Author Archive: aenriquez

The Sports Hernia

The sports hernia has been getting the buzz lately as many high-profile athletes have been diagnosed with it. But what is it?

A sports hernia is more accurately called athletic pubalgia. There is no real hernia but it is characterized by pain in the pubis seen in athletes. It is an increasingly common injury but the cause is not known. It may occur because of an imbalance of the strength of the muscles that attach to the pubis. In athletes involved in a rigorous workout happening all year round, it is possible that the lower extremity muscles may become preferentially strengthened compared to the abdomen, leading to an imbalance that can result in tearing of muscle fibers in the groin or abdomen.

The pain from a sports hernia typically begins slowly and increases gradually with continued activity. It is usually a one-sided groin or abdominal pain and is associated with sports that require frequent bending, twisting, and turning at speed. It can worsen with sudden twisting or turning.

Other nonsurgical treatments include treatments include dry-needling, therapeutic massage, and ultrasound therapy
The diagnosis is clinical, based on the findings mentioned above, but they can be seen with other conditions. X-rays and other imaging techniques are used to support the diagnosis.

Conservative treatment begins with rest, which ranges from a few weeks to a few months. Anti-inflammatory medication such as NSAIDs can help with pain relief at this time. In some cases, oral steroids may be prescribed. Physical therapy is recommended following the initial rest period, which is focused on strengthening the abdominal muscles as well as stretching the lower abdominal muscles and leg muscles. Other nonsurgical treatments include treatments include dry-needling, therapeutic massage, and ultrasound therapy. Steroid injections, nerve blocks administered to the ilioinguinal and iliohypogastric nerves, or platelet-rich plasma (PRP) injection are other such options and have varying success rates.

 

If rest and conservative treatment fail, surgery is the definitive treatment. There are various surgical approaches targeted at reinforcing the abdominal muscles, and restoring balance of muscles across the pelvis as needed. Surgery typically requires 6- to 8-week period of intensive physical rehabilitation to rebuild muscle strength and endurance after surgery. Some surgical approaches may involve the placement of a synthetic mesh in the groin area to help stabilize the injury. While up to 80% of these procedures are reported to be successful, with the athlete returning to sport, some treatment-resistant cases of sports hernia require multiple surgeries.

Sports hernia is a new name for a known condition of athletic pubalgia, and it can be quite disabling, making it impossible for the athlete to play the sport. It is also quite likely to be misdiagnosed, so getting the right diagnosis is critical, which can sometimes mean getting second/third consults. Once diagnosed, the athletes have to work closely with their physicians to find a way to manage their injury, ensuring a successful and timely return to the sport.

Paget’s Disease of the Bone

Paget disease of the bone is a chronic condition that causes the bones to become dense, enlarged and deformed, leading to fragile bones that fracture. It is the most common bone disorder after osteoporosis in adults after the age of 50. The risk of Paget’s disease of bone increases with age and with family history.

Bone remodeling is defined as a process in which new bone tissue replaces old bone tissue. This process is affected by Paget’s disease, resulting in dense but brittle bones.  It most commonly affects the pelvis, skull, spine, and legs. Complications of Paget’s disease of bone can include broken bones, hearing loss and pinched nerves in your spine.

There are two types of Paget’s disease of bone: monostotic (when only one bone is affected), or polyostotic (when multiple bones are involved).
Paget’s is also associated with neurologic complications, such as deafness, facial nerve palsies, radiculopathies, and spinal cord compression
The exact cause of Paget disease of the bone is not known, but genetics are thought to play a role.

There is some evidence that viral infection may also have a role in its development. Proteins derived from the respiratory syncytial virus and measles virus are present in pagetic osteoclasts. Paget’s disease tends to aggregate in families. First-degree relatives of patients with Paget ’s have a 7- to 10-fold increased risk of developing the condition.

While about 70% of patients with PDB are asymptomatic, in the remaining cases, it presents with joint inflammation, bone deformity, pain, and predisposition to fractures.

 

Paget’s disease can cause skeletal deformities, such as bowing of long bones, enlarged skull, pelvic alterations, and osteoarthritis. It can lead to traumatic and pathologic fractures. Very rarely, it can lead to osteosarcomas, which have a poor prognosis (5-year survival rate of approximately 10%). Paget’s is also associated with neurologic complications, such as deafness, facial nerve palsies, radiculopathies, and spinal cord compression. If it affects the skull, that can lead to hydrocephalus, nerve entrapment, and cerebellar dysfunction, causing the symptoms of nausea, ataxia, incontinence, gait disturbance, or dementia. It is also associated with high cardiac output, hypercalcemia, and hyperparathyroidism, but these are all rare.

