Phoenix Rising Medical, PC
Medical, Legal and Business Consultants.
*Pulmonary, Sleep and Critical Care Medicine Consultation
*Behavioral Sleep Medicine Consultations
*Independent Medical Evaluations (IMEs)
*Workers' Compensation Evaluations
*Disability Evaluations
*Personal Injury Medical Evaluation
*Peer Reviews
*Medical Records Review
*Expert Witness
2545 Sheridan Drive, Suite 5
Tonawanda, NY 14150
Medical Director:
Taj M Jiva, MD (The University of the State of NY, 1999)
MBA (University of Massachusetts, Amherst) (2007)
MPH (Occupational Medicine, Medical College of Milwaukee, WI) (2004)
LLB (Hons) Northumbria University Law School, Newcastle Upon Tyne, England.(2011).
JD (2013). Northwestern California School of Law, CA.
LLM. (General law, UB Law School, Buffalo, NY) (2012)
Diplomat American Board of Internal Medicine, Pulmonary Medicine
Diplomat American Board of Sleep Medicine
Board Certified in Behavioral Sleep Medicine
Office Manager: Patricia
A. Czajka
Phone: 716-836-1388
Fax: 716-836-1399
Medical Services we provide:
Pulmonary Evaluation and Management:
Lung illness, emphysema, COPD, bronchial asthma, chronic bronchitis, lung cancer, pleural effusion, tuberculosis, occupational lung disease, asbestosis, silicosis etc. Pulmonary Function Tests, including spirometry, lung volumes, diffusion capacity test, 6 minute walk test, etc.
Sleep Medicine Evaluation and Management:
Obstructive sleep apnea, central sleep apnea, iinsomnia, restless legs syndrome, REM behavior disorders, etc. Diagnostic sleep studies, and CPAP titration studies, MSLT, MWT etc
Legal Medicine Reviews
IMEs, Workers' Compensation, Disability Evaluation, Peer Review, Medical Records Review, Expert Witness etc.
Obesity Management:
Obesity and Overweight----the following information is obtained
from Centers for Disease and Prevention web site to maintain uniformity in
diagnosis and management of obesity and its related health problems.
Our web
site may not provide complete clinical information about obesity and its health
related issues and evaluation and management by a certified clinical specialist
is always recommended. This web site is maintained for educational purposes only.
Research has shown that as weight increases to reach the levels referred to
as "overweight" and "obesity,"* the risks for the following
conditions also increases:
- Coronary
heart disease
- Type 2
diabetes
- Cancers
(endometrial, breast, and colon)
- Hypertension
(high blood pressure)
- Dyslipidemia
(for example, high total cholesterol or high levels of triglycerides)
- Stroke
- Liver and
Gallbladder disease
- Sleep
apnea and respiratory problems
- Osteoarthritis
(a degeneration of cartilage and its underlying bone within a joint)
- Gynecological
problems (abnormal menses, infertility).
Overweight is defined as a body mass index (BMI) of 25 or higher; obesity
is defined as a BMI of 30 or higher.
What services do we
provide?
1.
Education on obesity.
2.
Complete evaluation of obesity and its health
related complications if detected including various lipid abnormalities, pre-diabetes and metabolic syndrome etc.
3.
Complete Pulmonary Function Tests to assess the
effects of obesity on lung function, including restrictive lung patterns,
obesity-hypoventilation syndrome, hypoxemia states, etc.
4.
Diagnostic Polysomnography to assess the
presence of obstructive sleep apnea syndrome which contributes to progressive
weight gain, cardiovascular risk factors, hypertension, metabolic syndrome,
congestive heart failure.
5.
6 Minute Walk Tests to assess functional
capacity and cardiovascular fitness, oxygenation status, exercise capacity,
etc.
6.
Referral and Evaluation by nutritionist if
clinical indicated.
7.
Referral and Evaluation by an exercise
specialist if clinically indicated.
8.
Referral and Evaluation by a certified respiratory
therapist if clinically indicated.
9.
