Navigate weight gain challenges in Type 1 diabetes with Meri Sehat's expert guidance. Discover effective strategies for a healthy weight and diabetes management.

Weight Gain In Type 1 Diabetes And How To Address It

Madeeha Syed

This article or video has been vetted and verified by Meri Sehat’s specialists. It contains citations and research from validated sources.

What Is The Ketogenic Diet?

Overview

We know that there are three macronutrients in our diet that provide all the energy and nutrition we need to sustain our body&rsquo;s normal structures and functions. In a perfect world where everyone opted for a balanced diet, we would consume adequate quantities of these macronutrients. However, in reality a standard diet consists mostly of carbs (50 percent) with some fats (35 percent) and proteins (15 percent) thrown in.&nbsp; 
&nbsp;

Ketogenic diet

Keto is a low-carb, gluten-free and a low-to-moderate protein diet. It is very similar to the Paleo diet and Atkins diet.&nbsp;

In order to understand how a ketogenic diet works, we first need to establish how our body normally produces energy. Glucose is the main source of energy and is obtained mainly from carbs. Normally, a ketogenic diet comprises 75 percent fat, 20 percent of protein and only five percent of carbohydrates. But there are several renditions so you are allowed to switch these percentages around based on your daily needs.&nbsp;

Now where does your body generate the energy it needs if you eliminate carbs to such an extreme extent? It turns out that the body switches to metabolising fat for this purpose and conducts this via a process called &lsquo;Ketosis&rsquo;.&nbsp; 
&nbsp;

Fats are broken down into ketones and these ketones provide all the energy you need. This is where the name &lsquo;ketogenic&rsquo; is derived from &mdash; Keto for &lsquo;ketones&rsquo; and genic for &lsquo;producing&rsquo;. This primes your body to burn fat as a primary source of energy, which is why it&rsquo;s so well-known and widely used for <a href="https://merisehat.pk/article/five-myths-about-weight-loss">losing weight</a>.&nbsp;&nbsp;

It&rsquo;s important to note that our body is a living organism and there&rsquo;s no switch that can make it perform a different activity within a matter of minutes or even days. It will take your body a few days to adjust to employing fats as your primary energy resource and during that time you will feel all the negative impacts of having low glucose stores, including decreased focus, brain fog, nausea, vomiting, and irritability. This phase is commonly known as the &lsquo;keto flu&rsquo;.&nbsp; 
&nbsp;

Let&rsquo;s see some of the claims the proponents of the ketogenic diet make and how much weight they actually hold:&nbsp;

For Weight Loss: This is the main application of the keto diet and is a huge part of the current trend. Once your body gets used to burning fat for your daily needs it will also go ahead and burn your local fat stores. This helps shave off those few extra inches in a very short amount of time.&nbsp;

Another reason why this works for weight loss is the high fat content of your diet leads to satiety. Basically, this means you don&rsquo;t feel any cravings and also feel fuller for longer periods.&nbsp;

However, it is not good for long-term weight loss, and once you go back to your usual eating habits, you will quickly gain those extra pounds back. Putting your body through this kind of metabolic stress is also not advisable because it&rsquo;s very hard to sustain over a long period of time for many people.&nbsp; 
&nbsp;

For The Brain: Anecdotal evidence shows people feel sharper and more focused. Then again, some of them have also reported experiencing brain fog while observing a ketogenic diet.&nbsp; There is no clinical evidence for either of these claims. 
&nbsp;

This is actually well researched.&nbsp;

<ul>
	<li>Ketogenic diet works well for people who are either prediabetic or have Type 2 diabetes. This makes sense because people whose insulin doesn&rsquo;t work are constantly at risk of having high blood sugar levels. And a lifestyle of eating processed food doesn&rsquo;t help either. These are therefore classified as foods with a high glycaemic index &ndash; which essentially means that they raise your blood sugar very fast.&nbsp;</li>
	<li>People on keto achieve better insulin sensitivity over time. Simply because the diet gives the body less glucose to work with, enabling it to function optimally.&nbsp;</li>
	<li>It&rsquo;s also been found effective for heart disease, Alzheimer&rsquo;s, Parkinson&rsquo;s, certain sleep disorders, polycystic ovarian syndrome (PCOS), and metabolic syndrome.&nbsp;</li>
	<li>Cutting out carbs also helps control acne breakouts.&nbsp; 
	&nbsp;</li>
</ul>

For Childhood Epilepsy: This is what the ketogenic diet originally gained popularity for back in the 1920s and 1930s. Before new anticonvulsant medications and therapies were developed, children with epilepsy would fast in order to control their seizures. Keto replaced this successfully. One in seven kids benefit from a ketogenic diet.&nbsp;

Evidence-based science has established that children with refractory epileptic seizures experience seizures less frequently if they opt for keto.&nbsp; 
&nbsp;

For Cancers: Ketogenic diet has shown some promise when it comes to treating certain types of cancers, but the research is so far inconclusive.&nbsp; 
&nbsp;

There are some disadvantages to keto, including:

<ul>
	<li>Nutritional deficiencies&nbsp;</li>
	<li>Formation of kidney stones</li>
	<li>Frequent urination</li>
	<li>Increased thirst</li>
	<li>High levels of LDL (bad cholesterol)</li>
	<li>Increased incidence of certain cancers</li>
	<li>Constipation</li>
	<li>Indigestion</li>
	<li>Inconvenient and unsustainable over a long period of time</li>
	<li>Low blood sugar (hence the mental fog during the initial days)</li>
	<li>Tougher workouts (since you don&rsquo;t have glucose readily available for energy anymore)&nbsp;</li>
	<li>Keto flu: weakness, irritability, headaches, bad breath, and fatigue</li>
	<li>Dry mouth&nbsp; 
	&nbsp;</li>
</ul>

Bottom Line

The ketogenic diet is great for short-term weight loss if you are otherwise healthy. But, it&rsquo;s very tough to successfully carry out since it requires a drastic switch from a normal diet. Lack of conclusive research and knowledge means we don&rsquo;t know everything that might go wrong (or right!) on this diet. Safe to say, anyone planning to go on this diet needs to exercise a certain level of personal discretion.&nbsp;

Dr. Safia Mehmood

The Dos And Don’ts Of Keto

Keto or <a href="https://merisehat.pk/article/what-is-the-ketogenic-diet">ketogenic diet</a> has myriads of benefits. It is notorious as a shortcut to quick weight loss. Almost everyone has tried it at some point and they have also reaped its benefits. On the other hand, some people found that it was not their cup of tea; the experience left a bad taste in their mouth.&nbsp;

Even though it&rsquo;s not a new trend, there is plenty of misinformation around, which makes it harder to assess what you should actually do. The following tips would help you adapt a keto lifestyle while minimising its adverse effects.&nbsp; 
&nbsp;

Dos and Don’ts of Keto

Keto eliminates the need to count calories. As your body adjusts to using fat as the primary fuel, make sure to follow these rules:

<ul>
	<li>Fewer Carbs: You are allowed to consume only 5-10 percent of carbs. This is required for your body to switch to ketosis instead of using glucose as a primary source of energy.&nbsp;</li>
	<li>Just Enough Protein: When you consume an ample amount of protein, it&rsquo;s a signal for your body to convert it into glucose as well. This is exactly what we want to avoid while trying to elicit the keto state. Therefore, limit your protein intake to only 10-20 percent of your entire diet.&nbsp;</li>
	<li>Lots Of Fats: Your diet should primarily consist of fats (70-80 percent) to make the whole thing work.&nbsp;</li>
</ul>

There are free keto calculators available online that can help you measure exactly how much of these nutrients you consume daily.&nbsp; 
&nbsp;

To make it easier for you, you can eat:

<ul>
	<li>Meat: Devour red meat, sausages, chicken, and turkey. In other words, grass-fed meat.</li>
	<li>Seafood: This includes fatty fish like salmon, mackerel, trout, and oysters besides tuna, sardines, shrimps, and crab. See, keto&rsquo;s not about starving yourself.</li>
	<li>Non-Starchy Vegetables: Feed your belly asparagus, tomatoes, basil, spinach, broccoli, bell peppers, onions, celery, zucchini, lettuce, cauliflower, kale, broccoli, cabbage, jalapenos, cucumbers, eggplant, and Brussels sprouts.&nbsp;</li>
	<li>Cheese: Some good ol&rsquo; cheddar, goat cream, feta, parmesan, mozzarella, blue, brie provolone, and string cheese for flavour.</li>
	<li>Herbs: Don&rsquo;t forget to throw in thyme, rosemary, sage, mint, oregano, dill, parsley, cilantro, and basil.</li>
	<li>Seeds: Munch on flaxseed, chia seeds, and pumpkin seeds.</li>
	<li>Eggs, butter, peanut butter, and cream&nbsp;</li>
	<li>Plain Greek Yogurt, full fat yogurt&nbsp;</li>
	<li>Alternate Between Butter, Ghee, And Oil (extra virgin olive oil or avocado oil) for cooking or making creamy sauces.</li>
	<li>Nuts: Most of them are okay to eat. For example, almonds, pine nuts and walnuts. Avoid pistachios since they have a higher carb content.&nbsp;</li>
	<li>Plenty Of Liquid: Water, coffee or tea to go with your meals or otherwise. Use full fat cream or milk in your tea and coffee. Plant based milk such as soy, coconut, and almond milk are also keto-friendly.&nbsp; 
	&nbsp;</li>
</ul>

