obesity and health
Primary-care physicians now have a road map for dealing will overweight and obesity. .

Good news
When it comes to losing weight, confusion reigns, along with despair. Many people assume, incorrectly, that lost weight always returns in time. To advise doctors, on June 17 the National Institutes of Health published guidelines on identifying and treating overweight and obese adults. "These give the primary care physician a road map for how to deal with obesity," says James Hill, who helped develop the guidelines. "It tells them they need to be aware, that obesity and being overweight are a problem."

Using evidence from 394 randomized clinical trials, the guidelines listed the health benefits of losing weight through diet and exercise. For example:

Lifestyle changes (eating less and exercising more) can lead to weight loss that reduces blood pressure in overweight people with high blood pressure -- a contributor to heart disease and stroke.

Aerobic activity increases the fitness of the heart and respiratory systems and reduces blood pressure -- even if it does not reduce weight. If it does reduce body weight, exercise also improves blood fats, further reducing the risk of heart disease.

Weight loss produced by lifestyle changes improves blood glucose levels in overweight and obese people without adult-onset (type 2) diabetes, and may improve blood chemistry in type 2 diabetics.

Physical activity should be part of a comprehensive weight-loss program because it increases heart-lung fitness, modestly reduces weight, and may help maintain the lower weight. Exercise may also decrease abdominal fat, which is especially harmful to the cardiovascular system.

Aside from helping doctors deal with obesity, Hill says the guidelines will help set reasonable expectations. While many obese people want to lose massive amounts of weight and achieve pin-up dimensions, "We don't have the ability to produce massive weight loss," Hill says.

Although massive losses are rare, Hill says many studies of weight-loss programs demonstrate losses of 10 percent, a seemingly small reduction that can still spur massive improvements in health, by controlling blood pressure, reducing bad cholesterol levels, and preventing many cases of type 2 diabetes.

Even though there's no absolute proof that losing weight will actually make us live longer, we've decided to cancel our order for the third double-bacon cheeseburger and read what's new and hot in the weight-loss department.


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