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Obesity: Why Are Men Getting Pregnant?

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In this book, readers will come to understand why that "pregnant look" in men is so dangerous and what they can do to get past it.

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12 Chapters

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1. Obesity and Its Causes


Patients with an abdominal predominance of fat tissue have
more complications than those with a predominance
of fat tissue in the buttock and thigh region.


The causes of obesity are complicated. It is not as simple as reducing energy (caloric) intake and increasing energy expenditure (exercise). Age, gender, height, weight, waist circumference, metabolism, diet, genetics, fat cells, fat distribution, physical activity, stress, and possibly many chemicals in the environment are all related to some degree to whether a person struggles with a weight problem or notparticularly a potbelly.

This chapter begins a journey of discovery as to why a man gets a potbelly and what can be done to eliminate it, with the hope that by getting rid of the potbelly the health consequences related to it will be dramatically reduced.


Energy intake within the body is synonymous with the term caloric intake. Just as the energy from electricity is measured in watts, the energy from food is measured in calories, also known as chemical energy. A calorie is a measure of heat, specifically the amount of heat needed to raise the temperature of 1 gram (g) of water 1C. The term kilocalories is also used when talking about caloric intake. Thus, 1 kilocalorie is the amount of heat necessary to raise the temperature of 1 kilogram (kg) of water 1C. Technically, 1 kilocalorie is equal to 1,000 calories.


2. Health Risks of Obesity


Tell me what you eat, and Ill tell you how long youll live . . .


That pregnant look in men, often dismissed as just a middle-aged pouch, potbelly, or beer belly, is actually unmistakable physical evidence of an emerging, or already serious, health problem. You may already have a potbelly, or you may have a loved one with one. It is important to understand that if you or your loved one doesnt get rid of it by the fourth decade of life, the health consequences could be irreversible within as short a period as seven years, with diabetes the least of your medical troubles.

You have certainly seen men walking around shopping centers, beaches, county fairs, or even the gym appearing almost proud that their bellies are full. Some are, most arent. That is apparent after speaking with many. A potbelly is clearly one of the most striking visible contributions to our national epidemic of obesity.

The continuing rise in the prevalence of obesity nationwide is one of the reasons healthcare costs are going up, and why a good percentage of the cost of any goods sold in this country today goes toward covering healthcare premiums for workers. General Motors spends more on health care for its employees and pensioners than on the steel that goes into their cars, and Starbucks spends more on health care for their employees than they pay for coffee beans. Estimates are that the nation spends a minimum of $100 billion a year in deaths directly linked to obesity.


3. Dietary Changes


An unprecedented degree of convenience, a new generation of
better-for-you benefits, and the promise of a palate-pleasing but
not-too-provocative taste experience are driving American
food-selection practices, preferences, and patterns.


Science is still learning a great deal about what constitutes a healthy diet. For example, in early 2006 a major study was published that said eating a low-fat diet did not reduce the risk of cancer or cardiovascular disease in 49,000 women monitored for nearly twenty years. What is not explained is that fat comes in many forms. The study did not carefully look at the kinds of fats consumed from the day the study began to make the results useful and meaningful. Nevertheless, the medias reporting of the results probably contributed to some people increasing their fat consumption significantly based on the belief that the jury is in and no amount of fat in the diet is harmful to ones health. An unfortunate conclusion to reach.


4. Energy Balance


Theres no such thing as a free lunch.


While Chapter 3 discussed the concept of satiety (feeling full) and explored a wide range of popular diets, this chapter examines the role of compounds found in the body that act as chemical messengers or signals to the hypothalamus, the satiety center in the brain involved in regulating how much or how often we eat. The compounds mentioned by no means form an exhaustive list. New compounds are constantly being discovered. This isnt surprising, because the regulation of food intake and the human bodys ability to adapt to a remarkable range of diets cant be simple. The body comes equipped with a vast, integrated system of checks and balances to maintain its weight and support the energy and nutrient needs of billions of cells. However, when one or more of these mechanisms goes awry, the outcome may be obesity and with it a cascade of health problems.

