Scientific Weight Management

Karuna Healthcare's

Scientific Weight Management

Welcome to Karuna Healthcare!

 

We understand that you have approached us for regulating your weight and your desire to resolve your weight problem displays your will to do it. We want you to keep it up and stay motivated, while we help you understand how Scientific Weight Management will help you. Neither an overweight, nor an underweight is healthy. For adequate functioning body's mass distribution should be just right. Drastic and sudden weight loss and weight gain are both harmful. Hence, SWM concentrates on gradual weight gain or loss over a period of time and preserving body's vital processes and structures at the same time. Let's understand how.

Obesity:

A BMI of more than 25 indicates obesity. Obesity reduces the body's ability to regulate blood sugar levels by producing insulin, which can lead to diabetes or high blood pressure. Fat cells can result in excess production of sex hormone after menopause that may lead to breast cancer or uterine cancer.

Obesity is a disease in itself and can lead to various other diseases. Here are the commonest Obesity-Related Diseases (ORDs):

1. Diabetes, a disorder where the pancreas is not producing enough or sometimes not any insulin. Diabetes can lead to a whole host of other medical issues and obesity is one of the main causes.
2. Cancer has many different forms and types; many of them could be prevented with more attention to eating healthily and avoiding obesity.
3. Congestive heart failure is a condition in which your heart can't pump enough blood to your body's other organs.
4. Enlarged heart is another heart condition where the muscle of your heart becomes larger due to being overworked, which naturally happens if you are overweight.
5. Pulmonary embolism is a sometimes fatal blockage of an artery. Being overweight causes most people to reduce activity, and after time lack of activity can result in an embolism.
6. Polycystic ovarian syndrome is a condition in which cysts develop in your ovaries. These can burst, causing even further problems.
7. Gastro-esophageal reflux disease happens when stomach acid and juices flow from your stomach back up into your esophagus. It is common in overweight people.
8. Fatty liver disease is a reversible condition in which large pockets of fat accumulate in liver cells.
9. A Hernia is caused when the hole in the diaphragm weakens and enlarges.
10. Erectile Dysfunction is the inability to develop or maintain an erection, which can be caused by a medical problem due to obesity.
11. Urinary incontinence is the inability to control urination. It is frequently associated with obesity, weak bladder and pelvic floor muscles
12. Chronic renal failure, meaning your kidneys fail to work, is a much greater risk to those who are overweight or obese.
13. Lymph edema is a condition that occurs from a damaged or dysfunctional lymphatic system, sometimes caused by people suffering from obesity actually crushing their own lymphatics.
14. Cellulitis is a spreading infection, involving both the dermis and subcutaneous skin tissues, resulting from poor lymph flow caused by obesity.
15. Stroke is caused by a lack of blood supply to your brain.
16. Pickwickian syndrome is characterized by sleep apnea resulting from obesity placing an excessive load on your pulmonary system.
17. Depression is a condition where a person feels miserable constantly, even to the point of being suicidal. It can be worse for someone who also has a weight problem.
18. Osteoarthritis is a clinical syndrome in which low-grade inflammation results in pain in your joints. It is caused by abnormal wearing of the cartilage, oftentimes due to obesity.
19. Gout occurs when uric acid accumulates in your blood. Nerve endings then become irritated, causing extreme pain, which is made worse by carrying extra weight.
20. Gallbladder disease commonly affects overweight people as a result of high blood cholesterol levels, which cause gall stones.

Metabolic Syndrome or Syndrome X:

It is a combination of medical disorders that increase the risk of developing cardiovascular disease and diabetes mellitus.

The World Health Organization criteria (1999) require presence of one of diabetes mellitus, impaired glucose tolerance, impaired fasting glucose or insulin resistance,

AND two of the following:

1. Blood pressure: ≥ 140/90 mmHg
2. Dyslipidemia:
   1. triglycerides (TG): ≥ 1.695 mmol/L and
      1. high-density lipoprotein cholesterol (HDL-C) : ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)
   2. Central obesity: waist : hip ratio : > 0.90 (male); > 0.85 (female),
   3. or Body Mass Index > 30 kg/m²
   4. Microalbuminuria: urinary albumin excretion ratio ≥ 20 µg/min or albumin : creatinine ratio ≥ 30 mg/g

Complications:

