In South Africa, obesity and excess weight are primary contributors to cardiovascular problems. According to the World Health Organization some 1.5 billion people are overweight with a third of those obese.
Frequently Asked Questions
- 1What is Obesity?
- 2How does obesity affect health?
- 3How is Obesity diagnosed?
- 4What are the limitations of the BMI index?
- 5How does obesity lead to Leptin Resistance?
- 6What are the Causes and Risk Factors for obesity?
- 7How is Obesity managed at Health Renewal?
- 8What in office treatments can be done at Health Renewal?
- 9What integrative supplements are recommended?
- 10What are the essentials for managing Obesity?
- 11What are the risks and complications of this condition and its management?
- 12Can a wellness gene test be done at Health Renewal?
- 13How do I get started?
- 14How often should I see the integrative Doctor at Health Renewal?
- 15Health Renewal tip: How does one prevent obesity?
Obesity is the disease of the millennium. In South Africa, obesity and excess weight are primary contributors to cardiovascular problems. According to The Heart and Stroke Foundation of SA, obesity has more than doubled globally since 1980, with at least 2.8 million adults dying each year from conditions caused by excess weight. According to the World Health Organization some 1.5 billion people are overweight with a third of those obese.
- Obese individuals run up to a 3 times increased risk of death- compared to an individual who is in their normal weight range.
- The life span of an Obese individual is shortened by an average of 8 to 10 years. For every 15 extra kilo's, risk of early death increases by around 30%.
- Healthcare costs associated with obesity are exceeding those associated with smoking.
- Cost and possible side effects of prescription weight loss medication have influenced overweight patients to seek alternatives including nutraceuticals, see nutraceuticals below, to aid dramatic fat loss.
Obesity is generally diagnosed and defined by analysis of weight, body size and composition. Body mass index also known as BMI, is the most commonly accepted metric for defining obesity. BMI is a surrogate measurement of adiposity, calculated as body mass (in kilograms) and divided by height squared (in meters). The World Health Organization (WHO) defines overweight and obese as BMI's of ≥ 25 and ≥ 30 kg/m2.
Although BMI is strongly correlated with total body fat, it is not without limitations;
- Important racial considerations can influence the BMI results (e.g. Asians typically carry more body fat and Africans less than Caucasians at any particular BMI).
- BMIcalculations are solely dependent on the net weight and height of an individual. It does not consider muscle or bone mass.
- BMI does not differentiate between body fat and muscle mass. This becomes misleading with regards to the amount of fat in an individual.
- BMI can be combined with waist circumference dimensions, which can estimate an individual's abdominal fat content (abdominal or visceral fat is a greater risk factor for obesity-related diseases than total body fat). Waist circumference dimensions of >102 cm (40 in.) for men, and >88 cm (35 in.) for women carry a higher risk of obesity-related disease such as type 2 diabetes, cardiovascular disease and hypertension.
- BMI is unable to provide an accurate determination of body fat percentage. A Body Stat analysis using a special machine is available at all Health Renewal clinics to give a more accurate determination of Body Renewal fat water and lean muscle percentages.
- BMI can underestimate the amount of body fat in the following individuals; Elderly people, individuals who have muscle wasting problems such as paraplegics who have wasting of lower limb muscles, individuals with Anorexia Nervosa and morbid obesity.
The complex system of appetite control can become perturbed in obesity, due to excess fat stores which contribute to constant elevated leptin levels. This leads to down regulation of cellular sensitivity to the effects of leptin, a physiologic state known as leptin resistance. Weight loss efforts put forth by obese individuals may be undermined by failure of the leptin system to suppress their appetite, resulting in excessive hunger.
Adiponectin, another hormone derived from fat cells, is an anti-obesity signaling molecule; the signaling of adiponectin may be disrupted in obesity-related diseases as well as states of insulin resistance. Evidence suggests that leptin and adiponectin can work together to combat insulin resistance. Enhancing fat cell signaling consequently represents an important aspect if any comprehensive weight-loss strategy.
Natural Aging-weight gain and progression to obesity may be caused by imbalances in energy input and expenditure in several ways. The natural aging process associated with hormonal changes, predominantly decreases in sex and thyroid hormones. These contribute to a decrease in metabolism and energy expenditure. Advancing age is associated with insulin sensitivity which interferes with appetite control as well as physical activity which subsequently reduces energy expenditure. Decreased mobility and obesity in an aging individual have reciprocal effects on one another (increase in weight and reduction in muscle mass leads to decreased mobility and energy expenditure.
