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Obesity - problems and interventions. Students are responsible for paying any fees associated with the completion of the background check. All students pursuing the Minor in Wellness must complete the following 18 semester credit hours:. The concept of how it works is actually not too complicated. The Flex Belt is perfect for the on-the-go consumer who feels he or she has no time to dedicate to staying in shape. Rice diet or other special diet supplements e.

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The Chinese Health Qigong Association, established in , strictly regulates public qigong practice, with limitation of public gatherings, requirement of state approved training and certification of instructors, and restriction of practice to state-approved forms.

Through the forces of migration of the Chinese diaspora , tourism in China , and globalization , the practice of qigong spread from the Chinese community to the world.

Today, millions of people around the world practice qigong and believe in the benefits of qigong to varying degrees. Similar to its historical origin, those interested in qigong come from diverse backgrounds and practice it for different reasons, including for recreation , exercise , relaxation , preventive medicine , self-healing , alternative medicine , self-cultivation , meditation , spirituality , and martial arts training. Qigong is commonly classified into two foundational categories: As moving meditation, qigong practice typically coordinates slow stylized movement, deep diaphragmatic breathing, and calm mental focus, with visualization of guiding qi through the body.

While implementation details vary, generally qigong forms can be characterized as a mix of four types of practice: There are numerous qigong forms. Many contemporary forms were developed by people who had recovered from their illness after qigong practice.

In , the Chinese Health Qigong Association officially recognized four health qigong forms: In , the Chinese Health Qigong Association officially recognized five additional health qigong forms: Whether viewed from the perspective of exercise, health, philosophy, or martial arts training, several main principles emerge concerning the practice of qigong: Over time, five distinct traditions or schools of qigong developed in China, each with its own theories and characteristics: Health is believed to be returned by rebuilding qi, eliminating qi blockages, and correcting qi imbalances.

These TCM concepts do not translate readily to modern science and medicine. In Daoism various practices now known as Daoist Qigong are claimed to provide a way to achieve longevity and spiritual enlightenment , [66] as well as a closer connection with the natural world. In Buddhism meditative practices now known as Buddhist Qigong are part of a spiritual path that leads to spiritual enlightenment or Buddhahood.

In contemporary China, the emphasis of qigong practice has shifted away from traditional philosophy, spiritual attainment, and folklore, and increasingly to health benefits, traditional medicine and martial arts applications, and a scientific perspective. Qigong has been recognized as a "standard medical technique" in China since , and is sometimes included in the medical curriculum of major universities in China. Conventional or mainstream medicine includes specific practices and techniques based on the best available evidence demonstrating effectiveness and safety.

Integrative medicine IM refers to "the blending of conventional and complementary medicines and therapies with the aim of using the most appropriate of either or both modalities to care for the patient as a whole", [73]: Scientists interested in qigong have sought to describe or verify the effects of qigong, to explore mechanisms of effects, to form scientific theory with respect to Qigong, and to identify appropriate research methodology for further study. People practice qigong for many different reasons, including for recreation , exercise and relaxation , preventive medicine and self-healing , meditation and self-cultivation , and training for martial arts.

In recent years a large number of books and videos have been published that focus primarily on qigong as exercise and associated health benefits. Practitioners range from athletes to the physically challenged.

Because it is low impact and can be done lying, sitting, or standing, qigong is accessible for disabled persons, seniors, and people recovering from injuries. Qigong is generally viewed as safe.

Cost for self-care is minimal, and cost efficiencies are high for group delivered care. Although clinical research examining health effects of qigong is increasing, there is little financial or medical incentive to support research, and still only a limited number of studies meet accepted medical and scientific standards of randomized controlled trials RCTs. A systematic review of the effect of qigong exercises on cardiovascular diseases and hypertension found no conclusive evidence for effect, [5] and generally poor quality of research on the potential effects of affecting blood pressure.