 

Tests that can be done to confirm/support the diagnosis include:

  • Serum alkaline phosphatase: these levels are raised in any condition of bone growth or an increased activity of bone cells.
  • Bone scan: This is a nuclear imaging test that shows blood flow to the bone and cell activity within the bone, which helps determine areas of abnormally high bone turnover. It detects up to 50% more lesions than seen on x-ray films.
  • X-ray films: It is the main mode of its diagnosis. It shows osteolytic, osteoblastic, or mixed lesions. Other characteristic features include transverse lucent areas, enlargement of bones, expanding lytic changes, thickened cortices, or osteoporosis with lytic involvement in the skull.
  • Bone biopsy: These may be done to confirm the diagnosis through tissue assessment, but they are mostly done if the malignant transformation of the bone is suspected, which is characterized by cortical destruction and the presence of a soft tissue mass outside of the bone.

Treatment is targeted at suppressing osteoclastic activity.  The most commonly used agents are the bisphosphonates (such as Etidronate) that inhibit bone resorption. Intravenous options are also available, such as pamidronate. Salmon and human calcitonin are also FDA-approved and are given subcutaneously.

Occupational Repetitive Strain Injury

Repetitive strain injuries (RSI) are a group of disorders that most commonly develop in workers whose work involves excessive and repetitive motions of the neck and upper extremity. There are quite a few occupations that comprise such activities. It is also quite common in people involved in sports activities.

 

It all starts with taking a careful history, performing a proper physical examination and specific diagnostic maneuvers to detect these musculoskeletal injuries.

 

RSI may be present in a range of ways – cervical syndrome, tension neck syndrome, thoracic outlet syndrome, and frozen shoulder syndrome. Injuries involving the elbow, wrist and hand joints include epicondylitis, carpal tunnel syndrome and ulnar nerve entrapment.

RSI may also occur as a result of sports and recreational activities

RSI is especially common in all kinds of workplaces. The disorders of the forearm flexor tendons are most common among workers at assembly lines and trainees, whereas the cervical rotation and side-flexion are most affected in office workers. RSI may also occur as a result of sports and recreational activities. These injuries result from repetitive and forceful motions, awkward postures, and other sports/work-related conditions and ergonomic hazards.

 

Occupationally induced RSIs are costly, creating a strong incentive for physicians to become familiar with the symptoms, signs, and risk factors so that they can be diagnosed early and properly treated.

 

Hand/forearm-related RSI are common in office settings – such as carpal tunnel syndrome, cubital tunnel syndrome, Guyon canal syndrome, lateral epicondylitis, and tendonitis of the wrist or hand. The diagnosis is clinical but MRI and ultrasonography can be used for the diagnosis, but the role of such imaging in the diagnosis of upper limb disorders remains unclear. Once diagnosed, exercise can be beneficial for non-specific upper limb disorders. Other options, such as the immobilizing hand braces and open carpal tunnel surgery release are beneficial for carpal tunnel syndrome. Nonsurgical management, such as topical and oral non-steroidal anti-inflammatory drugs, and corticosteroid injections are helpful for lateral epicondylitis. Exercise is probably beneficial for neck pain, as are corticosteroid injections and exercise for shoulder pain.

 

In general, mainstay of treatment is mainly conservative and consists of rest, application of ice or heat and anti-inflammatory drugs. It typically takes a few or months to completely resolve.

 

It is very important to make necessary modifications in the workplace in order to prevent many of these injuries. Assessing the exposure of workers to known risk factors is essential The ergonomics of the workplace should properly be studied and accounted for in order to prevent workplace-related RSI. Training staff and performing necessary workplace changes would allow the staff to more effectively use their workplace through increased office ergonomics knowledge and skills. Once such training and interventions are in place, it leads to an increase in workers’ office ergonomics knowledge and awareness, and that results in a significant decrease in work-related musculoskeletal disorders.

 

RSI that is sports-related, can also be prevented by getting professional training to ensure the technique is right and the chance of injury is minimized.

Anxiety and Bone Health

Anxiety has already been known to be harmful to our body in many ways, such increased cardiovascular risks. It’s now becoming apparent that anxiety and persistent stress are linked to an increased risk of bone fractures in postmenopausal women as per a recently published study in the journal of The North American Menopause Society (NAMS).

