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Adult children home for the holidays may be noticing something for the first time about an aging parent. Dr. Kathleen Rogers, chief of geriatrics for Cleveland Clinic Akron General, offers some guidance on how to approach the sensitive subject.

As local and out-of-town relatives gather for the holidays, it may be a time when they notice that aging parents or loved ones are showing different behaviors that might be a clue to potential decline.

Perhaps theres been an incident where the loved one has forgotten where they are going, or the house seems more disorganized. Or maybe your loved one is more agitated or has taken a fall.

Dr. Kathleen Rogers, chief of geriatrics for Cleveland Clinic Akron General, offers some guidance on how to approach the sensitive subject.

Q: What is geriatric medicine and at what age would someone see a geriatrician?

A: My definition of geriatrics are patients who are high risk. You might be a 40-year-old who has had a heart attack or stroke and youre in a wheelchair and ready to go to a nursing home. That would typically be a time for a referral to a geriatrician.

Q: So a geriatrician is a specialist and not meant for primary care?

A: Correct. Im a specialist. You can call a geriatrician directly, but I would recommend starting with your primary care physician since your doctor knows you better. We can partner with your primary.

Q: Is there a checklist of things family members should be looking for that might cause concern?

A: Watch their behavior. If theres too many people in the house, the person might be aggravated and aggressive or more quiet and withdrawn. Usually, thats a symptom of something deeper. Sometimes with memory loss, they dont want their family to know and their coping mechanisms are behavioral.

Another thing is disorganization. If a loved one used to be very organized and was able to plan a whole dinner for the holiday and all of the sudden, theyre burning the pot or dont know how to do multiple things, that could be a concern. If they cant hold a conversation, that could be a symptom of hearing loss or vision loss if they cant see well.

One of the biggest red flags would be finances. Did they miss or overpay a bill? Did they get scammed of thousands of dollars or suddenly go shopping or gambling? Those are symptoms of behavioral issues that may be a sign of a deeper problem like a memory issue.

Have they had a fall recently or having balance issues?

Has there been extreme weight loss, not from exercising, which could be a sign theyre not eating. Are there any issues with independence, such finances or cooking?

Q: How do you tell the difference between just getting old and potential dementia?

A: Sometimes it takes time. The earlier you can get a loved one to a specialist or primary care, the more testing we can do or see what diagnosis were dealing with. With dementia, your basic daily living functions are impaired, which could be shopping, finances, driving, remembering lists or appointments or names of people.

With regular aging, you dont normally see all these domains getting affected. Theyre still able to function well and have good coping mechanisms.

Q: Could it be a one-off? If mom forgets one bill, I dont have to rush her to a specialist?

A: Correct but if that happens, you may want to keep a close eye to see if other things are affected. Maybe she forgot to take a pill or two or forgot appointments. Or there could be behavioral changes. Maybe she put her jewelry somewhere to hide it thinking somebody is coming to take it, but with memory issues, she forgot where she put it and then paranoia comes in because she thinks someone did take it.

Q: Whats the difference between memory loss, dementia and Alzheimers?

A: Dementia is a symptom of an underlying problem. Dementia is also an umbrella term for multiple diagnoses, the most common of which is Alzheimers dementia.

Q: How does one approach this very sensitive subject?

A: Ask your loved one how they feel about whats going on. Depending on his or her personality, this could be a difficult conversation. If you notice theyre more nervous than usual, ask if theres a reason or situation causing them to be nervous.

For example, if theres too many people around, they maybe cant focus on one conversation and it may be a hearing loss issue, which can impair your memory.

I cannot stress enough that a lot of people dont think correcting vision or hearing is important. Your brain is like a muscle. If you dont use it, it atrophies. There can be memory loss associated with vision or hearing loss that is not corrected.

Q: How can you talk with your siblings about your concerns and without your parent feeling like the kids are ganging up?

A: Have a conversation with other family members and see if theyve noticed things. Then maybe sit down with the loved one one-on-one to candidly ask them about it without making it a big deal.

Q: What do you do if the parent gets agitated and doesnt want to talk about it, or is upset that the children are acting like the parent?

A: It depends on the situation. If you see there is possible for potential harm because there might be a pot left that might cause a fire, you may want to be a little more assertive and say Do you mind if I go with you to the next doctors appointment? Go with them to keep accountability not only with them, but their doctor.

Q: As a doctor, do you like advocacy on the part of adult children?

A: Yes. Ive had times when patients come all by themselves with pretty severe memory loss and because of their confidence and coping abilities, they can make up good stories which seem pretty plausible. When a family member is there to say Maybe Mom should not be driving because shes had four tickets going to the grocery store, that gives me a different perspective. I also encourage family members to call me, if they cant come to an appointment.

Q: Can physical things like falling also be a sign of mental decline?

A: A fall could be a sign of something deeper or something from a disease state. Maybe you have depression or have been laying in bed for days and youve lost muscle mass and maybe that made you fall. Or maybe you have an inner ear problem and have vertigo. Any fall in an older person should be investigated.

Studies have shown that once youve had a fall, the chances of you falling within the next three months is almost approaching 50%. It affects your physical state. Your doctor may want to test your blood to see if theres a reason you fell. Or maybe you need physical therapy to help your balance or muscle tone and reinforcing a normal gait with strengthening exercises to help prevent future falls.

The only two interventions proven over and over again for success for memory loss are physical exercise and a healthy diet.

Q: What kind of exercise do you suggest?

A: Moderate exercise of 30 minutes three times a week can moderately improve memory and function. Brisk walking, slightly higher aerobic exercises. Not heavy weight lifting. Something slightly more than normal or that challenges you more physically. Physical activity helps with circulation and there is a direct link to better cognition.

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Holidays offer chance to size up aging parents well-being - Canton Repository

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Nov 29th, 2019 | Filed under Extreme Weight Loss
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Casting agents have sent out a call for anyone struggling at an extreme weight 600 pounds or heavier for a new reality series based in Georgia.

According to Crazy Legs Productions, the series will follow a morbidly obese individual on a journey of extreme weight loss aided by bariatric surgery performed by Dr. Charles Procter Jr. of Beltline Bariatric & Surgical Group based in Atlanta.

Producers say the participant will benefit from support on and off-camera during each step of the process, from doctor appointments to challenges of eating healthier and exercising to finding out if they qualify for surgery and having the procedure if they do.

Candidates, or their friends and family, can go toCrazyLegsProductions.comand click on the Now Casting tab to fill out the application. Questions on the form include: "Will you have a hard time changing your lifestyle? and "What foods will be the most difficult to give up?"

While most of Procter's patients weigh around 300 to 400 pounds, the show centers on his larger patients, some of whom tip the scales at more than 750 pounds. Some patients are so large, they are unable to visit the office in person and require a home visit.

In a year, most participants are able to lose 100 to 300 pounds, according to producers. "Even more importantly," says a news release, "the weight loss results in dramatically improved lives, with a reduction of obesity-related diseases like diabetes, high blood pressure and sleep apnea."

