Women’s Health Issues 13 (2003) 74 –78 MIND CONTROL OF MENOPAUSE Jawaid Younus, MDa, Ian Simpson, MDb, Alison Collins, RNb, Xikui Wang, PhDca London Regional Cancer Centre, London, Ontario, Canada b Western Memorial Regional Hospital, Corner Brook, Canada c Department of Statistics, University of Manitoba, Winnipeg, Canada Received 29 July 2002; accepted 14 November 2002 The primary
- A |
J |K |
U |V |
Iveridgehealthclub.co.ukWeight Management Clinic12-week eating & exercise management programme.
The following information will help you to understand more about weight management and it will also help you make a decision to weather you feel a clinic is something you would benefit from. It will take you just 10 minutes of your time to read and may help you to take the 1st step towards a new, healthier you. What is being 'overweight' and what is being 'obese'?There is now an agreed method of measuring weight in order to detect whether individuals are outside the normal weight range. The method uses the individual's height and weight measurements to calculate (weight divided by height squared) the Body Mass Index (BMI). A person with a BMI of less than 25 is not overweight. A BMI between 25 and 30 is classified as being 'overweight' whereas a BMI of 30 or more indicates 'obesity'.
A person of height 5'9" weighing 12 stones 7 pounds has a BMI of 26 and is therefore overweight. If he/she was 14 stones 7 pounds then the BMI would be 30 and he/she would now be classified as obese.
A large waist measurement of 100cm also confers greater risk in a person who is overweight or obese.
To qualify for our weight management clinic, you must be overweight (have a BMI of 25 or more) or have a waist measurement of 80cm or more.
Why is there so much interest in obesity at present?Obesity is now reaching epidemic proportions in the western world. There are estimated to be 90 million obese people in the USA and 9 million in the UK and the numbers are growing. The rate of increase in the UK over several years now means that 18% of women and 16% of men are obese and that a further 34% of women and 45% of men are overweight. The prevalence of obesity amongst adults in England more than doubled between 1980 and 1996.
Why are we becoming overweight?Recent changes in lifestyle are mainly to blame. The increased availability and greater consumption of high-fat, high-energy foods combined with a dramatic fal -off in physical exercise is the main problem. Obesity is becoming particularly worrying amongst children where profound reductions in physical activity have led to a quarter of al children being overweight. Genetic factors account for about 40% of obesity. This can be seen when most or al members of a family are overweight; however over-consumption and under activity are stil important factors. Patients with a genetic predisposition may require medical assistance to help them lose weight and maintain their new body weight.
Medical causes such as an under active thyroid or other hormonal imbalances are not very common. However, they must be excluded because if present, such conditions must be treated.
• Being overweight increases the chances of developing many diseases including:• diabetes• heart disease• raised blood pressure• gal stones• some urogenital and gastrointestinal cancers• osteoarthritis especial y of the hips and knees• blood clotting disorders• problems breathing especial y when asleep.
It is also clear that being overweight reduces one's lifespan: the greater the degree of obesity, the greater the reduction in years of life. The greatly increased levels of obesity today are therefore an important public health issue in the western world. As such there has been much media interest recently and the medical profession has issued clinical guidelines on the management of overweight and obese people.
Does losing weight help one's health?Obese people with co-existent weight related problems (such as heart disease, high blood cholesterol, diabetes, high blood pressure and shortness of breath) who lose some weight have a significantly increased life-span.
Any weight reduction is beneficial and a loss of between 0.5 and 9 kg has been shown to reduce the chance of early death.
Weight loss alone improves the outcome of the following co-existent diseases: • diabetes• high blood pressure• high blood cholesterol• weight bearing joint damage and pain Weight loss of 5-10% in those people who already have non-insulin dependent diabetes improves the blood sugar levels and reduces the requirement for medication.
In those with high blood pressure a weight loss of just 1kg reduces a fal in pressure of 1-2mmHg. Further weight reduction produces additional incremental fal s.
Weight loss in the obese also results in reductions in blood levels of cholesterol.
Clearly there are also benefits in the improvement of self-esteem, well-being and mood as wel as breathing and pain in weight-bearing joints.
Who needs to lose weight?Anyone with a BMI between 25 and 30 (e.g. a person of 5'7" who weighs over 11 stones 6 pounds) should aim to reduce weight through exercise and healthy eating.
People with a BMI greater than 30 (e.g. a person of 5'7" who weighs over 13 stones 10 pounds) may need to be offered additional treatment to reduce their weight such as a weight management clinic. A clinic will address eating triggers, behavioral issues as well as underlying conditions that may be dug up during a clinic.
People who have a weight related risk factor such as heart disease, diabetes, stomach acid reflex, knee osteoarthritis, high blood pressure, high cholesterol; centralisation of body fat ("big around the middle") should be treated at a lower threshold weight. Such people should be offered treatment if their BMI is 28 or more (e.g. a person of 5'7" who weighs over 12 stones 12 pounds).
How much weight needs to be lost?The aim of weight management is to prevent or reduce the health consequences of obesity. Even a weight loss of 5-10% reduces significantly the health risks associated with obesity. For a person weighing 15 stone, this would amount to between three quarters and one and a half stone. Some people may lose greater amounts of weight but maintaining the new weight may be more dif icult.
The goal is to achieve modest weight loss, and then the goal weight needs to be maintained.
Continued weight loss beyond six months is unlikely and the objective thereafter is weight maintenance.
Weight needs to be lost slowly (1 to 2lbs per week) in order that the loss be maintained.
How can weight be lost, and the loss maintained?Weight loss is initiated with a combination of a supervised diet, a programme of exercise and a change in behavior.
