Obesity is a modern day scourge which affects half a billion people, roughly 12 percent of the world population; a disconcerting figure. An ever increasing dependence processed food coupled with a sedentary lifestyle has resulted in an alarming spread of the disease. Yes Obesity is a disease; it is a condition of the body when excess body fat has accumulated which may cause serious health problems including reduced life expectancy. In scientific terms, a person having BMI (Body Mass Index) of more than 30 kg/m² is termed as obese. 

A diet with greater dependence on processed food, with are high in saturated fats and refined carbohydrates is a primary cause of obesity. Calorie consumption per day has increased drastically in developed countries and regions.On the other hand,our lifestyles have become less active. If we go back in time, we would see that our economies were mostly dependent on agriculture, hunting, gathering and so on. Today, with improvements in mechanized transport, we no longer have to walk miles to retrieve basic amenities  we do not have to toil in the fields for eight hours a day; unfortunately, most societies have not made the proportionate change in calorie consumption.
The progress in food science technology and food industries have given rise to newer means and methods of processing and preparing food; most of them catering to only the taste buds, with scant or no regard for the health or nutrition aspect.
Not all forms of obesity can be attributed to lifestyle and eating patterns; disorders of the endocrine system, like hypothyroidism is known to cause obesity.Steroidal medications are also responsible in certain cases. Eating disorders, mostly a result of psychiatric problems is a significant factor of obesity. People in depression are notorious for binge eating, which more often than not, lead to obesity.
Human evolution has taught the body to store excess food as fat in order to survive during times of food crisis. But with modern day constant supply of food, these reserves are never used.

The best way to combat obesity is by incorporating healthy lifestyle changes. These include regular exercise, intake of a clean diet, avoiding processed and food high in saturated fats. The importance of regular exercise cannot be overemphasized. Not only does it help to lose weight, it will also improve the cardiovascular health. A combination of aerobic exercise with light to moderate weight training would help a long way to combat obesity. Changes in dietary habits, by incorporating whole foods, lean proteins and monosaturated fats should also help. Avoiding processed food high in Sodium, Fat and high glycemic index carbohydrates is integral. Besides this some lifestyle changes should be incorporated. Taking the stairs instead of the lift, having small meals at regular intervals, drinking adequate water can go a long away, in preventing and controlling obesity.

In certain situations however, more needs to be done. In cases of endocrine disorders, a good endocrinologist would prescribed medications to control the hormone secretions in order to normalise them. In cases of psychiatric obesity, intervention is required in the form of counselling and family support. A comprehensive effort is required to motivate the individual, along with medications as and when necessary to control the cravings. Recent developments in medical science have come up with many drugs which help to control obesity.

In certain cases of morbid obesity, bariatric surgery can be opted for. Bariatric surgery contains a variety of surgical procedures used to treat obesity. Surgery should be considered as a treatment option for patients with BMI of 40 kg/m² or greater, who have tried and failed to get results with a controlled diet and exercise program along with oral drug therapy. However before proceeding with such surgery, counselling and psychiatric evaluation is a must. Then client should also be made aware of possible side effects and long term issues with surgery. Many patients have benefited from such surgical procedures.

Creatine and Strength Improvements

Creatine is the most popular sports supplement, across the globe today. But the history of Creatine goes back a long way; it was first isolated and discovered by a  French scientist named Chevreul, who named it after the Greek word for flesh, in 1832. In 1912, Harvard University researchers Otto Folin and Willey Glover Denis found proof that ingesting creatine can dramatically boost the creatine content of the muscle. In the late 1920s, after finding that the intramuscular stores of creatine can be increased by ingesting creatine in larger than normal amounts, scientists discovered creatine phosphate, and determined that creatine is a key player in the metabolism of skeletal muscle.  Creatine, as a sports supplement gained popularity, or notoriety, in the 1992 Olympic Games held at Barcelona. A newspaper reported that Linford Christie, the gold medallist in the 100metres had used creatine before the event. Thus began the association of creatine in sports and fitness industry. EAS (Experimental and Applied Sciences) was one of the first companies to manufacture creatine commercially. Since then, creatine is the most widely used sports supplement in the world, cutting across sporting disciplines and nationalities.

Creatine, or methylguanidine-acetic acid, is a naturally occurring amino acid that’s found in meat and fish, and also made by the human body in the liver, kidneys and pancreas from arginine, glycine and methionine. It is converted into creatine phosphate and stored in the muscles where it is used for energy. Energy production involves the conversion of ADP (Adenosine diphosphate) into ATP (Adenosine triphosphate). When ATP loses one of its phosphate molecules and becomes ADP, the creatine stored in the body (as creatine phosphate) donates its phosphate to ADP which converts to ATP and produces energy. Since, certain sports and resistance training, requires an instant anaerobic energy, creatine supplementation have greatly benefitted them.