Various outside weight loss programs like Weight
Watchers, etc if clinically indicated.
10.
Referral and evaluation by an endocrinologist if
clinically indicated.
11.
We provide all pertinent information on obesity
management and its health related issues in the form of brochure, video
programs, exercise techniques, etc. This information is available on CDC sites
as above.
12.
Referral and Evaluation by a cardiologist.
13.
Referral and Evaluation by a bariatric surgeon
if clinically indicated.
If you have any questions or
comments regarding this program, please do not hesitate to contact us by email
on this web site or phone call.
Thanks for your support in the
success of this program.
Sincerely yours,
Staff at Phoenix
Rising Medical, PC
American society has become 'obesogenic,' characterized by environments that
promote increased food intake, non healthful foods, and physical inactivity.
Policy and environmental change initiatives that make healthy choices in
nutrition and physical activity available, affordable, and easy will likely
prove most effective in combating obesity.
The Division of Nutrition, Physical Activity, and Obesity (DNPAO) at Centers
for Disease and Prevention is working to
reduce obesity and obesity-related conditions through state programs, technical
assistance and training, leadership, surveillance and research, intervention
development and evaluation, translation of practice-based evidence and research
findings, and partnership development.
The prevalence of obesity is explained in a slide presentation format. You
may view the slides online or download them as a Microsoft PowerPoint Document
(PPT).
Overweight and obesity are both labels for ranges of weight that are greater
than what is generally considered healthy for a given height. The terms also
identify ranges of weight that have been shown to increase the likelihood of
certain diseases and other health problems.
Overweight and Obesity Trends Among Adults
After a quarter century of increases, obesity prevalence has not measurably
increased in the past few years but levels are still high — at 34 percent of
U.S. adults aged 20 and over.
Since the mid-seventies, the prevalence of overweight and obesity has increased
sharply for both adults and children. Data from two NHANES surveys show that
among adults aged 20–74 years the prevalence of obesity increased from 15.0%
(in the 1976–1980 survey) to 32.9% (in the 2003–2004 survey).
Overweight Trends among Children and Adolescents
This Journal of American Medicine (JAMA) article reports the
prevalence of high body mass index (BMI) for age among children and adolescents
showed no significant changes between 2003–2004 and 2005–2006 and no
significant trends between 1999 and 2006. Rates of overweight and obesity
remain high with 31.9% of children and adolescents aged 2 through 19 years at
or above the 85th percentile of the 2000 BMI-for-age growth charts.
Overweight is a serious health concern for children and adolescents. Data
from two NHANES surveys (1976–1980 and 2003–2004) show that the prevalence of
overweight is increasing: for children aged 2–5 years, prevalence increased
from 5.0% to 13.9%; for those aged 6–11 years, prevalence increased from 6.5%
to 18.8%; and for those aged 12–19 years, prevalence increased from 5.0% to
17.4%.
Related Resources
Includes national estimated cost and state-level estimated costs of overweight
and obesity in the U.S.
If you're interested in worldwide obesity statistics, CDC's Cancer Atlas
tracks some data in their Risk Factors section.
Defining Overweight and Obesity
Overweight and obesity are both
labels for ranges of weight that are greater than what is generally considered
healthy for a given height. The terms also identify ranges of weight that have
been shown to increase the likelihood of certain diseases and other health
problems.
Definitions
for Adults
For adults, overweight and obesity
ranges are determined by using weight and height to calculate a number called
the "body mass index" (BMI). BMI is used because, for most people, it
correlates with their amount of body fat.
- An adult who has a BMI between 25 and 29.9 is
considered overweight.
- An adult who has a BMI of 30 or higher is considered
obese.
- See the following table for an
example.
HeightWeight
RangeBMIConsidered5’
9"
124
lbs or less
Below
18.5
Underweight
125
lbs to 168 lbs
18.5
to 24.9
Healthy
weight
169
lbs to 202 lbs
25.0
to 29.9
Overweight
203
lbs or more
30
or higher
Obese
It is important to remember that
although BMI correlates with the amount of body fat, BMI does not directly
measure body fat. As a result, some people, such as athletes, may have a BMI
that identifies them as overweight even though they do not have excess body
fat.