Postmenopausal women are already prone to developing osteoporosis, for which they are prescribed vitamin D. Their risk of developing fractures is a major concern and this risk grows as they age. Stress and anxiety now add to this concern by adding another common predisposing factor.

Studies have shown that women with anxiety disorders were almost twice as likely to develop osteoporosis than were those without anxiety. High anxiety levels have been shown to be associated with low bone mineral density, which is a key indicator of fracture risk. The most common sites of osteoporotic fractures in these women are the lumbar spine and femoral neck.
In addition to these risk factors, cigarette smoking, sedentary lifestyle and prolonged use of steroids are major risk factors of osteoporosis-related increased fracture risk.

Anxiety may cause more oxidative stress, which may be related to osteoporosis in postmenopausal women
There are several ways anxiety may affect bone health. It is postulated that there may be some degree of systemic inflammation in people with high anxiety levels, which leads to bone loss. Anxiety and stress cause high cortisol levels in the blood, which has a known effect on bone demineralization and brittleness. Anxiety may cause more oxidative stress, which may be related to osteoporosis in postmenopausal women. To make matters worse, you may be more prone to falls if you have an anxiety disorder. Furthermore, some antidepressants may also cause a decrease in bone mineral density as well.

 

Based on this, it is becoming increasingly evident that mental issues, specifically anxiety and stress should be addressed in all patients – this is even more important in women postmenopausal age as stress and anxiety in this population can lead to significantly high fracture risk. Approximately 7% of the world suffers from an anxiety disorder, and it is as common in women. There is a link between anxiety and low vitamin D levels, which might explain the connection between anxiety disorder and bone fractures.

 

Women’s peak bone mass is said to be at age 35. Ever woman seeing a doctor should be screened for anxiety disorders and high-stress levels during their clinic visits. They should be taking 1200 mg of calcium a day in order to minimize the risk of developing osteoporosis. It is also important to have sufficient magnesium and vitamin D — from either sun exposure or supplements. Furthermore, having a healthy lifestyle with activities such as walking, lifting weights, ensure good bone health.

In addition, these women should also avoid smoking, excessive drinking, taking excessive thyroid replacement medications, and/or medications such as steroids or proton pump inhibitors. If anxiety issues are indeed found on screening, they should be addressed and professionally handled – with various techniques including mindfulness, cognitive therapy, self-calming strategies, yoga, etc.

 

Do Vestibular Disorders Go Away With Manual Lymphatic Drainage?

The vestibular sensory organs in our inner ear, the cochlea, and the semicircular canals are responsible for our balance and proprioception/position. When these organs are damaged with disease or injury, it can lead to dizziness, vertigo, balance problems, and other symptoms. These can be transient as people are able to recover after a few weeks of normal activity due to vestibular compensation. Conversely, the symptoms can be lasting, affecting a person’s ability to maintain posture and balance.

 

A person with a vestibular disorder may have difficulty in maintaining balance and may adopt an exaggerated hip sway, swivel the entire body while keeping the head still when turning to look at something, or always look down to avoid a confusing swirl of activity. Ironically, these mannerisms can worsen the vestibular symptoms and often cause headaches, muscle tension, and fatigue.
Meniere’s disease is the most common vestibular disorder this procedure is considered for

Endolymphatic sac decompression is a procedure that involves draining of the excessive endolymph from its sac in order to decompress it. It is sometimes indicated for Ménière’s disease or secondary endolymphatic hydrops to relieve endolymphatic pressure in the cochlea and vestibular system. Meniere’s disease is the most common vestibular disorder this procedure is considered for. It is characterized by vertigo, tinnitus, hearing loss, imbalance and a feeling of pressure deep inside the ear. While there are several treatment options for it, including betahistine, cyclizine, steroid injections, and gentamicin injections, but endolymphatic sac decompression is considered for refractory cases.

 

There are multiple ways to perform this procedure. One method involves removing the mastoid bone surrounding the endolymphatic sac and allowing the sac to decompress. Alternatively, a shunt may be placed into the endolymphatic sac so that the excess fluid can drain out into the mastoid cavity.

Endolymphatic sac decompression is performed as an outpatient procedure. During the procedure, an incision is made behind the ear and the mastoid bone is exposed. The bone is fragmented to reveal the endolymphatic sac and a hole is cut into the outer layer of the sac using a laser. A shunt is then inserted into the sac and the incision is closed. The procedure takes approximately 90 minutes and is performed under general anesthesia. If there are no adverse events, the patient is discharged an hour later. Most patients return to work the day after surgery. The patient’s hearing gradually improves in the ensuing few weeks and then returns to normal.

