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Epidemic of Obesity and its

Consequences

Dr. Shiv Jindal

February 10th 2013

Objectives

Definition

How big is this problem?

Consequences

Prevention and treatment

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Definition of Overweight & Obesity

Based on Body Mass Index (BMI)

BMI is calculated by dividing body

weight in kg by height in meters

squared (kg/m2).

Example: Weight 65 kg

Height 1.6 meters or

2.56 meters squared

BMI is 25.6

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Table 2: Body Weight

Classification & Risk of Health

Problems by BMI

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Measure

BMI (kg/m2)

Weight

Classification

Risk of Health

Problems

<18.5 Underweight Increased

18.5-24.9 Normal Weight Least

25.0-29.9 Overweight Increased

>30.0 Obese

30.0-34.9 Class I High

35.0-39.9 Class II Very High

>40.0 Class III Extremely High

CMAJ 2005, 172:995

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Obesity

Total body weight is the sum of:

1. Muscle, bone, organ & tissues

2. Fat

3. Salt & water

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Pre-adipocytes

Normal eating, orderly ‘storage’

Adipocytes

Over-nutrition, disorderly ‘storage’

Dysfunctional

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How Does Excess Fat Create All

These Health Problems?

Overloads organs with fat

Heart, liver, muscle, airways & others

Secretes hormones

Promotes inflammation

Promotes thrombosis

Causes insulin resistance & diabetes,

overproduction of insulin & cancer

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Health Problems Related to Obesity Phenotype: Appearance & social problems

Metabolic: Diabetes risk increased 4x

High BP risk increased 3x

High lipids

Diseases: Heart risk increased 1.5x

Sleep apnea

Cancer

Joint problems

Kidney disease

Mental (Alzheimer, depression) 7

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Health Problems Related to Obesity

Premature aging

Shortened life-span

Prothrombotic state

Salt sensitivity

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Visit to a Children’s Hospital

Metabolic syndrome

Obesity

Diabetes

High BP

Abnormal lipids

Premature aging of blood vessels &

potential risk of heart attack, stroke &

death before age 50

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Obesity Hypoventilation Syndrome

(OHS)

Fat deposited in airway passages

Adverse affect on breathing

Lack of oxygen & excess of carbon

dioxide

Heart, respiratory failure & sudden

death

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Excessive Weight in Childhood

Persists through adulthood

Linked to many health problems in

adulthood including:

– Abnormal blood clotting

– Thickening of arteries

– Fatty liver

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How Big a Problem is

Overweight & Obesity?

1.5 billion adults are overweight & obese

(Worldwide 2010)

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USA Canada Britain China

Adults % Overweight 70 59

Obese 36 24 25

Children % Obese 17 11.7

Note: 16% of world’s children are underweight

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Cost of Obesity

Lower productivity

Chronic diseases

Premature aging

Shortened lifespan

Very high % of health care budget (20%)

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Reasons for Overweight & Obesity

Economic growth

Unhealthy food & beverages

Bigger portions

Processed foods

Too much fat, sugar & salt

Increased sedentary activity

TV, videogames, computers, smart phones

Less physical exercise

More cars, fewer bicycles

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Prevention of Obesity Education & awareness at various levels

Individual level

– Will power

– Controlled consumption of food & beverages

– Physical activity

– Yoga

– Proper sleep

Government

Food Industry

Pharmaceutical companies 15

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Treatment of Obesity

Same as in prevention (monitoring food &

beverage intake, exercise, adequate

sleep, yoga)

Pills

Surgery (bariatric)

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Why We Cannot Lose Weight

Food as an addiction

Hormonal changes

– Gherlin, Leptin, Dopamine

External factors

– Social gatherings, restaurants, etc.

Socioeconomic status

Psychological factors

Genes

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Helpful Measures in Daily Life

Record weight regularly

Record BMI regularly

Measure waist circumference (central

obesity)

Measure hip circumference

Keep record of what you eat & drink

Keep record of your physical activity

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Table 3: Body Weight

Classification & Risk of Health

Problems by Waist Circumference

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Waist circumference Risk of health problems

Men

<102 cm (40 in) Lower

>102 cm (40 in) Increased

Women

<88 cm (35 in) Lower

>88 cm (35 in) Increased

(CMAJ 2005, 172:995

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Table 1: Life Expectancy (years)

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Canada India

Women Men Women Men

At birth 83 78 66 63

At age 60 25 21 18 17

At age 65 20 17 15 14

At age 80 10 8 7 7

Good health till age: 57 54

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How Big a Problem is

Overweight & Obesity?

1.5 billion adults are overweight & obese

(Worldwide 2010)

USA Canada Britain China

% Adults

Overweight 70 59

Obese 36 24 25

% Children

Obese 17 11.7 22

Note: 16% of world’s children are underweight