disorders including sleep apnea, narcolepsy, restless leg syndrome, insomnia to name a few. Learn more…

Medical aesthetic program offers a wide variety of advanced laser skin treatments including oxygen super facials, photofacials, microneedling, PRP (Platelet Rich Plasma) therapy, non-ablative laser skin resurfacing,botox, fillers and aesthetic treatments. The variety of technology and technique, combined with knowledgeable staff, allows doctors to customize treatment plans to each patient. One-size-fits-all procedures are not performed at W8MD Weight Loss, Sleep & Aesthetic Centers. Learn more…

IM and IV nutrition therapy includes booster shots for B12, vitamin B complex, Vitamin C, Detox treatments and IV nutrition therapy. Studies have shown that as many as 39% of those taking vitamins on a regular basis in a nursing home setting were not absorbing the same vitamins they are taking by mouth leading to significant deficiencies. Learn more…

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W8MD weight loss, sleep and medspa center locations

Pennsylvania

Call 215-676-2334

New York

2632 E 21st Street Ste L2 Brooklyn New York 11235.

Call 718-946-5500

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See also

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Tired of being overweight? W8MD can help


W8MD Weight Loss, Sleep & Aesthetic Services

Pennsylvania

Call 215-676-2334

New York

2632 E 21st Street Ste L2 Brooklyn New York 11235.

Call 718-946-5500

New Jersey

  • W8MD Weight Loss, Sleep & MedSpa in Cherry Hill, NJ at 140 E. Evesham Road, Cherry Hill, NJ 08003.

Call 800-W8MD-007

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W8MD's insurance weight loss program

W8MD can help?

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W8MD’s insurance medical weight loss program is one of the best ways to lose weight fast in NYC, King Of Prussia, Philadelphia, New Jersey and other places.

  • Our weight loss program is based on clinically proven measures to help you lose weight.
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Prab R. Tumpati, MD Founder, WikiMD & W8MD

Dr Tumpati is a board certified physician with significant practice experience in managing sleep disorders, internal medicine, aesthetic and obesity medicine. As one of the few physicians that have the privilege of a fellowship training in Obesity Medicine, Dr Tumpati is very passionate about educating the public and physicians about how some of the nutritional concepts were misunderstood. As the founder of W8MD Weight Loss, Sleep and MedSpa centers, Dr Tumpati is the medical director for the New York, New Jersey and Pennsylvania locations and commutes weekly between the locations.

Popular weight loss searches


How Can W8MD Help?

W8MD’s insurance physician weight loss program is unique in many ways with a comprehensive multidisciplinary approach to weight loss that addresses all the complex issues leading to weight gain, both in adults and children. Since its inception in 2011, W8MD has successfully helped thousands of patients succeed in not only losing weight but also keep it off with an ongoing maintenance plan.

Sleep medicine program uses state of the art technology including the convenient home sleep studies or in lab sleep diagnostic studies to diagnose and treat over 80 different sleep disorders including sleep apnea, narcolepsy, restless leg syndrome, insomnia to name a few. Learn more…

Medical aesthetic program offers a wide variety of advanced laser skin treatments including oxygen super facials, photofacials, microneedling, PRP (Platelet Rich Plasma) therapy, non-ablative laser skin resurfacing,botox, fillers and aesthetic treatments. The variety of technology and technique, combined with knowledgeable staff, allows doctors to customize treatment plans to each patient. One-size-fits-all procedures are not performed at W8MD Weight Loss, Sleep & Aesthetic Centers. Learn more…

IM and IV nutrition therapy includes booster shots for B12, vitamin B complex, Vitamin C, Detox treatments and IV nutrition therapy. Studies have shown that as many as 39% of those taking vitamins on a regular basis in a nursing home setting were not absorbing the same vitamins they are taking by mouth leading to significant deficiencies. Learn more…

W8md-weight-loss-logo.jpg

W8MD weight loss, sleep and medspa center locations

Pennsylvania

Call 215-676-2334

New York

2632 E 21st Street Ste L2 Brooklyn New York 11235.

Call 718-946-5500

New Jersey

  • W8MD's NJ weight loss, sleep and medical spa in New Jersey at Cherry Hill, NJ at 140 E. Evesham Road, Cherry Hill, NJ 08003.

Call 800-W8MD-007

Weight loss success stories | Physicians join w8md weight loss physician network.

