الفهرس 
INTRODUCTION
Diseases Associated with ObesityOnly 14 pages are availabe for public view
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Abstract
The general objective of the present study was to study the factors acting as obstacles to loss weight among obese individuals. To identify the patterns of bodyweight changes among obese individuals following body weight reducing programs. Investigate the obstacles to maintain reduction of body weight. Study the changes in body composition as a result of weight loss.
The study was designed as longitudinal and cross sectional study, involving subjects attending two nutritional obesity clinics in Alexandria. A total number of 203 obese individuals (42 males, 161 females) were selected randomly from individuals attending the obesity clinics. One hundred and twenty eight subjects were interviewed at their first visit to clinic were followed for 6 months. Another seventy five were studied retrospectively, through examination of their records, to obtain information relevant to the study variables.
Information obtained included name, Place of residence, age, sex, marital status, educational level, occupation and smoking. Personal and medical history and History of obesity which included onset of obesity, current body weight, previous attempts to reduce body weight, number of attempts to reduce body weight, period between attempts, type of attempts, supervision during attempts, rate and pattern of loss of body weight, obesity in family, reasons for trying to loss body weight, sources of knowledge about nutrition.
Body weight was measured to the nearest 0.1 kg using a digital floor scale. Height was taken by a stadiometer to the nearest centimeter with the subject standing barefooted. Waist circumferences were measured to the nearest centimeter using a flexible steel tape with the subject standing. Body composition measurements were measured by using Bioelectrical Impedance Analysis (BIA) is a method used to estimate adiposity. Body mass index was calculated as weight in kg divided by the height in meters squared.
The dietary treatment provided a standard hypocaloric balanced diet (1200–1350 kcal/d) with 15–20% of the energy intake from protein, 25–30% from lipid and 50–55% from carbohydrates. A high intake of complex carbohydrates and fiber was recommended. Patients were strongly encouraged to adhere to three main meals a day and two snacks based on fresh fruit. The patients were all strongly recommended to weekly follow up visits.
After completion of data collection, data were revised, coded and fed to the computer. Statistical analyses were carried out using SPSS version 13.0 software for tabulation and analysis.
Result of the study revealed that:
• Obese individuals tend to lack motivation to conform the program a good percent DROPped out within a short period of 3 months 30%. The number of those who discontinue increases by time to reach 60% by the end of 6 months.
• Not all those who get involved in weight reducing program lose weight, in 3 months about 61.58% lose body weight, 8% failed to lose body weight and 30% DROPped out.
• Most of the individuals who were involved in the program in their forty. Females seek help at an earlier age than males.
• Females seek help at body weight less than males.
• After 3 months there was a shift in the distribution of individuals from the higher body weight category to the lower one in both genders.
• After 6 months the shift in distribution from higher to lower body weight category continues.
• Males tend to lose body weight more than females but they regain their body weight at the end of 6 months whatever females more concerned about their body weight.
• The best response to lose body weight among females was observed among both youngest age group ≤20 years and the oldest age group 41+ years.
• Failure to reduce BMI and DROPping out were more in working individuals.
• Individuals who had several attempts to reduce body weight, failed to reduce body weight.
• Failure to reduce body weight was more among individuals who started obesity at childhood.
• Reduction of body weight was more among individuals with negative family history of obesity in their families.
• Percent of reduction of body weight increased by using combination of diet plan with other methods.
• By (BIA) the obese individuals who showed a positive response to the weight reducing program as indicated by a reduced BMI, had a lower initial BMI, smaller initial waist circumference, less initial percent total body fat, than those who failed to reduce their BMI. The weight of body fat, percent of fat, were lower in those who reduced the BMI. The lean body mass, the percent body water, total body water and resting basal metabolic rate were higher in those who reduced their BMI compared to those who failed to reduce their BMI. The individuals who were discouraged and DROPped out had the worst body composition.
RECOMMENDATIONS
• Prevention and treatment of overweight and obesity in children, adolescents and adults by monitor BMI and waist circumference as indication of obesity and predictor of chronic diseases.
• A comprehensive healthy lifestyle intervention (combining behavior and dietary modification, activity enhancement and dietary counseling) for overweight and obese people through education could be a long term preventive program.
• An energy-reduced diet and regular physical activity as the first treatment option for overweight and obese adults to achieve clinically important weight loss and reduce obesity-related symptoms.
• The role of schools should be stressed as pivotal settings for the promotion of healthy active living and school-based prevention programs to reduce the risk of childhood obesity and its consequences in adulthood.
• Future research should be directed at understanding the impact of, nutrition, physical activity levels, environments, biological factors, psychological factors and genetics on obesity and obesity-related health risk.