OBESITY

AbdulThomas

Definition of obesity

• 2 definitions of Overweight and obesity – abnormal or excessive fat accumulation that may

impair health.– labels for ranges of weight that are greater than

what is generally considered healthy …the terms identify ranges of weight that have been shown to increase the likelihood of certain diseases and other health problems.

– a BMI ≥ 25 is overweight– a BMI ≥ 30 is obese

• BMI – provides the most useful population-level measure of overweight and

obesity as it is the same for both sexes and for all ages of adults– considered a rough guide because it may not correspond to the same

degree of fatness in different individuals (gender, ethnic group, age, variations in muscle mass)

• Body fat percentage measurements– Methods of measurement

• Skin fold methods (pinch test) using calipers • Bioelectrical impedance analysis

– Problems• Does not account for distribution of fat • abdominal fat distribution (beer belly) vs “gynoid” fat distribution (spread

more evenly around the body– Waist circumference measures

• Measure of your risk of getting illnesses related to increased body fat

US Czech Republic

Libya UK Germany Norway Greece Sweden Botswana Pakistan Malawi India0

5

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Obesity rates 2008 based on CIA world factbook%

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US UK Czech Republic Greece Germany Sweden Norway India0

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Obesity rates 2012 based OECD health stats

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Does obesity= unhealthy/ lazy?

Sumo wrestlers

– Strict training regimes• stamping, arm thrusting and shuffling

– 5,000 cal– Diet:

• Chankonabe protein sources chicken, fried fish, tofu or beef and vegetables (daikon, bok choy) with rice.

• Beer

– Higher levels of subcutaneous fat and lower levels of visceral fat– Type II diabetes, triglycerides, and hypertension are still higher in

highly active sumo wrestlers when compared to age-matched controls of normal BMI status

– The incidence of diabetes mellitus, gout, and hypertension in wrestlers was 5.2, 6.3, and 8.3%, respectively, all values being considerably higher than in controls.

Causes• Genetic predisposition-

– If one or more parents are obese then higher chance (Genetics effect hormones involved in fat storage e.g. leptins)

– Slow metabolism (KSR2 mutation has been found to slow metabolism

• Obesogenic environment– Chronic sedentary lifestyle– Overeating-especially foods high in fat have higher energy densities.

– Diet high in simple Carbohydrates-carbohydrates increase the sugar levels in the bloodstream causing insulin to be released. Insulin causes fatty tissue to be produced causing weight gain.

• Medications-certain antidepressants, anticonvulsants, diabetes medications(sulfonylureas), most corticosteroids(prednisone)

• Psychological Factors- food as a negative coping mechanism. Relationship between stress and visceral obesity (30 percent of people seeking treatment for binge eating)

• Diseases- Hypothyroidism, Insulin resistance, polycystic ovary syndrome, Cushings syndrome.

Other Causes

• The society which we live in today • Changes in the availability of food(America)• Childhood Weight

Health Risks

• Insulin Resistance• Type 2 diabetes -associated with fat around waist

• High Blood Pressure• Hypercholesterolemia• Stroke• Heart Attack-risk of developing coronary disease increased 3 to 4 times. Finnish study-

risk of death from heart disease increased by 1percent for every 1 Kilogram gained in weight

• Congestive heart failure

• Cancer

Other Health Risks

• Gallstones

• Gout

• Osteoarthritis

• Sleep Apnea

treatment• bariatric (pertaining to weight) surgery: BMI ≥40 or ≥35

– Gastric bypass– Gastric band

• dietary restriction and exercise• Traditional diet and exercise programmes• Traditional diet and exercise programmes improved by

cognitive and behavioral psychology • Pharmacological treatment

– Orlistat– Lorcaserin hydrochloride– Depression medications

Prevention

• Altering obesogenic environments– encourage healthy eating and regular exercise

• changing perception of obesity– Education– fat shaming- shows that it makes it worse. weight

bias

References

• http://www.circ.ahajournals.org/content/107/10/1448.long• http://

www.blood-pressure-hypertension.com/special-cases/high-blood-pressure-obesity.shtml

• http://www.everydayhealth.com/high-cholesterol/obesity-high-cholesterol-metabolic-syndrome.aspx

• http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Obesity---Stroke-Connection_UCM_311771_Article.jsp

• http://www.webmd.com/sleep-disorders/sleep-apnea/sleep-apnea

• http://weightloss.about.com/od/obesityhealth/a/gallstones.htm