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Obesity with Abdominal and Subcutaneous fat, BMI>35 and High Triglyceride (In blood)usually associated with difficulty in doing daily routine tasks and often one or more life threatening disorders.

The best treatment for Morbid Obesity begins with Abdominal and Subcutaneous fat, BMI>35 with CAP under medical supervision reverses the factors that created the condition. This is done by providing optimised nutrition with low calories, improving metabolic rate by maintaining a safe level of activity and avoiding toxic exposure including medications that may promote weight gain which reduces the stress associated with weight reduction.

Here it should be understood that the time taken for reversal of weight will be roughly the same as after bariatric surgery without the risk of a virtually non – reversible surgery and need for lifelong supplementation in many cases.

CAP also helps lower Triglyceride levels. Associated health problems can also benefit from health optimisation.

As bariatric surgery also requires lifelong diet control and physical activity to prevent return to initial weight it is best to check out the options first.

Morbid Obesity often has an early start and is often associated with some underlying causes.

In Morbid Obesity it is essential to reduce the fat deposits with a primary focus on biologically active secondary fat deposits for best results.

The most dangerous challenge of Abdominal obesity is the feeling of having lost control over some aspect of lifestyle that has triggered the change. Usually this is accompanied by a change in priorities as well. Most people primarily associate overweight and obesity with a lack of exercise and the feeling that it is a natural part of aging.
30% of overweight consider themselves normal weight and 70% of obese consider themselves as just overweight.

Very often if not under clinical supervision weight loss can be confused with water loss and muscle loss in the body. Very few understand that their hunger and fatigue are not satisfied by the nutrient deficient food they were currently consuming and a change in nutrition would be needed to satisfy their real body needs.

Perceptions like the above promote short cut solutions for quick results which often have minimum benefits over time. These repeated efforts make it difficult to identify practical solutions to reduce the risks associated with the condition before becoming a victim of such diseases. Soon obesity becomes a chronic and complex condition.

In Morbid Obesity it is essential to reduce the fat deposits with a primary focus on biologically active secondary fat deposits for best results in a clinically supervised manner.

The second challenge is to understand how the individual can use lifestyle optimisation to control further damage, return to a perceived healthy target weight and protect against other lifestyle related diseases and maintain a desired quality of life.

A full understanding of health optimisation has helped many patients with Generalised Obesity to reduce weight to desired levels under clinical supervision. This makes weight reduction less stressful, improving on body composition and prevents weight gain later as the person’s attitude changes with the confidence of success. Most importantly the person starts to evaluate healthy options in food and activity like never before.

This helps to protect against associated health conditions high cholesterol, triglycerides diabetes, hypertension, respiratory problems, osteoarthritis, certain cancers, etc.

Symptoms

Symptoms of overweight and obesity are often ignored as the solution is thought to be too difficult to attempt again after previous failed attempts. Soon it becomes the area of presenting excuses to oneself and others putting the blame on the circumstances.

Diagnosis of Morbid Obesity can be made from BMI, body mass index, calculated using the formula weight/(height in meters)2. If the BMI of the person is >35 it is considered Morbid Obesity. Morbid obesity is considered an indication for a major surgery called bariatric surgery for weight reduction. If the patient with Morbid Obesity is not able to reduce weight with lifestyle correction, it is an indication for bariatric surgery, which forcefully limits the persons eating ability and intestinal absorption. Bariatric surgeries are major surgeries done endoscopically under anesthesia and are inherent with many short and long term complications and side effects.

