Medical support
Our Experts
The medical world and societies in general were preoccupied with malnutrition and its consequences on health and on the social and the economic development in most African, Asian, and South American countries.
This was also the case in the early 80s. But the galloping urbanization, the sedentary lifestyles, and the improvement of food production have indeed led to various health problems and especially the emergence and rapid increase of overweight and obesity which are regarded as indicators of good health and social success in people’s minds. Overweight and obesity have led to an epidemiological transition manifested by a high prevalence of chronic non-transmissible diseases (Diabetes, Hypertension, Dyslipidaemia, Cardio-vascular diseases, and cancers).
Obese people often become predisposed to have these diseases and they experience deterioration in the quality of their lives, increased health expenditures, and sometimes progress to physical and functional disabilities. Surprised by the huge number of people suffering from obesity and the obvious links between obesity and health problems, doctors tried and still try to fight obesity, sometimes with aggressive, costly and dangerous methods. "Experts" of all types are struggling to prescribe different diets leaving behind the other factors favouring the installation and the worsening of obesity. The population studies, including a large number of obese people, eventually recognize the limits of a particular diet because obesity is often associated with various psychological disorders, a feeling of failure, and finally an abandonment of medical prescriptions, and a demobilisation. The results of weight loss diets are not commensurate with the effort provided and the deprivations agreed upon.
During a conference on obesity in Zarzis, Sophie and Jana, two formerly obese women, told me about a new way that can be an alternative to the therapeutic attitudes which we offer to our obese patients. I was struck by the originality of the Smart and Light program, especially by the idea of a totally supervised personal care plan for people suffering from obesity, a plan that includes the sum of Sophie and Jana’s experiences as formerly obese women (overeating, sedentariness, lack of self-confidence, and sometimes even social and professional marginalization).
The program of Smart and Light seminars appears to occur within pleasant conditions and to provide nutritional information that is based on an accurate scientific knowledge. What is attractive about this dietary program is the fact that far from all forms of weaning or deprivation, it focuses on the revival and the development of the self, which is ignored by the participants for a while, and that it opts for a moderate physical activity that is adapted to the rhythm of overweight people. In short, it is a program which revolves around the recovery of the self, and an invitation to move forward unabated in the fight against obesity in order to prevent its consequences.
Moreover, the clarity of Smart and Light program as well as its efficiency are put under the microscope of surveillance and monitoring, since the logbook which is rich in information, allows the participants to carry on the program or to start it at home and provides feedback containing objective and useful information that would help ensure the continuity and uninterrupted evaluation of the objectives and practices of the program. It is better to be modest in the beginning and to guarantee medium and long-term gradual loss of superfluous kilograms/pounds rather than to suffer in vain.
I think that’s exactly the quality of the Smart and Light program."
In France, health authorities are launching a third national prevention plan about obesity. Despite the efforts of the teaching staff, medicine and the media, the epidemic tends to be aggravated.
The same findings were made at the international level, and even if a part of humanity is malnourished, the pandemic is spreading. Obesity as a disease depends much more on a poor quality of nutritional balance than on the total quantity food.
In rich countries, the prevalence of obesity is inversely proportional to the income or the social status, and emerging countries are not spared anymore. When you learn about the cost of the implications of this scourge on the overall health expenditure, we understand that this fight is a public health issue on a collective human, individual, and economic level. It is important to facilitate any initiative based on a pedagogy of good dietary habits. The Smart and Light concept is an example of a good choice.
Here is a method that goes beyond an effective diet. This philosophy allows an individual awareness and each case becomes an example on its own. I am pleased to see that Tunisia is involved in such a program.
When I first met Sophie Reverdi, she had troubles trying to lose the 40 kilos/ 80 pounds she gained when she was pregnant with twins.
I prescribed my diet to her and within few months she definitely lost her surplus of kilos/ pounds.
She told me that she tried many diets which did not fit to her personality as an obese woman. She claimed that mine was best suited to what she always referred to as "specific" personality. Then she told me about her story and informed me about her desire to help, in her turn, people suffering from obesity. She presented her project to me and I soon felt that her idea was innovative: to match an attractive, balanced and healthy diet to a coaching method which encourages and motivates patients. Moreover, I really liked the idea of preparing gastronomic recipes out of the allowed aliments list. I witnessed the evolution of Smart and Light and I am delighted to see that such a beneficial program could finally see daylight. I think many obese patients were waiting for such a program.
The fact that Sophie knew very well how to turn her suffering into an effective and concrete reality, therapeutically speaking, makes such a program a promising one.
The logbook is the essence of the Smart and Light philosophy; it does not only show the readers the right way but it also helps them think about their own situations as people suffering from obesity. The personal memento part is moving. It explains step by step how many hardships overweight people go through until they can realize what they long for.
The program also includes the organization of seminar dealing with various and precise topics such as understanding metabolism which is the basis of dietetics and the process of hyperproteinic diet. The seminars are followed by lessons about cooking and the benefits of coaching. In addition, Sophie extends the sphere of her activities and produces "gastronomic and dietary meals" which can be found in supermarkets, in school canteens and in home-delivery services. She even thinks of investing in a series of restaurants "Smart and Light" which will offer these meals at reasonable prices. When we look at the World Health Organization’s frightening forecast concerning the increase of the number of obese people, we naturally encourage such well-organized concepts as the Smart and Light program.
I really wish success to Sophie and I will be delighted to be one of her firm and committed supporters.