A systematic review of the effect of qigong exercises on biomarkers of diabetes mellitus concluded that there was insufficient evidence for effect due to methodological problems with the underlying clinical trials.

A systematic review on the effect of qigong exercises on reducing pain concluded that "the existing trial evidence is not convincing enough to suggest that internal qigong is an effective modality for pain management. A systematic review of the effect of qigong exercises on cancer treatment concluded "the effectiveness of qigong in cancer care is not yet supported by the evidence from rigorous clinical trials. Therefore, the authors concluded, "Due to limited number of RCTs in the field and methodological problems and high risk of bias in the included studies, it is still too early to reach a conclusion about the efficacy and the effectiveness of qigong exercise as a form of health practice adopted by the cancer patients during their curative, palliative, and rehabilitative phases of the cancer journey.

A systematic review of the effect of qigong exercises on movement disorders found that the evidence was insufficient to recommend its use for this purpose. Many claims have been made that qigong can benefit or ameliorate mental health conditions, [78] including improved mood, decreased stress reaction, and decreased anxiety and depression.

Most medical studies have only examined psychological factors as secondary goals, although various studies have shown significant benefits such as decrease in cortisol levels, a chemical hormone produced by the body in response to stress.

Basic and clinical research in China during the s was mostly descriptive, and few results were reported in peer-reviewed English-language journals. The White House Commission on Complementary and Alternative Medicine CAM Policy recognized challenges and complexities to rigorous research concerning effectiveness and safety of CAM therapies such as qigong; emphasized that research must adhere to the same standards as conventional research, including statistically significant sample sizes, adequate controls, definition of response specificity, and reproducibility of results; and recommended substantial increases in funding for rigorous research.

Of particular concern is the impracticality of double blinding using appropriate sham treatments, and the difficulty of placebo control, such that benefits often cannot be distinguished from the placebo effect. Qigong is practiced for meditation and self-cultivation as part of various philosophical and spiritual traditions.

As meditation, qigong is a means to still the mind and enter a state of consciousness that brings serenity, clarity, and bliss. Qigong for self-cultivation can be classified in terms of traditional Chinese philosophy: Daoist, Buddhist, and Confucian.

The practice of qigong is an important component in both internal and external style Chinese martial arts. T'ai Chi Ch'uan , Xing Yi , and Baguazhang are representative of the types of Chinese martial arts that rely on the concept of qi as the foundation.

T'ai Chi Ch'uan Taijiquan is a widely practiced Chinese internal martial style based on the theory of taiji "grand ultimate" , closely associated with qigong, and typically involving more complex choreographed movement coordinated with breath, done slowly for health and training, or quickly for self-defense.

Many scholars consider t'ai chi ch'uan to be a type of qigong, traced back to an origin in the seventeenth century. In modern practice, qigong typically focuses more on health and meditation rather than martial applications, and plays an important role in training for t'ai chi ch'uan, in particular used to build strength, develop breath control, and increase vitality "life energy". From Wikipedia, the free encyclopedia.

For the artist, see Qigong artist. Qi and Chinese martial arts. Retrieved 10 February The Way of Qigong: Random House of Canada. Way of the Dragon Pub. Cochrane Database Syst Rev 6: Yang's Martial Arts Association.

Li, Qi, and Shu: An Introduction to Science and Civilization in China. Archived from the original on 17 October Retrieved 14 October Falun Gong and the future of China. The root of Chinese Chi kung: Qigong for health and martial arts: Retrieved 7 December In Livia Kohl ed. Taoist Meditation and Longevity Techniques. Center For Chinese Studies: University of Michigan, Ann Arbor.

Making religion, making the state: Le qigong, une expression de la modernité Chinoise. Mélanges en homage à Léon Vandermeersch. Qigong, Psychiatry, and Healing in China. Chinese medicine or pseudoscience. John Wiley and Sons. Modernisation of the Chinese Past.