1. Atherosclerosis
2. Diabetes
3. Heart attack
4. Kidney disease
5. Nonalcoholic fatty liver disease
6. Peripheral artery disease
7. Stroke

 

Evaluation:

We begin with analyzing few aspects about your body. We record your

2. Symptoms
3. History of past illnesses and treatments
4. Family History
5. Physical Constitutional Factors
6. Mental State and Stress Factors
7. Physical General Examination
8. Age
9. Sex
10. Activity
11. Height
12. Waist Circumference
13. Hip Circumference
14. Neck Circumference
15. Arm Circumference
16. Thigh Circumference
17. Leg Circumference
18. Arm Circumference
19. Forearm Circumference
20. Wrist Circumference

 

We then take you to 'Karadascan'. Please note that readings are to be taken only:

1. After waking
2. 2 hours after breakfast, lunch, dinner, drinking lots of water or alcohol, vigorous exercise, sauna or taking a bath
3. After keeping your cell phone, pages or other devices away

It cannot be done if:

1. You undergo regular dialysis
2. You have medical electronic implants and pacemakers

It will give details about:

2. Weight
3. Subcutaneous Fat %
4. Body Age
5. Body Mass Index
6. Resting Metabolism
7. Visceral Fat
8. Body Fat % (Whole Body, Trunk, Legs, Arms)
9. Skeletal Muscle % (Whole Body, Trunk, Legs, Arms)

 

We also require few routine tests. They include:

1. Hemoglobin
2. Lipid Profile
3. Fasting and Post Lunch Blood Sugar
4. TSH, T3, T4
5. Urine Routine
6. Others (if indicated)

Together we put together your findings and provide you with Weight Management Report.

 

Understanding various aspects of Weight Management Report:

Everybody is concerned about their weight. But what is the basis for determining your ideal weight? They key is BMI.

What is BMI?

Body Mass Index or BMI is calculated using your height and weight. BMI is a reliable indicator of body fatness for people. BMI does not measure body fat directly, but research has shown that BMI correlates to direct measures of body fat. BMI is used as a screening tool to identify possible weight problems for adults. Maintaining an ideal weight can help prevent obesity, excessive weight loss and other related diseases and ensure longevity.

BMI (kg/m2)	Definition
<18.5	Underweight
18.5-24.9	Ideal Weight
25-29.9	Overweight
30-39.9	Obese
40-49.9 or 35-49.9 with Obesity-Related Diseases	Morbidly Obese
50-59.9	Super Obese
60-69.9	Super Super Obese
>70	Hyper Obese

 

The ideal BMI is 22. BMI of more than 25 makes people susceptible to Obesity-Related Diseases (ORD).

It is not applicable for professional athletes and body builders who have increased muscle mass contributing to body weight.

 

Waist to Hip Ratio:

The WHR has been used as an indicator or measure of the health of a person, and the risk of developing serious health conditions.

Waist to Hip Ratio Chart
Male	Female	Health Risk
0.95 or below	0.80 or below	Low Risk
0.96 to 1.0	0.81 to 0.85	Moderate Risk
1.0+	0.85+	High Risk

 

Research shows that people with "apple-shaped" bodies (with more weight around the waist) face more health risks than those with "pear-shaped" bodies who carry more weight around the hips.

Risk of BMI Related Diseases
BMI	Rating	Waist Size
		< or = to	> or = to
		40 in. (men) or	40 in. (men) or
		35 in. (women)	35 in. (women)
18.5 or less	Underweight	--	N/A
18.5-24.9	Normal Weight	--	N/A
25.0-25.9	Overweight	Increased	High
30.0-34.9	Obese	High	Very High
35.0-39.9	Obese	Very High	Very High
40 or greater	Extremely Obese	Extremely High	Extremely High

 

Body Fat:

Body Fat is of 2 types: Subcutaneous Fat and Visceral Fat. SC fat is under the skin while visceral fat is around the internal organs.

Some amount of fat is important as it provides insulation to the inner organs, stores energy and regulates hormone levels in the body, while excess predisposes to illnesses.

Body Fat Percentage:

BFP refers to the amount of body fat mass in regards to the total weight.

Body Fat Percentage
Gender	Male	Female
Low (-)	5.0-9.9 %	5.0-19.9 %
Normal (0)	10-19.9 %	20.0-29.9 %
High (+)	20-24.9 %	30.0-34.9%
Very High (++)	25.0-50.0 %	35.0-50%

 

Visceral Fat:

Too much visceral fat is closely linked to increased fat levels in blood stream, which can lead to diseases such as High Cholesterol and Diabetes.

