Weight loss treatments. INTRODUCTIONObesity is a major international public health problem and Americans are among the heaviest people in the world. The percentage of obese people in the United States rose steadily until 2. Because it so hard to keep weight off over time, it is important to have as much information and support as possible before starting a diet. You are most likely to be successful in losing weight and keeping it off when you believe that your body weight can be controlled. This article discusses how to get started with a weight loss plan, including changes in your behavior, what you eat, and weight loss medications. Weight loss surgery is discussed in a separate article. The BMI is calculated from your height and weight (calculator 1 and calculator 2). People who are obese and who have a larger waist size may need more aggressive weight loss treatment than others. Talk to your health care professional for advice. Types of treatment — Based on your measurements and your medical history, your doctor or nurse can determine what combination of weight loss treatments would work best for you. Treatments may include changes in lifestyle, exercise, dieting and, in some cases, weight loss medicines or weight loss surgery . Weight loss surgery, also called bariatric surgery, is reserved for people with severe obesity who have not responded to other weight loss treatments. Your first goal should be to avoid gaining more weight and staying at your current weight (or within 5 percent or 5 pounds). Many people have a “dream” weight that is difficult or impossible to achieve. Bipolar disorder 2, 3, 4, 10, 15; weight loss and obesity 7, 13, 14, 21, 24; alcohol dependence 8, 27; binge eating disorder 5, 29. DOSAGE FORMS AND STRENGTHS. Topiramate tablets are available containing 25 mg, 50 mg, 100 mg or 200 mg of Topiramate, USP. The 25 mg tablets are white, film coated. I just started Topamax. I'm on 25mg/day and will increase by 25mg/week until I reach 100mg. I heard the weightloss effect depends on the dose. People at high risk of developing diabetes who are able to lose 5 percent of their body weight and maintain this weight will reduce their risk of developing diabetes by about 5. This is a success. Losing more than 1. LIFESTYLE CHANGESPrograms that help you to change your lifestyle are usually run by psychologists, nutritionists, or other professionals. The goals of lifestyle changes are to help you change your eating habits, become more active, and be more aware of how much you eat and exercise, helping you to make healthier choices. This type of treatment can be broken down into three steps. To figure out what triggers you to eat, keep a record for a few days of everything you eat, the places where you eat, how often you eat, and the emotions you were feeling when you eat. For some people, the trigger is related to a certain time of day or night. For others, the trigger is related to a certain place, like sitting at a desk working or driving past a favorite fast- food outlet. Eating — You can change your eating habits by breaking the chain of events between the trigger for eating and eating itself. There are many ways to do this. For instance, you can. Whole grains, fruits, vegetables, nuts, and yogurt are associated with lower weight over four years, as contrasted with weight gain seen when eating french fried potatoes or chips, sugar- sweetened beverages, and red or processed meats . This is not a reward for weight loss; instead, it is a reward for changing unhealthy behaviors toward healthy ones. Do not use food as a reward. Some people find money, clothing, or personal care (eg, a haircut, manicure, or massage) to be effective rewards. Treat yourself immediately after making better eating choices to reinforce the value of the good behavior. You need to have clear behavior goals and you must have a time frame for reaching your goals. Reward small changes along the way to your final goal. Other factors that contribute to successful weight loss — Changing your behavior involves more than just changing unhealthy eating habits; it also involves finding people around you to support your weight loss, reducing stress, and learning to be strong when tempted by food. The support person needs to understand your goals. As an example, you will need to learn how to say “no” and continue to say no when urged to eat at parties and social gatherings. Topamax 25 mg Tablets - Summary of Product Characteristics (SPC) by Janssen-Cilag Ltd. Develop strategies for events before you go, such as eating before you go or taking low- calorie snacks and calorie- free drinks with you. This is why many commercial groups are successful. Family support is also essential; if your family does not support your efforts to lose weight, this can slow your progress or even keep you from losing weight. If you eat a piece of cake that was not planned, you may respond by thinking, “Oh, you stupid idiot, you've blown your diet!” and as a result, you may eat more cake. A positive thought for the same event could be, “Well, I ate cake when it was not on my plan. PACKAGE LEAFLET: INFORMATION FOR THE USER Topiramate Accord 25 mg film-coated tablets Topiramate Accord 50 mg film-coated tablets Topiramate Accord 100 mg film-coated. Medscape - Anticonvulsive, migraine-specific dosing for Topamax, Trokendi XR, Qudexy XR (topiramate), frequency-based adverse