Very frequently weight that is lost is soon put back on. This is extremely common as people fall back into old habits. It must be realised that once the weight is lost, maintenance of the new body weight will require a change in lifestyle.
Exercise does not have to be too strenuous. Brisk walking for 20 minute each day for five days of the week can help reduce weight and also maintain the new weight. Our weight management clinic, unlike other ones, addresses and includes a full programme of exercise. We stress the importance of improving metabolism through exercise and include a 24-station session of metabolic boosting exercise in each session. Al sessions are guided by a specialist who will encourage you to work at a safe and effective level to suit you and your body.
Exercise real y is the key to maintaining a healthy weight forever.
What is the role of medicines in weight loss?Obese people and some overweight patients with risk factors may need help with medicines that help reduce weight and maintain its loss. Such people may require medical therapy if after a period of dieting and behavioral modification they have not lost suf icient weight. Those with a genetic predisposition to obesity may especial y need such assistance.
Two new drugs that work through novel pharmacological mechanisms are now available.
Xenical orlistat is a medicine that reduces the absorption of fat eaten in food from the gut. It is used along with an individual y tailored low-fat diet and behavioral modification. Orlistat is itself not absorbed from the gut into the body and therefore is free from systemic side effects. As it reduces fat absorption it increases the amount of fat in the faeces.
Reductil sibutramine is a medicine that is absorbed into the body and acts by increasing the body's metabolism resulting in weight reduction. It also makes one feel 'full-up' earlier thus helping to reduce the volume of food intake.
These medicines are unlike older drugs for obesity, which were noted for unpleasant and dangerous side effects. The medicines are however prescription only medicines and need to be prescribed by a physician with regular review of the patient.
Prescott-Clark P, Primatesta P (eds). Health survey for England. 1996. London: HMSO. 1998. Jung RT. Obesity as a disease. Br Med Bul . 1997: 53: 307-21. Lew EA. Mortability and weight: insured lives and the American Cancer Study. Ann Intern Med. 1985; 103: 1024-9. Huber HB. The importance of obesity in the development of coronary risk factors and disease: the epidemiological evidence. Ann Rev Public Health. 1986; 7: 493-502. Clinical management of overweight and obese patients. A report of the Royal Col ege of Physicians. The Royal College of Physicians of London. 1998. Williamson DF, Pamuk E, Thun M et al. Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40-64 years. Am J Epidemiol. 1995; 141: 1128-41 Colditz GA, Wil et WC, Rotnitzky A, Manson JE. Weight gain as a risk factor for clinical diabetes mellitus in women. Wing RR, Koeske R. Epstein LH, et at. Long-term effects of modest weight loss in type II diabetic patients. Arch Intern Goldstein DJ. Beneficial health affects of modest weight loss. Int J Obese. 1992; 16: 397-415 How can The Weight Management Clinic help me?The Weight Management Clinic is held by experienced dieticians and wellbeing advisors al whom have experience and a keen interest in weight management.
A specific programme of eating and behavior modification plan is designed for each individual. Al patients are careful y followed up with regular reviews on diet and behavioral control.
We run a clinic at set times each week. (Check with reception for current times on 01132 887 666) The 1st 30 minutes of your personal consultation involves a discussion relating to your diet. This is then fol owed with a 30-minute metabolic boosting exercise session. The exercise sessions are held in our unique on-site metabolic circuit room. Help is always at We provide everything you need in order to lose your excess weight and keep it off for good. All you need to do is take the 1st step and commit yourself to the exercise and eating management programme.
Our promise to you.
We real y do want to help you succeed in losing weight and help you to keep it off. When the 3-month programme comes to a close, we can offer additional support to help you maintain your new way of life. We offer a 1 to 1 consultation support service that you can access should you stil feel the need for that extra motivation and support each week. This is a great way to add motivation when things get tough. It will also ensure you keep practising the eating and exercise guidelines set out in the 1st 3 months. If not, we would love you to send us an email update every month about your progress after our clinic. Each individual will receive a free 15-minute follow up consultation after the 12-week clinic has finished.
We promise as much support and advice as you need to achieve a healthier approach to eating and we guarantee to help you get it right once and for al with our help. What now?If your BMI is above 25, you may be eligible for a place on the clinic. Simply cal us and arrange an appointment on 01132 887 666. We can take your details and arrange for our dietician to book an appointment with you. You DO NOT have to commit any monies until you have spoken to a dietician who will explain the clinic in more depth. Once you ful y understand what is involved, then you can decide to make a booking for your initial consultation and payment is required upon your 1st visit.
Al enquiries are dealt with in the strictest of confidence. Cal Today! Application Conditions – Please read before applying.
*You must be available for 12 consecutive weeks ideal y although this is not essential. A maximum of 2 weeks can be rol ed over during the 12-week plan.
*Al sessions must be booked in advance at reception or directly with the trainer or wel -being advisor.
*Al customers must fill out a screening form with personal details and sign a health declaration as well as a personal commitment form.
*You do not have to be a member of Iveridge Health Club to attend the sessions although members wil receive a discount off our clinics.
*The full package price includes 12 support sessions as wel as 12 exercise sessions. Further exercise sessions are available at an extra cost to non-members.
*It is at the dietician or well-being advisors discretion to re-arrange an appointment if circumstances deem necessary. Sessions that are cancel ed within 24hours or not attended will be taken from the package al ocation.
Thermodynamics and Kinetics of in situ Nitroxide Mediated Polymerization L. Bentein, M.-F. Reyniers, G.B. Marin University Ghent, Belgium, Laboratory for Chemical Technology Controlled radical polymerization (CRP) is a promising polymerization technique that enables to produce well-defined, end-functionalized polymers at milder experimental reaction conditions than living ionic polymerization. An