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New reality show in Georgia seeks the morbidly obese - Chattanooga Times Free Press

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Nov 25th, 2019 | Filed under Extreme Weight Loss
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Ford v Ferrari (or Le Mans 66 if youre in the UK) opened in theaters last week to strong critical acclaim after making a solid impact on the Fall festival circuit. The story of one of motor racings most indelible rivalries and the engineering marvels required by Ford to take on the might of Enzo Ferrari is a highly enjoyable and often thrilling drama that looks set to be the new favorite movie of every dad on the planet (thats a compliment, I swear.) In a film full of gripping car chases and old-school action movie razzle-dazzle, what remains the most striking about Ford v Ferrari is its use of good old-fashioned star power. Matt Damon and Christian Bale have seldom been more charming or likable in their roles as engineer Carroll Shelby and driver Ken Miles, the odd couple who love and hate each other in equal parts and work in tandem towards a shared dream of ambition and revolution. The pairing reminded me a lot of Brad Pitt and Leonardo DiCaprio in Once Upon a Time in Hollywood, another instance of two major A-List stars working together to combine their full-on movie-star charisma in a way we seldom see in the age of franchises and hot-button IPs. Sometimes, you just need a real celebrity in a role (its no surprise that the first names approached for the Ford v Ferrari project were Pitt and Tom Cruise.)

As someone who has typically respected Christian Bales work but rarely warmed to him as an on-screen presence, I found myself wholly won over by his performance as Ken Miles. As the hot-headed driver who craves speed and has no time for bureaucracy, he gets to be a proper lad, Brummie accent and all. Little is known about Miles himself and theres very little filmed footage of him, so Bale had the freedom to fully flesh out this enigmatic figure without having to worry about pleasing the audiences preconceptions of who this man was or how they knew he acted. As a result, it may be my favorite Bale performance since Bruce Wayne or Patrick Bateman.

When we think of Christian Bale as an actor, the first thing that usually comes to mind is his penchant for physical transformation. His name is typically the first to come up when we consider massive weight gain or loss for a role, and in many ways, its become his trademark. For American Psycho, he spent months training and exercising to achieve the perfect physique of Patrick Bateman as described in the novel. He infamously dropped down to 121 pounds (55kg) for The Machinist by going on an intense crash diet of apples and coffee, right before winning the role of Batman and having to gain the muscular body of Bruce Wayne in six months. He gained a total of 100lb in that period, but then lost 30 of that when Christopher Nolan said hed gotten too big. The 30lb weight loss for The Fighter helped bring him to Oscar glory, while the 43lb gained for American Hustle landed him another nomination. The slouch he affected for the role, which helped shorten his height by three inches, resulted in a herniated disc. And then, of course, there was the role of Dick Cheney in Vice, and the weight gain for that was extreme, even by Bales standards: 40lb of pure fat, which the film delights in showing the audience at every opportunity. Ironically, Bale had previously dropped out of playing the role of Enzo Ferrari in an as-yet-unmade film by Michael Mann over fears the required weight gain would be detrimental to his health. Bale has now said hes done with the extreme weight loss and gain see-saw.

Its almost a clich now to talk about bodily transformations and acting, as well as its intersections with perceived glory and awards bait. When we see an actor or actress do something to radically change their body or face, we tend to think theyre on the hunt for an Oscar. Just look at the borderline-insulting cycle that surrounded Charlize Theron when she put on weight and wore prosthetics to play Aileen Wuornos in Monster, or the shock of Joaquin Phoenixs strange twisted form in Joker, the result of a 55lb weight loss. For a lot of people, both inside Hollywood and out, the true force of acting comes in those moments of obvious difficulty. These transformations are designed less to be looked at and more to be gawked over. They invite shock and awe as well as a hefty dose of encouraging disgust in viewers. We want to be bowled over by someone doing something we could never do, by seeing a familiar face totally morph into that of another to the point where we no longer recognize them. Its one of the reasons biopic performances tend to fare well with Oscar voters and the public at large: Not only do we get a full-body transformation but we have something to directly compare it to in order for us to judge whether the performance is good or not.

Bales major transformations have often included biopic roles but not exclusively so. He is an actor who has made bank both on being recognizably himself and through those transformations, from Batman to Dick Cheney. Other actors do this, of course, but they havent made their name so effectively on it as Bale has. We expect him to do this for every role now, regardless of how small or simple the undertaking is. People seem almost disappointed when he walks a red carpet looking like himself, but thats also a crucial part of the cycle: You need to be able to remind audiences, critics, and awards voters alike that the transformation is only temporary because that shows true commitment to the craft. Not only that, but we want to be reminded of their original beauty. Nothing says commitment like making yourself fat and ugly for the job but make sure you dont stay like that because then theres no place for you in Hollywood, no matter how talented you are.

It would be wrong to say Bale didnt undergo a transformation of sorts to play Ken Miles in Ford v Ferrari. He took on the role after Vice so he clearly dropped a lot of weight in time for shooting. He is lean but not distractingly so. This is the body of a man who keeps himself lithe enough to race in cars where lightness is key. He has a thick Birmingham accent and walks with the cockiness of a guy who wins all the time. It seems unusually simple, deceptively so, but its also the first Bale performance in a long time where he shows how effective an on-screen presence he is through sheer movie-star charm alone. You never forget that youre watching Christian Bale, which is a stark difference from his usual output, but therein lies its force. Sometimes, you need an undisputed A-List celebrity to get the job done, and at a time when such figures seem few and far between, its greatly appreciated from Bale. Normal is a bullsh*t term but this may be as mundane as Bale gets and its no less thrilling to watch. If nothing else, its nice not to have to constantly worry about this mans metabolism.

Kayleigh is a features writer for Pajiba. You can follow her on Twitter or listen to her podcast, The Hollywood Read.

Header Image Source: Getty Images.

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The Method of Christian Bale and The Joy of Watching Him Be 'Normal' - Pajiba

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Nov 25th, 2019 | Filed under Extreme Weight Loss
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Theres no one-size-fits-all plan: People interpret fruitarianism to suit their needs. Some fruitarians start the day by juicing 10 oranges. Others eat a banana-berry smoothie. Still others sit down to enjoy a plate of mangoes, melon, and almonds. A growing subset of vegans describe themselves as fruitarians, which may mean that up to 75 percent or more of what they eat is fruit.

Some people only eat raw organic fruit, while others allow dried or frozen fruit. Some fruitarians permit nuts and seeds, which grow on trees and can be categorized as fruits. Similarly, some may eat grains, which are considered to be the fruits of the plants which produce them. Some fruitarians round out their diets with leafy greens or other vegan-friendly foods. Others only eat sweet fruits.

Nutrition experts consider fruitarianism a fad diet that could cause malnutrition because so many food groups are left out of the diet, yet enthusiasts believe that the eating style works for them. Many fruitarians only eat home-prepared foods, to ensure that theyre not getting unwanted ingredients from restaurants. Heres what else fruitarians may experience:

Nibbling all day

Many fruitarians eat whenever theyre hungry, rather than consuming three meals. You may find you are grazing, says Beth Bluestone, RD, a registered dietitian at Cleveland Clinic Wellness. The calories are more quickly absorbed than from other foods. Youre going to burn through it fast.