  • Sign of poor nutrition and physical activity: Morbid obesity is usually associated with lack of both balanced nutrition and physical activity. Measurement of weight, abdominal circumference, calculation of BMI, body mass index are the usual methods for diagnosis and assessment of overweight and obesity.
  • Healthy body weight: This is calculated based on the height, physical activity and age. Generally BMI above 35 is considered Morbid Obesity.
  • Change of body composition causes varying symptoms of varying nature: Excess fat accumulated in the body leads to change in the body composition.This change in composition leads to many health problems which appear as varying symptoms.
  • Change of chemical composition: Human body is composed of around 65% water at molecular level and 65% oxygen, 18.5% carbon, 8.5% hydrogen and 3% nitrogen at elemental level. When fat accumulates body composition changes and percentage of carbon increases, oxygen and water percentage decreases.
  • Composition of the fat matters: The type of fat accumulated also has a major impact on health problems associated with obesity. If the accumulated fat is in the form of trans fat and omega 6 fat which promotes inflammation and chance of inflammatory diseases like allergies, asthma, autoimmune diseases, cardiovascular disease and cancer is high.
  • Body composition analysis: More accurate predictor of health issues associated with obesity is a body composition analysis to understand the lean mass fat mass ratio and segmental distribution of fat.
  • Desired body fat percentage: Ideal body fat percentage for adult male is around 16% and adult female is around 22%. If the body fat percentage goes above 20% in men and above 26% in female leads to derailment and weakening of the immune system.The current excess provides the extent of ideal correction needed.
  • Physical burden of excess fat: Excess fat and the excess weight burdens the spine and lower limb leading to back pain, heel pain and knee pain.
  • Fertility is compromised: Hormonal and autoimmune activities affect fertility.
  • Symptoms of associated conditions: It is important to have a special watch for symptoms which may may show up for associated risks of a variety of conditions like insulin resistance and type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease, stroke, sleep apnea, gallbladder disease, hyperuricemia and gout, osteoarthritis and certain cancers(colorectal and prostate cancer in men and endometrial, breast, and gallbladder cancer in women).

Morbid obesity is a result of a very high excess of calories and poor activity which may have an underlying cause in lifestyle, genetics, medications and certain disease conditions.

In Morbid Obesity fat accumulates around the internal organs in the chest and abdomen and peripherally under the skin and in between muscles.

This type of obesity starts at a relatively young age. If the accumulated fat is in the form of inflammation inducing omega 6 and trans fat health consequences will be more severe. Environmental and genetic factors can play a role in initiation of overeating, reduced physical activity and excess fat accumulation leading to obesity. In Morbid Obesity underlying medical factors have to be identified if any.

Excess body fat in the abdominal area is an energy store but has a negative impact on various body organs and systems by acting as an endocrine gland producing hormones that control our food intake, our immune functions and various metabolic activities which leads to many disease conditions.

  • Morbid obesity starts at a relatively younger age: Usually the individual has a memory of a relatively overweight childhood. Excess calorie intake through food as carbohydrate, fat or protein above the daily requirements for the activities will be converted to fat and deposited in the adipose tissues leading to weight gain and obesity.
  • Abdominal fat /Belly fat /Visceral fats: This is deposited around the abdominal organs is considered more dangerous than peripheral fat deposits.
  • Subcutaneous fats: The fat deposited under the skin and between the muscles are called peripheral obesity and is generally seen on arms, legs, neck and trunk.
  • Circulatory fat though often undetected would have been affecting the vascular health: Triglycerides / Circulatory fat is the fat found in circulating blood and blood vessels and is a major concern in spite of the general assumption of ignoring the same.
  • Excess fat in the liver can also occur: Excess fat deposition in the liver is called fatty liver which can lead to hepatitis, cirrhosis and liver cancer.
  • Fat composition is important: If the deposited fat is in the form of inflammation inducing omega 6 and trans fat the health issues related to obesity and inflammatory disorders will be more intense.
  • Hyper palatability is the key to poor nutrition: Easy availability and addiction to calorie rich taste enhanced food which is deficient in many essential nutrients, associated increased appetite, low physical activity and associated hormonal changes all contributes to the increasing incidence of obesity.
  • Nutrition and fat deposition: High calorie low protein, low fibre diets also promote weight gain.
    Gut bacteria derailment.This can be caused by foods having preservatives, tastemakers, colouring agents, imitation foods, highly processed non nutritious foods and by medications which damage the environment in the gastrointestinal tract leading to obesity.
  • Hormonal imbalance can cause obesity: Hormone imbalance in production or at receptor level can lead to obesity. Insulin, thyroid hormone, steroid hormones, leptin and ghrelin among others have a major role in the control of appetite and metabolism.
  • Menopause: The hormonal changes associated with menopause can trigger obesity unless managed with required care.
  • Obesity cause and reason for hormonal imbalance: either in production or at receptor level can lead to obesity. Insulin, thyroid hormone, steroid hormones, leptin and ghrelin has major role in control of appetite and metabolism. Obesity induces hormone imbalance and in reverse hormonal imbalance promote fat deposition and obesity.
  • Medicines and obesity: Many drugs used as medications for diabetes, especially insulin, insulin pump, oral hypoglycemic agents, many psychiatric medicines, anti epilepsy medicines etc can induce weight gain and obesity.
  • Hypoglycemia fear and obesity: Diabetic patients on medication over eat to avoid hypoglycemic attack, which leads to obesity and further deterioration of disease process and blood sugar control.
  • Alcohol is a weight put on especially beers and the accompanying food when compared to hard liquor alone: Just like carbohydrate and fat, alcohol also is a source of calories and yields 7 kcal from 1gm. Drinks like beer, wine, toddy etc are rich in carbohydrates.
  • Mental health: Stress associated overeating, eating disorders, insufficient or poor-quality sleep, certain genetic disorders, psychological disorders etc also predisposes to obesity.