&nbsp;Consider the following as strictly off limits

<ul>
	<li>Starchy Foods like bread, rice, pasta, and tortillas. Even healthy whole grains are too high in carbs.&nbsp;</li>
	<li>Sugary Foods, like candy, cakes, brownies, cookies, donuts, ice cream, sweetened yogurt, and breakfast cereals. Natural sugars present in fruits are off limit as well, except for some berries (strawberries, blackberries, and raspberries) in small amounts.&nbsp;&nbsp;</li>
	<li>Starchy Vegetables, such as potatoes, sweet potatoes, parsnips, carrots, corn, and beets.&nbsp;</li>
	<li>Fruit Juices, soda, smoothies, ice creams, and sweet alcoholic drinks.&nbsp;</li>
	<li>Peas, kidney beans, lentils, and chickpeas.&nbsp;</li>
	<li>Sauces like BBQ sauce, honey mustard, teriyaki, and ketchup.</li>
	<li>Processed Vegetable Oils and mayonnaise.&nbsp;</li>
	<li>Sugar, sweeteners, and syrups in your beverages, tea, or coffee.&nbsp;</li>
</ul>

Note: Don&rsquo;t go overboard with adding too much fat as that means your body perpetually burns the fat you consume instead of the fat you had stored previously. 
&nbsp;

While observing a keto diet, the best snack is no snack. But it&rsquo;s understandable how those cravings are hard to resist sometimes. Some of the easiest Keto friendly snack options could be:&nbsp;&nbsp;

<ul>
	<li>Hard boiled eggs</li>
	<li>Slice of cheese</li>
	<li>Cold cuts (salami, prosciutto etc.)&nbsp;</li>
	<li>Avocados</li>
	<li>Olives</li>
	<li>A handful of nuts</li>
	<li>Fresh vegetables with creamy dressings such as ranch&nbsp;</li>
	<li>Berries with whipped cream</li>
	<li>Dark chocolate (the higher the cocoa percentage, the less sugar the chocolate contains)</li>
	<li>Keto friendly snack bars from the market&nbsp; 
	&nbsp;</li>
</ul>

Fatigue, brain fog, irritability, nausea, and headaches are just some of the symptoms you might feel while switching to keto. This is dubbed as the &lsquo;keto flu&rsquo;. 
&nbsp;

In order to combat the keto flu, you could:&nbsp;

<ul>
	<li>Increase your water intake and make sure you are adequately hydrated throughout the day. Also, prefer vegetables with a high water content such as cucumbers, celery, tomatoes, zucchini, etc.&nbsp;</li>
	<li>Increase your sodium, potassium and magnesium intake by adding extra salt to meals. And make sure to take mineral supplements. It would help deal with other micronutrient deficiencies you might suffer in a keto diet.&nbsp; 
	&nbsp;</li>
</ul>

<ul>
	<li>Get in the habit of reading food labels. Educate yourself on your nutrient intake and what each food contains and which might sneak into your diet. This will also help you recognise if a meal is keto-friendly or not. For example, when you are eating out and the restaurant doesn&rsquo;t mention it on their menu.&nbsp;</li>
	<li>Minimise the adverse effects of starting a keto diet by starting a low-carb diet at first before going full keto.&nbsp;</li>
	<li>When exercising during your diet, take creatine supplements to boost your performance. Caffeine helps, too. You can also take Whey protein supplements for augmenting your protein intake.&nbsp;</li>
	<li>Avoid keto if you are on any antidiabetic medication as this can cause diabetic ketoacidosis, which is a serious complication.&nbsp;</li>
	<li>Proceed slowly and with caution. Monitor your bad cholesterol levels if you are not over the keto flu within the first week consult your doctor.</li>
	<li>Plan ahead to avoid a high-carb meal. Even one high-carb meal can disrupt the body&rsquo;s metabolism switch towards ketosis.&nbsp;</li>
	<li>The biggest complaint is that it&rsquo;s not sustainable. Who has time to meticulously prepare for meals when you have work and family to look after? If you fall in this category, sign up for meal delivery services to deliver keto friendly meals to your doorstep.&nbsp;&nbsp;</li>
	<li>Use sugar free gum to combat halitosis (bad breath) which you will inevitably suffer from.&nbsp;</li>
</ul>

Armed with all of this information, you should be able to follow a ketogenic diet properly.&nbsp;

Humza Khizer

This article or video has been recorded by a subject / domain specialists with a proven track record of excellence in their area. 

Move Over BMI, There Are Some New Kids On The Block!

Introduction

BMI (Body Mass Index) has always been the most popular way to measure the composition of the body, pertaining to health. However, current research indicates that BMI is not the most accurate and may have serious limitations<a href="#accordion">[1]</a>. 
&nbsp;

Understanding Disadvantages Of BMI And Its Alternatives

Although BMI is an affordable, easily accessible, and quick method to screen whether a person is healthy or not. Its accuracy is limited by the fact that the index does not take certain factors into account. These include: 
&nbsp;

<ul>
	<li>
	<h5>Body Fat Percentage</h5>
	</li>
</ul>

BFP (body fat percentage) is the percentage of fat tissue in your body, in comparison to the total body mass. It is measured using skinfold callipers, and bioelectrical impedance. However, for a more accurate measurement, a DEXA Scan is used. 
&nbsp;

BMI does not account for the difference between muscle and fat. Muscle tissue is denser compared to fat, and most weightlifters, despite being physically fit, are considered fat as per the body mass index. Moreover, body fat percentage is a better assessment of health because most diseases have a correlation with body fat and not body weight. 
&nbsp;

<ul>
	<li>
	<h5>Demographics</h5>
	</li>
</ul>

When BMI was originally created the data was taken from Anglo-Saxon bodies (European population). Hence, it is not a very accurate method of health depiction due to the presence of several other races and ethnicities across the world. 
&nbsp;

Despite a low BMI score, Asians have a higher incidence of metabolic diseases<a href="#accordion">[3]</a>. Moreover, a study conducted at Stanford revealed that healthy BMI values in Black women are higher than the standard BMI range; and in Hispanic women, the healthy BMI values are lower than the standard range<a href="#accordion">[3]</a>. Moreover, in black women, a BMI value of 33 is associated with a <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">risk of diabetes</a>, whereas in white women the risk is present with a BMI value of 29<a href="#accordion">[3]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Fat Distribution</h5>
	</li>
</ul>

Fat is also an important factor for determining overall health that the BMI fails to take into account. Moreover, fat in the upper body and visceral fat is correlated to health complications. For example, cardiovascular disease is linked to lower body fat in the gluteal and thigh region.

&nbsp;

<h4>"A high BMI can add to your stress. Head on over to the <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan </a>and check your stress level today!"</h4>

There are multiple other alternatives to track your health which can either be used individually or together. 
&nbsp;

<ul>
	<li>
	<h5>Waist-To-Height Ratio (WHtR)</h5>
	</li>
</ul>

The waist-to-height ratio measures the ratio of waist circumference to height, instead of the overall weight to height square. Moreover, the accuracy of WHtR is higher because central weight is taken into consideration. 
&nbsp;

<ul>
	<li>
	<h5>Why Is Central Fat Important?&nbsp;</h5>
	</li>
</ul>

It is important because it accumulates around the organs in the mid-section, which has a link with heart diseases. In fact, researchers have also analyzed that WHtR is more accurate for the prediction of diseases, compared to BMI<a href="#accordion">[4]</a>.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Measurements</h5>
	</li>
</ul>

Measurements have a relation with WHtR. It is the circumferential measurement of multiple body parts, for example, arm, legs, and waist. Many people use it for the prediction of their weight loss and weight gain.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Resting Heart Rate</h5>
	</li>
</ul>

Resting heart rate is defined as the number of heartbeats per minute, in a resting phase. It is a good measurement of one&rsquo;s cardiovascular health. The stronger your cardiovascular health, the lower your risk of heart diseases. However, resting heart rate should not be checked first thing in the morning.&nbsp; 
&nbsp;

<ul>
	<li>
	<h5>Skinfold Callipers</h5>
	</li>
</ul>

Subcutaneous fat or fat that sits under the skin is measured using skinfold callipers. This gives an estimate of the total body fat. However, it is always better to measure five to six parts of the body for accurate results. For example, your stomach and back. Moreover, with skinfold callipers, the key to accuracy is consistency.