University of Hawaii Press. Chinese medicine in contemporary China: The magnitude of the effect is small, and its clinical relevance is uncertain. Adverse events included gas, bloating, diarrhea, and increase in low-density lipoprotein LDL cholesterol. The authors concluded that the evidence from RCTs does not convincingly show that pyruvate is effective in reducing body weight; limited evidence exists about the safety of pyruvate. They stated that future trials involving the use of this supplement should be more rigorous and better reported.

The labeling of Saxenda states that liraglutide should not be used with insulin FDA, It also states that the the effects of liraglutide on cardiovascular morbidity and mortality have not been established. The labeling states that the safety and efficacy of coadministration with other products for weight loss have not been established.

In addition, liraglutide has not been studied in patients with a history of pancreatitis. Liraglutide for chronic weight management is contraindicated in the following conditions: Trial data showed that liraglutide, in combination with a reduced-calorie diet and increased physical activity, resulted in significantly greater weight loss than diet and physical activity alone. The SCALE phase 3 clinical trial program of the safety and effectiveness of liraglutide for chronic weight management included three clinical trials that included approximately 4, obese and overweight patients with and without significant weight-related conditions FDA, All patients received counseling regarding lifestyle modifications that consisted of a reduced-calorie diet and regular physical activity.

Results from a clinical trial that enrolled patients without diabetes showed that patients had an average weight loss of 4.

In this trial, 62 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 34 percent of patients treated with placebo. Results from another clinical trial that enrolled patients with type 2 diabetes showed that patients had an average weight loss of 3. In this trial, 49 percent of patients treated with liraglutide lost at least 5 percent of their body weight compared with 16 percent of patients treated with placebo.

The FDA approved labeling states that patients using liraglutide should be evaluated after 16 weeks to determine if the treatment is working FDA, If a patient has not lost at least 4 percent of baseline body weight, liraglutide should be discontinued, as it is unlikely that the patient will achieve and sustain clinically meaningful weight loss with continued treatment. Saxenda is a glucagon-like peptide-1 GLP-1 receptor agonist and should not be used in combination with any other drug belonging to this class, including Victoza, a treatment for type 2 diabetes FDA, Saxenda and Victoza contain the same active ingredient liraglutide at different doses 3 mg and 1.

However, Saxenda is not indicated for the treatment of type 2 diabetes, as the safety and efficacy of Saxenda for the treatment of diabetes has not been established. Saxenda has a boxed warning stating that thyroid C-cell tumors have been observed in rodent studies with liraglutide but that it is unknown whether liraglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma MTC , in humans FDA, Liraglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice.

It is unknown whether liraglutide causes thyroid C-cell tumors, including MTC, in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. The labeling states that liraglutide is contraindicated in patients with a personal or family history of MTC or in patients with multiple endocrine neoplasia syndrome type 2 MEN 2 FDA, The labeling states that patients should be counseled regarding the risk of MTC with use of liraglutide and informed of symptoms of thyroid tumors e.

The labeling states that routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with liraglutide. Serious side effects reported in patients treated with liraglutide for chronic weight management include pancreatitis, gallbladder disease, renal impairment, and suicidal thoughts FDA, Liraglutide can also increase heart rate and should be discontinued in patients who experience a sustained increase in resting heart rate.

Based on spontaneous postmarketing reports, acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis, has been observed in patients treated with liraglutide Novo Nordisk, After initiation of liraglutide, patients should be observed for signs and symptoms of pancreatitis including persistent severe abdominal pain, sometimes radiating to the back and which may or may not be accompanied by vomiting.

If pancreatitis is suspected, liraglutide should promptly be discontinued and appropriate management should be initiated. If pancreatitis is confirmed, liraglutide should not be restarted. Substantial or rapid weight loss can increase the risk of cholelithiasis; however, the incidence of acute gallbladder disease was greater in liraglutide-treated patients than in placebo-treated patients even after accounting for the degree of weight loss Novo Nordisk, If cholelithiasis is suspected, gallbladder studies and appropriate clinical follow-up are indicated.