Feeling bloated

The fiber and natural sugars in fruit may cause gassiness and bloating. Some people have trouble digesting large quantities of fructose, Bluestone says. It can cause abdominal discomfort, diarrhea. Tracy Morris, Fitbits nutritionist adds, Still, the huge amount of fruit required to meet your daily calorie needs is likely to cause some degree of bloating for most people.

Incorporating fats

A well-balanced diet contains fats, protein, and carbohydrates. Fruit is comprised mainly of carbohydrates, but fruitarians can get fat from avocados, nuts, and seeds. Plus, nuts and seeds may supply essential fatty acids. One [essential fatty acid] in particular is omega 3s, Bluestone says. Thats something that we can get from a plant source, but it depends if we are having nuts and seeds in the diet or not. Flaxseeds and walnuts, are a great source of omega 3s.

Seeking protein

It may be extremely difficult for fruitarians to get enough protein, although nuts, seeds, and grains can be valuable sources. I would even recommend fruitarians include some eggs, beans, or even steak once in a while, says Bart Wolbers, researcher at Nature Builds Health.

Vegans on a vegetable-rich can find it tricky to meet their protein needs if they arent including legumes or nuts and seeds-the fruitarian diet is extremely low in protein. We need essential amino acids, the building blocks of , to help to build and repair your muscles, organs, skin, blood, and to make different chemicals, like hormones, in your body. Fruit, although high in essential nutrients like fiber and vitamin C, isnt a source of protein. Were not able to meet all those building blocks of those different essential amino acids when your diet is that highly restricted, says Bluestone.

Considering supplements

Fruit contains fiber, vitamins, and antioxidants but is missing many essential nutrients that you need. People who follow this diet can be at a significantly increased risk of deficiencies in iron, protein, vitamin D, calcium, zinc, vitamin B6, and vitamin B12, says Amanda A. Kostro Miller, RD, LDN, who serves on the advisory board for .

Strict fruitarians may not want to take supplements. Protein supplements that are from a plant source, such as soy or pea protein would not fall into the fruitarian category, and thats where it becomes challenging, Bluestone says.

Rounding out the diet

Broadening your interpretation beyond sweet fruit will make the diet more balanced, healthier, and sustainable. Morris says, Experts around the world agree we should all be and less animal products-its better for our health and its better for the planet-but theres no need to limit yourself to only fruit. Why eliminate whole food groups which have been shown to improve health and add years to your life? Filling your plate with foods like vegetables, whole grains, legumes, nuts, and seeds is a smart eating strategy.

Signs the diets hurting your health

Fruitarianism isnt for everyone. Ashton Kutcher made headlines in 2013 when he was hospitalized after following the diet. If you feel hungry constantly, its time to abandon the plan. Symptoms such as low energy levels, confusion, tiredness, hair loss, hair thinning, muscle wasting, slow healing, extreme weight loss, or getting sick easier, says Bluestone, are signs its time to ditch the diet.

How to safely eat a fruit-heavy diet

If youre intrigued by the idea of subsisting mainly on fruits, ask a registered dietitian how to do it safely. Talk about what your health goals are and what youre trying to accomplish, Bluestone says. We can work together to make it happen, looking out to prevent malnutrition, and preventing them from adopting a long-term plan that would not be healthy.

This article is not intended to substitute for informed medical advice. You should not use this information to diagnose or treat a health problem or condition. Always check with your doctor before changing your diet, altering your sleep habits, taking supplements, or starting a new fitness routine.

Lisa Fields

Lisa Fields is a full-time freelance writer who specializes in health, nutrition, fitness, sleep and psychology. Her work has been published in Readers Digest, WebMD, Good Housekeeping, Family Circle, Womens Health, Shape, Self and other publications. She lives in South Jersey, outside of Philadelphia.

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Fitbit Inc. published this content on 21 September 2019 and is solely responsible for the information contained therein. Distributed by Public, unedited and unaltered, on 21 September 2019 15:56:01 UTC

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The Fruitarian Diet: What You Need To Know - Daily Stock Dish

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Nov 25th, 2019 | Filed under Extreme Weight Loss
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Trivia question: Which animals eye is bigger than its brain?

Q: Can dogs get diabetes? If they do, will they have to have insulin injections? Can they take pills instead? How about cats. I bet theyd be hard to give shots to every day!

A: When it comes to diseases, dogs and cats can have many of the same illnesses that are found in humans. Diabetes mellitus, or sugar diabetes, is a relatively common disease in pets. We tend to see diabetes in middle aged to older pets, and obesity is typically a major risk factor. Its interesting to note that diabetes is more common in female dogs and male cats. A brief explanation of the disease will help answer your questions.

Glucose (sugar) is needed to carry on cellular functions and chemical reactions within the body. It is the fuel that all cells need. Insulin is the hormone produced in the pancreas that acts as the key to unlock cells to allow glucose to enter and serve its purpose. If the pancreas is not producing insulin in sufficient quantities, or none at all, then the glucose level in the blood will continue to rise since it cannot reach its target area to perform its function. At this point, the body begins to use an alternative fuel source, body fat, and this can lead to a very dangerous condition known as ketosis or ketoacidosis.

Some of the symptoms of diabetes are well known, such as excessive drinking and urinating, and theres usually an extreme weight loss despite a good appetite. We also see lethargy, cataracts, coma and even death. A very small percentage of pets (usually cats only) can be treated with oral medication such as Glipizide, but the majority of patients require insulin injections once or usually twice daily. This can be a very complicated and challenging disease, and it takes a very dedicated and loving owner to treat a dog or cat for diabetes. In certain cases it can be very difficult to give twice daily injections to either dogs or cats. Their personality plays a role in how effectively they can be treated. It is possible for well regulated diabetic pets to live a relatively normal life.

If you suspect that your pet may be diabetic, get him or her to your veterinarian right away. All thats required for a diagnosis are some laboratory tests involving blood and urine.

Q: I read in a pet magazine that certain gums and mints can be like poison for dogs. What causes this? My friend told me its a substitute sugar called xylitol. She said some household products and many sugar-free foods contain it and that its pretty dangerous. Do you agree?

A: Xylitol, found in chewing gum, mints and even some types of nut butters, has fewer calories than real sugar and offers benefits for human dental health. Its also found in some toothpaste and lip balms. Despite the benefits for humans, even small amounts can sicken or kill a dog. Recently, the U.S. Food and Drug Administration released a strong warning for pet owners to keep these products out of reach of dogs. According to Preventive Vet, an online veterinary resource, Animal Poison Control for the ASPCA received 4,128 xylitol calls in 2018, and Pet Poison Helpline received around 3,600 xylitol calls in 2017.