Other methods of estimating body fat
and body fat distribution include measurements of skin fold thickness and waist
circumference, calculation of waist-to-hip circumference ratios, and techniques
such as ultrasound, computed tomography, and magnetic resonance imaging (MRI).
Definitions
for Children and Teens
For children and teens, BMI ranges
above a normal weight have different labels (at risk of overweight and
overweight). Additionally, BMI ranges for children and teens are defined so
that they take into account normal differences in body fat between boys and
girls and differences in body fat at various ages.
For more information on BMI
for children and teens (also called BMI-for-age),
Assessing
Health Risks Associated with Overweight and Obesity
BMI is just one indicator of
potential health risks associated with being overweight or obese. For assessing
someone’s likelihood of developing overweight- or obesity-related diseases, the
National Heart, Lung, and Blood Institute guidelines recommend looking at two
other predictors:
- The individual’s waist circumference (because abdominal
fat is a predictor of risk for obesity-related diseases).
- Other risk factors the individual has for diseases and
conditions associated with obesity (for example, high blood pressure or
physical inactivity).
For more information about the
assessment of health risk for developing overweight- and obesity-related
diseases, visit the following Web pages from the National Heart, Lung, and
Blood Institute:
Is there a quick answer to the question, "what contributes to
overweight and obesity?"
Overall there are a variety of factors that play a role in obesity. This
makes it a complex health issue to address. This section will address how
behavior, environment, and genetic factors may have an effect in causing people
to be overweight and obese.
The Caloric Balance Equation
- Overweight
and obesity result from an energy imbalance. This involves eating too many
calories and not getting enough physical activity.
- Body
weight is the result of genes, metabolism, behavior, environment, culture,
and socioeconomic status.
- Behavior
and environment play a large role causing people to be overweight and
obese. These are the greatest areas for prevention and treatment actions.
When it comes to maintaining a healthy weight for a lifetime, the bottom
line is – calories count! Weight management is all about balance – balancing
the number of calories you consume with the number of calories your body uses
or "burns off."
- A calorie is defined as a unit
of energy supplied by food. A calorie is a calorie regardless of its
source. Whether you’re eating carbohydrates, fats, sugars, or proteins,
all of them contain calories.
- Caloric balance is like a
scale. To remain in balance and maintain your body weight, the calories
consumed (from foods) must be balanced by the calories used (in normal
body functions, daily activities, and exercise).
If you are…Your caloric balance status is ….Maintaining your weight
"In balance." You are eating roughly the same
number of calories that your body is using. Your weight will remain stable.
Gaining weight
"In caloric excess." You are eating more
calories than your body is using. You will store these extra calories as fat
and you’ll gain
weight.
Losing weight
"in caloric deficit." You are eating fewer
calories than you are using. Your body is pulling from its fat storage cells
for energy, so your weight is decreasing.
Genetics and the environment may increase the risk of personal weight gain.
However, the choices a person makes in eating and physical activity also
contributes to overweight and obesity.
Environment
People may make decisions based on their environment or community. For
example, a person may choose not to walk to the store or to work because of a
lack of sidewalks. Communities, homes, and workplaces can all influence
people's health decisions. Because of this influence, it is important to create
environments in these locations that make it easier to engage in physical
activity and to eat a healthy diet.
The Surgeon General’s
Call to Action to Prevent and Decrease Overweight and Obesity 2001
identified action steps for several locations that may help prevent and
decrease obesity and overweight. The following table provides some examples of
these steps.
