HOW TO PREVENT OBESITY FOR WOMEN
A Weight-Loss Plan for Morbidly Obese Women
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If you're 100 pounds or more overweight or your body mass index measures 40 or higher, doctors classify you as morbidly obese. This level of obesity puts you at a dire risk of health complications and early death. A woman who is morbidly obese must take extra effort to reduce her weight, using lifestyle, dietary and possibly medical interventions, to reduce her risk of chronic disease. Before making changes, however, discuss your weight loss strategy with your doctor to make sure it's a safe plan that's right for you.
Changing Your Diet to Fight Morbid Obesity
The tried-and-true weight loss strategy of reducing your calorie intake works, whether you are 10 pounds or 100 pounds overweight. Cutting 500 to 1,000 calories per day from what you eat to maintain your weight yields a 1- to 2-pound weight loss per week. A doctor or a dietitian can help you determine what is a safe -- and not too radical -- calorie intake for you to lose weight.
Avoid foods that are high in fat and simple sugars -- specifically, fatty cuts of meat, full-fat dairy, white bread and white pasta, soda, sweets and processed snacks. Make approximately 50 to 55 percent of your calories come from complex carbohydrates -- particularly, vegetables, brown rice, oatmeal and sweet potatoes. Increasing your fiber intake also helps food digest more slowly so you don't experience as many physical cravings and bouts of hunger. High-fiber foods include fresh vegetables and fruits, as well as whole grains.
Lean proteins, such as grilled chicken, lean broiled steak and fish, improve satiety and can help you retain lean mass as you drop pounds. Go for about 0.55 grams per pound of your body weight per day, as long as this keeps you within your required calorie intake for weight loss. Small amounts of unsaturated fats are important for optimal bodily function, so have a teaspoon or two of olive oil, 1/8 of an avocado or 1/2 ounce of nuts at some meals.
Exercise That's Appropriate for the Obese
When you're obese, exercise feels harder -- every step puts excessive pressure on your joints. Once you've lost about 10 percent of your weight with dietary intervention, add light- to moderate-intensity exercise. In addition to burning calories, moderate exercise decreases blood pressure, increases your levels of good cholesterol and may delay the onset of type 2 diabetes.
When you first start exercising, even just 20 to 30 minutes every day of low-intensity movement will help. Break this up into 10-minute intervals, if needed, for stamina and adherence. Over time, work up to a more moderate intensity that makes you feel breathy and will raise your heart rate slightly. Eventually, do up to 90 minutes daily to lose weight, but this amount daily may take several months or even years to achieve.
Brisk walking, water exercise and cycling are appropriate forms of exercise, as they don't put too much additional impact on your back, ankles, hips and knees. Working with weights when you're morbidly obese -- which means your body is easily physically stressed and your range of motion is limited -- may be contraindicated. Talk to your doctor about when you can safely add regular strength training, which helps build muscle to assist in weight loss.
Psychological Interventions for Weight Loss
Incorporate lifestyle measures to help improve your adherence to a low-calorie diet and more physical activity. Enlist friends and family to encourage your efforts or seek support from the medical community and support groups, if you don't have the resources at home. Keep a food journal to track your intake and physical activity; seeing what you eat daily written on paper can help keep you accountable. A journal can also help you identify which types of triggers cause you to overeat -- whether it's that time of the month, stress, anxiety, boredom or loneliness. When you know these triggers, you can take steps to avoid them.
You might hope to lose weight quickly like people on reality weight-loss shows, but keep your expectations realistic. Losing more than 3 pounds a week two weeks after you changed your routine, increases your risk of medical complications related to weight loss, such as gall stones. Reality shows are about people who are on a 24/7 regimen and who have constant access to dietitians, fitness professionals and support from medical professionals. Real life is different -- you'll encounter day-to-day obstacles, personal defeats and temptations that you'll need to navigate on your own. Weight loss is a process, and when you have a lot to lose, it can take years to achieve a healthy weight.
Sometimes, depression accompanies severe obesity. If you feel this might be the case for you, talk to your doctor to get the appropriate help you need.
Medical Interventions to Help the Morbidly Obese
A very-low calorie diet that's medically prescribed and supervised may be warranted if you have immediate health issues that only quick weight loss will mitigate. These diets usually consist of 800 to 1,000 calories per day and yield about an average 3-pound per week-loss rate. Because they're so radical, you'll likely only be kept on this extreme calorie restriction for 12 weeks or less. A very low-calorie diet usually consists of specifically measured meal replacements, sometimes in the form of shakes, and require regular monitoring by your doctor.
Weight-loss surgery is also indicated in some cases of morbid obesity. This is not a treatment to enter into lightly; the risks of complications are great. Your doctor will determine if you're a good candidate, based on criteria such as your psychological stability, motivation level and social support. Bariatric surgery should be a last resort when efforts to exercise and following a lower calorie diet plan have proven insufficient.