Sugar-free gum, mints and lip balms are commonly found in purses, backpacks and loose in cars. To keep your pets safe, always put items well out of your dogs reach. Remember that a determined dog can easy chew or rip through zippers and snaps. Xylitol causes the pancreas in dogs to secrete insulin. The quick release of insulin after eating xylitol causes a dogs blood sugar levels to drop, sometimes to a life-threatening point.

The FDAs recent warning made note of nut butters, an item many wouldnt consider to contain xylitol. Nut butters are sometimes used in training or to coat pills that owners might need to give a dog. The FDA warns owners to read the labels on nut butters carefully to make sure the product doesnt contain xylitol. Other common items containing xylitol include some ice creams, many sugar-free gelatin products and some varieties of yogurts and puddings.

Portland-based Preventive Vet has a detailed list of products containing xylitol on its website: http://www.preventivevet.com. The site also gives tips for quickly assessing your dogs behavior and health if you feel theyve ingested this substance. If you suspect your dog has eaten a product with xylitol, keep the packaging (or whats left of it) and take your dog to the vet or an emergency animal hospital immediately.

Answer: Ostrich

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Points for Pets: Diabetes is relatively common disease in pets - WV News

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Nov 17th, 2019 | Filed under Extreme Weight Loss
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Earlier this week, Aaron shared that he was headed to his home state to see his mother, Momma Jane Carter, a recovering alcoholic. He wrote on Twitter that he feared she had relapsed: Im driving my pickup truck to get her stuff and move her out with me and get her back into treatment, Aaron said. But once he arrived in Florida, Jane was immediately alarmed by her sons weight, which had dropped from around 160 pounds to 115, she told TMZ. Aaron is currently undergoing tests. My sons [sic] strength with what the family is putting my son through hasnt changed in over 20 years, Jane wrote on Instagram.

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Aaron Carter Hospitalized In Florida Following Extreme Weight Loss - Refinery29

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Nov 16th, 2019 | Filed under Extreme Weight Loss
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Authors: Jason C. Casey1, Robert L. Herron2, and Michael R. Esco3

1Departmentof Kinesiology, University of North Georgia, Oakwood, GA, USA2Department of Sports Management, United States Sports Academy,Daphne, AL, USA3Department of Kinesiology, The University of Alabama, Tuscaloosa,AL, USA

Corresponding Author:Robert L. Herron, MA, CSCS*D, ACSM-RCEP1 Academy DriveDaphne Al, 36526rherron@ussa.edu251-626-3303

Jason C. Casey,PhD, CSCS*D, EP-C is an Assistant Professor of Kinesiology at the University ofNorth Georgia in Oakwood, GA. His research interests focus on fatigue andrecovery associated with exercise, athlete monitoring, and sport-relatedmeasurement issues.

Robert L. Herron, MA, CSCS*D, ACSM-RECP iscurrently faculty member and Sport Management doctoral student at the UnitedStates Sports Academy. Roberts areas ofresearch interest include: measurement and evaluation in sport-related researchand recovery from exercise stressors or sport injuries.

Michael R. Esco, PhD, CSCS*D, FACSM is an associate professor of exercise physiology in the Department of Kinesiology at the University of Alabama. His research interests are in the areas of heart rate variability, body composition, athletic monitoring, and cardiovascular physiology.

ABSTRACT

The purpose ofthis study was to assess the utility of using BMI-based equations (BEQ) toestimate body-fat percentage (BF%) in female-collegiate gymnasts. As such, the agreement between BF% estimateswith BEQ and air-displacement plethysmography(AP) were compared in twenty-two gymnasts (n = 22). Body mass, height, and BF% were assessed viaAP and BEQ [Jackson et al. (JBMI), Deurenberg et al. (DBMI),and Womersley & Durnin (WBMI)]. Results: The assessmentsproduced the following estimated BF%: AP = 20.3 3.6%; JBMI = 26.9 3.9%; DBMI = 26.4 2.2%; and WBMI = 27.9 2.5%. BF%estimated via AP was significantly lower (p < 0.001) than each BEQ. Weakcorrelations were found between AP and BEQ (JBMI, r = 0.12; DBMI,r = 0.07; WBMI, r = 0.12). The limits of agreement (constant error 1.96 SD) for each BEQ compared to AP were: JBMI = 6.6 9.5%;DBMI = 6.1 7.8%; and WBMI = 7.6 8.0%. These resultssuggest a wide range of individual differences existed between BEQ and AP.Furthermore, BEQ significantly overestimated BF% relative to AP in thisgymnastics population. Coaches and sportpractitioners are in need of a quick, practical, inexpensive, and accuratemethod of body composition assessment. Based on this study, BEQ does not meetthe needs of the practitioner when compared to AP. As a result, practitionersin the field need to consider other field methods of predicting BF% incollegiate female gymnasts.

Keywords: air-displacement, body mass index, percent fat, gymnastics

INTRODUCTION

Many factors,including body composition, influence performance and health of athletes.Desirable ranges of body fat percentage (BF%) and other anthropometricmeasurements vary between athletes, sports, and positions (9,20). However, itis generally considered that increased fat-free mass (FFM) is beneficial andexcess fat-mass (FM) is a detriment to athletic performance (11).

Coachesand other sport practitioners need a body-composition assessment method to bevalid, accessible, and easy to use (1).Body mass index (BMI) is one of the mostcommonly utilized body composition metrics and a popular method used todetermine the body size clasifications in the general population (24). BMI assessment is non-invasive and requires only ameasurement of height and weight. Thus, BMI is quite easy to assess, does notrequire a skilled technician, and is a time-efficient method of bodycomposition analysis. A primary concern of BMI is that the metric failsto distinguish between fat mass and fat-free mass and BMI alone may misclassifyobesity in some populations (14).Despite these limitation, research has shown that BMI and BF% are highlycorrelated in the general population (18).To better utilize this metric, severalregression equations have been developed to estimate BF% with BMI as a primaryvariable (6, 13, 26). However, little research has been conducted evaluating these equationsin an athletic population.

Validlaboratory methods of assessment have been used to estimate BF% and otherbody-composition metrics in athletes such as underwater weighing anddual-energy x-ray absorptiometry (10, 15).However, these methods are often expensive, difficult to access and require ahighly trained technician. Additionally, research has demonstrated value ofvarious field techniques which are often popular in a practical setting due tothe accessibility and ease of use (8, 15).Nevertheless, these techniques present different challenges. For instance,small changes in hydration status and fluid balance can influence the accuracyof BIA assessment. Thus, controlling for hydration should be a requirement withBIA but often ignored in practical settings (8, 17).Skinfold assessment has been shown to be accurate relative to laboratorymethods (15).However, skinfold assessment requires a skilled technician that is trained toprecisely locate anatomical markers and measure skinfold thickness at specificlocations on the body (3).Furthermore, there are and over 100 various body composition equations that maycontribute to validity and reliability issues (3).An alternative laboratory-based body compositionassessment method is air-displacement plethsymography (AP). AP is oftendeemed a faster and more user-friendly laboratory measure (23)and is regularly used in athletic settings. Additionally, evidence supports theuse of AP as a valid estimate of BF% in female athleteswhen compared to dual energy x-rayabsorptiometry (DXA) (1). Furthermore, AP has recently been used in theestablishment of descriptive values for body composition across a large sampleof female-collegiate athletes (9).