None of these mechanisms works aloneeach metabolic factor that sends an individual signal to the appetite center (the hypothalamus) initiates an orchestra of checks and balances to control body weight. Some of these factors may not signal appetite cues per se but rather indicate information received from stored body fat. This information may be simply, Hey, Im fat and happy now; you may stop eating! Or, by contrast, the information may be, Hey, Im getting too skinny for my liking! Eat, eat, eat!


5. Drug and Surgical Interventions


Drugs are approved based on several rounds of clinical trials, but those
trials may not uncover all risks. Clinical trials usually include no more
than a few thousand people taking the drug for a limited period of time.
The ultimate test comes when the drug is released to the market
to be used for longer periods.


Conventional surgical and prescription-drug alternatives are available for the treatment of obesity. Keep in mind that I am not a physician. Since surgical procedures and drug therapies are within the domain of allopathic medicine, consider the information in this chapter as an overview on the risks and benefits of surgical procedures and drugs, as reported by others. This information should not serve as a substitute for consulting with a qualified and licensed medical doctor.


Using gastric-bypass surgery to treat obesity is very controversial. It basically forces a reduction in food intake by limiting the amount of food you can consume at one time. Concerns about this procedure were highlighted in a letter to the editor that appeared in the New England Journal of Medicine in the summer of 2004 when maternal and fetal deaths after gastric-bypass surgery were reported, including a case from a prominent hospital affiliated with Harvard University.1 At the time the letter was published, the authors estimated that surgeons who treat obesity had performed some 103,000 such operations. By the end of same year, it was estimated that more than 150,000 gastric-bypass operations had been performed. This indicates how much the popularity of this procedure, which some believe will solve their obesity problem, is becoming. How safe is this procedure, and what kinds of invasive surgeries are there to treat obesity?


6. Regulation and Safety of Dietary Supplements


It is dangerous to be right in matters
on which the established authorities are wrong.


Numerous claims are made that dietary supplements can promote weight loss, affect appetite, reduce fat mass, or increase energy expenditure. If youre curious as to what is fact and what is fiction, the next two chapters should prove useful.

This chapter includes information about how dietary supplements are regulated in the United States and the safety of dietary supplements. The reason this discussion is so necessary is that the media has erroneously reported that supplements are not regulated. This is absolutely false. They are regulated, and the withdrawal of supplements containing ephedra is an example of the governments regulatory enforcement powers.

Some supplements have mechanisms of action and potential side effects similar to those mentioned for pharmaceutical drugs in Chapter 5. Most dietary supplements are considered very safe, with no reported adverse events, based on annual data compiled by government public-health agencies. But do they perform as claimed?


7. “Best-Bet” Supplements for Weight Loss


. . . a substantial percentage of Americans surveyed
reported that they regularly take dietary supplements
as a part of their routine health regimen.


After reviewing published papers on the safety and efficacy of dietary supplements for weight loss, especially those ingredients that claim to reduce fat mass around the midsection, some supplement ingredients were found to have much stronger scientific evidence to support their claims than others. These better substantiated ingredients sold as dietary supplements are discussed in this section. The ingredients, in alphabetical order, include:



Dehydroepiandosterone (DHEA)

Digestive enzymes

Garcinia cambogia extract

Green tea (Camellia sinensis) extract


After reviewing these seven dietary-supplement ingredients, you will find a much longer list of more than three dozen ingredients or products for which the evidence is less convincing in Chapter 8.


Chitosan is a dietary fiber derived from chitin, an aminopolysaccharide found in the shells of crustaceans. It is sold as a dietary supplement that is made from chitin. For chitosan to be effective as a weight-loss product, it needs to be around 80 percent deacetylated. It should also be rapidly soluble, so it can be taken just before a meal, which is critical to its performance; chitosan marketed as LipoSan meets this criteria.


8. Possible Weight-Loss Ingredients


. . . the manufacturer [of a dietary supplement] is required to have
substantiation that the claim is truthful and not misleading . . .


Thirty-five supplement ingredients represent a wide range of what is available in the marketplace, touted for its weight-lossrelated benefits. The ingredients discussed in this chapter were found to have varying degrees of support for their supposed benefits. Some ingredients look very promising but only when taken in very large amounts that might create safety concerns.

