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Doctor can you
give me something to lose weight?
Every doctor is familiar with the obese patient who
comes into the clinic with a request for "something
to get my weight down , doctor!"
"No drugs can reduce the weight", says Dr. O.P.
Kapoor, Profession of Medicine, J.J. Group of Hospitals,
Bombay.
Drugs for treatment for obesity fall into four classes :
- Appetite -depressants
- Amphetamine group of drugs.
- Hormones
- Diuretics.
- Laxatives and
Purgatives.
I eat
less, I lose weight. So what is the harm in taking
amphetamines to reduce hunger ?
The Amphetamine group of drugs have a powerful
stimulant action on the central nervous system. The drug
postpones sleepiness and fatigue, stimulates mental and
physical activity energy expenditure and well-being. It
also diminishes appetite when taken before meals. And
this effect is sought after to keep the reduce satisfied
with less quantity of food.
There is no doubt that amphetamine group of drugs reduce
appetite, for a time, in many cases. But in doing in so
may lead to partial starvation and loss of vital tissues,
muscle and organs from the body, thus leading to weight
loss - a dangerous consequence. Its stimulant action may
cause extreme irritability, sleeplessness and the patient
becomes tired and ill- looking.
In many patients drug tolerance occurs. This means that
the drug in given doses fails to reduce appetite in the
patients after a few months. This requires that the dose
of the drug be increased. But whether any drug should be
used for months to prevent such a fundamental feeling as
hunger is a debatable point.
There are often clear reasons against these drugs as they
can cause :
- Increase in heart
rate-tachycardia or even heart block.
- High blood pressure.
- Abdominal pain and
spasms of bladder and rectum.
- Addition, chronic
restlessness and hyper excitability alternating
with melancholia - a mental state characterized
by extreme-sadness.
Dr.Sir Adolph Abraham,
honorary medical officer to the British Olympic team, in
the "News Chronicle " slimming series, writes,
"The employment of amphetamine group of drugs in
treatment of obesity is by no means without danger.
"
My own advice is a reminder that amphetamine group of
drugs, or for that matter any other drugs, taken without
medical advice is dangerous, and that as yet there is no
valid drug or medicine that can make you lose weight
naturally and just as important -keep you at the proper
weight level.
What is
the role of thyroid hormones in the treatment of obesity
?
This vital hormone produced by the thyroid gland fans
body fire to a brighter glow. That is, the thyroid
hormone has the property to raise the basal metabolic
rate which is the rate at which food (fat) burns. If the
patients own thyroid gland does not produce enough
hormone - a condition called hypothyroidism, supplements
can make up for the deficiency. But the majority of the
obese persons have a basal metabolic rate that is normal
or higher than normal, and a normally functioning,
thyroid gland. Use of thyroid hormone in the treatment of
simple obesity can elevate blood pressure and can worsen
a heart condition. If you suffering from circulatory
disease, or from diabetes and you take thyroid extract
pills without consulting your doctor, you actually are
endangering your life.
Take the case of S.K. a young man twenty kilos over his
ideal weight. His marriage has been fixed. He wished to
shed off his excess weight as quickly as possible. A
well-wisher advised him to take thyroid pills and
convincingly illustrated a case where dramatic results
had been achieved with thyroid pills.
Desperate and foolish, S.K. resorted to thyroid
medication without consulting a doctor. S.K. soon
developed diarrhoea, generalized shakiness and increased
nervousness.
At the onset of these symptoms the young man was referred
to me. I immediately took him off thyroid medication.
Blood tests showed that " he was not a
hypothyroid." He was anemic due to loss of nutrient
material from the body resulting from constant diarrhoea.
He was placed on proper treatment for obesity and advised
to eat nutritionally balanced meals. He lost his excess
weight in ten months and has been able to maintain his
ideal weight since four years.
There is simply no scientific evidence that thyroid
extract will help cure obesity, unless the obesity is
caused by thyroid defect. Thyroid preparations must never
be used without proper blood tests and without the
consent of your doctor.
What is
a diuretic? How do they act?
Kidney is an unique organ of excretion. It holds back
useful elements in the blood and allows only waste
material to pass out of the body in the form of urine.
This property of the kidney is called selective
filtration.
Drugs belonging to the diuretic group, when taken by an
obese person ( or even non obese person), lead to
diuresis, a forceful expulsion of water in the form of
urine, by inhibiting the Selective Filtration action of
the kidneys. This forceful removal of water leads to
weight loss obviously water, not fat and the weight is
regained once water is drunk.
The Diuretics, along with forceful removal of water also
cause loss, of vital elements (K+) potassium, (Na+)
sodium etc. Causing harmful side effects similar to
dehydration.
Is it
safe to use Laxatives or Purgatives for treatment of
obesity ?
These group of drugs act by speeding the movements of
the intestines thereby preventing absorption of digested
food in the gastro-intestinal tract. This causes frequent
passage of stools (diarrhoea ) with water resulting into
weight loss. Unfortunately the weight loss is fluid and
nutritive material from the intestines and not fat loss.
The resulting thirst soon leads to drinking more water
and lost weight is quickly regained.
Continual abuse of laxatives and purgatives for weight
loss can seriously interfere with digestion and
absorption of food, and will eventually cause loss of
weight through malnutrition.
Could
you explain the Ayurvedic theory on the cause of obesity
in detail ?
The Science of Ayurveda in India is in practice for
more than 2000 years. Ayurveda has discussed at length
the factors responsible in achieving not only a long
life, but a healthy long life. Ayurveda gives importance
to nutrition, physical activity and positive thinking for
living.
The first question an ayurvedic doctor asks is not
"what disease does my patient have ?" but
" who is my patient?" By "who " he
does not mean your name but how you are constituted. He
looks for the tell-tale traits that disclose your body
type, also known as your "PRAKRITI". This
Sanskrit term means " nature" It is your basic
nature he wants to uncover before he turns to your
problem of obesity.
Your body type - "PRAKRITI" - essential nature
is, your biochemical individuality expressing innate
tendencies that have been built into every aspect of your
body.
Your body type whose tendencies you inherited at birth,
is the most natural guide to how you should eat, exercise
and make decision in every area of your life. Where do
the body types come from? Every one has essentially same
kind of cells and organs occupied by three operating
principles called "DOSHAS"
The three doshas are called Vata, Pitta, and Kapha.
Depending on the predominance of a dosha there are ten
body types.
Although the doshas regulate thousands of separate
functions in the body, they have three basic functions :
VATA DOSHA - Controls movements.
PITTA DOSHA - Controls metabolism.
KAPHA DOSHA - Controls structures.
VATA DOSHA : helps to breathe, circulate blood, pass food
through digestive track, send nerve impulses between
brain and the rest of your body.
VATA TYPES :- Are prone to insomnia, chronic
constipation, nervous stomach, anxiety and depression,
muscles spasm or cramps, irritable bowls, chronic pain,
high blood pressure and arthritis.
PITTA DOSHA :- Helps to process air and water and allow
proper intellectual function.
PITTA TYPES :- Are prone to rashes, acne, heart
burns,peptic ulcers, early balding and premature grey
hair, poor eye-sight, hostility, self criticism and heart
attack -related to stress.
KAPHA DOSHA :- Help to hold cells together and forms
connective tissues.
KAPHA TYPES :- Are prone to obesity, congested sinuses,
chest - colds, painful joints, asthama, and/or allergies,
water retention , depression, diabetes, high cholesterol,
and sluggishness in the morning. This simply outline the
broad shape of things. There is no simple one-to one
relationship between a disease and body type. Being a
Vata does not mean that nature has doomed you to get
arthritis nor does being a PITTA or KAPHA automatically
protect you from it. Illness is individual and depends on
the overall pattern of your life. With the body type
serving as an important influence, not a cause.
According to Ayurveda, there are seven body nutrients
(Dhatus) 1. Body fluids (rasa), 2. Blood, 3. Flesh, 4.
Bones, 5. Bone Marrow and nervous system, 6. Fat (Meda),
7. Generative Tissue. A healthy body means a balance or
equilibrium in the proper proportion of these seven body
nutrients. An increase or decrease in any one of the
seven nutrients results in disease of the body when any
of the seven nutrients reach saturation points and are
non -transformed into other vital stages "Fat"
starts accumulating.
The Ayurvedic doctrines and philosophy laid down by
eminent Ayurvedic physicians "CHARAK"
"SHUSHRUT" and "VAGBHAT" say :
Once a Dosha becomes unbalanced the others follow suit,
unless balance is restored. In a person prone to obesity,
once the Doshas, commonly, Kapha gets imbalanced, the
persons appetite increases and becomes irregular. When
this is followed by VATA aggravation, the person suffers
from false hunger pangs, craves for more food, eats
plenty and irregularly, thus upsetting the digestive
system. An increase in the "VAYU" factor, also
slows down the "PITTA" Dosha or metabolic
process of the body, and this in turn adds to the problem
faced by an already over-taxed digestive system. The
overall result is an accumulating of fat in the fat
cells. A person, thus affected, suffers from urinary
disorder, diabetes, (MADHU MEHA), heart disease (Hrid
rog). His fat increases so much that the buttocks, hips,
breasts and chest become flabby and hang loosely. He gets
lethargic, is drowsy, lacks enthusiasm. This person is
called STHOOLA" (OBESE).
COULD
YOU GIVE A GENERAL IDEA ABOUT THE AYURVEDIC - TREATMENT
OF OBESITY ?
In our Ancient books of Ayurvedic medicine, we find
reference to obesity, and its treatment. The text of
Bhava Prakash devotes chapters to this problem - they
mention certain herbs i.e. plants and their products,
that can successfully combat obesity. Haritaki:
Which reduces accumulated Vata. Although overweight is
usually as a result of Kapha imbalance, accumulated Vata
in addition to obesity can cause problems of the
digestive system such as bloating, gas, constipation.
"Amalaki": which rejenuvates tissues,
relieves irritation of digestive system and helps reduce
unhealthy food cravings.
"Bibhitaki" : which liquiefies and
expels kapha accumulation in the digestive system.
"Trikatu" : an aggregate of three common
spices "black pepper", long
piperand dry ginger promotes digestion.
"Guggul" : which reduces fat and toxins
and helps to check obesity.
Thus, we find , in India since ancient times, physicians
were aware of the problem of obesity and had taken
measure to control it. Although herbs are far more
effective and less harmful than conventional diet drugs
for controlling obesity, they must only be taken under
supervision of a qualified doctor.
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