Inwomen, excessively low BF% is linked with the deleterious health conditionscomprising the female athlete triad including; disordered eating, low bonemineral density, and amenorrhea (7, 20).Additionally, extreme weight loss and the related comorbidities are more commonin sports where aesthetics is a prominent aspect of the culture. As noted inprevious research, some female gymnasts, attempting to aesthetically conformfor sport, are known to achieve these physical goals by engaging in extremeweight loss behaviors associated with disordered eating (12, 22).

Furthermore,in sports where aesthetics are a prominent aspect of the associated culture,such as gymnastics (20),researchers have documented that, in female athletes, appearance is a majorfactor influencing body composition (19).Moreover, ones sense of body image may be distorted in female athletesparticipating in these sports (5, 25),even among athletes who present with a favorable body composition (5).As a result, the importance of regular, accurate assessment of BF% areheightened in these female athletes and more importantly inaccurateestimates of BF% may detrimentally impact the physical and psychologicalwell-being of the athlete.

Due to their speed and simplicity, BEQ may beattractive for coaches and sport practitioners who have limited access to moreadvanced measures (such as AP), have minimal time for body compositionassessment, or have limited training in techniques like skinfold assessment. However,there is little research available to compare BF% estimations from BEQ versus moreadvanced methods in athletes. The purpose of this study was to assess theutility of using BMI-based equations (BEQ) to estimate body-fat percentage(BF%) in female-collegiate gymnasts.

METHODS

Participants

Thisstudy utilized data from twenty-two (n = 22) female collegiate gymnasts (age =19 1 yr, height = 158.2 1.9 cm, body mass = 57.4 5.6 kg, and BMI = 22.9 1.8 kg.m-2). This study was approved by the InstitutionalReview Board at The University of Alabama.

Procedures

Tocompare three previously developed BEQ with AP, data was analysed from ade-identified database. Information obtained from this database for thepurposes of this study consisted of height, body mass, body composition via AP,and age. BMI was then calculated and subsequently, BF% estimates were derivedfrom the BEQ (6, 13, 26). BF% estimates fromeach BEQ were then compared to BF% estimates determined via AP.

Participants were instructed torefrain from exercise, eating, and drinking for at least 2 hours beforetesting. Height was measured to the nearest 0.1 cm using a stadiometer(Detecto, Webb City, MO) and body mass was measured to the nearest 0.02 kg viathe BOD POD electronic scale, calibrated to manufacturer guidelines with participantsbare foot. BMI was calculated as mass (kg) divided by height (m2).All values for BMI were rounded to the nearest 0.1 kg.m-2.

Body composition was assessedvia AP using a calibrated BOD POD (BOD POD body-composition system, model2000A; Life Measurement Instruments, Concord, CA). Prior to each testingsession, all BOD POD calibration procedures were completed according to themanufacturer guidelines by measuring an empty chamber and a calibratingcylinder of a standard volume (49.55 L). Researchers proceeded after successfulcalibration. Participants wore a tight-fitting spandex sports bra, spandexshorts, removed all jewelry, and were provided a swim cap to wear over theirhead to minimize the effect of hair on body volume assessment. A trainedtechnician then performed the BOD POD assessment.

Participants were asked to sitin the BOD POD in an erect position with hands folded in their laps for bodyvolume assessment. All BOD POD instructions were followed for the assessments.As directed by the manufacturer, two tests were performed to ensure reliabilityof the assessment. If the two original tests were not within 150 mL of eachother, two additional tests were performed to achieve reliable data. Thismethod of assessment is recommended by the manufacturer. Previous literaturehas demonstrated high test to test reliability of AP via these methods for bodymass (r = 1.0), BF% (r = 0.997), and fat-free mass (FFM) (r = 1.0) (9).

After completion of the test,the software predicted the following in all participants: thoracic gas volume,fat-free mass (FFM), fat mass (FM), and BF%. BF% was also predicted via thefollowing three previously developed BEQ: Jackson et al. (JBMI) (13),Deurenberg et al. (DBMI) (6),and Womersley & Durnin (WBMI) (26).See Table 1 for the equations.

Data Analyses

Statisticalanalyses were performed using SPSS version 20.0 (IBM, Somers, NY, USA). Arepeated-measures analysis of variance (ANOVA) was performed to determine meandifferences between BF% assessed via AP and the three BEQ using an alpha levelof 0.05. A Bonferonni post-hoc analysis was used as a follow-up procedure forpair-wise comparisons. Pearson product-moment correlation coefficients, Cohensd effect size (4),constant error, and the 95% limits of agreement via the Bland-Altman method (2)were also calculated.

RESULTS

Table2 represents the comparative statistics between AP and the BEQ. As indicated bythe repeated measures ANOVA and follow-up post hoc analysis, each BEQ provideda significantly higher estimation of BF% when compared to AP (p < 0.001). WBMIestimated the highest BF% and was statistically higher than JBMI (p= 0.03) and DBMI (p < 0.001). Furthermore, the effect size forthe comparison of AP to each BEQ was classified as large (Cohens d > 0.8).Weak correlations were found between AP and all BEQ. Additionally, AP had aweak correlation with BMI (r = 0.17).

Bland-Altmanplots evaluating the individual differences between AP and each BEQ are shownin Figures 1-3. The mean bias predicted for JBMI was 6.6% and the 1.96 SD ranged from -2.9% to 16.1% (Figure 1). As seen in Figure 2, the meanbias for DBMI was 6.1% ranging from ( 1.96 SD) -1.7% to 13.9%. Themean bias for WBMI was the largest at 7.6% and the 1.96 SD rangedfrom -0.4% to 15.6% (Figure 3).

DISCUSSION

Thepurpose of this study was to determine the agreement between three BEQ and APfor estimating BF% in female collegiate gymnasts. BEQ provide quick and simplemethods of estimating BF% that, if in agreement with more advanced assessmentmethods, would allow for increased accessibility and ease of testing forpractitioners in athletic settings. However, this study found that each BEQprovided a significantly higher estimate of BF% than AP. Additionally, all BEQshowed a wide range of individual error relative to AP (each BEQ demonstrated aconstant error of > 6.0%) according to the Bland-Altman method, as well asweak correlation coefficients. Furthermore, AP had a weak correlation with BMIalone (r = 0.17). Thus, it is recommended that practitioners avoid the use ofBEQ in the female collegiate gymnast population.

Gymnaststypically maintain a lower BF% and greater FFM(considered an athletic body type) compared to the average population. Thislikely serves as an explanation for the results found in this study, as BMI does not distinguish between FM and FFM oftenmisclassifying individuals with athletic body types (16). Thus as the results of this study indicate, theequations predominately dependent on BMI were not able to accurately predictBF% relative to AP in this sample of collegiate female gymnasts. It should benoted that it may be advantageous for the gymnastics athlete at this level ofcompetition to have a lower body height. Fields et al. (2017) demonstrated thatbody height for female collegiate gymnasts was statistically lower than fiveother collegiate female sports evaluated (9). Due to this typical body type (lower BF%, increased FFM, and lower bodyheight) BMI-based categorical interpretation, serves little-to-no use in thecollegiate, female-gymnast population.