Endolymphatic sac decompression has proven to be an effective treatment for patients with Meniere’s disease with vertigo and light-to-moderate hearing loss. In a recent study published in JAMA, endolymphatic sac surgery provided an improvement in major spells of vertigo in 77% of patients at 24 months after surgery. Furthermore, revision surgery provided an improvement in 65% of cases, especially those with recurrent symptoms more than 24 months after their original procedure.

Grade I Hamstring Strain

Hamstrings are the three muscles at the back of the thigh. They traverse between the hip and the knee and are named semimembranosus, semitendinosus and biceps femoris. They are involved in bending the knee., tipping the pelvis back when you lean backwards, and twisting the knee when the knee is bent.

 

A hamstring injury ranges from a strain to a muscle tear.
There are three grades of hamstring injury:

  • Grade I: a mild muscle strain
  • Grade II: a partial muscle tear.
  • Grade III: a complete muscle tear or tear of an attachment.

 

Grade I injury may take a few days to heal but a grade III injury can take months. We’ll focus on grade I hamstring injury in this article.

The best way to avoid hamstring injury is to spend time working on your hamstring strength

Grade I Hamstring injuries are very common in sports, especially those that involve sprinting, suddenly stopping and changing direction, and jumping. These include football, rugby, baseball and track running. They typically happen at the end of the swing phase of running, just before the outstretched leg touches the ground, as it is at this point that the hamstring muscles have to suddenly contract to bend the knee.

 

There are multiple predisposing factors for hamstring injury, such as:

 

  • Weak hamstrings – if they are not toned up and strong enough to handle the stress, they are more likely to get injured.
  • Lack of warm-up before exertion – Hamstring muscles are less likely to be injured when they are warmed up through brief stretching/contracting exercises. Keeping the legs warm with suitable clothing while warming up also helps a lot.
  • Tiredness – if the muscle is fatigued, it is more likely to get injured. Having good fitness overall helps.
  • Previous hamstring injury – You are much more likely to have a hamstring injury if you have had a previous one.
  • Older age – you are more likely to have a hamstring injury as you get older.

 

Interestingly, being overweight is not thought to be a risk factor for a hamstring injury.

The best way to avoid hamstring injury is to spend time working on your hamstring strength. A highly trained sportsperson will tend to do this as part of their training but anybody looking to do any activities that involve these muscles is probe to grade I hamstring injury and needs to warm up as well.

There are various approaches to hamstring rehabilitation, with varying times of immobilization to the type of exercise. The goal of any hamstring rehabilitation (especially so in cases of sportspersons) is to return to the previous level of performance while attempting to minimize the rate of injury recurrence. It has been shown that Grade I (and even II) hamstring strains can be aggressively treated with brief immobilization followed by early initiation of running and isokinetic exercises. This is likely to lead to early recovery of function and a relatively low reinjury rate.

Microfracture of the Knee – Recovery & Outcomes

Microfracture is a simple but cost-effective procedure performed to treat smaller cartilage injuries. It is not used to address defects with damage to the underlying bone. It also cannot be used to treat widespread arthritis in a joint. But it is an excellent choice as an initial treatment of smaller articular cartilage injuries.

 

Recovery process

After the microfracture repair of the knee, the post-operative recovery period is fairly complication-free. After the procedure has been performed in the patella and the trochlear groove, there will likely be mild transient pain or “gritty” sensation. The pain resolves sooner but the gritty sensation typically resolves with a few weeks. Patients may notice “catching” as the ridge of the patella rides over this area during joint motion. This may be apparent during continuous passive motion machine (CPM). If it is also painful, it is best to limit weight bearing; it should resolve within 3 months. Any residual swelling and joint effusion disappears within 8 weeks after microfracture. Sometimes, there is a recurrent effusion between 6 to 8 weeks after surgery but it is usually painless and typically resolves within several weeks.

 

Rehabilitation

The rehabilitation process is vital to the long-term success and functional outcome of these patients. Postoperative rehabilitation programs for microfracture procedures vary greatly based on lesion size, depth, location, quality of tissue, patient age, BMI, general health, and surgical details. Thus, the appropriate rehabilitation program must be highly individualized to ensure successful outcomes. The goal of rehabilitation is to restore full function in the shortest time possible without overloading the healing articular cartilage. It is imperative to create a healing environment while avoiding deleterious forces that may overload the healing tissue.

