Reduction of the life expectancy, diabetes, osteoarthritis, cancer, and cardiovascular diseases… The excess of weight is today a true threat for the organism. Statistically, this problem affects 1 in 3 French adult for the overweight (BMI between 25 and 30) and 1 in 10 for obesity (BMI higher than 30). Far from being exclusively a French problem, this plague is now being regarded as a world epidemic by the WHO: just in 2005, 25% of Americans were affected by obesity while they were 15% in England, Germany and Poland!

The pace of life called into question
This rise on the domestic scales is due to several reasons. Above all, to an excessively rich food (too many saturated fats and free sugars). This increase in calories is influenced since early youth by advertisements for products rich in fat and sugars… 2nd overweight factor: the decrease in physical activity related to technical progress (car, elevator, moving walkways…). The 3rd cause is of psychological origin. Missing, discomfort, separation, stress… It is then frequent to eat more than would be reasonable to compensate. Lastly, 4th and last vector for being overweight: genetic predisposition(less than 2% of the cases).

CALCULATE YOUR BMI
Before ringing the alarm belland seeking solutions, it is advisable to estimate the body mass undex (BMI). Its calculation is simple: weight (kg) divided by size2 (m).
Example: 70 kg / (1.75 X 1.75 m, or 3.0625 m2) = BMI of 22.9 (kg/m2). The only thing remaining to be determined is the nutritional state according to the WHO classification:

STATE ------BMI
Lean -------Less than 18.5
“normal” ---between 18.5 and 24.9
overweight -between 25 and 29.9
obese ------higher than 30

It should be noted that if the BMI is a reliable method for adults from 20 to 65 years of age, it is not, on the other hand, for the other age brackets and for pregnant women and athletes. Moreover, even if this index remains useful to get a general idea of the fatty mass, it remains insufficient for a precise diagnosis. The most important for that is to locate the site of adipose tissues (belly, hips, buttocks, face…) and their quantity.

There are solutions
To overcome the problem of weight overload, three great solutions are available: self prescription of weight loss products, nutritional reeducation with a specialist and following the “National Nutrition Health Program” (PNNS, programme national nutrition santé).

Self-medication: A short term answer
“It is easier to change religion than to change food habits”. This well-known saying in the diet world is confirmed by Dr. Alain Lecomte, pharmaco-vigilance manager at Arkopharma (French leader for self medication and for the sale of weight loss products). The doctor continues: “The food habits are anchored very deeply. They are part to the cultural identity. “ For more than 20 years the pharmaceutical laboratories in the whole world have taken advantage of this marketing opportunity: offering weight loss products which do not impose changing food habits. A practical solution. However limited. “For the treatment of the weight overload, self medication provides a temporary solution but can in no terms be considered a finality.” explains Dr. Lecomte. Because on this point, it is necessary to be clear: the field of intervention of the weight loss products is that of a few kilograms to be lost. “The obesity problems are to be dealt by medicine.” wants to emphasize the Arkopharma manager. How to test these products? Simple: just go to any pharmacy where they are available over the counter (no need for a prescription) and ask some advice to the pharmacist. “For the weight loss segment, we have in the pharmacy 30 low-calorie meal substitutes and as many plant-based treatments” explains Dr. Lecomte. 60 references just for one laboratory: Impressive! A good health which is easily explained… First, 80% of French declare being dissatisfied of their weight. Second: in themarket for food complements, weight loss constitutes, by far, the largest share of the sales for French pharmacies (139 million e in 2005, +14% compared to 2004). How do these weight loss products work: advantageously replacing meals by substitutes and destroying fat through treatments containing natural products (active lipolytics, soluble fibers, plants with caffeine…). The Arkopharma doctor concludes: “In all the cases, the suggested treatments are of short duration. Our range of weight loss products provides a help at the beginning, it does not pretend to replace true food hygiene.” Nutritional reeducation: a long term solution “Even if resorting to weight loss products is often the first reflex, this approach does not work.” Pascal Bonnefoi, nutritionist physician is categorical: thinking in term of pounds does not work. Because if the weight loss does indeed occur, the relapse, is direct. The specialist goes on: “it is necessary to go to the source of the problem to eradicate it, otherwise it occurs again.” Well-known by diet followers, this mechanism (pointed at as principal defect of the commercial products) is called the “yoyo effect”. The creed of the nutritionist physicians is very different. It is indeed, much more a question of learning how to stabilize rather than learning how to lose weight. With this in mind, these specialists propose a nutritional reeducation. In summary: provide the body with what it needs to function without any deficiency risk while indulging from time to time. “We start by evaluating the status” explains Pascal Bonnefoi, “in other words, an investigation into the food habits of the patient coupled with a blood biological evaluation”. This results in a customized weight loss program: protein rich pouches which satisfies while preserving the muscle (attack phase) and rebalancing the protein, sugar and lipid intakes (maintenance phase). A typical day? One fruit, a dairy product, a drink and cereals for breakfast. Salad, white meat, a starchy food and a fruit for lunch. “A snack in the afternoon with a dairy product or a fruit” continues the specialist “And for dinner, the same thing as for lunch, less the starchy foods. Because the body does not need as much energy to sleep… “In addition to the distribution of nutrients, the total number of calories does matter. Confirmation from Pascal Bonnefoi: “For a non active man, a good estimate is around 2 200 Kcal/day (1 800 Kcal for a woman). To be distributed with the greatest possible number of meals. “Indeed, with an equal energy contribution (without confusing eating and nibbling), one meal/day tends to increase weight while 5, 6, 7 or even 8 reduces it. Good to know… “The key for stabilization” adds the nutritionnist physician “resides in the physical activity which makes it possible to increase the
energy expenditure.” Less IN and more OUT: the weight maintenance is quite simply due to the ratio between the caloric intake and the burned calories. Last point: monitoring. To make sure that their patients continue to eat correctly, once the desired weight has been reached, the specialists carry out a dietetic follow-up for as many months as of the numbers of lost kilograms (example: 8 kg lost mean one visit per month for 8 months). Objective: food autonomy, only means of avoiding any relapse.

