Читать книгу Weight Loss Tailored for Women - Ohan Karatoprak MD - Страница 8

Here is an overview of the Body-Profile Type evaluation that will be detailed in Chapter 6. Each step of the Body Profile Type evaluation provides important information about you, leading you to your “individualized” Body-Profile Type weight loss and exercise programs.

The Body-Profile Type approach starts with determining Body-Fat Type. This involves measuring your height, weight and waist circumference, which will be used to estimate body fat percentage and body mass index (BMI). Using these measurements you will be able to determine your:

1) Body Fat Type

Obese, or

On the way to obesity, or

Normal body composition (normal body fat range)

2) Body-Profile Type: Type A, B, C, D, E or F.

Even though Body Mass Index (BMI) calculation is being used to categorize overweightness and obesity based on your height and weight ratio, in reality it does not determine your body fat percentage. While people with high BMI may be obese, some people can be obese with normal BMI measurement. Conversely, some people with a high BMI may not be obese if they have higher than average muscle mass, and normal body fat with normal waist circumference.

OBESITY IS EXCESS BODY FAT

NOT NECESSARILY EXCESS BODY WEIGHT

You may be wondering; how can this be true?

The BMI is a quick estimate method that uses a chart based system or quick calculation of height and body weight. In creating the BMI values, many general assumptions were made based on “population averages”. When you put these two variables together, assumptions + averages this leads to inaccuracies.

It is well known that the BMI measurement approach alone will underestimate body fat in older people and overestimate body fat in muscular athletic people. When men and women grow older, it is common for them to lose lean body mass, such as muscle mass and bone mass, and gain body fat, while maintaining a normal BMI. In this way, they can have the same total body weight but actually have more body fat. This category of normal weight obese, or “thin obese” people often goes unnoticed by the medical community, but these people still have the same disease risks as overweight obese people (high BMI and high body fat percentage).

After you know your body fat type, then you will like to know if you have metabolic syndrome. People who are obese, on the way to obesity, or normal body composition may or may not have a group of metabolic abnormalities referred to as “Metabolic Syndrome”.

Metabolic Syndrome includes the following five measurements:

High blood sugar,

Hypertension (high blood pressure),

Low good cholesterol (HDL),

High triglycerides and

Increased waist circumference.

Determining metabolic abnormalities is easily accomplished from a routine medical examination. It is common that most people already know about their health condition, but for people who are not sure, the Body-Profile Type system provides readers with handy Body-Profile Type Evaluation information in Appendix A they can use when working with a doctor. It is also routine advice for people who are about to engage in a fat loss nutrition and exercise program that they should first get a medical examination, and be monitored by their doctor or other qualified health professional.

The Body-Profile Type Approach also considers other health conditions that a person may have, and medications they may be taking. Certain health conditions and medications can contribute to obesity and can interfere with the fat loss process.

After knowing your Body Fat Type and whether you have metabolic syndrome or not, next step will be to determine your Behavioral Type Category. Using the Behavioral Type classification, a person’s existing nutrition and exercise program category will be determined. There are four behavioral type categories. The Body-Profile Type Approach classifies people into one of four Behavioral Type categories:

•Under-Eater and Under-Exerciser

•Under-Eater and Over-Exerciser

•Over-Eater and Under-Exerciser

•Over-Eater and Over-Exerciser

This behavioral categorization is another Body-Profile Approach medical breakthrough and provides important insights related to a person’s metabolic and lifestyle factors.

Your daily caloric intake will determine your behavioral eating category as follows:

Under-Eater, is someone who is eating less than 1800 calories per day.

Over-Eater, is someone who is eating more than 3000 calories per day.

For people who are under-exercisers, this provides important information as to their state of physical conditioning. This has a few implications concerning their metabolic rate and health. Regarding the person’s metabolic rate, under-exercisers are using less total calories a day and not using fat for energy very well either. Concerning metabolic health, when you are obese or on the way to obesity and have metabolic abnormalities from lack of exercise, a program of gradual exercise is required to gradually physically condition the body. This is where most exercise programs fail the obese or on the way to obesity under-exerciser, by making them follow an exercise program that is too advanced for their level of physical conditioning. This level of exercise increases the stress hormone cortisol, which stores body fat, and can increase Neuro Peptide Y secretion, which causes overeating. Neuro Peptide Y is a neurotransmitter in the brain that increases your appetite and slows down your metabolism. However, the specialized Body-Profile Type Exercise Program is designed to start out this type of under-exerciser person with an exercise regimen that is more suitable to their individual physical conditioning.

The over-exerciser category reveals that the dieter could be doing more harm than good from their exercise program. Typically an obese person who is over-exercising has an issue with secreting excessive cortisol (stress hormone) that makes a person store more body fat instead of losing body fat. Therefore excessive exercise is typically causing conflict with the fat loss process. With your Body-Profile Type analysis, you will find the proper exercise program that has the ideal balance of resistive and aerobic exercises for you to lose excess body fat.