People with large VF tend to have large abdomens, although this is not always the case.

Visceral Fat Results
1-9	Normal (0)
10-14	High (+)
15-30	Very High (++)

 

 

Subcutaneous Fat:

Fat tends to accumulate below skin, especially around upper arms, hips and thighs causing distortion of the body's proportions. Although not directly linked to disease, it is can lead to increased pressure on the heart and other complications.

Skeletal Muscle:

Skeletal Muscle is muscle that is connected to bone and used to move parts of the body. Skeletal Muscle can be increased through exercise and other activity.

Average Skeletal Muscle Percentage:

Average Male	Approx 28 %
Average Female	Approx 37 %

 

Resting Metabolism:

Regardless of your activity level, a minimum level of energy is required by the body to sustain its regular essential functions. Around 60-70 % of daily energy is used for Resting Metabolism and thus accounts for most of our daily energy consumption. If our daily food intake exceeds the amount needed for Resting Metabolism, daily activity metabolism and energy needed for metabolizing food taken, the additional energy is stored as fat. As the amount of muscle decreases, as with growing age, so does the amount of energy burned. If people continue to eat the same amount of food as when they are younger, then they tend to develop an increasing abdominal circumference.

Body Age:

Body age is based on your metabolism. A healthy body composition will lead to a younger age.

Optimal Calorie Intake:

It is calculated taking into account your resting metabolism and body mass and indicates the amount of calories you must take daily for maintaining health.

Safe Calorie Deficit:

It indicates amount of calories that can be reduced without compromising on your health. You can do this either by reducing food intake or increasing the activities.

Long-term Planning for a successful weight loss:

Ignoring a balanced diet and simply reducing food intake to lose weight can lead to a decline in muscle or bone. This may result in weight loss but not in the reduction in fat levels. So even though your weight goes down, your resting metabolism is reducing making the body more prone to putting on fat.

Repeated dieting and again gaining weight leads to increased visceral fat levels. It is easy to regain weight after sudden diets. This regained weight tends to appear as visceral fat rather than subcutaneous fat.

The most rational weight loss technique is slow but steady loss over period of few months, around 1-2 kg/ month, by reducing the fat percentage, increasing muscle mass and reducing body age, and achieving ideal Waist to Hip ratio and Body Mass Index.

Rules for Achieving and Maintaining Healthy Weight:

1. Change your mind for good. To lead a happy, healthy life with a permanently slender body, it's essential to change your self-image and eating attitude to a healthy point of view. You CAN learn to enjoy healthy food and feel satisfied eating less – IF you put your mind to it!
   
2. Create a supportive lifestyle. Those who lose weight and gain it back have failed to make the necessary mental, eating and lifestyle adjustments. Healthy permanent weight loss requires healthy permanent changes. So make a commitment to creating a new happy healthy lifestyle.
   
3. Eat a healthy low calorie diet. People successful at weight loss limit calories. They usually begin with a calorie chart, listing their numbers in a weight loss journal. They drink lots of calorie-free water and focus on filling high fiber and lean high protein foods with fewer calories per bite.
   
4. Be physically active regularly. Besides burning calories, exercise boosts your metabolism, builds lean muscle, removes toxins and helps you look and feel you're absolute best. So start pumping up the activity.
   
5. Focus on calories, not pounds. Put away the scales and concentrate on healthy new habits and counting calories, instead of pounds. Once you've reached your goal, get out the scales and weigh yourself about once a week to make sure you stay within 5 pounds of your target.
   
6. Find healthy entertainment. Most people use addictive sweet, salty and rich fatty foods destructively – to reward, entertain or avoid. It's time to stop emotional eating and use healthier ways to soothe you.
   
7. Plan ahead and pay attention. Don't leave home without some raw veggies and lean protein. Steer clear of temptations like buffet tables. If you must be around tempting food, prepare yourself ahead of time.
   
8. Be both patient and persistent. Everyone wants to lose weight fast. But going too fast can be a speed trap that stops you in your tracks. Like the tortoise and the hare, slow and steady wins the race. Both your mind and body need time to adjust to each and every pound lost.
   

 Get your Personal Diet Chart based on your SWM Report and Constitutional Profile.

We wish you all the best.