&nbsp;

Key Points

<ul><li>BMI is a quick and easy method of assessing a person’s health outcomes, but it has tremendous limitations.&nbsp;</li><li>BMI does not address demographics, body fat percentage, or fat distribution.&nbsp;</li><li>Therefore, alternates such as waist-to-height ratio, resting heart rate, and subcutaneous fat measurements can be used.&nbsp;</li><li>Waist circumference or even blood pressure can predict the overall risks and health condition.&nbsp;</li><li>Moreover, if anyone has concerns about their BMI or overall weight, they should consult their healthcare provider for a better understating.</li></ul>

[1] Abel, R.C., Somers, V.K., Sierra-Johnson, J., Thomas, R.J., Bailey, K.R., Collazo-Clavell, M.L. and Allison, T.G., 2008. Accuracy of body mass index to diagnose obesity in the US adult population. Int J Obes (Lond), 32(6), pp.959-966.

[2] Kurian, A.K. and Cardarelli, K.M., 2007. Racial and ethnic differences in cardiovascular disease risk factors. Ethnicity & disease, 17(1), pp.143-152.

[3] Stanford, F.C., Lee, M. and Hur, C., 2019, February. Race, ethnicity, sex, and obesity: is it time to personalize the scale?. In Mayo Clinic Proceedings (Vol. 94, No. 2, pp. 362-363). Elsevier.

[4] Ashwell, M., Gunn, P. and Gibson, S., 2012. Waist‐to‐height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta‐analysis. Obesity reviews, 13(3), pp.275-286.

Staff Writer

Online Consultation

Iqra Mazhar

Is Your Asthma Due To Your Mother’s Gestational Weight Gain?

Gestational weight gain and high BMI (body mass index) affects a majority of pregnant women. There are various factors such as social factors, environmental factors, maternal factors, and energy balance that could contribute to weight gain <a href="https://merisehat.pk/disease/lets-talk-about-sex-during-pregnancy">during pregnancy</a>.&nbsp; 
&nbsp;

Although gestational weight gain (GWG) is a natural response to accommodate a growing fetus, GWG that is either too high or too low contributes to long-term or short-term health complications. This specifically applies for women whose BMI is greater than 25 at the time of their pregnancy. 
&nbsp;

The number of women who experience excessive gestational weight gain while they are pregnant is increasing, irrespective of their socio-economic status. Institute of Medicine, USA, has worked on identifying optimal gestational weight, so healthcare providers can advise pregnant women accordingly<a href="#accordion">[1]</a>.

&nbsp;

Understanding The Impact Of Pregnancy Weight Gain On Childhood Asthma

Extreme gestational weight gain has a significant impact on pregnant women and their health. It increases risk of birth complications, and leads to long-term maternal obesity. 
&nbsp;

Additionally, excessive gestational weight gain is harmful for the child, especially because of increased risk of childhood obesity<a href="#accordion">[2]</a>. There is also enough evidence to link maternal obesity with childhood obstructive lung diseases, e.g., asthma<a href="#accordion">[3]</a>. 
&nbsp;

<h5>GWG And Asthma&nbsp;</h5>

Obesity during pregnancy is directly related to adverse outcomes in children, e.g., higher probability of developing asthma&nbsp; 
&nbsp;

The mechanism to identify this connection is fetal programming. It describes the in-utero exposure that influences gene expression and chronic diseases during childhood. The disease originates from metabolic and psychological adaptations, which are made by the fetus in response to in-utero exposures during critically sensitive developmental phases. Moreover, environmental and genetic factors also play a role in the immune modulatory effects. 
&nbsp;

<h5>The Effects Of BMI</h5>

It&rsquo;s difficult to gauge the effects of the mother&rsquo;s and the child&rsquo;s BMI on childhood asthma. Researchers have investigated the mediating effects of BMI by adding childhood body mass index to their variable models with two or more quantities, and further describing what would reduce the risk. 
&nbsp;

Some studies concluded that birth weight of babies and BMI at the age of eight partially affected childhood asthma due to gestational weight gain. However, other studies found minimal effects on childhood BMI<a href="#accordion">[4]</a>. 
&nbsp;

Another research studied the relationship between maternal pre-pregnancy BMI, gestational diabetes, weight gain, and the risk of wheezing in preschool offspring. The focus was on the growth, infection, and atopic mechanism. 
&nbsp;

The age group of the children in the study was 1-4 years and it was observed that mothers who had a history of asthma, atopy, and pre-pregnancy obesity, had kids at risk of pre-school wheezing.&nbsp; 
&nbsp;

Moreover, whenever the standard gestational weight gain deviated, it increased the risk of preschool wheezing. The results were independent of pre-pregnancy BMI and no difference was seen in mothers with history of atopy or asthma<a href="#accordion">[5]</a>. Additionally, child growth or eczema did not change the results either. 
&nbsp;

An overall higher risk of pre-school wheezing was seen in offspring of mothers with obesity before pregnancy, history of atopy, asthma, and gestational weight gain. Neither of these could be explained by infectious or atopic mechanisms. However, further research might be able to identify what the underlying mechanisms are.

&nbsp;

Childhood asthma is one of the most common chronic respiratory diseases. Considering that the death rate of children by asthma is 0-0.7 per 100,000 around the world, it is a cause for global concern. Moreover, the annual prevalence of asthma in children is 9.5%, which is higher compared to the 7.7% seen in adults<a href="#accordion">[6]</a>. Therefore, new tools have been developed to target preventive strategies, and improve health. 
&nbsp;

Studies suggest that asthma in children is associated with maternal weight gain before and during pregnancy. Moreover, pre-pregnancy weight gain is a global issue; it jumped from 13% to 22% within a decade (1993-2003). Overall, it indicates an increase of 69%.&nbsp; 
&nbsp;

Unfortunately, numerous studies have examined the link between GWG and pre-pregnancy obesity with childhood asthma, and the results remain inconclusive.&nbsp;

&nbsp;

A healthy and balanced diet can help the baby get the required nutrients for a healthy growth. However, the question that is commonly asked is how much extra calories are even normal? Extra calories are helpful and required in some cases, but eating for two is not recommended.&nbsp; 
&nbsp;

However it is important to note that the below caloric add-ons are applicable if a woman&rsquo;s weight is within a normal range and is moderately active. In this case, the recommended daily intake before pregnancy would be about 2,000 calories a day.&nbsp;&nbsp; 
&nbsp;

The caloric intake in pregnant women depends on the time of the pregnancy. For example, slight increase is good enough for the first trimester, which then needs to increase to an additional 300 to 350 calories per day during the second trimester. In the third trimester, an additional 450 to 500 calories per day are needed. If you&#39;re carrying multiple pregnancies, you could need an additional 300 calories per day for each baby. 
&nbsp;&nbsp;

Pregnant women need to consult their healthcare providers to know how much weight they can gain. Women who have the ideal weight according to their BMI should be able to gain 25-35 pounds during pregnancy, whereas underweight women have a margin for 28-40 pounds. Overweight women can gain only 15-25 pounds when pregnant<a href="#accordion">[7]</a>. 
&nbsp;

So, the general rule is that women can gain 2-4 pounds in their first trimester and 1 pound per week for the remaining pregnancy. Besides, women who are expecting twins can gain 35-45 pounds, which makes it an average of 1.5 pounds per week after the usual first trimester weight gain. It is very important for women with twin pregnancy to gain the right weight.&nbsp;

&nbsp;

Conclusion

It is advised that prenatal healthcare providers evaluate maternal weight at every visit. They should also monitor weight goals and provide counselling accordingly. More than 50% of women tend to exceed their weight gain goals and become overweight, which is a serious health hazard. It leads to low birth weight, failure to produce breast milk, cesarean deliveries, and postpartum weight retention. Furthermore, the offspring can also be overweight and suffer from macrosomia. 
&nbsp;

Although gestational weight gain is potentially threatening to women and the offspring, it is a modifiable risk factor. Diet and exercise during pregnancy helps in reducing the extra weight. However, these interventions have not improved neonatal outcomes significantly, and the effects on obese women are also limited. Thus, indicating that its best to achieve a healthy BMI prior to conception.

&nbsp;

[1] Rogozińska, E., Zamora, J., Marlin, N., Betrán, A.P., Astrup, A., Bogaerts, A., Cecatti, J.G., Dodd, J.M., Facchinetti, F., Geiker, N.R. and Haakstad, L.A., 2019. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials. BMC pregnancy and childbirth, 19(1), pp.1-12.