There were limitations to this study that may haveimpacted the results. Three specific limitations were: hydration status was notmeasured in the participants, phase of the menstrual cycle was not taken intoconsideration, and residual volume was estimated via AP standard process asopposed to directly measuring. Each of these could have impacted bodycomposition measurement. However, because all measurements were performedduring one session, the influence of total body water status would have influencedbody weight for all measures, making the impact on the results minimmal.

Further research to provide sport practioners with aquick and accurate method of assessing BF% should focus on formulas withadditional variables that do not rely as heavily on BMI. Taylor et al. (2012)developed a formuala utilizing BMI, hand-grip strength, waist circumference,and sex as variables (21). The results of the study indicated the BF%estimation from the formula did not differ from dual-energy x-ray absoptiomitry(DXA). In additon, the formula had a high correlation and low standard error ofthe estimate relative to DXA. However, this study included only participantsfrom the general population. It is unknown if the inclusion of these additional variables in the BF%estimation formula would result in a more accurate estimate of BF% in female athletes more specifically female gymnasts.

CONCLUSIONS

Regularmonitoring of body composition is a valuable component of strength andconditioning programs. Coaches and sport practitioners are in need of a quick,practical, inexpensive, and valid method of body composition assessment. BEQsignificantly overestimated BF% relative to AP in this gymnastics population.This indicates that the BEQ did not appropriately estimate group-mean BF%.Furthermore, a wide range of individual differences existed when comparing thethree BEQ with AP estimates in female-collegiate gymnasts.

APPLICATIONS IN SPORT

Dueto the aesthetic focus of gymnastics, inaccurate body composition data canfoster unhealthy body-image perceptions and exacerbate psychological issuesrelated to the development and progression of eating disorders (5, 20).Therefore, coaches and other sport practitioners should refrain from using BEQin female-collegiate gymnasts and should consider other practical means ofpredicting BF% in this population.

REFERENCES

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Nov 8th, 2019 | Filed under Extreme Weight Loss
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Kids show Sesame Street address opioid crisis in an online only episode. Veuers Natasha Abellard has the story. Buzz60

UPSTATE,S.C. Erika Haas calls it the pull.

When Haas was 24, her doctor prescribed OxyContin for back pain. She quickly progressed to heroin and then to methamphetamines. Now 30 and in recovery, she described the grip that meth had over her for more than five years.

Its like God tells you that if you take another breath, your children will die, she said, shaking her head and trying to hold back tears. You do everything you can not to take a breath. But eventually you do. Thats what its like. Your brain just screams at you.

The opioid epidemic appears to be subsiding in the northwest corner of South Carolina, a region known as Upstate.Some refer to this area as the Upcountry. Nationwide, the number of opioid-related overdose deaths is declining slightly. But a new variety of methamphetamine is taking its place as the No. 1 drug of abuse.

By most accounts, meth is much harder to quit. And the latest version of the illicit drug flooding the nation is cheaper than ever before.

Health officials: Use money from opioid lawsuits to bolster treatment and prevention

Primarily imported from Mexico by major drug traffickers, meth 2.0 is stronger, cheaper and far more plentiful than the old home-cooked variety. And with historic levels of funding from the federal government focused exclusively on fighting opioid addiction, states and counties are scrambling to find resources to combat this most recent drug plague.

In the small city of Greenville, Faces and Voices of Recovery staff work around the clock to provide a place people struggling with meth addiction can come to talk. CEO Rich Jones spends many evenings and weekends fundraising because little federal or state money exists to provide the kind of long-term support people in recovery from meth addiction need, he said.

Rebecca Maddox is executive director of the Phoenix Center of Greenville.(Photo: Submitted photo)

Across town, Rebecca Maddox runs Phoenix Centers Serenity Village, a womens residential addiction treatment facility. The center receives substantial funding from Medicaid because patients are either pregnant or have custody of their children and therefore qualify for the federal-state health plan for low-income people.

She said federal funding for the center has remained flat for more than a decade, except for recent money targeted for treating opioid addiction. But data showed that opioid use was declining in Greenville, so we didnt get any of that money this year, she said.

Sixty-three percent of the 81 women admitted to Serenity Village last year were treated for meth addiction. They include Haas, who is staying at the center with her three children.

When her heroin addiction caused her to lose everything, including her children, Haas said she decided to quit. Feeling sick and depressed as she came off the powerful drug, some friends gave me meth and told me it would make me feel better, she recalled. It made my sickness go away, or maybe I just didnt care about it anymore.

For a time, Haas got her kids back. But within weeks, meth began to take an even bigger toll on Haas life. She lost custody of her oldest kids again, yet she said she still found it impossible to quit. After losing custody of her youngest, who just turned 1, she said she knew it was time to quit.

She checked into Serenity Village, and for the first few weeks, Haas said she struggled every minute of the day. But now, after nearly three months, the pull is starting to fade.

When I get that pull, she said, I know I need to find someone who will tell me to play that tape again about whats going to happen to me and my kids if I pick up, she said, meaning if she started to use again. I just need to find somebody to talk to.

Authorities:40 pounds of seized fentanyl is enough to 'kill entire population of Ohio'

Pickens County, about 20 miles west of Greenville, has been hit hard by the meth surge.

Tucked into the foothills of the Blue Ridge Mountains and home to Clemson University, Pickens County is a destination for wealthy retirees who build multimillion-dollar homes on the shores of Lake Keowee and other scenic spots.

But jobs have been scarce and wages low ever since the cotton mills closed in the 1990s, creating stress and anxiety for many residents. That and its proximity to drug trafficking routes it is less than 20 miles off Interstate 85, the main artery to Atlanta have contributed to soaring meth use.

Between 2016 and 2017, the number of people seeking treatment for meth addiction nearly doubled in Pickens and the other nine counties in the Upstate region, according to data from the state drug and alcohol agency.

In the midlands and coastal regions of the state, including Charleston, opioid addiction and overdose deaths remain the biggest threat, according to state data.

Watch: Australian police find more than $200 million of meth inside Sriracha bottles

At Cafe Connections, a coffeehouse ministry in the town of Pickens, much of the talk is about families whose lives have been shattered by meth. The drug offers boundless energy to work extra shifts or clean the house until it turns ugly.

I can see on a personal basis what meth and other drugs are doing to our community. Homelessness wasnt a problem in Pickens a few years ago. Now, its a big problem, said Ann Corbin, who runs the cafe with her husband, Steve, and with support from the East Pickens Baptist Church and volunteers. Coffee, sweets and conversation are free at the cafe, a big airy former drugstore with cafe tables and cushy upholstered couches and chairs clustered along brightly painted walls.