PNNS: a simple but effective food hygiene
3rd solution : follow the State recommendations. Alerted by the medical profession, the French political power became aware of the extent of the phenomenon (the number of obese children doubled in 5 years) and of its social as wel as economic repercussions: obesity costs more than 6 billion euros per year for the medical insurance! Consequently, since January 2001, the State declared it “a public health priority” and established the “National Nutrition Health Program” (PNNS, programme national nutrition santé). What is it about? The PNNS is a set of food recommendations aiming at improving the health of the population. To publicize them, the State exploits a battery of means of communication: diffusion of a national guide, media campaign, proximity networks and Internet site (www.mangerbouger.fr).
 
Which method to adopt?
These three principal solutions each have advantages and disadvantages. The PNNS one is entirely free (no medical fees or any purchase of weight loss products) but requires a great personal discipline to follow the program without help. Self medication of weight loss products represents an inexpensive solution (public prices ranging between 5 and 15 Û for treatments lasting 10 days to 1 month) but only effective for short-term. Careful with the yoyo effect! Lastly, nutritional reeducation remains the most expensive solution: for a treatment of “10 kg weight loss”, between 1 000 and 1 500 Û for a man (16 visits + 100 protein-rich pouches) and between 1 200 and 1 700 Û for a woman (18 visits + 130 proteinrich pouches). But considering the results, it seems like the healthiest solution and the most advantageous one because durable on the long-term.

PNNS RECOMMENDATIONS
Fruits and vegetables: at least 5 per day
With each meal and in the event of a snack. Raw, cooked, natural or prepared. Fresh, frozen or in a can
Breads, cereals, potatoes and dry vegetables: with each meal and according to your appetite
Favor complete cereal food or the country bran bread. Favor variety
Milk and dairy products (yoghourts, cheeses): 3 per day
Favor variety. Favor the cheeses that are richest in calcium, with the least fat and the least salted
Meat, poultry, sea food and eggs: 1 to 2 times per day
In a quantity lower than that of the accompanying dish. Meats: favor variety of the species and
the least fat pieces. Fish: at least twice a week
Added fat: limit consumption
Favor vegetable fat (colza, olive oils…). Favor variety. Limit animal fat (butter, creams…)
Sweet products: limit consumption
Pay attention to sweetened drinks. Pay attention to fat and sweet food (pastries, desert, chocolate, ice cream…)
Drinks: water at will
During and between meals. Limit sweetened drinks (favor light drinks). Alcoholic drinks: not to exceed,
per day, 2 glasses of wine for women and 3 for men (2 glasses of wine are equivalent to 2 pints of beer
or 6 cl of strong alcohol)
Salt: limit consumption
Favor iodized salt. Do not salt before tasting. Reduce salt in cooking water. Limit the most salted cheeses and
delicatessen and the salted appetizers
Physical activity: at least the equivalent of a half hour of fast walk per day
To integrate in everyday life (walking, climbing stairs, bicycling…)