LocationSteps to Help Prevent and Decrease Overweight and
ObesityHome
- Reduce
time spent watching television and in other sedentary behaviors
- Build
physical activity into regular routines
Schools
- Ensure
that the school breakfast and lunch programs meet nutrition standards
- Provide
food options that are low in fat, calories, and added sugars
- Provide
all children, from prekindergarten through grade 12, with quality daily
physical education
Work
- Create
more opportunities for physical activity at work sites
Community
- Promote
healthier choices including at least 5 servings of fruits and vegetables
a day, and reasonable portion sizes
Encourage the food industry to provide reasonable food and beverage
portion sizes
Encourage food outlets to increase the availability of low-calorie,
nutritious food items
Create opportunities for physical activity in communities
Genetics
The Population
"Despite obesity having strong genetic determinants, the genetic
composition of the population does not change rapidly. Therefore, the large
increase in . . . [obesity] must reflect major changes in non-genetic
factors."
Hill, James O., and Trowbridge, Frederick L. Childhood obesity: future
directions and research priorities. Pediatrics.
1998; Supplement: 571.
How do genes affect obesity?
Science shows that genetics plays a role in obesity. Genes can directly
cause obesity in disorders such as Bardet-Biedl syndrome and Prader-Willi
syndrome.
However genes do not always predict future health. Genes and behavior may both
be needed for a person to be overweight. In some cases multiple genes may
increase one’s susceptibility for obesity and require outside factors; such as
abundant food supply or little physical activity.
Other Factors
Diseases and Drugs
Some illnesses may lead to obesity or weight gain. These may include Cushing's
disease, and polycystic ovary syndrome. Drugs such as steroids and some
antidepressants may also cause weight gain.
A doctor is the best source to tell you whether illnesses, medications, or
psychological factors are contributing to weight gain or making weight loss
hard.
Research has shown that as weight increases to reach the levels referred to
as "overweight" and "obesity,"* the risks for the following
conditions also increases:
- Coronary
heart disease
- Type 2
diabetes
- Cancers
(endometrial, breast, and colon)
- Hypertension
(high blood pressure)
- Dyslipidemia
(for example, high total cholesterol or high levels of triglycerides)
- Stroke
- Liver and
Gallbladder disease
- Sleep
apnea and respiratory problems
- Osteoarthritis
(a degeneration of cartilage and its underlying bone within a joint)
- Gynecological
problems (abnormal menses, infertility)
*Overweight is defined as a body mass index (BMI) of 25 or higher; obesity
is defined as a BMI of 30 or higher.
Related Resources
References
NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on
the Identification, Evaluation, and Treatment of Overweight and Obesity in
Adults. Available online:
The dramatic increase in the prevalence of childhood overweight and its health
consequences are associated with significant health problems and financial
burdens. This statement proposes strategies to foster prevention and early
identification of overweight and obesity in children, and for dietary and
physical activity interventions during physical check ups.
The National Institute of Health’s National Institute of Diabetes and Digestive
and Kidney Diseases (NIDDK) created a weight-control information network. This
site is an online resource for information on obesity, its causes, and health
risks, and provides measurement tools and relevant publications on the topic.
Recommendations
The U.S. Surgeon General calls upon the nation to work together in finding
solutions to the problem of obesity and overweight. To read the report, visit
the Surgeon General's Web site.
Surgeon General's Call to Action Fact Sheets:
The guidelines present an approach for
assessing overweight and obesity and established principles of safe and
effective weight loss. (This resource is hosted by the National Institutes of
Health.)
Resources On this Page
A resource guide for nutrition and physical activity programs to prevent and
control obesity and other chronic diseases. Topics cover obesity prevention and
control (including caloric intake and expenditure), increased physical
activity, improved nutrition (including increased breastfeeding and increased
consumption of fruits and vegetables), and reduced television time.
General Information about Weight, Nutrition,
and Health
CDC, Nutrition and Physical Activity
Achieving and maintaining a healthy weight isn't just about a
"diet" or "program". It is part of a ongoing lifestyle
that you can adopt now and stay with for years to come. A healthy weight
contributes to good health now and as you age.
CDC, Nutrition and Physical Activity
Information about the Body Mass Index (BMI), a calculated value used for
identifying overweight and obese adults, access to a BMI calculator, and links
to related information.
CDC, Diabetes Public Health Resource
Research studies have found that moderate weight loss and exercise can prevent
or delay type 2 diabetes among adults at high-risk of diabetes.