[2] Kominiarek, M.A. and Peaceman, A.M., 2017. Gestational weight gain. American journal of obstetrics and gynecology, 217(6), pp.642-651.

[3] Rusconi, F. and Popovic, M., 2017. Maternal obesity and childhood wheezing and asthma. Paediatric respiratory reviews, 22, pp.66-71.

[4] Harskamp-van Ginkel, M.W., London, S.J., Magnus, M.C., Gademan, M.G. and Vrijkotte, T.G., 2015. A study on mediation by offspring BMI in the association between maternal obesity and child respiratory outcomes in the amsterdam born and their development study cohort. PLoS One, 10(10), p.e0140641.

[5] Leermakers, E.T., Sonnenschein-van der Voort, A.M., Gaillard, R., Hofman, A., de Jongste, J.C., Jaddoe, V.W. and Duijts, L., 2013. Maternal weight, gestational weight gain and preschool wheezing: the Generation R Study. European Respiratory Journal, 42(5), pp.1234-1243.

[6] Liu, S., Zhou, B., Wang, Y., Wang, K., Zhang, Z. and Niu, W., 2020. Pre-pregnancy maternal weight and gestational weight gain increase the risk for childhood asthma and wheeze: an updated meta-analysis. Frontiers in pediatrics, 8, p.134.

[7] National Research Council, 2010. Weight gain during pregnancy: reexamining the guidelines.

What Is Hormonal Weight And How To Deal With It?

Have you ever felt like you&rsquo;ve tried everything to lose weight and it just doesn&rsquo;t work? That no amount of dieting or exercise keeps those few extra pounds off.&nbsp;

The solution to your weight loss may not be as simple as <a href="https://merisehat.pk/article/body-weight-exercises-for-strength-training">diet and exercise if the weight gain</a> itself is &lsquo;hormonal&rsquo;.

Hormones are chemicals, responsible for various functions that go on in your body, from digestion, sleep, mood swings, and sexual desires to metabolism. That is why having any kind of a hormonal imbalance can lead to health issues including, weight gain, low mood and that awful bloated feeling.&nbsp;

Hormones can make you gain and lose weight because they control how your body uses and spends the energy that is generated. Therefore, hormonal weight gain occurs when there is an imbalance in hormone production. This in turn can disturb levels of cortisol, thyroid, insulin, estrogen, and testosterone. 
&nbsp;

Signs And Symptoms

A classic sign of hormonal weight gain is the accumulation of fat around the abdominal area.

There are several hormones responsible for wreaking havoc on your body, your weighing machine and, as a result, your overall peace of mind. These include:

<h5>Thyroid</h5>

This hormone is responsible for regulating your metabolism and burning calories. In short, your body needs the right amount of thyroid hormone to burn calories. It also controls the body temperature, heartbeat, and the rate at which the food moves through the digestive tract. 
&nbsp;

<h5>Estrogen</h5>

Estrogen is a hormone responsible for sexual and reproductive health. But it can also trigger weight gain. Imbalances in estrogen levels can affect ovaries and cause PCOS (Polycystic ovary syndrome).

&nbsp;

<h5>Cortisol</h5>

This stress hormone is one of the silent culprits when it comes to weight gain and hormonal imbalances. Increased cortisol levels can lead to major weight gain as they are associated with addiction and cravings for sugary foods. The worst part is that this food makes you jittery and lazy. Hence, there is no motivation to work out to address the weight gain. A cortisol imbalance is like a double-edged sword. 
&nbsp;

<h5 dir="ltr">Insulin</h5>

The hormone responsible for energy. It pushes glucose into the cells. When insulin levels are too high, there is an excess of sugar in the blood. This extra sugar is converted to fat. This eventually leads to increased fatty deposits and cravings for sugary food.

 
In conclusion&nbsp;Shedding weight gain caused by an imbalance of hormones can take longer than expected.

&nbsp;

<h5>Exercise</h5>

Under the supervision of your doctor and certified trainer, you can try workouts like high-intensity interval training (HIIT), yoga, and strength training to release the happy chemicals (serotonin, dopamine, and norepinephrine) into your brain. These chemicals in turn reduce the level of stress hormones which are the major contributor to weight gain.

&nbsp;

<h5>Diet</h5>

Workouts and supplements without a proper diet can only take you so far. A balanced and doctor-supervised diet is crucial for weight loss. A diet that is specifically designed to offset hormonal weight has foods that have a naturally therapeutic and balancing effect on the body.

&nbsp;

Solution

Besides, the common sign of weight gain, other signs of hormonal imbalance might not always be apparent. We might think it is due to aging or genetics are at play for the fat that&rsquo;s being accumulated in our bodies. And this may not be true.&nbsp;

To be sure, the best thing to do is to get yourself tested after a thorough consult with a doctor. This way you can find out which hormones are in excess and which ones are not. You can then plan out your strategic weight loss journey without the pain of constant disappointments.

Hormonal weight loss is reversible. Patience and a plan are all you need.&nbsp;

Namwer Rao

Body Weight Exercises For Strength Training

Body weight exercises mean using your own body weight as resistance to train your muscles. If you’re someone who has never worked out a day in their life, doing bodyweight exercises is the perfect place to start. It’s great for building strength, endurance, balance, coordination and a nice lean muscular body. They are super convenient, can be done anywhere, costs no money and requires no equipment. There are also lower chances of injury that you might get with lifting weights that are too heavy. Another great thing about this mode of exercise is that you can easily mix and match or modify them according to your liking. You don’t have to get perfect at it from the get go and can start any of these bodyweight exercises at the beginner level. Once you perfect your technique, range of motion and your form you can move on to either the normal or tougher variations of these. Some of the easiest and most useful body weight exercises you can do anywhere and anytime are listed below. Most of these can be done in 3 sets with 12 – 15 repetitions.&nbsp;

Planks

&nbsp;This is one of those perfect exercises that challenge multiple muscle groups at once and are super easy to do. They can train muscles in you upper back, shoulders, arms, abs, oblique’s, glutes and quads while helping you work on your stability. They are also great for improving posture and provide your spine that much needed stability by strengthening core muscles, this means no more back pain!&nbsp;The correct way to do a plank is to make sure you are balancing yourself on your toes and elbows, if your are doing arm planks then you are supposed to balance yourself on your palms (start off in a pushup position) while keeping your core tight and your back straight. You can do elbow planks as a beginner or put your knees on the ground to make it easier. If you want to increase difficulty you can do either an active plank which requires you to flex and extend your abdomen or a marching plank where you balance yourself on alternate feet and arms. And no you don’t have to be able to hold a 1 minute plank in your first attempt. You can start off with as little as 20 seconds and build your capacity from there.&nbsp;

Side Planks

This is great for your obliques which usually get ignored amongst all the ab exercises. It also engages your glutes and shoulder muscles and is an overall effective body weight exercise. All the same rules as the plank apply, you can start with a 20 second side plank and you can start at beginner level.&nbsp;The correct way to do this is by putting one elbow on the floor and facing the front of your body entirely to one side while balancing yourself on your feet. You can drop down one knee to make it easier. If you are pro you can do an active side plank by adding a hip dip to make it tougher and challenge more of your muscles.&nbsp;

Mountain Climbers

&nbsp;Another exercise that engages and works multiple parts of the body including your core, abs, obliques, arms, back and shoulders. These can be done in sets of 3 with however many reps you&rsquo;re comfortable with (start with 10/15 and build up to 30). Since this is an active exercise that you can either slow down or speed up, it does give you similar benefit as <a href="https://merisehat.pk/article/why-is-both-cardio-and-strength-training-important-for-a-total-body-workout">doing cardio</a> by getting your <a href="https://merisehat.pk/page/sehat-scan/">heart rate</a> up and making you sweat.&nbsp;

In order to perform mountain climbers you start off in a push up stance, make sure your back is straight and nothing is sticking up, pick your feet and bring your knees to your chest. You can also bring alternate knees to your chest to engage obliques.&nbsp;&nbsp; 
&nbsp;

Squats

&nbsp;The most dreaded yet the most beneficial of exercises perhaps, squats work your lower back, glutes, quadriceps, hamstrings and calves. They also help you burn calories and are great for your joints Although there are a ton of variations of squats but here we are going to discuss the basic squat technique. You start off with your feet a little more than your shoulders’ width apart, you can extend your arms in the front, palms facing the ground and lower down slowly making sure you put all your weight on your heels. Depending upon your flexibility, balance and coordination you can go down as much as possible but note that the deeper your squat the better it works. Now after holding this position for 5 seconds or more, slowly come back up to your original standing stance. You can hold onto something in front of you for example a kitchen counter top in order to make it easier to get back up. Or, to make it tougher, you can stop coming back up entirely to a standing pose before going back into a squat.