Nutrition and Exercise Fat Loss Programs

The Body-Profile Type Evaluation will determine the personalized Body-Profile Type eating plans. The eating plans range in total daily intake from 1,800 calories per day to 3,000 calories per day. Also the carbohydrate composition will be different based on a person’s gender, and if they have metabolic syndrome or not. For example, an obese female under-eater, under-exerciser without metabolic syndrome may start on the 1,800 calories per day plan, consisting of 40%-45% carbohydrate (40% from starchy foods), 30%-35% protein and 25%-30% fat, while an obese female over-eater, under-exerciser with metabolic syndrome may start on the 2,200 calories per day nutrition plan consisting of 40%-45% carbohydrate (20% from starchy foods), 30%-35% protein and 25%-30% fat.

Regarding types of foods included in the Body-Profile Type eating plans, all types of healthy foods are included. However, there may be temporary periods were the amounts of certain foods are restricted or limited until hormonal balance is corrected and metabolic rate is improved, as indicated by the rate of body fat loss.

Achieving Weight Maintenance

Regardless of the person’s individualized starting point, the primary goal is to transition the individual from a condition of obesity to normal body composition and normal metabolism. As people achieve a normal body fat level they will be guided in to the weight maintenance nutrition and exercise programs. The basic macronutrient composition goal of the maintenance nutrition program is 40% to 45% Carbohydrate (with 40% from starch), 30% to 35% Protein (with at least 30% from legumes) and 25% to 30% Fat (low saturated fat). There will be additional guidelines to modify this basic maintenance plan based on individual lifestyle factors, including medical conditions and also how active a person is.

The Body-Profile Type maintenance exercise program provides for a minimum and maximum range of exercise, 5 to 6 days per week, using a combination of resistive and aerobic exercises.

For successful weight maintenance, it is recommended to conduct a Body-Profile Type evaluation every month. If body fat gain is detected, the person should be instructed to immediately start following the Body-Profile Type program used during the fat loss phase.

This weight maintenance strategy keeps the person motivated, and prevents them from reverting back to their previous state of obesity.

Body-Profile Type Nutrition Pyramid

The Body-Profile Type daily food intake pyramid, for promoting fat loss, health and longevity, is as follows.

SAMPLE OF DR. Karatoprak’s SUCCESS STORIES

As director of the weight loss clinic and my medical practice, people come to me when they are extremely overweight or obese and when nothing else they tried on their own worked for them. Here are a few of their stories, including one that is very personal to me, my son’s. Reviewing these case histories can help with your motivation, and to relate to the case study that may be similar to your situation.

Woman: Under-Eating, Over-Exercising

This is story of Rita who was an under-eater and over-exerciser. She was in her 50’s, tall, obese and worked as a teacher. During the initial interview at the weight loss clinic, she revealed she had been dieting continuously for about 2 years, and was now at the point where she was consuming just 700 to 800 calories a day, exercising 60 to 90 minutes a day of strenuous exercise. Remarkably she was not losing any weight.

I explained to Rita that her casual low calorie dieting has ruined her metabolism, and that her progressively low caloric intake lowered the metabolic rate at which her body uses calories. Additionally, severe hormonal imbalances were present that favor fat storage, i.e., storing a higher amount of body fat, and holding on to the body fat.

Based on this evaluation I told her that she needed an eating plan higher in calories than she was eating, to start making her metabolism work again. We also needed to adjust her food intake to get in the proper ratios of nutrients and follow an adequate exercise program. At first, Rita was not interested in what I had to tell her and she left my office. About a month later Rita returned to my office and said she was back to try my program because nothing else was working for her, and she really wanted to lose the excess body fat. I again explained to her that she was not losing weight because she is under-eating, as well as over-exercising, and slowing down her metabolism. I needed to put her on a higher calorie diet in order to stimulate her body to start burning more calories. Plus, she was over-exercising, which was increasing the secretion of a substance in the brain that was slowing down her metabolism, called Neuro Peptide Y. Furthermore, over-exercising increases the cortisol level that can promote body fat storage.

I started Rita on the 1,800 calories per day diet, because this is the lowest amount that the body needs to function, and to avoid sensing starvation; which is why most diets fail. I increased her caloric intake progressively. Her exercise program was changed to just 45 minutes walking 5 times a week, and 30 minutes of resistive exercise 2 to 3 times per week.

It took a short time for Rita’s metabolism to recover, and when it did she started to lose inches and pounds of body fat when the daily caloric intake reached 2,500 calories per day. This was what was appropriate for her body size and activity level. Then she eventually settled in to the 2,800 calories per day weight maintenance diet after losing the body fat.