Treatment challenges

The individual’s awareness of health optimisation can change Abdominal Obesity management from a hearsay reaction mode to a clinically supervised lifestyle correction for lasting benefits.

Challenges in medical treatment

In Morbid Obesity it is to optimise health to achieve desirable weight loss to provide the desired quality of life and avoid diseases associated with Morbid Obesity. If health is not optimised the body can revert to its earlier stage if not worse because of deficiency or excess in the body’s composition. This requires regular followup of the body parameters to ensure that the body receives all the needed inputs to achieve the target body composition and weight.

In Morbid Obesity it is essential to reduce the fat deposits with a primary focus on hormonally active secondary fat deposits for best results. Individuals who realise that they have a problem with weight that needs serious attention are at an advantage as they are able to follow the treatment requirements much better.

(In some very rare instances abdominal obesity will have its origin in genetic problems, rare metabolic syndromes and hormone imbalances but overall they all are very much impacted by the lifestyle of the individual. Identifying any such issues go a long way in planning the treatment protocol in such cases.)

Treatment objectives

In treating Morbid Obesity often the real treatment is removing the root cause and optimising health. This involves returning the body to a desired state. This requires a comprehensive intervention as the change begins when the individual understands the need and is confident in the treatment resources provided. This will make weight management a key to better health. This is the best response for preventing damage to other organs and tissues and the proper functioning of the immune and endocrine systems as well.

Similarly the patient has an active role in monitoring progress as the real results should be evident to them in the execution of their daily activities. Generally the individual will be having health issues and some may be concealed from view. This is why the role of health optimisation to improve the overall health of the individual is more important for both health and a better quality of life.

Approach – Root cause

The focus is on addressing the root cause by providing resources to rebuild the body composition, especially in the abdominal area which is the primary deposit of biologically active fat deposits and correct health parameters.

Morbid obesity is the result of excess fat accumulation in the body. To overcome this situation ideal method is to use this fat for the day to day calorie needs of the day by reducing the calorie intake in the daily diet while providing all the essential nutrients like protein, fibre, essential fats, vitamins and minerals in optimal proportion and increase physical activity to increase metabolism to burn more fat in the body.

In cell activation treatment for weight reduction calorie intake of the patient is reduced to 600-800 calories a day, while ensuring all essential nutrients in optimal proportion with the help of optimized nutrients, oils and salt based food and drink. Body metabolic rate is increased with the help of oxyflex a breath regulated, segmental, gentle aerobic, anaerobic and flexibility improving activity protocol which can be done on the bed without straining any part of the body. As there is no surgery or drugs involved there is no possibility of drug side effects.

Focus – Optimising Health

Optimising health is the foundation for protecting and maintaining the quality of life in Morbid Obesity.

  • Weight reductions around 5-10% a month: Cell activation treatment for weight reduction focusses on around 5-10% weight reduction each month.
  • Optimised low calorie diet: Low calorie optimized nutrient food provide all the essential nutrients in optimal proportion within the calorie limits of 650kcal per day.
  • Oxyflex stimulation: Increases circulation, oxygen, nutrient supply and promotes utilisation of fat for energy need and helps build muscle mass thereby correcting the lean mass fat mass ratio and body composition.
  • Oxyflex increases the metabolic rate and takes up the excess glucose and fat in the blood and brings blood glucose and triglyceride to normal level.
  • Body composition correction: Provides relief to a variety of lifestyle health issues like hypertension, diabetes, atherosclerosis, dyslipidemia, fatty liver, allergy, asthma, constipation, acidity, piles etc.
  • Reduces fat in the liver: Low calorie food along with oxyflex promotes removal of accumulated fat in liver cells and helps to recover from fatty liver.
  • Balances inflammatory and anti – inflammatory activity: Optimized nutrient food with high omega 3 fat and omega 3 to 6 ratio 1:1 balances the inflammatory and healing activities and reduces inflammation.
  • Improves immunity: Optimized nutrient food ensures all the nutrients needed for the strengthening of the immune system.
  • Physical burden reduction: Weight reduction and improved lean mass fat mass ratio will reduce strain on the limbs especially at knee and heel and reduce arthritis and associated pain.
  • Skin care provides better skin results with weight reduction: Optimized nutrient skin care protects, nourishes and strengthens the skin and prevent wrinkles and sagging of skin with weight reduction.
  • Physical appearance: Helps to regain body shape, beauty, confidence, personality, youthfulness and performance levels.
  • Metabolic age and chronological age: Reverse the accelerated metabolic age associated with obesity and help to bring down metabolic age preferably below chronological age.
  • Diagnostics: Check ups at regular intervals to monitor progress.