Lunges

The first noteworthy thing about lunges is that Jennifer Lopez prescribes them to get a body like hers. The second noteworthy thing is that they work your abs, back, quadriceps, glutes, calves and hamstrings while also helping you lose weight and build up more coordination and balance. These can be forward lunges, reverse lunges, side lunges or one of the countless other variations.&nbsp;Let’s see how to do a basic stationary lunge: you stand in the same wide stance with your feet parallel to each other as you do at the beginning of a squat, hold your arms either in front of you or put them on your hips, lift up one leg and put it in front of you as far as you can go, bend your knee at a 90 degree angle and slowly lower yourself while keeping your upper body straight. As a beginner this is the easiest body weight exercise you can start off with. To make it tougher put one leg up onto something behind you before going into a lunge.&nbsp;

Pushups

The classic pushup works your chest muscles (pectorals etc.), shoulders, arms (triceps, deltoids), glutes, quads and abs. It’s also great for your back and joints. It has quite a few variations too and can be simplified for those who are just starting off.&nbsp;&nbsp; In order to do a pushup you first need to get on all fours and position your arms just a little wider than your shoulders, make sure you keep your elbows lax because this is where the movement will be, keep your back straight and core tight and slowly lower your chest to the ground as far as you can go. Your elbows should end up at a 90 degree bend. Beginners can start with wall pushups as it still engages your core and works your glutes, abs and quads or you can drop down to your knees and perform the rest of the pushup as it is. If you have been working out for a while and consider yourself a pro, you can make it harder by doing a lifted pushup which requires you to keep your feet up on an elevated surface. This helps you put more weight on your hands.&nbsp;&nbsp;

AL SHIFA CLINIC KARACHI

Syed Intisar Hussain

This article or video has been viewed by many visitors, and is popular.

Anorexia Nervosa: Answering Your Questions

At the same time that doctors in the United States and France were reporting incidents of anorexia nervosa among their patients, Sir William Withey Gull, a British physician, came up with the term to describe the disorder in 1874<a href="#accordion">[5]</a>.&nbsp;

&nbsp;

Being diagnosed with anorexia means you weigh at least 15% less than your normal body weight<a href="#accordion">[6]</a>. The disorder becomes dangerous when you lose too much weight, as a result of which health complications arise; in severe cases, even death can occur.

&nbsp;

So, yes, anorexia nervosa is a serious eating and mental health disorder that can easily ruin lives. The silver lining is you can treat it and, more importantly, you can recover from it. Of course, a full recovery is a long process; since it involves a&nbsp; therapy, behavioral modification, and nutritional education all together to not just ensure progress, but to also ensure that there&rsquo;s no relapse.&nbsp;

&nbsp;

However, the fact that the disorder is treatable is doing little to prevent it. While the overall incidence rate has remained remarkably steady over the past few decades<a href="#accordion">[1]</a>, the number of cases of anorexia are steadily - and quite alarmingly - increasing among young people (under the age of 15); whether they&rsquo;re due to early onset or early detection, it is still unclear.&nbsp; &nbsp; 
&nbsp;

<h5>Should you be worried? 
&nbsp;</h5>

Especially when modern anorexia nervosa treatment centers provide residential and outpatient treatment programs, many of which are geared specifically toward teenagers. Well, in a nutshell, yes.&nbsp;

&nbsp;

The primary reason is that most people just cannot see that they are underweight. Especially these days when, triggered by the picture-perfect social-media addicted world, a lot of us suffer from body image disturbance, i.e., we view our own body as unrealistically large and constantly negatively evaluate our physical appearance.

&nbsp;

Did you know, that&rsquo;s a key symptom of anorexia nervosa? Where you or your kid frequently concentrate on body parts, trying to get rid of &lsquo;excess&rsquo; weight in a specific area of the body. &lsquo;Trying to get rid of it&rsquo; because let&rsquo;s face it - your attempts will fail; according to scientific evidence, spot reduction is just not possible. But, as anorexics, you won&rsquo;t think that way and you will keep on analyzing different body parts that you think need to be &lsquo;slimmer&rsquo;. 
&nbsp;

If you can identify this trait in yourself or in your child, contact your doctor or an eating disorder specialist immediately. The earlier you begin treatment, the better your chances are at overcoming anorexia nervosa.&nbsp;

&nbsp;

But, that&rsquo;s not all. Let&#39;s have a look at some commonly asked queries about <a href="https://merisehat.pk/disease/anorexia-nervosa">anorexia nervosa</a>.

<div>&nbsp;</div>

Understanding FAQs about Anorexia Nervosa

<h5 style="margin-left:0px; margin-right:0px">What Happens to your Body in Anorexia?</h5>

&nbsp;

Besides the mental pressure, your body is deprived of the necessary energy due to malnutrition. As a result, your body&#39;s normal functioning will slow down, which will further affect your health in various negative ways.

&nbsp;

One of the complications of anorexia is your body&#39;s organs will stop working, especially in the later stages. For instance, if your blood test shows elevated levels of liver enzymes, then that&rsquo;s an indication of organ failure. Also, the electrolyte imbalance and fluid loss in the body induced by malnutrition can affect the heart, kidneys, GIT, and brain<a href="#accordion">[7]</a>. 
&nbsp;

<h5 style="margin-left:0px; margin-right:0px">Will Anorexia Damage your Brain?</h5>

<h5>&nbsp;</h5>

Anorexia is a mental health condition characterized by compulsive food restriction. Many anorexics reportedly have cognitive problems as a result of their restricted diet. In severe cases, it does lead to brain damage. 
&nbsp;

<h5 style="margin-left:0px; margin-right:0px">Is Anorexia Nervosa an Inherited Disorder?</h5>

<h5>&nbsp;</h5>

Although it&rsquo;s considered a psychological issue, the eating disorder frequently runs in families, implying that it has a genetic component. Researchers have discovered 2 genes that help determine the risk of having the disease<a href="#accordion">[8]</a>. Furthermore, studies have also shown that if your parents, siblings, or even your child is anorexic, then the risk of you having the disorder is also high - at least, 10 times higher than those who have no family connection whatsoever to the eating disorder<a href="#accordion">[9]</a>. 
&nbsp;

<h5 style="margin-left:0px; margin-right:0px">What is the Normal age of Onset?</h5>

<h5>&nbsp;</h5>

Anorexia nervosa has recently been observed in children as young as 6. However, the normal age of onset is 14-21<a href="#accordion">[10]</a>. Most girls are likely to develop anorexia nervosa when they are around the age of 15<a href="#accordion">[1]</a>. These are critical developmental years; therefore, adolescent anorexia nervosa treatment is necessary in this case. If your anorexic kid is an adolescent, it is usually best to look for a treatment tailored to this age group.&nbsp; 
&nbsp;

Anorexia can affect anyone, but it is much more common in females and girls. It usually occurs in teenage or early adulthood. 
&nbsp;

<h5>When should you Worry about Anorexia? 
&nbsp;</h5>

You should be worried if:

<ul>
	<li>You are constantly preoccupied with dieting, food, calories, and weight</li>
	<li>You make a lot of complaints about being &quot;fat&quot;&nbsp;</li>
	<li>You refuse to consume entire food groups, such as carbohydrates 
	&nbsp;</li>
</ul>

<h5>Which Doctor should you see for Anorexia Nervosa? 
&nbsp;</h5>

In addition to an eating disorder therapist, it is necessary to seek the advice of a psychiatrist. 
&nbsp;

<h5>What Effects does Anorexia have on your Personality?</h5>

&nbsp;

Have you felt an increased level of harm avoidance of late? That is a personality trait characterized by worry, negative thinking, doubt, and shyness. And you&rsquo;ll be experiencing it if you suffer from anorexia. 
&nbsp;

<h5>How&rsquo;s Amenorrhea Linked to Anorexia Nervosa?&nbsp; 
&nbsp;</h5>

If you are restricting your caloric intake through excessive diet or excessive exercise, your body won&rsquo;t be able to obtain the nutrition it needs to function; your hormone levels will drop and your periods will stop. This absence of periods is known as amenorrhea and it will affect you once you lose a certain amount of weight. 
&nbsp;

<h5>Can Anorexic Women Recover and Become Pregnant? 
&nbsp;</h5>

A complete recovery from anorexia means you will have a better shot at pregnancy. This is because as an anorexic woman, you&rsquo;ll neither menstruate nor ovulate<a href="#accordion">[11]</a>. As a result, it&rsquo;s more difficult to become pregnant at that stage. 
&nbsp;

