Overweight is associated with

• Diabetes

• Cancer

• Sleep Apnoea

• Osteoarthritis

• Fatty liver disease

• Psoriasis

• Dementia

• High Blood pressure

• Cardiovascular Disease

Relationship of BMI to Excess

Mortality

300Age at Issue

Bray GA. Overweight is risking fate. Definition, classification,

prevalence and risks. Ann NY Acad Sci 1987;499:14-28.

20-29250

Body Mass Index (kg/[m2])

200

150

100

50

150

30-39

20 25 30

Low

Risk

4035

High

Risk

Moderate

Risk

META-ANALYSIS OF 1.4 Million people – NEJM Dec 2010

Excess weight is a MAJOR risk factor for

diabetes in US adults, 2001 (n=195, 005)

4.17.3

14.9

0

10

20

30

Normal Overweight

BMI 25-29.9

Obese

BMI 30-39.9

Prevalence of diabetes (%)

Obese

BMI 40

25.6

Mokdad et al. JAMA 2003; 289: 76-9

Relative Risk of Developing Cancer

in MalesCancer Type Relative Risk if

Overweight

Relative Risk if

Obese

Oesophegeal 1.5 2.3

Thyroid 1.3 1.7

Colon 1.2 1.5

Renal 1.2 1.5

Normal weight finishes at

Male 12st 2lbs

78Kgs

Female 10st 3lbs

65 kgs

Normal Weight

Waist < 32inches

Female

Waist < 37inches

Male

Toxic environment we live in…

Unsuspected calories abound

Unsuspected Calories

Unsuspected Calories

Burning a lot less energy (per half

hour)

Calories Burned 2004 Calories Burned 1984

Lift (2 mins) 3 Take Stairs 19

Order take away 1 Cook Meal 70

Load Dishwasher 23 Wash Up 80

Watch TV 35 Play Cards 52

Go to car wash 35 Wash Car 104

Play Video Game 53 Play Basketball 280

Ride Lawn Mower 88 Mow Lawn 193

Benefits of weight reduction in

overweight• 5 to 10% loss from presenting body weight

- 20% reduction in all cause mortality

- 40% reduction in diabetes related mortality

- 37% reduction in cancer deaths

- 10mmHg reduction in systolic BP

- Improved lipid profile

Overweight - diet/lifestyle change only required

• Diet – 500 kcalorie deficit/day

healthy eating priciples

• Activity - No consensus

Up to 90 minutes daily

(8 days a week)

• No approach works without this

Who would you rather be?

• Man on Left = Driver

• Man on Right = Conductor

Physical Activity at Work

• Prof. Jerry Morris, – Physical Activity Epidemiology

– Lancet 1953

• 31,000 London Transport Workers– Drivers and Conductors

– London Double Decker Bus

• Drivers had higher rates of Coronary Occlusion (heart attacks) and higher early mortality than conductors

ResultsCoronary Artery Disease of 31,000

London Transport Workers

00.20.4

0.60.8

11.2

1.41.6

Coronary Occulsion

(MI)

Early Mortality

(within 3 days of MI)

Rate

per 1

000

Drivers

Conductors

Morris JN et al., Lancet 1953

ResultsCoronary Artery Disease of 31,000

London Transport Workers

00.20.4

0.60.8

11.2

1.41.6

Coronary Occulsion

(MI)

Early Mortality

(within 3 days of MI)

Rate

per 1

000

Drivers

Conductors

Morris JN et al., Lancet 1953

Normal Weight

Waist < 32inches

Female

Waist < 37inches

Male

2010 – 25,650 papers on

overweight

• 4 Key points for weight management

2010 – 25,650 papers on

overweight

• 4 Key points for weight management

- Never miss breakfast

2010 – 25,650 papers on

overweight

• 4 Key points for weight management

- Never miss breakfast

- Weigh yourself once a week

2010 – 25,650 papers on

overweight

• 4 Key points for weight management

- Never miss breakfast

- Weigh yourself once a week

- Build activity up to 90 minutes daily

2010 – 25,650 papers on

overweight

• 4 Key points for weight management

- Never miss breakfast

- Weigh yourself once a week

- Build activity up to 90 minutes daily

- Watch the calories