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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