The ingredients or category of ingredients reviewed are listed and presented in the following order:


Alpha ketoglutarate (AKG) and other metabolic intermediates

Arginine and ornithine

Amino acids

Bitter orange (Citrus aurantium)


Coenzyme Q10 (CoQ10)

Coleus forskohlii

Conjugated linoleic acid (CLA)


Dimethylglycine (DMG), trimethylglycine (TMG), and betaine

Essential fatty acids





Guarana (Paullinia cupana)


9. Supplements to Treat Depression


The most common assumption about the link between depression
and obesity is that being overweight is viewed negatively by
our society and this is internalized as self-rejection.


There is considerable evidence that the consequences of obesity can range from a sense of lowered self-esteem to clinical depression. This does not mean that everyone obese has a lowered self-esteem or suffers from clinical depression. In fact, obesity is not associated with any specific personality type, but anxiety and depression are common. Many obese individuals who are diagnosed with binge eating disorder often are comorbid with depressive illness. Comordibity means that they are coexisting conditions, illnesses or disorders, that occur at the same time.

What is depression?

Depression is a medical condition that affects at least 20 million Americans each year. A persons mood, thoughts, physical health, and behavior all may be affected. Symptoms commonly seen in depression include:


10. Exercises to Enhance Weight Loss and Improve Health


The significance of avoiding sedentariness increases over time
as a factor associated with normal weight.


During interviews with men who looked pregnant because of the size of their potbellies, I asked them if they engaged in any exercise. Repeatedly, they told me that they just did not have time to do so, yet they realized that they needed to. Some mentioned problems with their backs or joints as a reason for not exercising. However, when asked how many hours they spent watching television, the answers ranged from ten or twelve hours a week to considerably more than sixty hours a week, depending on their employment or retirement status. Many spent additional hours in front of their computers at home.

A number of surveys have determined that American adults have on average forty-one hours of free time available to them each week, hours unrelated to time needed for either work or sleep. On average, sixteen of these free hours, or 30 percent of free time is spent watching television. Sedentary activities, such as watching television, are believed by many researchers in the field of preventive medicine to contribute to a lifestyle that can play a part in premature death, reduced mental abilities, and considerable morbidity.


11. Releasing Stress, Reducing Weight


Over 80 percent of diseases are associated with unhealthy lifestyles
and self-destructive behaviors and thus are subject to
healthy alterations in behavior.


By now it is evident that weight gain and obesity, especially if there is an accumulation of intra-abdominal fat, will increase the risk for developing high blood pressure, coronary heart disease, stroke, high cholesterol and other dyslipidemias, osteoarthritis, and type 2 diabetes. It should also be clear that there is more to dealing with intra-abdominal obesity (potbelly) that just losing weight. At the top of the list is controlling stress, one of the most important measures that affects metabolism.

During times of stress the adrenal glands become active and employ the hypothalamic-pituitary-adrenal (HPA) axis to keep matters in balance. In chronic stress the same reaction happens, but because the stress is continuous, the HPA axis doesnt rest and have time to recharge, which eventually results in exhaustion and metabolic disharmony. Slowly, as exhaustion sets in, the adrenals do a poorer job of regulating blood pressure and other essential functions. No wonder. The adrenals are in a state of constant high alert. It is during this state that increased levels of cortisol, the stress hormone, contribute to food cravings, especially of highly processed carbohydrate- and fat-rich foods.


12. Getting Started: Quick Tips to Start Losing Your Potbelly


And in the end, its not the years in your life that count.
Its the life in your years.


While I was writing this book, I came across a front-page article in USA Today with the following headline: Based on body index, 56 percent of NFL [National Football League] players are obese.1 What also caught my attention were the attempts by some players to claim that because they were professional athletes, the results of the study were flawed; they pointed out that they were also muscular. In response, the director of health and fitness for the Oschner Clinic Foundation in New Orleans, who has helped to evaluate hundreds of NFL players, said:

The players who are at greatest risk for heart disease, diabetes, and stroke are the offensive and defensive linemanthey are the walking dead; they just dont know it. And they need to do something about it.

He concluded his remarks by pointing out that you cannot just look at the body mass index (BMI) of these players; you have to look at total percent of body fat and waist circumference because, as he said, abdominal obesity is the biggest risk to a man. His advice to football players is relevant to every overweight man with a potbelly: Simply put, get rid of that potbelly before it destroys your health!



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