Most of us ignore the rules of the functioning of our body, and that's why we are misusing it.
Obese people do not correctly identify the causes of their overweight, nor the contours of their illness.
They don’t have a very clear perception of the phenomenon of obesity.
This is understandable because if anyone can make a diagnosis of this strange disease (because being big is easily seen), which is as we shall see only a symptom of this pathology, it is unclear why a normal person, whose energy input and output vary from day to day,
maintains a stable weight, while the obese person gains weight.
It is because we ignore so many things that theories abound and consequently we become confused about what to do and where to begin.
But one thing is certain: whatever the reasons for the excess of weight, only one solution has been found so far to treat it: the dietary adjustment which must be understood, and successfully followed.
It is clear to me that if I had understood the operation of my body at a younger age, and if I had assessed the damages that I made it undergo by "stuffing" it, and then have them repaired, I would have certainly done things differently towards this earthly vehicle that has been entrusted in me since my birth, and which is my first "ally" in life.
"Becoming obese means filling one’s fat cells with lipid matter reserves.
The fat cell, the adipocyte, is not only a place of storage, it is also a small factory that produces fat which it immediately releases under the influence of various stimulants depending on the needs of the body.
To store fat, it is necessary that the cell has at its disposal available material in surplus, because the immediate energy needs of body are imperative.
The accumulation of reserves in the adipocyte can occur only if we put at its disposal a mass of energy that is higher than that demanded by the organic needs, i.e., it is necessary that the
supply is higher than the basic needs ..."
This may briefly explain the phenomenon of weight gain, but it is also essential to know what are the dangers we might face if we are too fat.
Understanding The PathologyGeneral complications
Obesity engenders a range of medical complications. These are sometimes very specific, such as sleep apnea, or nonspecific, such as angina pectoris or hypertension, but with a very high frequency compared to normal people.
Thus, we can affirm that obesity is responsible, within the same age group, for a very important rate of mortality and morbidity up to such an extent that the multiplier factor may be 10.
Cardiovascular complications
Obesity predisposes people in a certain and important way to cardiac and vascular complications:
Blood pressure increases with weight, and hypertension, as a disease, is three times more frequent in obese people than
in the normal population.
The risk of arterial thromboembolic diseases is equally increased.
There are also other cardiac diseases: heart failure, cardiac arrhythmias and risk of sudden death.
The vein risk is increased: venous insufficiency of lower limbs
(varicose veins, heavy legs), risk of phlebitis (it is doubled in obese people
weighing over 100 kg), whose most dangerous consequence is lung embolism
The frequency of diabetes and high cholesterol in obese patients augments those
risks because we know that these two diseases may cause an additional vascular risk.
Pulmonary complications
Sleep apnea is a typical complication of obesity, affecting one third of the morbidly obese people and 10% of the other obese people.
The venous thromboembolism disease is given impetus by obesity.
That is to say the incidence of phlebitis and postoperative (or spontaneous) pulmonary embolism is highly increased.
Endocrine and Metabolic complications
They are very numerous.
The most frequent and classic is diabetes:
The medical literature is abundant on this subject. Most often, and in all cases at
The initial stage, it is about a kind of diabetes said to fat, not dependent on insulin, and therefore is able (at least initially) to be cured through diet and weight loss, possibly accompanied with oral antidiabetic drugs (tablets).
At a later and more serious stage of obesity, this diabetes can become insulin-dependent and therefore requires daily injections of insulin. Diabetes is a potentially very serious disease, since it is responsible for a series of deleterious side effects: cardiac and vascular complications (atheroma, angina pectoris, coronary thrombosis, diseases of the retina which can lead to blindness etc..). The risk of diabetes in obese patients is three times higher than in the normal population..
Disorders of blood lipids
It’s about the increase in circulating fats, which considerably increase in their turn vascular and cardiac risks.
This risk is five times higher in obese people than in normal people.
The most common disorder is the increase of blood triglycerides.
There is also an increase in blood cholesterol, especially 'bad' cholesterol (LDL cholesterol) at the expense of 'good' cholesterol (HDL).
Osteo-articular complications
Obesity generally causes pain in all joints. Some of them are particularly affected: the knees, the hips, and the spine. The phenomena of osteoarthritis are very pronounced, with a premature aging of the joints and a state of disability.
Herniated discs are also common, with repeated lumbago and sciatica. Whatever the degree of obesity, physicians specialized in rheumatology or orthopedics often urge their patients to lose substantial weight, not only to improve their fatigue symptoms or the premature aging of a joint, but also prior to undergoing a surgical operation whose results might be bad.
Other complications of obesity
Cutaneous complications: mycosis and maceration of folds,
Excessive sweating, ulcers of the lower limbs.
Increased frequency of certain cancers: endometrial, breast, colon,
rectum, and prostate.
Gastro-intestinal complications: biliary lithiasis (or stones in the gallbladder),
hepatic steatosis (fatty liver), acid reflux oesophagitis.
And we must also understand what our body endures on a daily basis because of our excess of weight: shortness of breath, headaches, tired and swollen legs, the thighs that rub, fatigue, backache, gestures and movements that we are no longer able to perform such as bending or going up the stairs.
Moreover, obesity is responsible for multiple handicaps which are manifested in difficulties in our daily life: rejection by the others and feelings of loneliness; relationship problems and in getting hired; reduction in the quality of life, in physical and sport aptitudes etc…