Dietary Guidelines for Americans, published jointly by the Department
of Health and Human Services (HHS) and the Department of Agriculture (USDA),
provides advice about how good dietary habits for people aged 2 years and older
can promote health and reduce risk for major chronic diseases.
The Food and Nutrition Information Center (FNIC) at the National Agricultural
Library (NAL)
The Interactive Toolbox contains links to Web sites that allow consumers and
professionals to input information and receive individual feedback to help with
dietary assessment and planning, checking personal health risks, testing
knowledge, and evaluating needs.
MedlinePlus as service of the US National Library of Medicine brings together a
wealth of authoritative obesity information from NLM, the National Institutes
of Health (NIH), and other government agencies and health-related
organizations.
Department of Agriculture (USDA)
MyPyramid Plan can help you choose the foods and amounts that are right for
you. An online dietary assessment that provides information on diet quality and
related nutrition information. It also assesses physical activity.
Weight-control Information Network NIDDK
This glossary defines words that are often used when people talk or write about
obesity, physical activity, and weight control. It is written for people who
are overweight or obese, or interested in learning more about obesity, physical
activity, nutrition, and weight control.
Regular physical activity offers many health benefits. The new Physical
Activity Web site provides information on the importance of physical activity
and how to make it part of your life.
Department of Health and Human Services (HHS)
Weight-loss success stories, Small Step tips, and other resources for
maintaining and losing weight.
Department of Health and Human Services (HHS)
A call to action that outlines strategies that communities can use in helping
to address the problems of overweight and obesity.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),
Weight-control Information Network (WIN)
General information, publications, and other resources on weight control,
obesity, physical activity, and related nutritional issues for the general
public, health professionals, the media, and Congress.
Weight Loss and Maintenance
National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK),
Weight-control Information Network (WIN)
Some overweight people face challenges trying to be active. Find out how to get
more active no matter what your size.
National Institutes of Health (NIH), National Heart Lung and Blood Institute
(NHLBI)
Guidelines for the measurement of overweight and obesity and steps for safe and
effective weight loss.
ASBP offers information on the problem of obesity, tips on weight loss, and
a referral program to bariatric physicians (specializing in obesity treatment)
for professional consultation.
National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK),
Weight-control Information Network (WIN)
Fact sheet that discusses binge eating disorders.
National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK),
Weight-control Information Network (WIN)
Fact sheet to help consumers make an informed decision about joining a
weight-loss program.
Federal Trade Commission (FTC), Weight Loss & Fitness
Consumer information on topics such as finding the right weight loss program
and avoiding deception.
Food and Drug Administration (FDA), Center for Food Safety and Applied
Nutrition (CFSAN)
Links to information related to losing weight.
CDC, Nutrition and Physical Activity
Links to additional information and resources on nutrition.
Regular physical activity offers many health benefits. The new Physical
Activity Web site provides information on the importance of physical activity
and how to make it part of your life.
National Heart, Lung, and Blood Institute (NHLBI) offers a national education
program designed for parents and caregivers to help children 8-13 years old
stay at a healthy weight.
The booklet "
Finding
the Balance: A Parent Resources" offers an array of easy to use
practical tips and tools for parents and guardians to help their children and
families eat healthy, increase physical activity, and decrease screen time.
Federal Citizen Information Center
Booklet designed to help consumers ask the right questions to choose a safe and
effective weight loss method and to determine if their weight puts them at risk
for health problems.
Education and Research
The CDC's Legislative Database contains summaries of state legislative
bills related to nutrition and physical activity from 2001 to present. Links
are provided to each state legislature site to obtain the full-text version of
the bill.
United States Department of Agriculture (USDA) This report presents a summary
of the papers and the discussions presented at a workshop focused on health
economics research on the causes and consequences of rising obesity in the
United States.
National Institutes of Health (NIH), National Heart, Lung, and Blood Institute
(NHLBI)
Information on an initiative designed to help reduce the prevalence of
overweight along with the prevalence of physical inactivity in order to reduce
the risk of coronary heart disease (CHD) and overall morbidity and mortality
from CHD.