The pain resolves sooner but the gritty sensation typically resolves with a few weeks

Paste grafting

In order for microfracture to work consistently, the healing tissue must be stimulated to form cartilage rapidly and durably. The progenitor/stem cells and bone paste can be added to a super microfracture of the lesion in a technique called Paste grafting. The healing process can be augmented by injections of growth factors and hyaluronic acid lubrication injections during the healing period.

 

Outcomes

The studies are showing mid-term and long-term success for microfracture in the knee. Multisite microfracture was seen to have poorer outcomes. This is likely because multiple cartilage injuries are indicative of a more advanced disease process. It has been found that patients younger than 45 years had significantly improved outcomes after microfracture as compared with those older than 45 years. Patient age and BMI have been found to be significant predictors of postoperative improvement after microfracture.

 

Overall, presence of a single cartilage lesion, lower BMI, or being a male has been found to result in greater functional improvement after microfracture. Moreover, larger defects (>3.6 sq.cm) and prior surgery were both independent predictors for future surgery after microfracture.

Stem Cell Therapy for Dementia

Stem cells are undifferentiated cells of a multicellular organism that is capable of giving rise to indefinitely more cells of the same type, and from which certain other kinds of cell arise by differentiation. There are a number of diseases were harvested stem cells can be used therapeutically to repair damaged or lost cells. They have been used for joint repair and wound healing.

 

Signs and symptoms of dementia vary from patient to patient and there is a wide spectrum of clinical severity and associated conditions. Cognitive changes include memory loss, confusion, difficulties with language, communication, finding the right words, reasoning, solving problems, dealing with complicated tasks, organizing, and planning, etc. Furthermore, it can cause depression, personality changes, anxiety, paranoia, hallucinations etc.

Dementia is the next frontier for stem cell therapy. The medical community is now turning to stem cell therapy how it can treat dementia and Alzheimer’s. Dementia may be defined as a loss of cognitive or intellectual function. The most common type of dementia is Alzheimer’s disease. At present, there is no cure for it.

 

In the 90’s, it was discovered that stem cells exist in certain areas of the brain and that they constantly divide, producing new cells. This led to the research that focused on differentiating these from ordinary brain cells and studying how stem cells in the brain are regulated so that they can be stimulated to become the kind of nerve cells needed in the brain.

 

Patients with Alzheimer’s disease lack the stem cells as compared to those with healthy brains, but stem cells nevertheless do exist inside their brains as well. The reduction of stem cells is believed to be due to plaque formation in the brain and the cells.  There are now experimental drugs that stimulate stem cells to produce more nerve cells in animal models with Alzheimer’s. This causes stem cells to create nerve cells when introduced into the diseased brain. This result was shown to cause improvement in behaviors and memory testing in the animals. This is an exciting development as it can translate into successful therapies in humans as well.

 

Majority of so-called “regenerative medicine clinics” in the world aren’t dispensing safe and effective stem cell therapies. It is very important to differentiate between them and state-of-the-art treatment centers that base their therapeutic services on the latest research and use safe means of delivering these treatments. We have the most advanced stem cell procedures available today. We have highly trained and experienced, board-certified doctors and staff who are experienced and professionally trained in performing stem cell procedures. Moreover, we use only the most potent resources of viable stem cells that are harvested on the same day for procedures. We provide excellent post-procedural rehabilitation, diet and supplement protocols to improve the likelihood of success.

Factors and Different Treatments for the Dreaded Scoliosis

Scoliosis is a condition that causes the spine to curve forming a “C” or “S” shape. The curved spine can irritate and stretch nerves, strain joints comprised of two bones, affect the posture, and make muscles fatigued. It causes pressure on the disks between the spinal vertebrae making them inefficient shock absorbers and causes strain with pressure on facet joints of the spine. The cause is unknown and there is no cure. Managing symptoms associated with the condition is the main course of treatment.

 

The single worst symptom is pain. The condition impacts quality of life and is a long-term disability. The curve is not usually painful but when changes cause it to become painful, it is debilitating. For some patients, over-the-counter medication helps them cope with the pain and discomfort, while others require stronger pain relievers that are taken several times a day. Pain is individualized and each person perceives it differently. Pain medications are not a long-term solution because they have no impact on the source of the pain.