Sex hormone and thyroid hormone insufficiencies/imbalances-Levels of sex hormones, such as testosterone and dehydroepiandrosterone (DHEA), weaken with age in both genders. This may lead to an increase in fat mass, reduction in lean body mass or central fat redistribution. Similarly, declining thyroid hormone levels are related to reduced metabolic rate and thus obesity. Obesity and low testosterone have a complex relationship; low testosterone can be considered both a cause and consequence of obesity.
The thyroid, which is a central regulator of metabolism, assimilates signals from the brain and secretes thyroid hormone (thyroxine or T4) to influence metabolism in a variety of tissue.
Body weight, composition, energy expenditure and body temperature may all be affected by thyroid dysfunction. A depressed thyroid function is associated with declining thermogenesis, which is the transformation of stored energy into heat, as well as weight gain and metabolic rate.
Underactive thyroid activity is most common as individuals' age; hypothyroidism is 3.7% of the general population however is five times more common in individuals that are 80 and older as opposed to 12 to 49 year olds'.
In addition to a result of being obese, increased levels of leptin and insulin in obese people may be symptomatic of a resistance to activities. Insulin is a hormone that assists cellular uptake of glucose, mainly in the muscles, liver and adipose tissue. Once insulin resistance develops, glucose levels are no longer controlled by insulin and blood levels become elevated. Additionally, when higher levels of insulin and leptin subdue the desire to eat and stimulate energy expenditure, they become unable to perform this function in resistant individuals.
Body Renewal's Leptin Facilitator: Rhodiola Rosea, Red Korean Ginseng and Resveratrol are combined to improve leptin resistance.
Insulin resistance is a result of sustained hyperinsulinemia (high insulin levels) and becomes complicated by obesity and chronic inflammation. In order to improve insulin sensitivity, one must follow the approaches that are an essential part of successful weight loss. These include use of a low-cost prescription drug called metformin, which is approved for the maintenance of type 2 diabetes and may help reduce body fat as well as natural compounds which assist by promoting insulin signaling.
Contact between leptin and the inflammatory biomarker C-reactive protein(CRP) in cell culture suggests a role of chronic inflammation in leptin resistance as well as appetite loss. Based on findings, mediators that ease inflammation such as Curcumin which is a plant compound & Omega-3 fatty acids in fish oil may assist in combatting the harmful effects of leptin resistance as well as lower CRP levels.
Increase in daily food intake contributes to weight gain and eating out may encourage overeating. Supplementing with green coffee extract before meals and CLA which can slow down carbohydrate absorption will help reduce after-meal spikes in glucose levels.
Chronic stress, appetite low levels and changed Seratonin signaling of the neurotransmitter serotonin (usually associated with depression), may be associated with weight gain. Chronic stress can compromise the function of gastrointestinal, hormonal and immune systems. Chronic stress is associated with obesity and metabolic syndrome. Stress raises the production of the hormone cortisol which when combined with excessive food intake, promotes the development of visceral obesity.
In order to obtain an appropriate weight loss strategy, we need to understand ones overall risks. Adequate levels of thyroid hormone are needed in order to minimalise obesity risk; thyroid deficiency may be improved with hormone replacement. Weight gain in both women and men are generally associated with low levels of estrogen and testosterone therefore sufficient DHEA is vital for sex hormone production. Risk factors for obesity- related diseases include high blood pressure (Hypertension), chronic inflammation as well as high cholesterol.
In addition, The Body Renewal medical weight loss program is offered at Body Renewal. This program uses hCG together with a low calorie, low glycemic eating program to improve Leptin resistance and facilitate dramatic weight/ fat loss.
Body Renewal Medical Weight loss program: Insulin resistance and diabetes can be dramatically improved if one can lose between 5 to 10 % of body weight. If the program is strictly followed to; patients can lose between 8 and 15 kilograms of fat over 4 weeks, generally find it quite easy, and feel good with high energy levels. In fact, depressed patients have mood elevation 10 days into the program. Many of our patients have tried numerous other well known diets but find this to be the magic one that actually works.
i-lipo laser lipolysis is a low level laser therapy and is available at Body Renewal which helps with centimeter reduction and weight loss. Low level laser therapy (LLLT) such as i-lipo has been proven to restore a lean state of adipocyte without inducing cell apoptosis/ death. It is hypothesized that i-Lipo LLLT could serve as an adjunct to other dietary therapies to promote insulin sensitivity and reduce the risk of diabetes because a lean state is produced in the fat cell. Lean state means improved insulin sensitivity, resulting in less insulin needed for glucose metabolism. Less insulin equates to less fat being deposited.
