The Goals for Weight Loss as well as Energy Restrictions

Sonia Roman, … Arturo Pandoro, in Dietary Interventions in Liver Disease, 2019,

4.1.1 The Goals for Weight Loss as well as Energy Restrictions

Losing weight through exercise and diet is the primary strategy. It is crucial to set realistic goals for sustainable as well as healthy loss of weight. Since the majority of NAFLD patients are overweight or obese, a weight loss strategy ranging from 5% to 10% of the initial weight over the course of six months is ideal. 43 According to various therapeutic guidelines for NAFL/NASH (Table 1.1) According to the guidelines, the weight loss of 3%-10 percent is recommended. Steatosis improvement is evident with a 3%-5 percent loss in body weight in comparison to a 7%-10% reduction that can be associated with improvement in the histopathological manifestations that are characteristic of NASH. 40 However, a weight reduction of 10% or more is necessary for resolution of NASH and the regression of fibrosis. 44 Energy restriction via diet is necessary to reduce weight. This is why it is suggested that energy be reduced by a minimum of 500 kcal/day, and then 1000 calories per day or 30% than the required energy. The energy intake recommended in women ranges from 1200 – 1500 kcal/day and 1500-1800 kcal/day for men (considering fitness levels and personal needs). This aim intends to promote healthy weight loss, which amounts to around 0.5-1 kg per week. 43 In contrast, a significant loss of >1.6 kg/week should be avoided because it may aggravate NASH and lead to the formation Gallstones. 45


Weight Management: How to Find the Healthiest Balance

Jacqueline B. Marcus MS, RD, LD, CNS, FADA, in Culinary Nutrition in 2013,

Diet Aids

The process of losing weight and keeping it off isn’t easy because it requires a everyday effort to be aware of the amount of calories consumed and what activities you are engaging in. The lure of dietary aids can be a tempting. Using pills and other potions to shed the pounds fast is a lot easier than dieting and exercising, regardless of cost. But are they safe, and what are the long-term consequences?

Supplements to diet and herbal products are commonly used to aid in weight loss. For the United States, the Dietary Supplement and Health Education Act of 1994 (DSHEA) allows manufacturers to classify herbal products in addition to nutritional supplements into food. But it also allows manufacturers to avoid certain regulations from the FDA. Therefore, weight-loss aids do not have to meet the same strict standards as prescription drugs or generic medications. Some are sold with no proof of their efficacy or safety. Manufacturers may make health claims based on their own review and interpretation of studies without FDA authorization. However the FDA may remove a products off its market if it’s discovered to be dangerous. This is particularly important given the amount of products available are available via the Internet. It is important to note that the US Federal Trade Commission (FTC) helps in regulating trafficking. Certain of these diet aids are shown in Table 10-2-2 [24-2724-27. Since there isn’t any guarantee that they are secure or efficient, as with other alternatives to nutrition and overall health let the buyer beware. Some potential long-term effects can be extremely dangerous.

A variety of prescription and over-the counter medications are available to tackle the increasing health issue of obesity. They do this by inhibiting the enzyme lipase , which is required to digest fats; blocking taste buds and numbing them as well as increasing the brain chemical norepinephrine which signalizes the body to eat less; decreasing appetite as well as other methods.

Possible side effects include a decrease in absorption of fat-soluble vitamins digestive problems, and an increase in blood pressure and heart rate. In fact “Dieter’s Tea,” widely available in certain grocery stores, could cause extreme extreme dehydration, stomach issues, and in some cases, death.

Pulmonary Disease

LAURA E. NEWTON MA, RD, SARAH L. MORGAN MD, in Handbook of Clinical Nutrition (Fourth Edition) (2006).

Respiratory Function

When body weight declines it results in a diminution in the capacity and size of the diaphragm and the respiratory muscles’ function. In emphysema hyperinflated lungs alter the size of respiratory muscle and hinder their performance. With malnutrition the diaphragm and intercostal, and accessory muscles are catabolized to generate energy, resulting in diminution in the ability to breathe. Inflammation, infection, as well as decreased protein intake lead to a drop in serum albumin, which lowers the oncotic pressure , resulting in pulmonary Edema. Undernutrition also affects the parenchyma of the pulmonary parenchyma, by reducing collagen synthesis as well as increasing the rate of proteolysis. This could manifest as reduced production of surfactants as well as alveolar collapse.

Weight-reducing surgery for women planning the birth of a child: where are we today?

Siara Teelucksingh … Surujpal Teelucksingh, in Obesity and Obstetrics (Second edition), 2020

Pregnancy outcomes after weight-reducing surgery

The reproductive benefits after weight-reducing surgery not only begin with the increase in fertility and improved sexual performance, but could extend to the outcome of pregnancy too. In a study of case-control that compared pregnancy outcomes among women who had undergone bariatric surgeries versus the same age and BMI as women who did not undergo surgical procedures, they found some noteworthy benefits [47(47). These findings were comparable to those outlined in a massive study of meta-analyses and reviews of more than 8000 pregnancy outcomes post-bariatric surgery [49and 49. In summary, in comparison to those who underwent the bariatric procedure, there were lower rates of gestational diabetes and hypertension caused by pregnancy, as well as a significant reduction in neonates who were large for their dates. The requirement for surgical delivery was also less (the number of patients to treat ranging from 5 to 11). It was also evident that there is a tendancy to less postpartum hemorrhage, with the the number required to benefit being 21. The main risk to the fetus was minimal for dates (odds ratio of 2.16 with number of harms 21,), IUGR (odds ratio: 2.16 and number needed to cause harm at risk: 66), and preterm delivery (odds ratio 1.35 with a number required to harm 35). In the end, the results showed that there was no change in incidence of preeclampsia. The neonate’s needs for ICU involvement, congenital anomalies, and death were not affected. On the other hand, there was moderately increased risk for low birth weight, preterm delivery, and high risk for small-for-gestational age. Despite the latter, there also appears to an ongoing benefit throughout early childhood. There are also reports from two small studies on the increase in children born to parents who have undergone GBS that show the benefits of the anti-obesity surgeries are passed on to their children. In the study carried out in southern Brazil, the rate of obesity among children born to 19 women before the surgery occurred at 55% and it dropped to 31% for children born to these mothers following bariatric surgery. In another study, 118 children, aged between 2 and 18 years, born to women who had undergone biliopancreatic bypass surgery were compared with children born before the women had surgery. These findings also suggested that surgery to prevent obesity in the mother confers advantages to their children The prevalence of obesity was reduced to the levels of the general population. Obesity was decreased by 52%, and severe obesity was reduced by 45% [49-52(49-52) (Tables 31.3 as well as 31.4).

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