 

There are several factors that affect how well the nerves work to decrease pain. These factors are:

  • Genes
  • Environment
  • Medication
  • Personal beliefs or perception

Surgical intervention is generally recommended when the curve is greater than 40-degrees

The most common pain is due to muscle strain as the individual tries to compensate for the curve while completing activities of daily living. (getting dressed, taking a bath, cleaning…)

The basic treatments for muscle strain include over-the-counter pain relievers, hot packs, cold compresses for inflammation, and rest. Often a brace is worn but can be uncomfortable and burdensome. Surgical intervention depends on the progression of the condition.

 

Finding appropriate treatment(s) begin with:

  • Talking to your healthcare provider
  • Participating in alternative therapies
  • Wearing a brace for support, if able to tolerate
  • Possible surgical intervention

 

Physical Therapy can help with pain management by incorporating exercises to improve back strength and flexibility. Stretching often is recommended. If an activity causes increased pain, stop doing it and rest. Other recommended therapies and programs include Pilates and Yoga to promote balance, develop deep and superficial muscles, and relax the mind.

 

Other treatments and therapies that can help alleviate pain and improve coping skills include:

  • Chiropractics
  • Massage Therapy
  • Acupuncture
  • Hydrotherapy
  • Steroid or Anesthetic Injections
  • Counseling
  • Surgical spinal fusion

Counseling can include Cognitive Behavioral Therapy (CBT). Cognitive Behavioral Therapy allows a counselor and patient to identify ways to manage and cope with pain and limitations. It can help the individual to overcome beliefs or behaviors that aggravate or cause more spinal damage and leads to the identifying techniques, like meditation, that help with mental ability to deal with pain (coping skills).

 

Surgical intervention is generally recommended when the curve is greater than 40-degrees. It is done to ensure the curving stops. Without surgery, the spinal curve would continue to increase by 1-2 degrees annually. But surgery has risks, so alternative therapies are recommended first.

The Causes and Treatment of Severe Obesity

Obesity is on the rise in the United States. It is caused by an increase in size and number of fat cells. A scale called Body Mass Index (BMI) is used as a measure to calculate obesity. A normal BMI is 20 or less but a BMI greater than 30 indicates obesity. Obesity is a serious condition with several causes and health complications.

 

Causes of obesity include:

  • lack of sleep
  • unhealthy diet
  • genetics
  • sedentary lifestyle and inactivity
  • age
  • changes in hormones within the body
  • sometimes, hypothyroidism or polycystic ovary syndrome.

 

There are different types of fat in different areas of the body. Three types of fat are brown, white and beige. The body uses these stores of fat to fuel the body, regulate body temperature, and store energy for later use. Fat builds up when there are more calories coming into the body than what is being used for energy. Brown fat builds up in the belly area in and around organs. Belly fat is more dangerous than the other two.  It interferes with the endocrine and immune systems and promotes chronic inflammation and obesity-related complications.

Treatment depends on the cause and severity of the obesity

Risks associated with obesity are as follows:

  • osteoarthritis in hips, back, and knees
  • gallbladder disease due to excess cholesterol
  • sleep apnea, fatigue, and other breathing problems
  • heart disease and stroke
  • elevated cholesterol
  • cancer due to abnormal cell growth
  • elevated blood pressure due to damage to arteries leading to other health problems
  • Diabetes
  • Fatty Liver disease
  • low quality of life
  • mental illness – clinical depression, anxiety and other mental disorders
  • body pain and difficult physical functioning
  • pregnancy problems like gestational diabetes and pre-eclampsia

 

Treatment depends on the cause and severity of the obesity. Communication with your healthcare provider can help with making a weight loss plan. Lifestyle changes are at the top of the list and include :

 

  • eating a heart-healthy diet
  • increasing physical activity as tolerated
  • an FDA approved weight loss medication
  • surgical intervention (gastric bypass or gastric sleeve for example)

 

Healthcare providers have dieticians on staff that can provide guidelines for a low-calorie healthy diet plan. Weight-loss is dependent on setting individual goals and being compliant with the agreed upon plan. Weight loss can decrease the effects of obesity on hips, back, and joints. Exercise programs will improve breathing issues, decrease high blood pressure, decrease diabetes symptoms and in some cases, the need for certain medications.

According to the U.S. Surgeon General, 35 percent of women and 31 percent of men are seriously overweight, and 15 percent of children between the ages of six and nineteen are overweight. Public health officials are warning consumers that inactivity and poor diet are catching up to tobacco as a significant health threat.

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