effects, comprehensive interactions. Now I should do something to get back on track.” A positive approach is much more likely to be successful than a negative one. It is important to find a way to get through these difficult times without eating or by eating low- calorie food, like raw vegetables. It may be helpful to imagine a relaxing place that allows you to temporarily escape from stress. With deep breaths and closed eyes, you can imagine this relaxing place for a few minutes. As with all weight loss programs, you are most likely to be successful with these plans if you make long- term changes in how you eat. CHOOSING A DIET OR NEW EATING PLANA calorie is a unit of energy found in food. Your body needs calories to function. The goal of any diet is to burn up more calories than you eat. A typical meal plan for one day may include. Low- fat foods are those that contain less than 3. Fat is listed on the food facts label (figure 1). For a 1. 50. 0- calorie diet, this would mean about 4. Low- carbohydrate diet — Low and very- low- carbohydrate diets (eg, Atkins diet, South Beach diet) have become popular ways to lose weight quickly. Meat and fish contain very few carbohydrates. Side effects of very- low- carbohydrate diets can include constipation, headache, bad breath, muscle cramps, diarrhea, and weakness. Mediterranean diet — The term “Mediterranean diet” refers to a way of eating that is common in olive- growing regions around the Mediterranean Sea. Although there is some variation in Mediterranean diets, there are some similarities. Most Mediterranean diets include. Use low- fat dairy products (skim milk, fat- free yogurt, low- fat cheese). Substitute fish or poultry for red meat. A modest amount is up to one (4 ounce) glass per day for women and up to two glasses per day for men. Which diet is best? Any diet will help you to lose weight if you stick with the diet. Therefore, it is important to choose a diet that includes foods you like. Fad diets — Fad diets often promise quick weight loss (more than 1 to 2 pounds per week) and may claim that you do not need to exercise or give up your favorite foods. Some fad diets cost a lot of money because you have to pay for seminars, pills, or packaged food. Fad diets generally lack any scientific evidence that they are safe and effective, but instead rely on . These plans are a waste of time and money and are not recommended. A doctor, nurse, or nutritionist can help you find a safe and effective way to lose weight and keep it off. WEIGHT LOSS MEDICINESTaking a weight loss medicine may be helpful when used in combination with diet, exercise, and lifestyle changes . However, it is important to understand the risks and benefits of these medicines. It is also important to be realistic about your goal weight using a weight loss medicine; you may not reach your “dream” weight, but you may be able to reduce your risk of diabetes or heart disease. A lower- dose version (brand name: Alli) is available without a prescription in many countries, including the United States. The recommended dose of the prescription version is 1 capsule three times per day, taken with a meal; you can skip a dose if you skip a meal or if the meal contains no fat. After one year of treatment with orlistat combined with lifestyle changes, the average weight loss is approximately 1. Cholesterol levels often improve and blood pressure sometimes falls. In people with diabetes, orlistat may help control blood sugar levels. Side effects occur in 1. These problems are more likely when you take orlistat with a high- fat meal (if more than 3. Side effects usually improve as you learn to avoid high- fat foods. Severe liver injury has been reported rarely in patients taking orlistat, but it is not known if orlistat caused the liver problems . Lorcaserin appears to have similar efficacy as orlistat. After one year, the mean weight loss is approximately 1. Adverse effects of lorcaserin included headache, upper respiratory infections, nasopharyngitis (inflammation in the nose and throat), dizziness, and nausea, occurring in 1. Lorcaserin is usually taken twice daily, with or without food. If you take lorcaserin, your doctor should monitor you closely to evaluate your weight loss. If you do not lose at least 5 percent of your initial body weight within 1. Lorcaserin should not be used in individuals with reduced kidney function or during pregnancy. In addition, lorcaserin should not be used with certain drugs (including many medications used to treat depression). Topiramate is used for the prevention of migraine headaches and epilepsy. Patients taking topiramate for these indications lose weight, but the way this works is uncertain. Phentermine and extended- release topiramate are available in combination as a single capsule (brand name: Qsymia). In one- year trials studying phentermine- topiramate, patients taking the medication lose approximately 8 to 1. If you do not lose 5 percent of your initial body weight after 1. The most common adverse events are dry mouth (1. There is also a risk of psychiatric (eg, depression, anxiety) and cognitive (eg, disturbance in attention) adverse events; this risk increases with larger doses of the medication. Although phentermine- topiramate improves blood pressure slightly, it is also associated with an increase in heart rate.
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