Man: Over-Eating, Over-Exercising

Steve, who was 33 years old car salesman, came to our weight control center. He was overweight, but close to the obese category. Five days a week after work Steve was going to the gym exercising and lifting weights for one and a half to two hours. He was eating excessively to build the muscle, and consuming protein shakes. At night he was drinking two to three beers with dinner. So when I calculated his food intake, Steve was eating about 5,500 calories per day, and was a classic example of an Over-eater, Over-exerciser.

The first course of action for Steve was to reduce his daily caloric intake to 2,200 calories and reduce his time exercising, and his caloric intake was progressively increased. After several weeks, I determined Steve’s ideal caloric intake was about 3,000 calories per day. I adjusted Steve’s exercise pattern too, starting with cardiovascular for 45 minutes 5 to 6 days per week, with 30 minutes to 45 minutes of resistive exercise 3 times per week. Steve did terrific, and lost the excess fat pounds quickly, it took only three months to reach his goal. At the start of the program Steve had a beer-belly even though he was exercising, which he finally was able to lose using my approach.

Woman: Over-Eating, Under-Exercising

Kelly was 53 years old working as a secretary, a sedentary job. Kelly has a life long struggle with being overweight. But during the last six years since she went in to menopause she gained 40 more pounds. She was frustrated with this and came to the weight control center for help. On her own, Kelly was cutting back the fat intake seeing if this would help her lose weight. So she wasn’t eating fatty foods, she was eating more carbohydrates, and she was drinking 4 to 6 diet sodas daily, and snacking on diet cookies thinking she was cutting down her calories a bit. She was actually eating between 3,000 to 4,000 calories a day, mainly carbohydrates, and was not exercising.

This pattern of behavior made Kelly the classic Over-eater, Under-exerciser. Plus, being in menopause, her hormonal changes caused her to gain even more excess body fat. In Kelly’s case we started by cutting her calories. I started Kelly on an easy exercise program of walking just three times a day for 15 minutes, and also the appropriate resistive exercise. The reason for this program was that Kelly never exercised before, and needed a beginner program to start with, but also a program that would be sufficient enough to stimulate her body to start burning more calories. If she started with too much of exercise, this would have created imbalance with her producing cortisol and Neuro Peptide Y hormones that can cause her to put more fat on. In this way, starting slowly, Kelly was able to stick to her exercise program and experience successful weight loss for the first time in her life.

Kelly’s story is one of the most common I encounter. The good news is that it is the easiest type of obesity / overweightness to treat using my approach.

Man: Under-Eating, Under-Exerciser

John was a 46 year old air conditioner repair man who was really obese when he first came to my office. He was eating only one time a day, dinner, which was a good well balance meal. He was drinking coffee and diet soda all day. He was very frustrated because he was not losing any weight. When he came to me, he had no idea that under-eating by eating just one meal a day (about 1,200 calories) and not exercising could make him keep gaining more weight. He had some major hormone imbalances, including male breast enlargement, which is a common problem in men with high body fat levels; this causes the male hormone testosterone to get converted to the female hormone estrogen, and stimulate development of the dormant breast tissue. John was a classic Under-eater, Under-exerciser.

I put John on 5 small meals per day eating program, eliminating coffee and soda. Exercise was again easy and convenient, just 15 minutes of walking, 3 times a day; also, 3 times a week of resistive training for about 15 minutes, followed by progressively increasing his exercise according to the Body-Profile Type Exercise Approach. He had a slight cardiomyopathy from his obesity, which made him short of breath and easily fatigued. He did tremendously well on the program and finally was able to lose the excess fat weight.

Teenager

Like most parents, my wife and I did our best to teach our son Mark good nutrition and fitness habits. So growing up he was eating healthy in the house. However, Mark was also eating outside the home with his friends, which lead to over-eating. Also he was not exercising enough. Mark was a typical stubborn teenager, and was not taking my advice even though I was an expert in weight control. It was a delicate situation, because he would tend to get depressed when I would have a conversation about his weight. At 15 years old his waist size was about 36 inches and he was a chubby overweight teenager.

One day Mark came to me and said that he wanted to talk to me about helping him lose weight. It was a good time, because he was ready to listen and follow my advice. He was eating about 4,000 calories per day, and drinking a tremendous amount of milk, eating a lot of sandwiches and desserts, he was eating very little vegetables and fruits. Even though he did not have junk food at home, he was getting hold of it outside the house.

Now that Mark was interested in losing weight, I finally was able to put him on a proper diet. I started him off on a 2,400 calories diet. I also put him on a beginner exercise program, as he was not very athletic; just would occasionally play some recreational basketball with his friends. The exercise program included some resistive and aerobic exercise. It was 6 days a week aerobic exercise and resistive exercise 2 to 3 days per week. In just 3 months he lost the excess body fat and reduced two sizes. After 6 months his waist size dropped from 36 to 28 inches. He also grew 3 inches during this period. Now Mark is maintaining a good lean body, and following a healthy diet and exercise program. I also noticed that he improved in his school work and he is playing terrific basketball.