When liraglutide is used with an insulin secretagogue e. The labeling recommends lowering the dose of the insulin secretagogue to reduce the risk of hypoglycemia. Renal impairment has been reported postmarketing, usually in association with nausea, vomiting, diarrhea, or dehydration, which may sometimes require hemodialysis Novo Nordisk, The labeling recommends using caution when initiating or escalating doses of liraglutide in patients with renal impairment.

Serious hypersensitivity reactions e. The labeling recommends that patients stop taking liraglutide and seek medical advice if symptoms of hypersensitivity reactions occur. Liraglutide should be discontinued in patients who experience suicidal thoughts or behaviors.

Liraglutide should be avoided in patients with a history of suicidal attempts or active suicidal ideation. The labeling states that nursing mothers should either discontinue liraglutide for chronic weight management or discontinue nursing Novo Nordisk, The labeling states that the safety and effectiveness of liraglutide have not been established in pediatric patients and is not recommended for use in pediatric patients.

In addition, the cardiovascular safety of liraglutide is being investigated in an ongoing cardiovascular outcomes trial. Lingwood stated that there is a critical need for improved technologies to monitor fluid balance and body composition in neonates, particularly those receiving intensive care. Bioelectrical impedance analysis BIA meets many of the criteria required in this environment and appears to be effective for monitoring physiological trends.

These researchers reviewed the literature regarding the use of bioelectrical impedance in neonates. It was found that prediction equations for total body water, extracellular water and fat-free mass have been developed, but many require further testing and validation in larger cohorts. Alternative approaches based on Hanai mixture theory or vector analysis are in the early stages of investigation in neonates.

The authors concluded that further research is needed into electrode positioning, bioimpedance spectroscopy and Cole analysis in order to realize the full potential of this technology. These investigators reviewed available information on the short- and long-term effects of intervention treatment on body fat composition of overweight and obese children and adolescents and, to obtain a further understanding on how different body composition techniques detect longitudinal changes.

A total of 13 papers were included; 7 included a multi-disciplinary intervention component, 5 applied a combined dietary and physical activity intervention and 1 a physical activity intervention. Body composition techniques used included anthropometric indices, BIA, and dual energy X-ray absorptiometry. Percentage of fat mass change was calculated in when possible.

Findings suggested, no changes were observed in fat free mass after 16 weeks of nutritional intervention and the lowest decrease on fat mass percentage was obtained. However, the highest fat mass percentage with parallel increase in fat free mass, both assessed by DXA was observed in a multi-component intervention applied for 20 weeks.

The authors concluded that more studies are needed to determine the best field body composition method to monitor changes during overweight treatment in children and adolescents. Two reviewers independently screened titles and abstracts for inclusion, extracted data and rated methodological quality of the included studies.

These investigators performed a best evidence synthesis to synthesize the results, thereby excluding studies of poor quality. They included 50 published studies. Mean differences between BIA and reference methods gold standard [criterion validity] and convergent measures of body composition [convergent validity] were considerable and ranged from negative to positive values, resulting in conflicting evidence for criterion validity.

These investigators found strong evidence for a good reliability, i. However, test-retest mean differences ranged from 7. However, they stated that validity and measurement error were not satisfactory.

Goldberg et al stated that the sensory and gastro-intestinal changes that occur with aging affect older adults' food and liquid intake.

Any decreased liquid intake increases the risk for dehydration. This increased dehydration risk is compounded in older adults with dysphagia.

The availability of a non-invasive and easily administered way to document hydration levels in older adults is critical, particularly for adults in residential care. This pilot study investigated the contribution of BIA to measure hydration in 19 older women in residential care: The authors concluded that if results are confirmed through continued investigation, such findings may suggest that long-term care facilities are unique environments in which all older residents can be considered at-risk for dehydration and support the use of BIA as a non-invasive tool to assess and monitor their hydration status.