- Health Renewal encourages anyone striving to lose weight to consider adopting a CALORIE RESTRICTED DIET but nutrition-dense diet.
- Increase Physical Activity is one of the most effective means of attaining a negative energy balance, which facilitates weight loss. Physical exercise should be undertaken regularly in accordance with one's overall health and mobility. Anyone with a physical impairment, such as extreme obesity or severe osteoarthritis, should consult a healthcare provider prior to embarking on an exercise regimen.
Restore Resting Energy Expenditure(REE);
- Green tea extract
- Omega 3 Fish oil
Restore Healthy ADIPOCYTE (Fat Cell) signaling with;
- Irvingia gabonensis
Restore Brain SEROTONIN/Suppress Hunger Signals;
- Pharmaceutical support
Control Rate of CARBOHYDRATE ABSORPTION and Glucose Synthesis;
- Propolmannan (before meal)
- Green Coffee bean extract
Restore Youthful HORMONE Balance;
- Dehydroepiandrosterone(DHEA):depending on blood test results
- 7-Keto® DHEA
- Bio-identical (natural) hormone replacement therapy (if needed): as directed by an experienced physician
- Thyroid hormone replacement therapy (if needed): as directed
- Aromatase inhibitor (if needed; men only)
Restore INSULIN Sensitivity;
- Pharmaceutical support: Metformin
Inhibit the LIPASE Enzyme;
- Green tea extract (std. to 98% polyphenols)
An individual who is overweight or obese increases the risk of diseases such as;
- Cardiovascular disease
- High blood pressure
- Malignancies such as breast, prostate, pancreatic and colon cancer
- Excess body weight also affects mobility and interferes with restful sleep,
- Contributes to digestive disorders
- Can contribute to an overall lower quality of life than that enjoyed by lean individuals.
A multi-gene DNA test can routinely be added to assessment of;
- blood cholesterol and
- glucose levels,
- blood pressure and
- Body mass index (BMI) as part of Wellness Programs offered by healthcare practitioners.
It includes analysis of variation in clinically useful genes that may contribute to:
- Abnormal cholesterol levels,
- Homocysteine accumulation,
- Blood clotting,
- Iron overload and
Some of these abnormalities contribute to the development of type 2 diabetes, obesity and hypertension. Oxidative stress, detoxification of carcinogens and oestrogen exposure are also important considerations in this context.
This pathology supported genetic test is performed in conjunction with assessment of any food allergy or intolerances known to be associated with many chronic disorders. The results of the genetic test are combined with clinical indicators and lifestyle factors to identify a combination of risk factors that may lead to disease development or progression, if left untreated.
Make an appointment to consult with your Health Renewal Doctor and they will assist you in measuring your blood levels and advising you of further preventative measures and supplements to reduce weight.
Depending on blood tests; investigations to rule out medical conditions that need treatment, one could expect to follow up with your physician from anything between every 2 weeks to once every 3 months.
- Limit your total fructose intake to less than 25g per day (which is equivalent to 2 low fructose fruits) as Fructose can increase your hunger and lead to overeating by triggering changes in your brain. Effective treatment of obesity requires turning off your fat switch (limiting fructose) and improving the function of your cells' mitochondria.
- Limit fructose from fruit to 15 grams a day. For example 1 cup berries contains between 3 to 4 g of fructose, an orange=6.1 g, a banana=7.1g, an apple=9.5 g, 1 cup grapes 12.4 g & 1/2 mango=16.2g. Fructose is also metabolized to fat in your body far more rapidly than any other sugar, and the metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which drives up blood pressure and can cause gout.
- High fructose diets will lead to obesity, insulin resistance, fatty liver and high triglycerides, signs of inflammation, vascular disease and high blood pressure. Fruit juices are high in Fructose, so strict avoidance is recommended. Likewise, honey is very high in fructose. A far safer alternative is to use pure glucose (dextrose) or Stevia or Xylitol.