Improved health status reflects in self confidence and quality of life.

Total health improvement overcomes the disadvantages of obesity in daily life apart from other serious and silent health challenges.

The goal of cell activation treatment is optimization of health and not just weight reduction. Cell activation treatment focuses on optimal functioning of the body at a cellular level including all 50-70 trillion cells of the body. So while utilising excess fat and reducing weight it controls and reverses the comorbidities associated with obesity like elevated blood sugar, elevated insulin level, elevated triglyceride level and many other blood parameters too. Likewise reversing obesity with cell activation will help to control and possibly reverse other health issues like diabetes, hypertension, arthritis, allergy, asthma, psoriasis, eczema, autoimmune diseases, cancer etc too.

  • Weight reduction of 5-10%: Cell activation treatment for weight reduction helps the patient to achieve around 5-10% weight reduction each month.
  • Type 2 diabetic patients can stop insulin and hypoglycemic medications.
  • Reverses diabetes related conditions: Normalisation of blood sugar will slow down / arrest diabetic foot and neuropathy, retinopathy and nephropathy.
  • Improves vessel health: Optimisation of health and reversal of circulatory fat, normal glucose levels and balanced inflammatory activity improves vessel health and helps prevent associated conditions like blocks, ruptures etc.
  • Improves organ health: Improve kidney function, liver function and other organ functions and help to recover from fatty liver, liver cirrhosis, renal failure etc if started early.
  • Improves array of lifestyle related health conditions: Help to recover from other health issues like irritability, depression, hypertension, constipation, piles, asthma, allergy, skin disease, osteoporosis etc.
  • Improves body strength: Optimized nutrient food along with oxyflex stimulation increases muscle and bone mass, strengthens the body, improves flexibility and prevents falls and fractures.
  • Reverses accelerated aging: Reducing the accumulation of advanced glycosylation end products (AGEs) inside the cells and in intra cellular fluid improves cell health.
  • Skin health is improved: Optimized nutrient skin care nourishes and protects the skin, helps in prevention and healing of ulcers and delays aging signs like wrinkles and dryness.
  • Metabolic age below chronological age: Regain body shape, strength and youthfulness and slow down the aging process and help to keep metabolic age below chronological age.

Patient options

The informed patient is the key to treatment success.

  • Cell Activation Program (CAP) is normally a 3 month Outpatient Program for Health Optimisation. However depending on individual requirements the duration may be extended depending on the health challenge and the extent of improvements required in body parameters. An initial evaluation visit is essential and follow up visits vary case by case.
  • When you notice anyone who is overweight or obese trying to reduce weight please DO NOT make fun of the person if he is not succeeding but do your bit to help him find a better way. Please appreciate that he is able to understand that obesity is a disease that needs treatment.
  • If you have the feeling of loss of strength you should have a check up to see if you are having abnormal muscle loss which may be concealed by your fat.
  • If you have Morbid Obesity you should have a thorough check up at the earliest to prevent the progression of the weight gain and other associated damage.

Message for Medical Practitioners - Overweight, Obesity

In Science Behind you will be able to get an understanding of the approach of Health optimisation by Cell activation for different health conditions and disorders.

Case Study is a compilation of sample patient cases where Health optimization with Cell activation has been beneficial for a wide variety of different health conditions and disorders.

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1. I am 37 years and my BMI is 43. I am having hypertension and on insulin for diabetes. I have tried dieting and exercise many times and lose a couple of kilos but I feel exhausted and miserable and cannot concentrate on my office work.I have visited some bariatric centres but am not convinced as yet. Can CAP be useful to me ?

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3. I am 56 years old and my BMI is 48. I have been advised bariatric surgery but my diabetes is not in control, I have hypertension and my GFR is 50. I have been asked to undergo a weight reduction program to improve the outcome of my bariatric surgery. Can CAP be helpful for this ?

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