<h5>Can Anorexia Harm Your Baby during Pregnancy? 
&nbsp;</h5>

If you do become pregnant while you&rsquo;re still anorexic, both you and your baby will suffer. It&rsquo;s highly probable that you have a premature delivery and your baby has a low birth weight. Moreover, it&rsquo;s a complicated pregnancy because anorexia can lead to a miscarriage or it can require an emergency Caesarean section; as an anorexic mom-to-be, you will also be more vulnerable to postpartum depression<a href="#accordion">[11]</a>. 
&nbsp;

<h5>What Effects will Anorexia have on a Male Body? 
&nbsp;</h5>

Anorexia causes a decrease in the male hormone testosterone and vitamin D. Testosterone contributes to the strength of muscles and bones. Low testosterone is directly linked to loss of bone mineral density and anorexic males experience it more than female anorexic patients<a href="#accordion">[7]</a>. 
&nbsp;

<h5>Does Anorexia Nervosa Trigger Hair Loss? 
&nbsp;</h5>

Hair loss is frequently linked to eating disorders like anorexia nervosa. This is because of the eating-related behaviors practiced by individuals with these conditions, such as starvation, self-induced vomiting, decreased food intake, and over-exercising, that cease nutrient intake and/or cause trauma or shock to trigger hair loss. 
&nbsp;

<h5>Does Anorexia Nervosa cause Seizures?&nbsp; 
&nbsp;</h5>

Seizures do not occur in every case of anorexia, but they are serious side effects that you should not ignore. Even if you do not have epilepsy or another epileptic condition, you may experience seizures due to anorexia.&nbsp; 
&nbsp;

<h5>Is Anorexia a Permanent Disorder? 
&nbsp;</h5>

You can reverse many temporary effects of anorexia if you and your doctor are able to diagnose and start on its treatment early. However, if it&rsquo;s left untreated for an extended period, anorexia can lead to a variety of long-term health issues, some of which are irreversible. 
&nbsp;

<h5>Can you overcome Anorexia Nervosa? 
&nbsp;</h5>

Although anorexia nervosa is a serious illness that can cause various health issues or even death when left untreated, recovery is possible with the assistance of eating disorder treatment specialists. This is why it&rsquo;s critical to educate yourself and begin your recovery process as soon as possible. 
&nbsp;

<h5>Do You need Hospitalization? 
&nbsp;</h5>

As an anorexic, you can experience severe, life-threatening weight loss. If your doctor believes that your life is in danger and they have no other choice, they may forcibly hospitalize you for better treatment. 
&nbsp;

<h5>Is Medication Beneficial for You?&nbsp; 
&nbsp;</h5>

No medications are approved for anorexia because none of them are effective.&nbsp;

&nbsp;

However, antidepressants and other psychiatric medications can help you deal with different mental health disorders, for example, depression or anxiety<a href="#accordion">[12]</a>. 
&nbsp;

<h5>What&rsquo;s the Prognosis of Anorexia Nervosa? 
&nbsp;</h5>

According to research, the standardized mortality ratio (SMR) for females is 15.9 and for males it&rsquo;s 22.4, with older age being a significant predictor of mortality. The mean age at death of an anorexic person is 41.3 years<a href="#accordion">[13]</a>. 
&nbsp;

<h5>How Often does Anorexia Lead to Death? 
&nbsp;</h5>

Anorexia can be dangerous to your health to the extent of causing death. Reports vary greatly, but generally the mortality rate ranges from 5-20%. Recent meta-analyses revealed a rate of 5.9%<a href="#accordion">[3]</a>. 
&nbsp;

<h5>How Long does it Take to Recover from Anorexia Nervosa?&nbsp; 
&nbsp;</h5>

No two people will be affected by anorexia the exact same way. Therefore, no two anorexia treatments will be the same. However, reportedly it takes a young anorexic patient anywhere between 6 months and 2 years to achieve complete healing<a href="#accordion">[14]</a>. 
&nbsp;

<h5>What is a Reasonable Goal for a Patient Suffering from Anorexia Nervosa? 
&nbsp;</h5>

The primary goal of your treatment should be to regain a healthy weight. You will not be able to get better from anorexia unless you return to a healthy weight and learn to consume appropriate nutrition.&nbsp; 
&nbsp;

The Netflix film &quot;To the Bone&quot; (2017) is a semi-autobiographical story about a 20-year-old girl struggling with anorexia nervosa and her recovery. It&rsquo;s a good representation of the various behaviors that may be displayed by someone suffering from an eating disorder.&nbsp;

&nbsp;

If you or someone you know is suffering from anorexia, don&rsquo;t sit there assuming that they&rsquo;re aware of their condition and will know when to ask for help. Anorexics often underestimate the severity of their illness and are hesitant to seek treatment. Early involvement schemes, such as education and screening, are critical to prevent persistent malnutrition, long-term health problems, and death.&nbsp; 
&nbsp;

<ul><li>Low body weight, a fear of gaining weight, and a distorted body image can all be symptoms of the potentially fatal eating illness anorexia.</li><li>Although it can afflict people of many ages, genders, races, and body types, anorexia is most frequently found in young women.</li><li>Anorexia can be treated successfully. Early assistance can aid in rehabilitation.</li></ul>

[1] van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;34(6):515.

[2] Silén Y, Sipilä PN, Raevuori A, Mustelin L, Marttunen M, Kaprio J, et al. DSM-5 eating disorders among adolescents and young adults in Finland: A public health concern. Int J Eat Disord. 2020;53(5):790–801.

[3] Neumärker KJ. Mortality and sudden death in anorexia nervosa. Int J Eat Disord. 1997 Apr;21(3):205–12.

[4] Wu H, Van Dyck-Lippens PJ, Santegoeds R, van Kuyck K, Gabriëls L, Lin G, et al. Deep-brain stimulation for anorexia nervosa. World Neurosurg. 2013;80(3–4):S29--e1.

[5] Till C. The quantification of gender: Anorexia nervosa and femininity. Heal Sociol Rev. 2011;20(4):437–49.

[6] Anorexia nervosa:symptoms, causes, diagnosis, treatment. WebMD.

[7] Mehler PS, Brown C. Anorexia nervosa - medical complications. Journal of eating disorders.

[8] How eating disorders are inherited. Science.

[9] Holland K. Is anorexia genetic? Healthline.

[10] GAfor. A beginner's guide to understanding anorexia nervosa. Resources To Recover.

[11] Anorexia nervosa. Anorexia nervosa | Office on Women's Health.

[12] Anorexia nervosa. Mayo Clinic.

[13] Yager J, Gaudiani JL, Treem J. Eating disorders and palliative care specialists require definitional consensus and clinical guidance regarding terminal anorexia nervosa: Addressing concerns and moving forward. Journal of Eating Disorders. 2022;10(1). doi:10.1186/s40337-022-00659-x

[14] Lauren Muhlheim PD. Why full anorexia recovery is crucial for Brain Health. Verywell Mind.

Neelam Asad

The Impact Of Stress On Weight Gain/Loss And Mental Health

In today&#39;s fast-paced and demanding world, <a href="https://merisehat.pk/disease/stress">stress </a>has become an inevitable part of our lives. Whether it&#39;s due to work pressure, relationship issues, financial concerns, or any other life challenge, stress affects us all at some point. Not only does stress take a toll on our mental well-being, but it can also have a profound impact on our physical health, particularly when it comes to weight gain or loss. 
&nbsp;

&quot;I always tell my clients to have fun when working out with me,&quot; says 33-year-old Ahsan Shah, a fitness trainer and consultant based out of Karachi with over 15 years of experience in managing fitness and weight loss with clients in both Karachi and Dubai. &quot;If they&#39;re not having fun and are stressed out, it will impact not only their motivation but also their cortisol levels,&quot; he says. &quot;This affects everything: whether they will be consistent in pursuing a healthy exercise and diet regimen and most importantly, how their body will respond to it.&quot;&nbsp;

&nbsp;

Weight gain and Stress

<h5>Weight Gain And Stress</h5>

Stress can significantly contribute to weight gain for various reasons. One of the main factors is the hormonal response triggered by stress. When we are under stress, our body releases cortisol, often referred to as the &quot;stress hormone.&quot; Cortisol plays a crucial role in regulating metabolism, blood sugar levels, and energy balance. However, prolonged or chronic stress can lead to consistently elevated cortisol levels, which can disrupt these processes.

Increased cortisol levels can cause an increase in appetite, particularly for foods that are high in sugar, fat, and calories. This can lead to overeating and indulging in unhealthy food choices as a way to cope with stress. Additionally, cortisol can promote the accumulation of fat, especially around the abdominal area, which is associated with an increased risk of various health problems, including cardiovascular diseases and<a href="https://merisehat.pk/disease/diabetes-type-1-and-2"> type 2 diabetes</a>.