- Replace sweetened drinks(whether they're sweetened with sugar, HFCS [high corn fructose sugar] or artificial sweeteners) with plenty of pure, clean water. Fructose/ fruit juice turns your fat switch on.
- Eat Healthily
- Consume healthy fats, like butter, eggs, avocados and nuts especially macadamia nuts which are higher in fat and lower in protein. Unheated oils such as 1T coconut oil, palm oil and olive oil are beneficial to the body.
- Eat plenty of raw food.
- Avoid all genetically engineered foods and processed foods.
- Avoid any product containing aspartame, which is derived from a GE organism.
- Walk regularly
- Make sure to incorporate high intensity interval training at least once or twice a week once you are closer to your ideal weight.
- Get an appropriate amount of SUNLIGHT (6 to 10 mins per day) on your skin (not face) to optimize your vitamin D 3 levels.
- Get plenty of SLEEP in terms of its effect on your metabolism and weight, lack of sleep has been shown to affect levels of leptin and ghrelin–two of the hormones linked with appetite and eating behavior. When you are sleep deprived, your body decreases production of leptin, the hormone that tells your brain there is no need for more food, while increasing levels of ghrelin, a hormone that triggers hunger (these are the same hormones detrimentally affected by a high-fructose diet, as discussed above).
- Manage your STRESS with exercise, meditation, yoga, prayer etc. see Adrenal burnout.
ReviewsSee all reviews
The team at Skin Renewal, particularly, Magda, changed my life. They took me from being unhealthy, over weight, unhappy to exactly the opposite. I lost +/-20 kgs, I run and train 6 days a week and I absolutely love my life. Nothing was ever to much trouble for them, I received tremendous support and encouragement from everyone. Magda specifically supported me through emotional upheaval in my personal life. She was firm when she needed to be and extremely supportive and understanding when things just got to be too much. This is not an easy way to loose weight, but it would have been impossible without Magda. She is simply the best!
Thank you for all the support.
Cindy is very clear and supportive. She motivates well and is a good "Injector". I have referred other to her as I know she will be right for them and help them through the programme.
The staff at Health Renewal Cape Quarter are all very friendly and professional. They always provide good feedback and tips to keep the motivation going!
This is an effective, healthy programme, and I have seen and felt the results! The staff walk you through it all and offer support throughout! Slender Wonder is highly recommended.
I have achieved fantastic results with the Slender Wonder Medical Weight Loss at Claremont Health Renewal. I lost 15kg all together. It is a manageable programme to be on and the Claremont team offer very good support!
I have found the staff at Health Renewal Claremont to be very professional, friendly and supporting. The staff (and Nurse Serena Pictor) are well trained and they are an asset to the branch. The service is excellent and I so appreciate the phone calls to remind you about your appointment. I love coming here and enjoying the beautiful surroundings! Thank you so much!
The Cape Quarter Health Renewal team works to get you where you want to be! The rest is up to you!
This has been a great experience. I have lost more cm's than weight and I feel more energized. I have new perspectives toward life. Thank you to the Fourways team and Health Renewal for making me part of the 2014 Slender Challenge.
Rivonia branch was really helpful and friendly while I was on the Slender Challenge and really gave me lots of info and guidance. Nurse Angela was really helpful and motivating during the 12week programme.The challenge was an amazing opportunity and thank you to Skin, Body and Health Renewal.
What an excellent programme - in all ways! Thank you Slender Wonder & Body Renewal for selecting me as a contestant in the 2014 Slender Challenge: this competition has transformed my life in many ways! The massive amount of weight I have lost (18kilo's in 12 weeks) has enabled me to perform better at work and has given me confidence and self respect. I once again feel good about myself! Thank you!!
It was a life changing 3 months, partaking in the 2014 Slender Challenge and Slender Wonder and Health Renewal. Overall it was difficult at times but in the end totally worth it. All for the better: better health all and all.
I have been doing the Slender Wonder programme for a year and half with the help of R.N Magda Brits. I have had a weight problem all my life, and this is the first time I have had someone help me with losing weight the healthy way. Magda has been tough but very kind and encouraging.
Christine is wonderfull! I would have not been this fit and motivated if it was not for her!