National Institutes of Health (NIH), National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK), Weight-control Information Network (WIN)
Information about grant programs to support obesity and nutrition research and
research training: the Clinical Nutrition Research Unit (CNRU) and the
Obesity/Nutrition Research Center (ONRC).
United States Department of Agriculture (USDA), Food and Nutrition Information
Center
Reports and studies on obesity.
CDC, Nutrition and Physical Activity
Document examining the evidence from available studies to determine whether
eating fruits and vegetables can help with weight management.
You will find CDC Growth Chart Training Modules, CDC Growth Charts 2000
Slide Set and other resources for using the 2000 CDC Growth Charts.
Childhood Overweight and Obesity
Overweight is a serious health concern for children and adolescents. The most
recent data indicate that in the United States about 16% of children ages 6–19
years are overweight.
CDC Division of Adolescent Health and School Health
General information about overweight among young people and general information
on healthy eating and physical activity in childhood and adolescence.
Center for Weight and Health, University of California, Berkeley
A tool kit designed to help communities respond to the increasing problem of
childhood obesity by mobilizing local resources.
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),
Weight-control Information Network (WIN)
American Academy of Pediatrics (AAP)
General information about childhood overweight and obesity.
This new report explores the influence of food and beverage marketing on the
diets and diet-related health of U.S. children and youth. The reports includes
the committee's recommendations for how various stakeholders can promote
healthful foods and beverages to children and youth.
Results of a qualitative study with children and parents to understand barriers
and opportunities for reducing children's television viewing.
Overweight is a risk factor for health conditions such as diabetes and is
associated with problems such as poor self-esteem. The good news is that
schools can help students and staff adopt healthy eating and physical activity
behaviors that are the keys to preventing obesity! Whether you are a teacher,
parent, student, or school administrator, you can make healthy changes at your
school.
The Department of Health and Human Services (HHS)
A child-focused site offering nutritional advice, games and activity
suggestions for children and parents as part of the obesity prevention
campaign. The computer-animated character Shrek encourages kids to go out an
play.
National Institutes of Health (NIH)
We Can! stands for Ways to Enhance Children's
Activity & Nutrition. We Can! is a
national education program designed for parents and caregivers to help children
8-13 years old stay at a healthy weight. Learn practical tips to help your family
find the right balance of eating well and being physically active to maintain a
healthy weight.
What services do we
provide:
1.
Education on obesity.
2.
Complete evaluation of obesity and its health
related complications if detected.
3.
Complete Pulmonary Function Tests to assess the
effects of obesity on lung function, including restrictive lung patterns,
obesity-hypoventilation syndrome, hypoxemia states, etc.
4.
Diagnostic Polysomnography to assess the
presence of obstructive sleep apnea syndrome which contributes to progressive
weight gain, cardiovascular risk factors, hypertension, metabolic syndrome,
congestive heart failure.
5.
6 Minute Walk Tests to assess functional
capacity and cardiovascular fitness, oxygenation status, exercise capacity,
etc.
6.
Referral and Evaluation by nutritionist if
clinical indicated.
7.
Referral and Evaluation by an exercise
specialist if clinically indicated.
8.
Referral and Evaluation by a certified respiratory
therapist if clinically indicated.
9.
Various outside weight loss programs like Weight
Watchers, etc if clinically indicated
10.
Referral and evaluation by an endocrinologist if
clinically indicated.
11.
We provide all pertinent information on obesity
management and its health related issues in the form of brochure, video
programs, exercise techniques, etc. This information is available on CDC sites
as above.
12.
Referral and Evaluation by a cardiologist
13.
Referral and Evaluation by a bariatric surgeon
if clinically indicated.
If you have any questions or
comments regarding this program, please do not hesitate to contact us by email
or phone call.
Thanks for your support in the
success of this program.
Staff at Phoenix
Rising Medical, PC
Additional
Resources:
http://www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm