Dagang Dagang

Percaya atau tidak, mendaftarkan merek dagang adalah tugas terberat yang harus dilakukan saat melindungi bisnis atau nama merek Anda. Jika Anda tidak serius tentang tanda Anda, itu mungkin benar-benar merugikan Anda baik dalam bentuk uang dan usaha, yang selanjutnya dapat menyebabkan kelebihan stres dan pelecehan mental. Selain itu, proses yang mendebarkan dan rumit ini melibatkan banyak tugas dan hal-hal yang harus dipertimbangkan ketika berpikir tentang memulai bisnis baru. Proses ini hanya dapat ditangani oleh pengacara merek dagang, yang ditunjuk oleh pemilik bisnis itu sendiri.

Agar tetap bebas gangguan dan menjalankan bisnis Anda dengan lancar, Anda harus mempertimbangkan poin yang tertulis di bawah ini yang akan membantu Anda merencanakan lebih baik untuk bisnis Anda pendaftaran merek.

• Pastikan itu unik – penting bahwa Anda menjaga agar merek dagang Anda unik dan sederhana sehingga pelanggan Anda dapat dengan mudah mengenali merek atau perusahaan Anda. Secara umum, merek dagang adalah simbol, yang digunakan oleh pemilik bisnis yang berbeda untuk membedakan produk dan kualitas pekerjaan mereka. Simbol dapat berupa logo, atau gambar, slogan, atau kata sesuai preferensi pemilik.

• Buat rencana yang tepat dan memulainya – ini termasuk membuat dokumen yang menyoroti semua kebutuhan bisnis Anda dan kemudian keluar dengan rencana yang disempurnakan dan luas untuk mencapai semua keinginan Anda. Pikirkan tentang bagaimana Anda akan memulai dengan usaha Anda dan bagaimana Anda akan menghabiskan uang Anda. Tulis semuanya dan berikan bidikan terbaik Anda untuk memenuhi semua kebutuhan Anda.

• Jaga agar tanda Anda sederhana dan subyektif – seperti di Amerika Serikat Paten dan Trademark Office (USPTO), merek dagang Anda harus aneh, menggugah, dan berubah-ubah. Jika seandainya tanda Anda tidak memenuhi semua persyaratan di atas, itu tidak akan dianggap sebagai yang sah.

• Berbagai manfaat lain – begitu Anda mendaftarkan merek Anda, Anda akan diizinkan untuk menggunakan merek Anda untuk tujuan komersial, mendaftar di negara lain dan mengajukan sengketa di pengadilan federal, membantu Anda menghindari masalah yang tidak perlu, menghemat waktu dan uang Anda, dan banyak lagi.

• Memenuhi semua persyaratan yang diperlukan untuk memulai bisnis baru – Anda harus menyelesaikan semua dokumen yang diperlukan sebelum memulai perdagangan baru, yang pada dasarnya termasuk melaksanakan sertifikasi wajib, mengambil kebijakan asuransi bisnis, mendapatkan persetujuan bisnis wajib, dan banyak lagi.

Hal terpenting yang tidak disebutkan di atas adalah, ‘untuk memilih nama merek yang sesuai’. Pastikan nama merek Anda pendek, unik, dan mudah diingat, karena ini akan membantu Anda menciptakan dampak positif pada pikiran pelanggan Anda.

Modern Modern

The rare coin market like any other healthy market has its ups and downs. Pre WWII coins have been around long enough to have an established market. The modern issue coins can and often have a flash-in-pan type following.

Rarity value in coins is in context to their market demand. If everyone in America became interested in silver coins, there wouldn’t be enough of any one coin to go around. For example, the 1921 Morgan was produced in huge numbers. Close to 87 million, in fact. That’s only around one 1921 silver dollar for every household.

Many modern collector coin issues are minted in relatively low numbers, but does that make them good investments? I consider many modern “rare” coins to be like jewelry. They have their intrinsic value in their precious metal content, but when you sell the coin, you might not get back the premium you paid for it.

The most risky modern “rare” coins I think are the ones hyped up in promotional material or catalogs. They often have a story about their conception or design.

Low mintage numbers may be given to indicate rarity, but more often than not, a conditional rarity is created because of numbers receiving a certain grade by a third party grading company Coinmarkets.

PCGS and NGC seem to be willing participants in grading modern common coins to give them a conditional rarity and legitimacy for the seller. The seller then asks four to ten times their worth to see if the market will buy the hype.

If you buy coins like these at the advertised prices, you might have to wait for a long time to sell them at a profit. Chances are you won’t have the promotional resources to package the coin so you educate/convince someone to buy your coin at a really inflated price.

Modern commemorative silver or gold coins are risky to buy at inflated prices. The commemorative market tends to forget the original reason for the coin being special, and often won’t pay for that specialness in the future.

Modern silver and gold coins don’t have the track record of the old established collector coins, which makes them somewhat risky as an investment. There are modern rare coins that appreciate in value fairly quickly, but I consider ten years to be a minimum track record for an investment coin.

However, if you have your hand on the pulse of future trends and can predict them with some accuracy, be contrarian. Buy the trend-maker coin and profit from it. Otherwise, simply buy the modern rare coin because you love it, and not concern yourself with future performance, because you don’t plan to sell it.

I prefer American Eagle silver and gold coins directly from the mint. They have an established track record. The baseball coins may be a flash-in-the-pan coin. The promotional material of course says they’ll sell for multiples of their issue price. They might… Then they might not. I won’t take the chance.

Few modern commemoratives have become modern rarities. The 2001 Buffalo silver dollar, I think is one exception. It sold out quickly and now sells for multiples of its original mint price. The 2011 25th anniversary silver eagle set looks like another hit for those lucky enough to have gotten their order in early on the day of sale.

When there’s frenzy over a newly released coin, and they actually do get multiples of their original issue price, you need to be on either side of the frenzy, not in the middle of it. Either be the first one to buy some ahead of the crowd, or patiently wait out the frenzy to see where the dust settles.

Kasino Kasino

Ketika Anda sedang berlibur (dan bahkan ketika Anda tidak) memiliki flutter di kasino benar-benar dapat memompa darah dan ketika Anda menyebutkan kasino, dua kata menonjol di pikiran banyak orang. Las Vegas.

Las Vegas terkenal dengan kasinonya dan memiliki beberapa yang terbesar di dunia. Jutaan berkunjung setiap tahun untuk memiliki pengalaman seumur hidup dan jika Anda belum pernah mengunjungi kota sebelum waktunya Anda turun ke agen perjalanan lokal untuk memesan perjalanan. Sejak dijadikan legal pada tahun 1931, perjudian telah menjadi bagian utama dari Las Vegas dengan kasino yang ditawarkan kepada wisatawan ke mana pun Anda pergi termasuk di dalam beberapa hotel.

Wisatawan ke Las Vegas tidak datang untuk mandiriqq pemandangan dan monumen tetapi mereka datang mencari sensasi kasino. Dengan slot penny untuk first-timer dan mereka yang tidak ingin bertaruh besar dengan meja roulette dan blackjack di mana banyak uang dipertaruhkan. Apakah Anda ingin hanya pergi untuk pengalaman atau mencari untuk memenangkan hidup mengubah jumlah uang, Anda akan menemukannya di meja-meja kasino Las Vegas.

Kasino Bellagio dan MGM Grand adalah dua yang terbesar dan sering dikunjungi oleh banyak orang setiap hari. Mereka begitu terkenal dan terkenal di seluruh dunia bahkan penggemar non-perjudian tahu nama mereka. Kedua kami termasuk dalam box office hit Oceans Eleven yang memiliki beberapa bintang film terbesar di sekitar sebagai bagian dari para pemain. Jika Anda mengunjungi Vegas maka Anda harus mencoba dan mengunjungi Bellagio atau MGM Grand karena mereka adalah rumah dari kasino.

Keberhasilan kasino-kasino ini telah melihat lebih banyak lagi di seluruh dunia sehingga untuk membawa pengalaman kasino ini kepada massa. Sekarang ada banyak kasino online di mana orang dapat memiliki kepakan setelah seharian bekerja keras atau bersenang-senang dengan teman dan keluarga. Popularitas kasino masih meningkat dengan banyaknya orang yang bermalam dengan teman-teman di mana kesenangannya tidak ada habisnya dan merupakan alternatif yang baik untuk bermalam di kota di mana Anda akhirnya melakukan hal yang sama seperti biasanya.

Marketing Marketing

Social-media has impacted our own lives in various methods and also at times with no understanding it. Doing so, it has a significant impact on the progress of businesses. Even though you can find managers who live in a country of refusal which societal media marketing has nothing to perform their surgeries, if used efficiently it may reap them in a million ways.

Considering integrating the sphere of social networking on your company affairs? You’re looking for the perfect track! From the possiblity to increase your earnings to getting access to your worldwide audience, it is the need of businessmen within the century and beyond.

1. Chance to Getting Recognized

You might be running a marvelous brand name, but it’s most certainly not attaining its possible in case it will not get recognized with consumers. Social media allows you to create others gain awareness of your own brand new. This could be the initial measure toward creating your organization. So the next time when prospective customers stumble upon your brand-new Twitter, then you know that you’re getting there!

2. Know and Get Connected to Your Target Market

Marketing can find much harder on occasion. That really is only because upcoming the suitable target audience is just a task. Gladly, happy are such times at which you had to knock doors along with your samples to hunt for the potential customers. The world of social media attracts all your web visitors close to you personally. The one alive nextdoor, at an identical city or even outside the country get the ability to know that you.

As you learn from the target market, it offers you a opportunity to acquire personal with them. Going throughout the posts and tweets of your intended audience can allow you to get aware of latest trends and reevaluate your plans accordingly curtidas no instagram.

3. You’re the Minute Problem Solvers!

Almost all of us know that the annoyance out of the changing times where you’d to await the manager of the new to deal with our issue. Since these were just available in man or woman, it was an activity to confront them. Fortunately, societal media has solved this grave issue of people along with businesses. Now, your brand can become everywhere, and fix any issues. Most importantly, the period differences around the globe have become insignificant as you are able to solve problems through your societal accounts instantaneously!

4. A Possiblity to Increase Brand Loyalty

Let us enter the sneakers of customers first. Are you the one that gives out a bit of relief once you figure out a particular new on face book, Twitter, P interest, Instagram and also such? Without even understanding the upgrades that continue coming up on the homepage of most these social platforms influence our minds in so many methods.

If you’re running a brand, then you’re certainly benefiting from excellent news. If you participate on interpersonal media, clients tend to rely on that your brand more.

5. Enriched Revenue

Have excellent deals for your own customers? You don’t have to wait for these to pop up during the last hours of a saturday and sunday. It readily takes up the job! If you benefit your followers with sales and supplies associated with your product, your company will increase unimaginably! Social Media Marketing can be an art form on the planet and businessmen have every purpose to understand it.

Still believing? Oh well, it is free of charge! In the event you manage yourself, it will undoubtedly be absolutely the least expensive and productive marketing and advertising tactics.

 

Sportsbook Sportsbook

Apakah Anda penggemar olahraga? Apakah Anda suka uang tumbuh? Bagaimana dengan judi atau sedikit spekulasi? Jika jawaban Anda positif, Anda dapat menyukai buku olahraga diskon!

Pertama-tama, apa itu buku olahraga? Buku olahraga adalah cara bagi pemain bertaruh pada berbagai jenis olahraga seperti sepak bola, golf, sepak bola, hoki, baseball, basket, tinju, dan pacuan kuda. Itu juga terkenal karena ras, buku olahraga atau buku. Menariknya, situs taruhan ini sangat populer di Amerika Serikat dan juga telah menyebar ke bagian lain dunia. Taruhan tidak tetap. Tetapi bersifat dinamis dan bervariasi tergantung pada jenis game.

Legalitas bervariasi di berbagai belahan dunia. Misalnya, di Amerika Serikat, ada sekitar 150 saluran berlisensi, semuanya di kasino Nevada, meskipun mereka dilarang di 49 negara bagian yang tersisa. Di banyak negara lain, buku-buku olahraga sering disebut “bookmaker” atau bookmaker, dan mereka sepenuhnya legal.

Di masa lalu, saluran taruhan judi online  ini dalam mode offline memerlukan transaksi tatap muka. Namun, munculnya teknologi dan perkembangan komputer dan Internet telah mengubah dinamika banyak bidang. Taruhan olahraga juga tersedia online. Ada banyak keuntungan untuk buku-buku olahraga online karena mereka menarik lebih banyak penawaran meskipun tidak kontak tatap muka. Biaya juga lebih rendah karena beroperasi dengan overhead minimal dan manfaat ini ditransfer ke taruhan melalui pemotongan harga. Harga diskon ini juga dapat berupa diskon tambahan atau insentif.

Sekarang, langkah berikutnya dalam evolusi dari olahraga offline ke taruhan olahraga online adalah mengurangi olahraga jus. Jika Anda bertanya-tanya tentang hal itu, pikirkan lebih lanjut. Cara sederhana untuk memahami adalah saluran taruhan biasa mengenakan biaya untuk taruhan. Biaya ini disebut sebagai “jus”. Sekarang, beberapa menawarkan “mengurangi jus” yang berarti bahwa saluran ini meningkatkan penis dengan mengurangi biaya lebih banyak. Jus alami adalah 10% dari taruhan. Jika, $ 100 hingga $ 110 untuk jus standar, sementara juicer mungkin menawarkan harga yang sama di $ 107 atau bahkan $ 105!

Sekarang, Anda dapat melihat mengapa sportsbook populer menjadi kurang populer. Taruhan olahraga akan mendapat manfaat dari konsep ini. Seperti situs taruhan ini menawarkan lebih sedikit jus untuk memotong keuntungan mereka meskipun mereka menghitung dalam jangka panjang, akan bermanfaat bagi mereka karena mereka mendatangkan lebih banyak pelanggan. Selain itu, taruhan olahraga online bekerja untuk meningkatkan belanja publik dengan mengurangi sebanyak mungkin sehingga bisnis terus menghasilkan keuntungan.

Namun, penawar harus berhati-hati dalam membaca syarat dan ketentuan dan tidak terburu-buru tanpa memahami apa yang mereka masukkan. Ini juga merupakan ide yang baik bagi mereka untuk memeriksa kredibilitas situs taruhan olahraga yang mereka pertaruhkan. Beberapa situs ditemukan mengadopsi praktik yang meragukan. Namun, ada situs web yang terkenal sportsbooks yang dapat dipercaya trusters berdasarkan pada track record mereka.

Online Online

Pemain AS masih bertanya “apakah itu Hukum untuk bermain di Kasino Online USA?”. (Kasino USA adalah keliru, SEMUA Kasino didasarkan di suatu tempat selain di Amerika Serikat) Sudah empat tahun sejak undang-undang UIGEA (Undang-Undang Penegakan Undang-Undang Permainan Hukum yang Tidak Sah) Presiden Bush menandatangani 13 Oktober 2006 yang berlaku 1 Juni 2010. Biarkan saya menyatakan bahwa itu tidak sekarang, dan tidak pernah ilegal.

Maksud dari RUU lumpuh ini awalnya adalah untuk menghentikan itudomino pencucian uang, tidak menghentikan Pemain Kasino dari bermain di Kasino USA. Mereka mengejar “pengolah uang” tanpa banyak berpikir dan dalam proses menyulitkan pemain untuk melakukan setoran hukum ….. jika Anda ingin membaca seluruh kisah tentang bagaimana semua ini benar-benar berkembang: Lihat tautan di bawah ini

Saat ini ada lebih dari 2.000 Kasino Online di Internet dan sekitar 160 kasino uang sungguhan yang menerima Pemain Kasino AS.

Kenapa hanya 160? Kembali pada tahun 2006 banyak Kasino yang pemasaran global memutuskan akan lebih mudah untuk hanya melompat kapal dan tidak menerima Pemain Kasino USA, daripada berurusan dengan masalah deposito yang tertunda. Hasil dari ini adalah Pemain Kasino USA panik takut pembalasan, dan berhenti bermain sama sekali.

Minat baru yang sangat besar dalam Perjudian Online telah terjadi dalam beberapa tahun terakhir, tetapi, rasa takut dan rasa ingin tahu yang berlebih-lebihan itu legal dan aman, masih ada.

Hilangkan ketakutan Anda. Aman, menyenangkan, dan legal. Yang sedang berkata, sekarang, karena selalu, perlu untuk menggunakan hati-hati dalam meneliti pilihan Anda dari Kasino untuk bermain. Ada beberapa hal yang harus dicari dalam memilih Kasino bereputasi yang aman.

Pertama Apakah Hukum Perjudian Daring di wilayah hukum Anda?

Saat ini ada negara bagian yang telah memberlakukan undang-undang setempat yang melarang segala bentuk judi online mereka: Michigan, Illinois, Oregon, Louisiana, Wisconsin, Washington, Indiana, Nevada, Dakota Selatan. Jika Anda tinggal di salah satu negara bagian ini, saya minta maaf tetapi Anda tidak akan dapat mengunduh atau melakukan setoran atau bermain secara gratis di Kasino Online mana pun. Silakan periksa undang-undang negara bagian Anda sendiri.

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In other words, triumph from the electronic market place is dependent upon how good a small business can meet its clients’ desires for internet remedies. Fully being truly a critical internet promoting tool, most mobile programs are playing with a very important part in aiding organizations along with their promotion objectives. The benefit of amobile program is based greatly on its being able to standout since you can find countless of programs on the market not able are just the ideal. Without Regard to Business and Company version, your Cellular program ought to possess the next qualities as a Way to Be Extremely Powerful and effective:

Simplicity

Cluttered, simple, and more complicated aspects will spoil user-experience. In a location where folks would rather get applicable and uncomplicated alternatives, your cellular program should furnish alternatives in a easy method. Simplicity becoming an integral element of an userfriendly program, it requires a handy graphical user interface along with crystal clear navigation. This really is but one of those critical qualities which help cellular programs bring and maintain a faithful after Download ACMarket.

Optimization

Since we have been aware of their variety and value of handheld gadgets, your cellular program needs to really be optimized for most sort of cellular phones along with tablet computers. I-OS and Android really are just two fundamental platforms which need to be handled. Be certain your program runs sleek across all of makes and apparatus.

Large functionality

Exactly what exactly do people do as soon as an program takes an excessive amount of time for you to start? Your cellular program has to establish fast devoid of keeping end users awaiting. The operation of a program is likewise confirmed by top quality guarantee and you also have to bear this in your mind.

Upgrades and consumer participation

The majority of the programs have been downloaded also
used

merely as soon as. As a way to prevent that, it’s necessary for you to bring the section of pleasure therefore end users stay participated and delight in the adventure. Routine upgrades may also be essential to give an program with sustained recognition. Bear in mind, just regularly upgraded programs can endure the ferocious rivalry.

Desirable Style and Design

Desirable visuals usually do not matter if it regards website promotion. Taking in to consideration that the high degree of rivalry, program designers and developers must earn their product or service distinctively desirable. Assessing a program in a one-of-a-kind and familiar manner is crucial.

Purposeful and elastic

Successful programs help end users having some thing. Many companies produce mobile programs without a simply a screen in their goods and solutions. Your program ought to have the ability to fix a issue and give some thing invaluable. Therefore much as adaptivity is worried, successful programs adapt with people’ choices and prerequisites.

Marketing Marketing

While Insta-gram proceeds to increase in fame, many readily accessible clients simply awaiting enjoy the own image, it merely is logical for companies to develop into busy within the social networking system. Some organizations might believe that they all need to do is publish a picture and await followers to remark and enjoy their own image; yet however it can take slightly bit more hard work than it to gain in the promotion advantages which may be acquired via the site.

Certainly one of those first items a fresh user needs to perform is always to have whole benefit of this Bio part that’s featured at peak of one’s own profile. This invaluable distance ought to be utilised to spot that which your enterprise is, whatever you can do, and also your internet site details. You also ought to create this distance interesting for people, incorporate just a tiny personality that’ll reveal you aren’t yet another boring firm attempting to hop onto the Insta-gram band-wagon. You also ought to connect most one’s societal media marketing accounts for the Insta-gram account. This can permit one to share with you videos and images you’ve shared. This really is actually a huge means to grow visitors between most one’s different societal networking reports. If your company features a face-book page, then you will include things like connections to a Insta-gram accounts comprar seguidores no instagram.

The graphics that you just pick to talk about for your own Insta-gram accounts ought to really be particular and maybe not just promotional. In the event you include graphics which are somewhat more particular in character and perhaps not some thing which is seen at a magazine, then you also will start to construct a lifestyle which can be certainly more approachable and personable. These would be the kinds of graphics that followers may associate with and love on the normal foundation. Additionally you will see why these sorts of pictures frequently get the maximum opinions and interaction one of followers compared to some other graphics which are frequently published with additional organizations.

To be sure your graphics are available by curious parties, so you also ought to include things like Hash-tags. Vigilantly chosen Hash-tags will guarantee your graphics appear searching outcome and find the interest of these individuals you’re working to get to. It’s been demonstrated that end users that utilize a minimum of five hash tags received probably the maximum interaction from end users. For those who created a favorite hash-tag on different societal networking sites, then you should keep touse this hash-tag onto Insta-gram at the same time.

Insta-gram has lots to provide organizations as being a promotion software, however only supposing it’s utilised within the right method. In the event you have a few of the methods that we’ve recorded previously ought to soon start to observe a gain in followers in addition to interaction amongst end users. When you have not already established an Insta-gram account, you can wish to accomplish therefore whenever you possibly can.

Perjudian Perjudian

Meskipun mayoritas penjudi akan menghargai perjalanan ke Vegas, kita tidak punya waktu atau uang untuk melakukannya. Namun, itu tidak berarti bahwa kita tidak dapat memiliki kesenangan yang sama dengan mereka yang telah melompat ke penerbangan berikutnya. Kasino online memberi kita banyak permainan dan peluang perjudian sebagai kasino terbaik di Nevada.

Kasino online memberi Anda kesempatan untuk menikmati pelangiqq hiburan dan kegembiraan yang datang dengan perjudian, tanpa pernah meninggalkan kenyamanan rumah Anda sendiri. Anda akan mendapatkan poker, blackjack, rolet, slot, dan game hebat lainnya, tanpa suara, lampu yang mengganggu, dan kerepotan lain yang datang dengan kasino “langsung”. Kasino online memiliki semuanya: kenyamanan, privasi, dan kesenangan! Apa lagi yang bisa Anda minta dalam hiburan online?

Kasino daring juga memberi Anda kesempatan besar untuk bermain hanya melawan kasino, atau dengan orang lain yang tidak pernah Anda lihat. Ini sangat bagus untuk orang-orang yang bukan penjudi “serius”, karena banyak pemain yang lebih terlatih yang tahu cara menonton dan menghafal ekspresi Anda, dan dapat menggunakan wajah Anda sendiri melawan Anda.

Ketika Anda bermain di kasino virtual, bagaimanapun, lapangan bermain telah agak diratakan, dan Anda perlu lebih bergantung pada keterampilan Anda di permainan, bukan trik-trik kecil. Anda melihat dengan tepat apa yang akan dilihat lawan Anda, dan Anda bebas berperilaku sesuka hati. Bersemangatlah dengan tangan yang hebat. Melompat untuk kesenangan. Berteriaklah pada lawan ketika mereka membuat Anda frustrasi. Mereka tidak akan pernah tahu! Perjudian virtual berarti Anda dapat berjudi sesuka hati dan menjadi diri sendiri seperti yang Anda lakukan.

Semua ini tersedia di kasino online apa pun yang diberikan, dengan keuntungan tambahan bahwa Anda tidak pernah menghabiskan uang atau mengambil cuti untuk terbang – atau mengemudi – semua jalan ke kasino terdekat – atau tidak begitu terdekat -. Anda tidak akan pernah merasa lelah karena harus pergi ke kasino online. Selain itu, tidak ada yang dapat menjual minuman Anda terlalu mahal – kecuali toko kelontong Anda bengkok.

benefícios benefícios

Se você está acima do peso, não está sozinho. Em 2007, 2 de 3 americanos estão acima do peso ou obesos. Como sociedade, estamos nos tornando cada vez mais conscientes de que a diminuição da atividade, juntamente com o aumento da ingestão calórica e a má nutrição, lentamente, mas inevitavelmente, sobrecarregam a capacidade de nossos corpos de manter um peso saudável.

Estar acima do peso ou obeso coloca você em sério risco de desenvolver muitas doenças relacionadas à obesidade. Essa é a má notícia. A boa notícia é que reduzir seu peso reduz quitoplan drasticamente esses mesmos riscos. Para aqueles pacientes que sofrem destas condições, a perda de peso pode melhorar significativamente ou corrigir completamente estas condições.

Resistência à Insulina e Diabetes Mellitus

A obesidade leva à resistência à insulina, uma resposta biológica diminuída ao hormônio insulina. Essa resistência é caracterizada pela elevação da insulina circulante, diminuição da capacidade de armazenar glicose e propensão ao armazenamento de gordura.

Em pacientes com diabetes mellitus não dependente de insulina, os níveis séricos de glicose melhoram dentro de alguns dias após o início de um programa de perda de peso. Um estudo mostrou que os níveis médios de glicose no sangue em jejum em pessoas com diabetes tipo 2 diminuíram de 290 mg / dL para 110 mg / dL em 3 dias em resposta a uma dieta de muito baixa caloria. Medicação (agentes orais ou insulina) pode ser grandemente reduzida ou eliminada em tais casos. Outro estudo relatou que, após uma perda de peso de 23 kg (22% do peso corporal inicial), todos os pacientes em uso de agentes orais e 82% dos pacientes em uso de insulina foram capazes de descontinuar a medicação. Resultados semelhantes foram relatados com perdas de peso de 9,3 kg. Em geral, pacientes com uma redução de 15% no peso corporal total podem considerar a suspensão de agentes orais. Diminuições menores no peso corporal total podem até curar “pré-diabetes”, um risco cardiovascular significativo.

Hipertensão

A hipertensão melhora com a perda de peso em pessoas com excesso de peso. Em pacientes que seguiram dietas de muito baixas calorias (DMVs), um estudo relatou uma diminuição significativa na pressão arterial sistólica em 81% dos pacientes e na pressão diastólica em 62% dos pacientes (6). Os pacientes que receberam uma dieta de 800 a 1.200 kcal que tiveram uma perda de peso média de 10,5 kg apresentaram reduções nas pressões sistólica e diastólica de cerca de 20 mm Hg. Em cerca de três quartos desses pacientes, a pressão arterial voltou ao normal. Adicionando um regime de exercícios para perda de peso levou a melhorias ainda maiores na pressão arterial.

Dislipidemia

A obesidade é frequentemente associada a uma elevação dos triglicerídeos séricos e do colesterol total. A proporção de LDL para colesterol HDL é geralmente elevada, resultando em um risco ainda maior de ataques cardíacos e derrames. Todos esses valores geralmente melhoram com a perda de peso. Frequentemente, os níveis de triglicerídeos em jejum que podem chegar a 1.000 a 1.500 mg / dL retornarão aos níveis normais (apneia do sono

A obesidade pode estar associada a comprometimento funcional respiratório leve a grave. O aumento da obesidade está associado à diminuição da saturação de oxigênio. Duas desordens primárias ocorrem: síndrome de hiperventilação da obesidade e apneia do sono.

Pacientes com hipoxemia (níveis baixos de oxigênio no sangue) e apnéia do sono melhoram rapidamente com a redução de peso. Para cada redução de 1% no peso, os pacientes com apnéia do sono diminuem seus índices de apnéia-hipopneia (a quantidade que eles param de respirar à noite) em 3%. De fato, muitos pacientes com apnéia do sono que dormem com máquinas CPAP são capazes de parar de usar suas máquinas de respiração à noite após a perda de peso.

Uma perturbação da ventilação-perfusão (uma incompatibilidade na respiração versus circulação) é comum em pessoas obesas. Este distúrbio pode resultar em insuficiência cardíaca. Estas condições também melhoram com a perda de peso. Com perda de peso significativa, a função pulmonar essencialmente normal pode ser alcançada e a função cardíaca pode ser normalizada.

Síndrome metabólica

A gordura intra-abdominal é metabolicamente ativa e está associada a sério risco à saúde. A Síndrome Metabólica descreve um conjunto de fatores de risco cardiovasculares que se combinam para produzir um estado pró-inflamatório e pró-trombótico (hipercoagulável). Esta condição leva a doenças vasculares que resultam em ataques cardíacos e derrames e um estado pró-inflamatório associado a um aumento da incidência de vários tipos de câncer. Estima-se que mais de 50 milhões de americanos estão atualmente em risco, mas menos de 5% são diagnosticados.

Para se qualificar para a Síndrome Metabólica, são necessários 3 de 5 dos seguintes componentes: 1. aumento da gordura intra-abdominal definida por uma circunferência da cintura maior que 40 polegadas nos homens e 35 polegadas nas mulheres 2. pressão alta 3. triglicerídeos elevados 4 baixo colesterol HDL 5. diabetes ou pré-diabetes. A obesidade abdominal está presente em 84% dos pacientes com Síndrome Metabólica.

Em resumo, a localização da gordura é importante. A gordura intra-abdominal é metabolicamente ativa e perigosa e pode levar a ataques cardíacos, derrames, cânceres e muito mais. Felizmente, o tratamento de 1ª linha para a Síndrome Metabólica é a redução de peso e o aumento da atividade física. Circunferência da cintura e gordura intra-abdominal diminuem acentuadamente como tipo de perda de peso tipicamente vivenciada pelos pacientes na Jumpstart Medicine. Síndrome do Ovário Policístico A Síndrome do Ovário Policístico (SOP) afeta 5 a 10% das mulheres em idade reprodutiva. Ocorre em associação com obesidade, diabetes tipo 2 e infertilidade anovulatória. Como mencionado acima, a perda de peso melhora o diabetes. A perda de peso em pacientes com SOP também pode melhorar significativamente seu potencial reprodutivo (fertilidade) .Doença articular degenerativa Dor lombar e osteoartrite do joelho são mais comuns em pessoas obesas. Mulheres obesas são 4 vezes mais prováveis ​​e homens obesos 5 vezes mais propensos a desenvolver osteoartrite dos joelhos. Felizmente, a dor e incapacidade associadas ao joelho melhoram ou desaparecem com a perda de peso. De acordo com o Estudo Framingham, uma perda de peso de 11 libras em mulheres diminuiu o risco de osteoartrite do joelho em 50%. O grau de melhora varia com a quantidade de danos estruturais, mas o alívio muitas vezes pode ser completo com perda moderada de peso. Estigmatização social e preconceito Além de sofrer riscos à saúde, os indivíduos obesos também sofrem discriminação e diminuem a competitividade em nossa sociedade. Em comparação com uma contraparte de peso normal com credenciais de outra forma iguais, uma pessoa obesa é menos provável de ser contratada para um trabalho e mais provável de ser paga menos se ele ou ela recebe o trabalho. Indivíduos obesos têm menos probabilidade de serem admitidos em faculdades competitivas do que seus candidatos com peso normal. Outros benefícios Como os riscos que acompanham os procedimentos cirúrgicos gerais são maiores em pacientes obesos, muitas vezes é benéfico reduzir o peso do paciente antes de tentar um procedimento eletivo maior, como uma operação ortopédica, colecistectomia ou bypass gástrico. Uma redução de 5% a 10% no peso corporal ou uma mudança de 5 unidades no índice de massa corporal (IMC) pode reduzir a duração da hospitalização e da incidência de complicações pós-operatórias.