Wat 'n ongelooflike "stunning" ervaring! Die ondersteuning wat mens kry is regtig fantasties! Christine het 'n empatiese "touch" wat mens so spesiaal en uniek laat voel! Sy verstaan voorwaar 'n vrou se kop! Die hele span by Health Renewal Willowbridge, van die Dokter tot die personeel & terapeute vorm 'n passievolle en energieke netwerk om jou as vrou te ondersteun gedurende gewigsverlies! En mens kry resultate! Dankie julle. Hierdie program beveel ek aan almal wat weer met selfvertroue die lewe in die oe wil kyk, julle is tops!
Christine is a positive lady, who makes you feel positive about losing weight. I reached my ideal weight in record time, and feeling good about myself again!
It is great that the programme is explained in "Great Detail". I know what to expect and how to proceed. Knowledge is Power!
Christine has been wonderful! She is very supportive and always friendly. She is excellent in explaining and understanding. This has been, and is, the best experience I have had in my mission to loose weight!
I am so glad I found Slender Wonder and Health Renewal Willowbridge! I struggle to lose weight but Slender Wonder makes it possible. All the staff are so friendly and brilliant. Thanks to Christine who is encouraging me and helps me to get my self confidence back. She told me I can make it, so I did it!
The staff at Health Renewal Constantia are very competent, friendly, helpful and professional. It is a pleasure to come to this clinic and see Dr Fred and Nurse Serena for my Slender Wonder and IV treatments.
I came to Health Renewal Constantia 4 weeks before my trip to NYC and was very desperate to lose weight. From the front desk to the nurse I felt at home, my weight issue became a sisterly one. The calls to make sure I am here for my appointment to the information (products) so that I can get the maximum experience and weight loss that I needed. The staff knows me by my full name Thokozile, a breath of fresh air because I am almost always asked tor a shorter version. Thank you for the love, Thokozile.
Friendly and motivating! Just what is needed for a weight loss programme! Every visit is a nice experience with Christine!
Baie dankie vir 'n pragtige, rustige omgewing. Vriendelike mense en 'n warm ontvangs! Ek weet sommer ek gaan 'n lang pad saam met jou kan stap, Christine. Dankie dat jy verstaan en empatie het met my.
My consultant (Christine) is lovely and I feel so comfortable with her. She explained everything beautifully and encourages me without making me feel insecure. I remain a loyal client.
It is always a pleasure to come and see Christine for my two weekly weigh-in! She is always so friendly and really motivates me to go the extra mile with regards to my weight loss! Thank you Christine for always inspiring me!
Christine is vir my 'n groot inspirasie in my stryd. Dit voel asof sy presies verstaan waarmee ek nou besig is. Ek voel nooit onder druk nie, maar ervaar tog wel dat haar ondersteuning my motiveer om totaal en al suksesvol uit hierdie proses te stap. Dankie Christine, jy is my rots!
I have had a wonderful experience here at Health Renewal Willowbridge, Christine has been there for me throughout everything with the Slender Wonder programme! Christine is really dedicated, 100% to her clients. I always feel at home when coming to see her. I will always remember the friendliness!
Is has been a pleasure to come back every time! Although loosing weight is not always that easy, my journey here has been amazing with great support!
Die wonderlikste persoon wat ek nog ontmoet het. Ek sal Christine aanbeveel by enige persoon. Sy motiveer ons so baie en praat moed in. Al wat ek kan se is dat ek die Here dankbaar is vir so 'n persoon wat my lewe gekruis het. Ek kan net se: "Christine bo!!"
Christine, dankie dat jy my so tuis en gemalik laat voel; 'n afspraak is altyd opbouend en ek voel goed wanneer ek by die Health Renewal Willowbridge kliniek uitstap. Hou so vol!
I am so pleased with Christine... she does a lot more than tracking weight and giving advice - she is PART of my journey and heart and soul in this with me. Every session leaves me inspired. Thank you Christine!
Christine is 'n wonderlike mens. Ons is so bly dat ons by haar uitgekom het. Sy motiveer ons fantasties. As daar enige probleme is was sy daar vir ons. Sy loop nou regtig 'n ekstra myl saam met 'n oorgewig persoon wat gewig wil afskud. Ek persoonlik kan net se sy is 'n fantastiese mens!
Friendly and always helpful! The treatments are always on time, which is wonderful!
Christine at Health Renewal Willowbridge always offers warm and friendly welcome and treatment experience. She is knowledgeable, patient and precise in everything she does.
Altyd vriendelik, behulpsaam. Skoon en net lekker om Skin Renewal to besoek. Ek bly in Centurion! Ry al die pad na hierdie awesome plek!