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Super Morbid Obesity & Body Mass Index
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As of 2009, more than 10 million American adults were morbidly obese, according to an article published in "Archives of Surgery." A morbidly obese person has a body mass index of 40 or more, while a super morbidly obese individual's BMI is 50 or more. Super morbid obesity increases the risk of cardiovascular disease, gout, osteoarthritis, gallbladder disease and early death, and patients often find that conventional weight loss measures are unsuccessful.
Body Mass Index
BMI, a number calculated from an individual's height and weight, correlates to the person's body fat. BMI does not measure fat directly but it is often a good estimate of the percentage that would be round using direct body fat methods of measurement. Used as a screening tool, BMI serves as an indicator that the individual needs further assessment by a health care provider to determine if he is overweight or obese. More direct methods of body fat measurements, including skin-fold thickness measurement, underwater weighing, dual-energy x-ray absorptiometry and isotope dilution, are more expensive or require special training.
BMI and Obesity
BMI categories help evaluate the degree of obesity in a particular person. A person with a BMI of 18.5 to 24.9 is considered to be in the healthy range. An individual with a BMI of 25 to 29.9 is considered overweight, and a person with a BMI of 30 or more is considered obese. A person with a BMI of 40 to 49.9 is morbidly obese and an individual with a BMI of 50 or more has super obesity or super morbid obesity, according to a 2009 article published in "Archives of Surgery."
Super Morbid Obesity
Super obese individuals, those with a BMI of 50 or greater, may carry 150 or more excess pounds on their bodies. For example, a healthy weight for a person 5 ft. 7 in. tall is 121 to 153 pounds. A person of the same height with a BMI of 50 would weigh approximately 319 pounds -- 166 to 198 pounds more than a person in the healthy weight range.
Risks of Super Morbid Obesity
Morbid obesity was responsible for 82,066 deaths in 2000, according to a 2009 article in "Archives of Surgery." Morbidly obese individuals are at higher risk for high blood pressure, digestive diseases, kidney stones, diabetes, gallstones and joint pain, and their life spans are reduced by an estimated four to 20 years. Treatment for super morbid obesity may include a very low-calorie diet supervised by a physician and accompanied by an exercise rehabilitation program, but weight loss surgery offers better long-term results. Unfortunately, super morbidly obese individuals are more susceptible to postoperative complications, according to a 2009 study, and are more likely to get blood clots, wound infections, hypertension, obstructive lung disease and complicated diabetes mellitus.
The Best Exercise for Someone Morbidly Obese
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Although the term morbid obesity is a technical one, it also aptly describes the extent of discomfort and depression a person who is severely overweight often experiences. If you are morbidly obese, your body mass index is greater than 40 or greater than 35 if coupled with an existing comorbid condition such as diabetes or hypertension. More simply, you also are classified as morbidly obese if you weigh 100 pounds or more over your ideal body weight. If you are badly overweight, the best exercise or exercises are ones that are low impact and easy to perform. Several forms of exercise fit this criteria.
Walking
All you need to begin a walking program is a good pair of walking or running shoes that will comfortably absorb your body weight. Start by walking just two to five minutes per day, then add an extra two minutes every third day. Your initial goal is to walk 30 minutes per day, but you can break up that amount into a number of five- or 10-minute walks. In 2005, researchers at the University of Colorado released findings that suggested obese people burn more calories per mile by walking slowly instead of briskly. A slower pace might lower the risk of arthritis and injuries to joints as well. So it's fine to make like a turtle -- slow and steady is a winning formula.
Water Exercises
The water can be a godsend for the morbidly obese. The water reduces the gravitational load on your body by as much as 90 percent, aiding your joints and bones. If you are self-conscious about your weight, the pool also shields you from a certain amount of embarrassment. You can use a pool in a variety of healthy ways, from walking to swimming to water aerobics classes.
Stationary Bikes
Riding a stationary bike is another proven form of low-impact exercise. A recumbent bike, as opposed to a upright stationary bike with the same small seat as a regular bicycle, is your best bet. You can sit comfortably on a chair-like seat, which eases pressure on your back and joints. Start with five minutes of peddling and gradually increase the time and intensity of your workouts. A stationary bike also allows you to watch TV or read, which might make the time pass more quickly and enjoyably.
Considerations
It is essential to check with your doctor before beginning an exercise program if you are morbidly obese. Remember to drink plenty of water to stay hydrated during and after exercise -- you will sweat more that a person of normal weight. Although the American College of Sports Medicine recommends that people who are overweight or obese exercise for 150 minutes or more per week to stabilize or reduce weight and as much as 250 to 300 minutes per week to lose a significant amount of weight, those are long-term goals. Don't push yourself too hard at the beginning. It took a long time to gain the weight, and it will take time to lose it. But it you stick with it, you won't be morbid forever.
Best Exercise for Morbidly Obese People to Lose Weight
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Obesity is a serious health condition that can lead to diabetes, heart disease and other medical complications. The Highland Hospital Bariatric Surgery Center defines morbid obesity as having a body mass index of over 40 or being over 100 pounds overweight. Minor weight loss can begin to reduce the effects of obesity and lead to healthier benefits. In addition to a balanced, low-calorie diet, you must include physical activity to lose weight. The morbidly obese should start slowly on an exercise plan and increase the time and intensity of workouts as they gain strength.
Identification
Many people who are morbidly obese have medical conditions and disabilities that require physician monitoring. According to the American College of Sports Medicine, if you are morbidly obese, you should undergo a stress test to identify your current level of fitness prior to starting an exercise regimen. A stress test can help your doctor determine a base level from which you should begin to prevent injuries and overexertion that could lead to further complications.
Features
Anyone who has not exercised in a while or who begins a new exercise program will feel some discomfort. Muscles that haven't been used can become painful when engaged. An appropriate exercise for the morbidly obese may include some discomfort, but should not create significant lasting pain. Muscle reaction typically is delayed and felt the day following exercise. Any physical activity that causes pain while you are doing it and continues the next day should be stopped and reported to your doctor.
Effects
For many with an excess of 100 pounds or more, bariatric, or weight loss, surgery is one way to shed weight and reduce the risk of developing debilitating diseases. While the surgery shrinks the size of the stomach to reduce the person's ability to eat excessively, exercise is an important tool to build muscles and endurance. According to the journal "Orthopedics," exercise performed prior to the surgery also can help to speed up recovery and help patients become more efficiently active. Exercises that can prepare patients for a more successful surgery include swimming, biking, water aerobics and walking.
Considerations
Any physical movement can burn calories and help you lose weight. Morbidly obese patients are encouraged to increase movement. According to the journal "Orthopedics," however, exercise for muscle building, endurance and calorie burning are those activities that fall outside of the scope of everyday activities. Walking to and from the bathroom doesn't count as exercise, although walking around the block does count.
Benefits
The benefits of weight loss include improved cardiovascular performance, increased endurance and overall general well-being and are best achieved through regular, structured exercise. According to the National Heart, Lung and Blood Institute, the possible consequences of exercising when you're morbidly obese include a heart attack, cardiac arrest or high blood pressure. The benefits of starting an exercise program outweigh the risks, however, and risks reduce rapidly as you build endurance.
Effective Exercises for Morbidly Obese Women
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"Morbidly obese" is a descriptive term rather than a specific medical diagnosis. You'll get different definitions depending on who you ask. A good general guideline is that you weigh noticeably more than the minimum weight that would adversely affect your health. Morbidly obese women often want to lose weight, but their size makes most kinds of exercise too hard on their bodies. However, there are a few exercises that even the extremely overweight can succeed with, beginning the long journey toward a healthy weight.
Walking
A daily walk is a low-impact workout that burns more calories the heavier you are. A 300-lb. woman walking at a moderate pace will burn as many calories as an athletic woman jogging the same distance. According to Dr. Mehmet Oz in "You: The Owner's Manual," you can get results from any walk that helps you break a light sweat. If you find even walking is hard on your legs at first, you can use a walking stick to help you along on your earliest workouts.
Water Exercise
Fat is less dense than water. Since one challenge of exercising for morbidly obese women is the weight of their fat, exercising in water can be an ideal choice because the buoyancy supports much of the weight. You can find many different water exercise options at your local gym or community pool. Some examples include water aerobics, walking in water, swimming laps and even practicing tai chi or yoga while partially submerged. For women who would rather not be in front of men in their bathing suits, some facilities offer single-sex classes throughout the week.
Tai Chi
Tai chi is a form of exercise and meditation that originated in China. The practice involves moving through a series of martial arts postures that improve balance, burn calories and strengthen your muscles. Moving so slowly makes this exercise workable for the overweight, seniors and other people whose bodies aren't up for a more aggressive workout options. If you're unable to stand for an extended period, you can even benefit from practice while sitting in a chair.
Strength Training
Strength training burns fewer calories than cardio workouts but still carries health and weight-loss benefits. Obese people often find they have surprising success with strength training because they're used to carrying and lifting the heavy weight of their bodies all day long. A course of weight training can also strengthen the muscles that support your hips, knees and ankles -- joints that often have trouble when severely overweight people begin to do exercises that require standing up. According to Miriam Nelson in "Strong Women Stay Young," strength training is especially important for women, as the weights can help strengthen your bones to slow the onset of osteoporosis in your later years.
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