Everyone here knows someone who uses meth or has lost a family member to its ravages, Corbin said. People have set aside long-held prejudices against drug users to focus on helping families who have been destroyed by meth.

The leap in deaths has been dramatic. The Pickens County coroner, Kandy Kelley, said 25 people died of a drug overdose in the county last year, topped by 39 as of September this year, mostly from a combination of meth, opioids and other substances.

At Behavioral Health Services of Pickens County, a state-funded drug treatment center a few doors down from the cafe, more people are seeking treatment for meth addiction than ever before, Executive Director Angela Farmer said. And those in treatment are having a much tougher time quitting.

Crime: Brothers who allegedly left their grandma to die in a fire, but saved meth lab equipment indicted

Farmer, a licensed counselor and Pickens native, has seen a lot of changes in the habits of Pickens drug users over the 22 years shes worked here.

More meth users are injecting the drug than smoking or snorting it as they did in the past, Farmer said, and people are starting to use it at a younger age.

Our patients are struggling a lot more and they relapse more, and it takes them longer to engage in treatment, Farmer said. Most of our patients are compliant with their treatment for opioids, but they find it harder to stop using meth.

With roughly 2,400 clients in a county of 120,000, Behavioral Health Services, which occupies nearly a full block of offices on Main Street, is bursting at its seams.

The countys 50-year-old jail also is overflowing. In November, a new facility will open, providing more than triple the current jails capacity. And its staff will include an addiction treatment practitioner and a mental health counselor, thanks to a grant from the U.S. Justice Department.

We havent been able to respond to as many of the drug-related crimes as we would like in the last couple of years, because we havent had anywhere to put them, Pickens County Sheriff Rick Clark said. Its always a balancing act.

Clark and other law enforcement officials say most of the meth supply in the region comes from Atlanta, where illicit labs convert liquid methamphetamine from Mexico into crystal powder for dealers to distribute across the South.

Nationwide, the advancing meth scourge has yet to capture the kind of public response the opioid epidemic was, even though the nationwide spike in meth-related deaths in the past two years was steeper than the spike in opioid deaths two decades ago when that crisis began.

In the first decade of the opioid epidemic, the number of overdose deaths rose fourfold, from 3,400 in 1999 to 13,500 in 2009, based on aStatelineanalysis of data from the U.S. Centers for Disease Control and Prevention. With the advent of cheap and powerful imported meth, the spike in deaths has been much sharper. Meth overdose deaths increased fourfold in half as much time, from 2,600 in 2012 to 10,300 in 2017.

Still, meth users are less likely to die of an overdose than users of painkillers and heroin. Instead, meth kills most of its victims slowly.

Addiction 101: How opioids, cocaine, other drugs rewire the brain

Opioids cause relatively little physical damage to chronic users, unless they take too high a dose. But meth takes a severe mental and physical toll on chronic users, destroying their appearance and substantially shortening their lives.

If you want to know whether a town has a meth problem, just go to Walmart and take a look around, Pickens Chief Deputy Chad Brooks said. Its symptoms are unmistakable: rotting teeth, skin lesions, extreme weight loss and premature aging.

The CDC only records meth-related overdose deaths typically heart failure or stroke resulting from using too much of the drug in a short period. It doesnt include deaths from long-term use.

Despite the nations growing recognition because of the opioid crisis that addiction is a disease, Sheriff Clark said, society still tends to look down on meth users.

I hate to say this, Clark said, but the reason were not hearing as much about the meth problem at the national level is that we dont have as many pretty people dying of meth as we do with opioids.

On average, patients addicted to meth require at least 90 days of intensive counseling and therapy to get started on recovery. And even then, nearly all of them can be expected to relapse multiple times before reaching sustained recovery, treatment experts say.

Crystal meth accelerates the reward circuits in the brain more powerfully than any other drug we have, said Dr. Paul Earley, an addiction physician in Georgia and the board president of the American Society of Addiction Medicine.

Theres no doubt that it causes the most rapid downhill course of any drug.

With heroin, people Keith Richards [of the Rolling Stones], for example can go on using the drug for 30 or 40 years without medical problems, as long as they dose it right, the doctor said. But with meth, 100% of people who use the drug experience severe and rapid physical deterioration.

The Federal Drug Administration has approved three medications for the treatment of opioid addiction. Research is underway on meth addiction medications. Behavioral Health Services is one of seven sites funded by the National Institute on Drug Abuse in a study of the effectiveness of two drugs extended-release bupropion sold as Wellbutrin and extended-release naltrexone sold as injectable Vivitrol in easing detoxification and promoting recovery from meth addiction.

Farmer said Wellbutrin, a mild stimulant, seemed to alleviate the depression and exhaustion that typically occurs when people are coming off meth. She didnt see as much evidence for Vivitrol warding off cravings.

But so far, no medications have been clinically proven to be effective in the treatment of meth addiction.

If someone is addicted to opioids, they can get medication-assisted treatment pretty quickly, said Charlie Stinson, executive director of GateWay Counseling Center, a state-funded treatment center in Clinton, another hard-hit Upstate town.

The problem is if they kick that addiction and start using meth, they can be out of luck when they decide its time for treatment.

Statelineis a nonpartisan, nonprofit news service of the Pew Charitable Trusts that provides daily reporting and analysis on trends in state policy.

Whether it's cocaine, vaping or even your phone, addiction can alter your brain without you even being aware. Just the FAQs, USA TODAY

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Nov 5th, 2019 | Filed under Extreme Weight Loss

Season 4 ofThis Is Usfinds Toby (Chris Sullivan) and Kate (Chrissy Metz) going through a rough patch. They struggle with all of the typical new parent stressors, as well as their baby having a special need.

Toby and Katedeal with these new intricacies of their marriage in very different ways. Toby found that working out has helped him, but Kate is not happy abouther husbands weight-loss. Lets take a look at what fans are saying about Kates reaction. Warning: Season 4 Spoilers

Two episodes in a row, Kate has reacted poorly to Tobys new fit figure. The first time she sees her husband with his shirt off in a long time, she is mad at him. Kate is overweight, to begin with, and the couple met at a support group for people with eating disorders.

Fans took to Reddit to show their disappointment in Kates reaction. One fan wrote, If I managed to lose some weight and gain some muscle, my wife would congratulate me. Kate? Somehow takes it as an insult that Toby thinks shes fat.

Kate believes Tobys health is a reflection of her. She immediately begins to think that she is not good enough for him. He initially hides his workouts from her, which makes things worse.

Another viewer on Reddit wrote, She cant stand the fact that Toby is taking better care of himself. It begins to make us wonder about her emotional state and how she got to this point.

As fans began discussing Kates anger towards Tobys weight-loss, more profound things came about. Season 4 has shown us that teenage Kate (Hannah Zeile) had a boyfriend during her teenage years who seemed a bit controlling. The show has not yet revealed to us what happened with the relationship, but Reddit users have their theories.

One fan started the theory, I have a feeling we might understand more after we find out what happens with her boyfriend.