Buffa et al defined the effectiveness of bioelectrical impedance vector analysis BIVA for assessing 2-compartment body composition. Selection criteria included studies comparing the results of BIVA with those of other techniques, and studies analyzing bioelectrical vectors of obese, athletic, cachectic and lean individuals. A total of 30 articles met the inclusion criteria.

The ability of classic BIVA for assessing 2-compartment body composition has been mainly evaluated by means of indirect techniques, such as anthropometry and BIA. Classic BIVA showed a high agreement with body mass index, which can be interpreted in relation to the greater body mass of obese and athletic individuals, whereas the comparison with BIA showed less consistent results, especially in diseased individuals.

The authors concluded that specific BIVA is a promising alternative to classic BIVA for assessing 2-compartment body composition, with potential application in nutritional, sport and geriatric medicine. Haverkort et al noted that BIA is a commonly used method for the evaluation of body composition.

However, BIA estimations are subject to uncertainties. These researchers explored the variability of empirical prediction equations used in BIA estimations and evaluated the validity of BIA estimations in adult surgical and oncological patients.

Studies developing new empirical prediction equations and studies evaluating the validity of BIA estimations compared with a reference method were included. Only studies using BIA devices measuring the entire body were included. Studies that included patients with altered body composition or a disturbed fluid balance and studies written in languages other than English were excluded. To illustrate variability between equations, fixed normal reference values of resistance values were entered into the existing empirical prediction equations of the included studies and the results were plotted in figures.

Estimates of the FM demonstrated large variability range relative difference The authors concluded that application of equations validated in healthy subjects to predict body composition performs less well in oncologic and surgical patients. They suggested that BIA estimations, irrespective of the device, can only be useful when performed longitudinally and under the same standard conditions.

Gibson et al stated that VLEDs and ketogenic low-carbohydrate diets KLCDs are 2 dietary strategies that have been associated with a suppression of appetite. However, the results of clinical trials investigating the effect of ketogenic diets on appetite are inconsistent. To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, these researchers conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analog scales VAS before in energy balance and during while in ketosis adherence to VLED or KLCD.

Although these absolute changes in appetite were small, they occurred within the context of energy restriction, which is known to increase appetite in obese people. Thus, the clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss, although individuals may indeed feel slightly less hungry or more full or satisfied.

Ketosis appears to provide a plausible explanation for this suppression of appetite. The authors concluded that future studies should investigate the minimum level of ketosis required to achieve appetite suppression during ketogenic weight loss diets, as this could enable inclusion of a greater variety of healthy carbohydrate-containing foods into the diet.

Bueno and colleagues examined the effect of replacing dietary long-chain triacylglycerols LCTs with medium-chain triacylglycerols MCTs on body composition in adults. These researchers conducted a meta-analysis of RCTs, to examine if individuals assigned to replace at least 5 g of dietary LCTs with MCTs for a minimum of 4 weeks show positive modifications on body composition.

Two authors independently extracted data and assessed risk of bias. Weighted mean differences WMDs were calculated for net changes in the outcomes. These investigators assessed heterogeneity by the Cochran Q test and I 2 statistic and publication bias with the Egger's test. Pre-specified sensitivity analyses were performed. A total of 11 trials were included, from which 5 presented low risk of bias.

The overall quality of the evidence was low-to-moderate. Trials with a cross-over design were responsible for the heterogeneity. The authors concluded that despite statistically significant results, the recommendation to replace dietary LCTs with MCTs must be cautiously taken, because the available evidence is not of the highest quality. Changes in blood lipid levels were secondary outcomes. Identified trials were assessed for bias. Mean differences were pooled and analyzed using inverse variance models with fixed effects.