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 National Cancer Institute (November 2011). "Nutrition in cancer care (PDQ)". Physician Data Query. National Cancer Institute. Retrieved 3 July 2013.
  2. ↑ 2.0 2.1
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8
  4. ↑ Page 67 in: The role of nutrition in maintaining health in the nation's elderly: evaluating coverage of nutrition services for the Medicare population. Author: Institute of Medicine (U.S.). Committee on Nutrition Services for Medicare Beneficiaries. ISBN 0-309-06846-0, ISBN 978-0-309-06846-8
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 5.7 National Collaborating Centre for Acute Care (UK) (February 2006). "Nutrition Support for Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition". NICE Clinical Guidelines, No. 32. National Collaborating Centre for Acute Care (UK).
  6. ↑ 6.0 6.1 6.2 6.3 6.4
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5
  8. ↑
  9. ↑
  10. ↑ National Collaborating Centre for Chronic Conditions (UK). "Type 1 Diabetes in Adults: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care". NICE Clinical Guidelines, No. 15.1. Royal College of Physicians UK. Retrieved 3 July 2013.
  11. ↑ 11.0 11.1
  12. ↑
  13. ↑
  14. ↑ 14.0 14.1
  15. ↑
  16. ↑
  17. ↑
  18. ↑
  19. ↑ 19.0 19.1 19.2 LeBlanc, E (October 2011). "Screening for and Management of Obesity and Overweight in Adults". Evidence Syntheses, No. 89. U.S. Agency for Healthcare Research and Quality (AHRQ). Retrieved 27 June 2013. Unknown parameter |coauthors= ignored (|author= suggested) (help)
  20. ↑ 20.0 20.1 Institute for Quality and Efficiency in Health Care. "Health benefits of losing weight". Fact sheet, Informed Health Online. Institute for Quality and Efficiency in Health Care. Retrieved 27 June 2013.
  21. ↑ "Being underweight poses health risks". Mayo Clinic. Archived from the original on 4 March 2007. Retrieved 13 January 2007.
  22. ↑ "The 2000 Calorie Diet – and the RDAs". Retrieved 2010-07-19. Template:Medrs
  23. ↑ http://www.cnpp.usda.gov/Publications/DietaryGuidelines/2010/PolicyDoc/ExecSumm.pdf 2010Template:Full
  24. ↑ "1200 Calorie Diet". Retrieved 2010-07-19. Template:Medrs
  25. ↑ "High-Protein Diet for Weight Loss". WebMD.
  26. ↑
  27. ↑ Harmon, Katherine (4 October 2010). "Sleep might help dieters shed more fat". Scientific American. Retrieved 20 October 2010.
  28. ↑
  29. ↑ http://www.webmd.com/diet/news/20120626/all-calories-not-created-equal-study-suggestsTemplate:Full
  30. ↑ http://www.scientificamerican.com/article.cfm?id=when-dieting-not-all-caloTemplate:Full
  31. ↑ "World Health Organization recommends eating less processed food". BBC News. 3 March 2003.
  32. ↑ "Choosing a safe and successful weight loss program". Weight-control Information Network. National Institute of Diabetes and Digestive and Kidney Diseases. April 2008. Retrieved 2011-01-26.
  33. ↑ Albgomi. "Bariatric Surgery Highlights and Facts". Bariatric Surgery Information Guide. bariatricguide.org. Retrieved 13 June 2013.
  34. ↑ "Gastric bypass risks". Mayo Clinic. 2009-02-09.
  35. ↑
  36. ↑
  37. ↑
  38. ↑ 38.0 38.1
  39. ↑
  40. ↑
  41. ↑
  42. ↑ Kirby S. "Signs of eating disorders: crash diets". disordered-eating.co.uk. Retrieved 2011-01-26. Template:Medrs
  43. ↑ Academy of Nutrition and Dietetics. (2011). Staying away from fad diets. Retrieved 1-16-12, from http://www.eatright.org/Public/content.aspx?id=6851.
  44. ↑ "The facts about weight loss products and programs". DHHS Publication No (FDA) 92-1189. US Food and Drug Administration. 1992. Retrieved 2013-05-14.
  45. ↑ Template:Cite press release
  46. ↑ 46.0 46.1 "No evidence that popular slimming supplements facilitate weight loss, new research finds". 14 July 2010. Retrieved 2010-07-19.

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