Then others agreed, writing, I was looking for this take. The last episode shook me, and I think were about to see what really pushed her over the edge. Ive been thinking for a while that theres more to her problems than blaming herself for Jacks death. If they take this story where I think they are, poor, poor Kate.

Users on Reddit have been hypothesizing that something very traumatic happens with Kate and her teenage boyfriend, Marc (Austin Abrams). Some believe he may have sexually assaulted her, while others think he could have been very controlling.

Fans are all in agreement that Kates emotional reaction to Tobys weight loss stems from the trauma that occurred with her and the mysterious boyfriend during her teenage years.

During the season 3 finale, we saw an older Toby without Kate or a wedding band. Fans began wondering if their relationship lasts through the years.

This past weeks episode indeed shows how much Toby is trying to make things work. He suggests a getaway so they can have some intimate time together. Kate is still reeling from Tobys extreme weight loss and fitness, but Toby reassures her that he still loves her and finds her attractive.

The couple certainly has their challenges, but fans want to believe that they will last in the long run. One fan on Instagram wrote, I absolutely love you and toby together from day one! You guys are amazing!

You can watch Toby and Kates relationship play out every week on This Is Us, Tuesday nights on NBC.

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Oct 31st, 2019 | Filed under Extreme Weight Loss

A Lincolnshire woman who preaches body positivity is set to appear on a BBC documentary which digs into issues surrounding obesity in the UK.

Courtney Belle will appear on the new documentary Who Are You Calling Fat? in which a group of obese people live together and discuss the issues surrounding what its like to live as an overweight person.

From a fat activist who objects to the word "obesity" and is an "intuitive eater" to a man diagnosed with diabetes who is desperate to lose weight and save his health, every housemate has a startlingly different point of view.

The 26-year-old, who has dealt with her weight since a young age, went on several extreme diets that left her ill throughout her teens, the Mirror reports.

However, five years ago she became a member of the BoPo (body positivity) community - a movement which calls on everybody to have a positive body image, no matter what they look like.

John Wass, a Professor of Endocrinology and an Obesity Empowerment Network member who was a consultant to the series, says he hopes the show will kick-start a very important national debate.

He says: "We are living through a global pandemic, where obesity is now considered a bigger problem than world hunger.

"The series explores a number of crucial medical and policy issues, and also promotes empathy and understanding. The cure is not as simple as just eating less and exercising more.

"We now know science is identifying genes that contribute to weight and obesity by affecting appetite.

"There are also people in the series who describe themselves as body positive, a small but increasingly vocal movement in 'fat politics' that responds to years of stigma and discrimination.

"It is important we hear and understand all points of view in this often heated debate."

Courtney says she decided to go on the show to try and remove the stigma around being fat after becoming a self-love advocate and prolific instragrammer.

"I couldn't look in the mirror," she says. "In my eyes, I wasn't good enough unless I was thin. Even after losing 5st it wasn't enough. I spent a long time hating myself."

"I took part because I want to change the stigma surrounding fat people. I want an end to fat shaming, body shaming and to show that body positivity and health can fit together."

In the show Courtney will live with eight other obese people in a house in Oxfordshire for a week. They are:

Plus-size model, influencer and graphic design student David says he is fat, successful and happy.

I love myself! he says. I dont look like everyone else because Im not. The fact no one is me is my superpower.

Weight and size shouldnt determine respect or self-worth.

David, battling for plus-size fashion on the high street, says he took part because so few men are willing to speak out. He says: People should watch because its time we got an honest perspective on being a plus-size person.

The prison supervisor is a serial dieter with a binge-eating disorder, struggling with her weight since childhood.

I started to gain weight when my parents separated when I was six or seven, she says. I found comfort in food. I was 12st when I was 12 and at my heaviest I was nearly 28st at 40.

Babs, who fears ridicule, got type 2 diabetes and was told to lose weight. She is in the series to raise awareness of mental health around obesity.

She says: Its time to recognise eating disorders come in many forms, not just bulimia and anorexia, and we dont need to be constantly told to eat less and move more.

A campaigner to end the stigma obesity weight, Sarah has had a rollercoaster journey with her weight.

She shed 8st and did a triathlon after appearing on an extreme weight loss TV series in 2012. But when filming ended, it was a battle to keep the weight off. Now, she is the director of charity Obesity UK and wants the condition recognised as a disease.

I want to change the narrative, she says. I want people to see people with obesity are not just lazy and eat too much. Its much more complex.

I have struggled with my weight my whole life. I still dont like my body, but I am more at peace with myself.

The stand-up comics motto is Here for a good time, not a long time. During filming, he took the group to watch a gig, where his fat jokes were put under the microscope.

Some days Im comfortable in my body, other days I hate it, he says. Im not happy. I want to change who I appear to be. Other days I appreciate my depth as a human and understand my differences.

Having always avoided GP visits for fear of what he might be told, the series encourages him to get a diabetes test and vow to attend medical checks. He says: Some people look after cars better than Ive looked after my health."

Hitting 25st five years ago, Del opted for bariatric surgery and has now lost 10st and runs marathons.

He says: My journey from morbid obesity and weight-related illnesses to great medication-free health has already inspired others. I was in a dark place, now Im in the best shape ever.

Sales director Del has even climbed Mount Kilimanjaro and run the London Marathon since his operation.

He says: I wanted to show that by eating less and doing more physical activity, which I now do, there are more benefits than just being able to fit into a pair of skinny jeans. Your health truly is your wealth.

The writer, performer and comedian calls herself a fat activist and wants to change perceptions of fat people.

Losing weight 10 years ago didnt bring her happiness, so she decided to switch her focus from weight loss.

Ive always been fat. Not only that, but I was the fattest. But being thin didnt make me happy. It just meant I could buy more clothes.

Miranda, who doesnt think obesity should be labelled a disease, now runs club nights and social events for plus-size people and wants more fat people represented on TV. Im so tired of seeing fat girls as just the funny best friend or the one desperate to diet.

When he was diagnosed with type 2 diabetes last year, Jack was scared for his future and decided to finally take action.

He began eating more healthily and started an exercise regime, and is now losing weight. My weight had ballooned to 24-and-a-half stone. I feel it is largely a consequence of my own actions. I want to show that some fat people actually want to take ownership and accountability.

HGV driver Jack frequently battles Victoria in the series when she claims obesity doesnt mean ill-health. He invited a type 2 diabetes sufferer to the house to talk about how the disease led to his leg being amputated last year.

The body confidence coach and fat activist is very vocally anti-diet.

After battling low self-esteem and body image issues, she identifies as an intuitive eater meaning she eats what she wants, when she wants.

She thinks fat and health are not related and dislikes the words obesity and overweight. She says: Fat people are dying because of the stigma and lack of care in this fatphobic society.

I spent my life trying to diet my way to worthiness. It didnt work.

I hope people will take away from this series that fat people are all different. Its OK to be fat.

Who Are You Calling Fat? airs on BBC2 tonight, Monday, October 28 and tomorrow, Tuesday, October 29 at 9pm.

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Oct 31st, 2019 | Filed under Extreme Weight Loss
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