Furthermore, stress can disrupt sleep patterns. Lack of sleep or poor-quality sleep is linked to weight gain as it affects hunger-regulating hormones, such as leptin and ghrelin. When we don&#39;t get enough sleep, ghrelin levels increase, stimulating hunger, while leptin levels decrease, reducing feelings of fullness. This imbalance can lead to excessive calorie intake and weight gain over time. 
&nbsp;

<h5>Weight Loss And Stress</h5>

On the other hand, stress can also lead to weight loss in some individuals. During stressful periods, some people may experience a loss of appetite or have difficulty eating due to digestive disturbances. This can result in inadequate nutrition and unintentional weight loss. Moreover, stress can increase metabolic rate and energy expenditure, causing some individuals to burn more calories than they consume, leading to weight loss. 
&nbsp;

<h5>Mental Health And Stress</h5>

The impact of stress on mental health is widely recognized. Chronic stress can contribute to the development or exacerbation of mental health conditions such as anxiety and depression. These conditions can have a profound effect on a person&#39;s overall well-being and can further contribute to weight gain or loss.

Stress and mental health are closely intertwined. For some individuals, stress can trigger emotional eating or binge eating episodes as a coping mechanism to alleviate negative emotions. This can create a vicious cycle where stress leads to unhealthy eating habits, resulting in weight gain, and in turn, worsening mental health symptoms.

Conversely, stress can also lead to loss of appetite, decreased interest in food, or even disordered eating patterns. In severe cases, chronic stress can contribute to the development of eating disorders like anorexia nervosa or bulimia nervosa, which can have serious consequences on both physical and mental health. 
&nbsp;

<h5>Managing Stress And Promoting Well-being</h5>

To mitigate the negative effects of stress on weight and mental health, it is crucial to implement effective stress management strategies. Here are some recommendations: 
&nbsp;

<ul>
	<li>Regular Exercise: Engaging in physical activity can help reduce stress levels, promote weight management, and enhance overall well-being. Exercise releases endorphins, the body&#39;s natural mood elevators, which can counteract the negative impact of stress hormones. 
	&nbsp;</li>
	<li>Balanced Diet: Adopting a balanced diet rich in whole foods, fruits, vegetables, lean proteins, and healthy fats can support both physical and mental health. Avoid using food as a coping mechanism for stress and opt for healthier stress-relief strategies. 
	&nbsp;</li>
	<li>Adequate Sleep: Prioritize good sleep hygiene and aim for seven to eight hours of quality sleep each night. Establishing a consistent sleep routine can improve stress resilience, aid in weight management, and enhance mental clarity. 
	&nbsp;</li>
	<li>Stress Reduction Techniques: Explore stress reduction techniques such as meditation, deep breathing exercises, yoga, or mindfulness practices. These techniques can help calm the mind, reduce cortisol levels, and promote relaxation. 
	&nbsp;</li>
	<li>Seek Support: Don&#39;t hesitate to reach out for support from friends, family, or mental health professionals. Talking about your stressors and emotions can provide relief and help you develop healthier coping mechanisms. 
	&nbsp;</li>
</ul>

bottom Line

Stress can have a significant impact on both weight management and mental health. It is important to recognize the interplay between stress, weight gain/loss, and mental well-being. By implementing effective stress management strategies and seeking support when needed, individuals can better navigate the challenges of stress and promote their overall health and well-being.

Umna Salah

Weight Loss Supplements Exposed

Obsessed with quick fixes and instant results? Well, I don&rsquo;t blame you. Aren&rsquo;t we all? Especially when it comes to securing the hourglass shape worthy of glossy magazine covers. The only issue is &ldquo;we don&rsquo;t have time&rdquo; for the (tried and tested) diet/exercise route.&nbsp;

So now imagine if we were to go to a pharmacy and see weight loss supplements placed strategically next to the counter. Imagine the pharmacist saying we don&rsquo;t need a prescription and that they yield magnificent results. The allure is simply undeniable. But is it love at first sight or a scam at first sight?

How do we know if they deliver on their claims or if they are just another gimmick in a crowded market? Let&rsquo;s discover the real story of these pills and potions! 
&nbsp;

Understanding weight loss supplements

Over-the-counter (OTC) weight loss supplements are readily available in pharmacies, health food stores, and online platforms without a prescription. They come in various forms, including pills, powders, and teas, claiming to aid <a href="https://merisehat.pk/article/weight-loss-supplements-exposed">weight loss</a> through mechanisms such as fat burning, appetite suppression, or metabolism boosting.

For instance, if you&rsquo;re obese, then appetite supplements can make you feel full faster or lessen your appetite so that your calorie intake is reduced and you&rsquo;re able to lose weight. Alternatively, fat-burning supplements increase the resting metabolic rate and reduce fat absorption by your body.

One of the primary concerns surrounding over-the-counter weight loss supplements is their safety. Unlike prescription medications, these supplements are not subject to rigorous testing and regulation by health authorities. As a result, their safety profiles can be uncertain, with the potential for adverse effects ranging from mild digestive issues to serious health complications. 
&nbsp;

Studies have shown that some ingredients commonly found in these weight loss pills, such as caffeine and green tea extract, may have modest effects on weight loss when combined with diet and exercise. However, the magnitude of these effects is often small, and long-term sustainability is questionable. Simply put, more research is needed to corroborate these results.

Recently, there has been growing scrutiny and calls for stricter regulation of OTC weight loss supplements. Health authorities have raised concerns about misleading marketing claims, undisclosed ingredients, and contamination with harmful substances. Despite efforts to improve transparency and oversight, challenges remain in ensuring the safety and efficacy of these products. 
&nbsp;

Some popular OTC supplements available include:<a href="#accordion">[1][2][3]</a>

<ul>
	<li>Orlistat &ndash; According to a review of controlled trials, the medication is said to provide a significant decrease in body weight. Side effects of weight loss pills include gastrointestinal issues and risk of kidney damage. It is recommended with a low-fat, low-calorie diet for adults with a BMI of 25 or above.</li>
	<li>Garcinia Cambogia &ndash; One review showed mixed results, with some people losing weight and others not. Adverse effects include nausea, headaches, and risk of liver damage.</li>
	<li>Glucomannan &ndash; It&rsquo;s not confirmed whether this fiber supplement promotes weight loss or not. Side effects include feeling bloated. It is generally recommended for females, especially when combined with garcinia cambogia.</li>
	<li>Conjugated Linoleic Acid &ndash; Believed to promote weight loss, this supplement may also lower HDL cholesterol levels and some people have even experienced greater insulin resistance and heart attacks after taking it.</li>
	<li>Green Tea &ndash; Consumed as a pill or in beverage form, it reportedly aids metabolism. It may also have an antioxidant, anti-inflammatory, and anti-cardiovascular effect. However, there is little research on its long-term effectiveness for weight loss. 
	&nbsp;</li>
</ul>

Note: The FDA has banned certain drugs for consumer use, including sibutramine and lorcaserin. Check with your doctor before buying these drugs. 
&nbsp;

If you&rsquo;re considering any of these products, it&#39;s essential to approach them with caution and skepticism. Remember, they&rsquo;re not medicines that would help treat or cure your condition.

Consulting with a healthcare professional before starting any new supplement regimen is advisable, especially if you have any underlying health conditions and allergies or if you&rsquo;re taking medications. You should also reconsider buying and using weight loss supplements if you&rsquo;re pregnant or breastfeeding.<a href="#accordion">[1]</a>

You may need to take a few vitamins and minerals, such as B-complex, multivitamins, iron, and magnesium, to give your body the extra boost it needs to ensure it keeps functioning effectively for weight loss.<a href="#accordion">[3]</a>

However, focusing on sustainable lifestyle changes, such as a balanced diet and regular exercise, remains the cornerstone of successful weight management. According to the CDC, losing 1-2 pounds per week through lifestyle modifications is a more sustainable option than shedding weight quickly.<a href="#accordion">[4]</a> 
&nbsp;

While some ingredients may offer modest benefits, the overall landscape of over-the-counter weight loss supplements is fraught with uncertainty. As consumers, it&#39;s crucial to be informed and prioritize evidence-based approaches to achieve long-term health and wellness goals. 
&nbsp;

<ul>
	<li>Over-the-counter weight loss supplements are widely accessible in various forms, including pills, powders, and teas, marketed to aid weight loss through mechanisms such as fat burning, appetite suppression, or metabolism boosting.</li>
	<li>Unlike prescription medications, they are not subject to rigorous testing and regulation by health authorities, raising concerns about their safety. Adverse effects, ranging from mild digestive issues to serious health complications, may occur.</li>
	<li>Efforts to improve transparency and oversight are underway, but concerns persist.</li>
	<li>Consult your doctor before starting any new supplement regimen, especially if you have any underlying health conditions or are taking medications.</li>
	<li>Sustainable lifestyle changes, such as a balanced diet and regular exercise, remain the cornerstone of successful weight management.</li>
</ul>

[1] Malia Frey MA. Your complete guide to weight loss pills and supplements. Verywell Fit. Accessed April 2, 2024

[2] Kubala J. 12 over-the-counter appetite suppressants reviewed. Healthline. September 25, 2018. Accessed April 2, 2024.