Many supplemental forms of Creatine are available today. Most major sports nutrition companies have their own unique formulation of Creatine. But the most popular still remains the Creatine Monohydrate (Creatine & Molecule of Water); another popular form of Creatine is CEE or Creatine Ethyl Ester. Some companies claim that CEE is better and faster absorbed by the body. Besides it is supposed to be void of the negative effects, reported by some, from Creatine monohydrate. But there are no credible scientific studies to confirm the same. Creatine supplements are available in the form of powder, capsules, and tablets.

The average daily requirement of creatine is 2g/day dependent upon body size and activity levels. It is acquired from meat and other animal products (50% of our daily requirement) and from endogenous synthesis in the kidneys, liver and pancreas. (Fillmore et al 1999). Vegetarians and others who don’t ingest meat or animal products are capable of synthesizing sufficient quantities endogenously. However, it is noted in the literature that their resting levels of creatine are generally lower than non-vegetarians. (Engelhardt et al 1998).

Traditionally Creatine is suggested to be taken with high glycemic index carbohydrates, like dextrose. It is supposed to enhance absorption. There are generally two widely used methods of taking Creatine. A “loading phase” in which 20 grams is taken for 5–7 days, followed by a maintenance phase of 3-5 grams a day for periods of 2–3 months at a time. The second consists of taking 3grams of creatine for a longer period of 28days-60days. The basic goal of both is to saturate the muscle cells with creatine.  

Creatine has since then received widespread popularity, in sports and bodybuilding athletes. There are various studies conducted over a period of time regarding the effect of creatine and muscular strength or energy enhancement. Many studies conducted, using different subjects have arrived at one conclusion- that creatine supplementation does improve strength and lean muscle in high intensity short duration training like resistance training.

Strength improvement had been observed in almost all studies conducted with creatine supplementation. It has seen to benefit a wide range of sports involving single bouts of high intensity exercise such as sprint running, swimming, cycling or multiple bouts such as soccer, rugby, football, hockey etc. Besides that creatine supplementation has proven results across a wide spectrum of people involved in weight training. An increased training load can be tolerated by athletes using creatine supplements. This has potential long term benefits for the athletes.

Creatine supplementation is shown to have beneficial effects on subjects undergoing weight training, especially conditioned athletes. Creatine supplementation has no noticeable ergogenic properties unless accompanied by resistance or interval training. In other words, creatine by itself cannot produce any strength gains.

Studies have also been conducted to ascertain the impact of creatine on older adults. A study conducted by Brose A, Parise G, Tarnopolsky MA from the department of Kinesiology, McMaster University, Ontario, Canada concludes that creatine supplementation increases muscle strength in supervised resistance training among older adults. This is a significant discovery, for most researches seems to conclude that creatine supplementation is effective only among young adults,

Creatine supplementation in endurance sports is a subject of wide debate. While most sports scientists have concluded that creatine supplementation has no noticeable effects on endurance training. In endurance athletes exercising at 60-70% of their VO2 max for 75 minutes there is a reduction of phosphocreatine stores to 40% of their resting values (Broberg and Sahlin 1989 and Balsom et al 1994). If, as in competition, they need a burst of power (the "kick"), there is potential that the use of creatine supplements could benefit them by extending the time and therefore the distance over which they can maintain this extra pace. Engelhardt et al (1998) performed a study on tri-athletes using a relatively low dose of creatine (30g given over a period of 5 days) and demonstrated an increase in performance. There is a need for further studies to be performed in this area.

There are some concerns with creatine supplementation too that have been raised by certain sports scientists. A widely reported side effect is the weight gain due to fluid retention. Though, recent studies have found that weight gain is minimal if slower loading of creatine is adopted. Besides that there are some unconfirmed reports that athletes training in hot and humid conditions reported side effects like bloating, stomach cramps and discomfort. This again is not confirmed and may be attributed to the peculiar climatic conditions. Certain reports say that some coaches believe that creatine supplementation may promote greater instances of muscle strains or pulls. Though no studies have found or confirmed the same. Some people have also raised concerns on adverse effects on kidney and liver, due to long term creatine use.

No study so far has reported any significant side effects besides weight gain. However it must be understood that long term studies on creatine use has not been performed. But the huge amount of studies, conducted over different gene pools in varying climatic conditions, have not reported any adverse effects on short term use. So it may be concluded that creatine supplementation is a safe and effective method of increasing fat free muscle mass and significant improvements in strength. Long term usage however is subject to debate and potential side effects should be considered, before regular use. Like all supplements, individual results are bound to vary, and it is imperative that a professional is consulted before using creatine.