Heterogeneity between studies was calculated using I 2 statistic. No differences were seen in blood lipid levels. Many trials lacked sufficient information for a complete quality assessment, and commercial bias was detected. Although heterogeneity was absent, study designs varied with regard to duration, dose, and control of energy intake. The authors concluded that replacement of LCTs with MCTs in the diet could potentially induce modest reductions in body weight and composition without adversely affecting lipid profiles.

However, they stated that further research is needed by independent research groups using large, well-designed studies to confirm the effectiveness of MCT and to determine the dosage needed for the management of a healthy body weight and composition.

They performed a search of English-language articles in the PubMed and Embase databases through April 30, Differences in weight loss between FTO genotypes across studies were pooled with the use of fixed-effect models. A meta-analysis of 10 studies comprising 6, participants that reported the results of additive genetic models showed that individuals with the FTO TA genotype and AA genotype those with the obesity-predisposing A allele had 0.

A meta-analysis of 14 studies comprising 7, participants that reported the results of dominant genetic models indicated a 0. In addition, differences in weight loss between the AA genotype and TT genotype were significant in studies with a diet intervention only, adjustment for baseline BMI or body weight, and several other subgroups.

However, the relatively small number of studies limited these stratified analyses, and there was no statistically significant difference between subgroups. Hypoxic conditioning has been previously used by healthy and athletic populations to enhance their physical capacity and improve performance in the lead up to competition.

Recently, HC has also been applied acutely single exposure and chronically repeated exposure over several weeks to over-weight and obese populations with the intention of managing and potentially increasing cardio-metabolic health and weight loss. At present, it is unclear what the cardio-metabolic health and weight loss responses of obese populations are in response to passive and active HC.

Exploration of potential benefits of exposure to both passive and active HC may provide pivotal findings for improving health and well-being in these individuals.

These researchers carried out a systematic literature search for articles published between and Studies investigating the effects of normobaric HC as a novel therapeutic approach to elicit improvements in the cardio-metabolic health and weight loss of obese populations were included. Inconclusive findings, however, exist in determining the impact of acute and chronic HC on markers such as triglycerides, cholesterol levels, and fitness capacity.

The authors concluded that normobaric HC demonstrated observable positive findings in relation to insulin and energy expenditure passive , and body weight and BP active , which may improve the cardio-metabolic health and body weight management of obese populations.

However, they stated that further evidence on responses of circulating biomarkers to both passive and active HC in humans is needed. The following indicates maximum ideal weight in shoes with one-inch heels based on body frame and height:.

Clinical Policy Bulletin Notes. Links to various non-Aetna sites are provided for your convenience only. Weight Reduction Medications and Programs. Aetna considers the following medically necessary treatment of obesity when criteria are met: Weight reduction medications, and.

Dexamethasone suppression test and hour urinary free cortisol measures if symptoms suggest Cushing's syndrome. Rice diet or other special diet supplements e. American Obesity Association, C. Guidance for treatment of adult obesity. Accessed March 16, Long-term pharmacotherapy in the management of obesity.

Gain and loss in weight. Department of Agriculture and U. Department of Health and Human Services. Nutrition and your health: Dietary guidelines for Americans. Home and Garden Bulletin. Government Printing Office; The effect of pharmacologic agents. Am J Clin Nutr. United States Pharmacopeial Convention, Inc. Drug Information for the Health Care Professional.

United States Pharmacopeial Convention; Introductory Nutrition and Diet Therapy. Drugs used in obesity. Therapy for obesity--today and tomorrow. Baillieres Clin Endocrinol Metab. Use and abuse of appetite-suppressant drugs in the treatment of obesity. American Society of Health-System Pharmacists; Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults.

The acute 1-week effects of the Zone diet on body composition, blood lipid levels, and performance in recreational endurance athletes. J Strength Cond Res.

Haller C, Schwartz JB. Pharmacologic agents for weight reduction. J Gend Specif Med. Weight loss with self-help compared with a structured commercial program: Pharmacological approaches to weight loss in adults. Technology Assessment Report No. Obesity - problems and interventions.

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