[3] Cafasso J. What are the best nutrients to boost your metabolism? Healthline. February 6, 2023. Accessed April 2, 2024.

[4] A guide to the top weight loss supplements in 2024. Forbes. April 1, 2024. Accessed April 2, 2024.

Shermeen Zuberi

Kickstarting Weight Loss: 10 Morning Habits To Embrace

The morning sets the tone for the rest of the day. By adopting a series of intentional habits, you can jumpstart your weight loss journey and create a positive foundation for achieving your fitness goals. 
&nbsp;

series of Morning Habits

<h5>1. Hydration Kickstart: Begin With A Glass Of Water</h5>

Drinking a glass of water as soon as you wake up helps kickstart your <a href="https://merisehat.pk/article/weight-loss-tips-avoid-these-8-habits-slowing-down-your-metabolism">metabolism </a>and hydrates your body after hours of sleep-induced dehydration. 
&nbsp;

<h5>2. Mindful Breakfast: Opt For Nutrient-Rich Choices</h5>

Choose a balanced breakfast that includes lean protein, whole grains, and healthy fats. A nutritious breakfast stabilizes blood sugar levels, reduces cravings, and provides sustained energy. 
&nbsp;

<h5>3. Morning Movement: Engage In Light Exercise</h5>

Whether it&#39;s a brisk walk, a few yoga stretches, or bodyweight exercises, incorporating light movement in the morning boosts circulation, metabolism, and overall energy levels. 
&nbsp;

<h5>4. Mindful Eating: Eat Slowly And Mindfully</h5>

During meals, focus on your food and eat slowly. Mindful eating promotes better digestion, prevents overeating, and allows your brain to register when you&#39;re full. 
&nbsp;

<h5>5. Protein-Packed Breakfast: Prioritize Protein</h5>

Protein-rich breakfasts keep you feeling full and satisfied, reducing the likelihood of overeating later in the day. Incorporate eggs, Greek yogurt, or plant-based protein sources. 
&nbsp;

<h5>6. Set Positive Intentions: Visualize Your Day</h5>

Take a few moments to set positive intentions for the day ahead. Visualize yourself making healthy choices and achieving your weight loss goals. 
&nbsp;

<h5>7. Meal Prep: Plan Your Meals</h5>

If possible, plan your meals and snacks for the day. Having healthy options readily available reduces the likelihood of making impulsive, less nutritious choices. 
&nbsp;

<h5>8. Get Sunlight Exposure: Step Outside</h5>

Exposing yourself to natural sunlight in the morning helps regulate your circadian rhythm, improves mood, and supports overall well-being. 
&nbsp;

<h5>9. Fiber Boost: Prioritize Fiber-Rich Foods</h5>

Include high-fiber foods in your breakfast, such as whole grains, fruits, and vegetables. Fiber aids digestion, promotes satiety, and stabilizes blood sugar levels. 
&nbsp;

<h5>10. Positive Affirmations: Practice Self-Encouragement</h5>

Engage in positive self-talk and affirmations. Cultivating a positive mindset helps reduce stress and emotional eating, contributing to a healthier lifestyle. 
&nbsp;

The morning is a powerful time to lay the foundation for your weight loss journey. By adopting these intentional habits, you create a proactive and positive start to your day. Remember that consistency is key, and over time, these habits can lead to significant progress in your pursuit of a healthier, happier you.

Rukhsana Rizwan

Recent research suggests that <a href="https://merisehat.pk/article/the-intricate-relationship-between-weight-gainloss-and-depression">weight gain</a> is more than part of the recovery process: individuals with T1D are more prone to putting on excess body weight than those without the condition. Compared to the general population, nearly 50% of the patients with T1D have greater hip and waist circumferences, making them either overweight or obese.<a href="#accordion">[1][2]</a>

Understanding the reasons behind this phenomenon and adopting appropriate strategies can help you manage diabetes effectively. 
&nbsp;

Understanding weight gain in type 1 diabetes

There are several causes of weight gain if you have T1D. 
&nbsp;

<ul>
	<li>
	<h5>Insulin Therapy</h5>
	</li>
</ul>

You need insulin to maintain optimal sugar levels. However, the therapy may also enable your body to store glucose as fat, subsequently leading to weight gain. 
&nbsp;

<ul>
	<li>
	<h5>Insulin Resistance</h5>
	</li>
</ul>

This is a condition where your body becomes less responsive to insulin. Your doctor may recommend higher doses or change the type of insulin to keep your sugar levels under control. There&rsquo;s one side effect, though &ndash; weight gain. 
&nbsp;

<ul>
	<li>
	<h5>Hypoglycemia</h5>
	</li>
</ul>

When your blood sugar levels drop too low, it can trigger intense hunger. You may end up overeating. If these episodes are frequent, they may lead to weight gain over time. 
&nbsp;

<ul>
	<li>
	<h5>Lifestyle</h5>
	</li>
</ul>

Not being active, having unhealthy eating habits, and even stress can be dangerous in terms of contributing to weight gain with T1D. 
&nbsp;

There&rsquo;s no one-size-fits-all strategy to lose weight. What works for&nbsp; someone may not be suitable for you.<a href="#accordion">[2]</a> 
&nbsp;

<ul>
	<li>
	<h5>A Healthy BMI</h5>
	</li>
</ul>

Before getting started on your weight loss journey, you need to know what a healthy BMI is for you. Your BMI is a ratio of your height and weight. A BMI of 25-30 is considered overweight, while over 30 makes you obese.

Your waist size usually depends on both your ethnicity and gender. For instance, women should ideally have a waist size of less than 80 cm, whereas men should aim for a waist size less than 94 cm. 
&nbsp;

<ul>
	<li>
	<h5>A Healthy Diet</h5>
	</li>
</ul>

It&rsquo;s great to sit down with your diabetes team before trying any new diet. Anything you eat will likely influence your blood sugar levels and your medication.

That said, the rule of thumb is that men require 2500 kcal/day and women require 2000 kcal/day for a healthy weight. However, this may vary given how active you are or what your weight management goals are.

You may want to focus on portion control and whole foods, such as lean proteins and whole grains. Drink water instead of sugary drinks, and don&rsquo;t take those second helpings. Also, try avoiding processed foods as much as possible.

In simple words, just don&rsquo;t skip meals and check your blood sugar levels regularly to avoid episodes of hypoglycemia.

Note: Don&rsquo;t worry if you don&rsquo;t see progress overnight or occasionally stop tracking your calories. The emotional stress may make you binge even more. 
&nbsp;

<ul>
	<li>
	<h5>Regular Physical Activity</h5>
	</li>
</ul>

Try to aim for nearly 30 minutes of moderate exercise for most days of the week. This will regulate your blood sugar levels. Moreover, techniques like yoga exercises can help reduce stress and prevent weight gain. 
&nbsp;

<ul>
	<li>
	<h5>Surgery</h5>
	</li>
</ul>

This is often kept as a last resort. Ask your doctor if you qualify for bariatric surgery. There are different types of options available, which influence how your gut hormones work and the way your body uses insulin, making them effective for weight loss. 
&nbsp;

Important!

Do not reduce or skip your insulin dosage to stop the weight gain. It is important to take your medications, insulin included, as directed by your doctor. Discuss your weight gain with your doctor to find effective solutions. 
&nbsp;

Losing extra weight will help you reduce your risk of complications like stroke and heart disease. Even losing 5% of your weight can greatly improve your cholesterol and blood pressure, which affects your overall health.

While weight gain can be a challenge for individuals with T1D, adopting healthy lifestyle habits and working closely with healthcare providers can help manage this issue effectively. 
&nbsp;

Key Takeaways

<ul>
	<li>If you have type 1 diabetes, insulin therapy, insulin resistance, binging during hypoglycemic episodes, and leading a sedentary lifestyle can contribute to weight gain.</li>
	<li>You can achieve better overall health and well-being by focusing on balanced nutrition, regular exercise, and proactive diabetes management.</li>
</ul>

[1] Mottalib A, Kasetty M, Mar JY, Elseaidy T, Ashrafzadeh S, Hamdy O. Weight Management in Patients with Type 1 Diabetes and Obesity. Curr Diab Rep. 2017;17(10):92. Published 2017 Aug 23. doi:10.1007/s11892-017-0918-8