childhood obesity

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Khushbu on Jul 21, 2012 Says :

great work on obesity.

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Slide 1 :

Overweight and Obesity Tchernavia SeQuita Howard

Slide 2 :

Overview Definition, Prevalence & Consequences of Obesity Healthy Lifestyles Assessment of Obesity Treatments for Obesity

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Definition Obesity is an abnormal accumulation of body fat, usually 20 percent or more over an individual's ideal body weight.

Slide 4 :

Definition of Overweight & Obesity Using BMI

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Calculating BMI Calculate Body Mass Index (BMI) = weight (kg) height squared (meters) Or… weight (pounds) x 703 height squared (inches)

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Prevalence of Obesity Childhood and adolescent obesity increased from 5% to 16% in the last 20 years Adulthood obesity increased from 12% to 21% in 10 years. 16 million US adults with BMI over 35 60 million US obese adults (BMI > 30)

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Prevalence of Adult Obesity, U.S.A. From CDC website: http://www.cdc.gov/nccdphp/dnpa/obesity/trend/prev_reg.htm

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Factors predispose to obesity Genetic – familial tendency. Sex – women more susceptible . Activity – lack of physical activity. Psychogenic – emotional deprivation, depression . Social class – poorer classes. Alcohol – problem drinking. Smoking – cessation smoking. Prescribed drugs – tricyclic derivatives.

Slide 9 :

Weight Gain: Medications

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Weight Gain: How Does It Happen? Energy imbalance calories consumed not equal to calories used Over a long period of time Due to a combination of several factors Individual behaviors Social interactions Environmental factors Genetics

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Weight Gain: Energy In 3500 calories = 1 pound 100 calories extra per day = 36,500 extra per year = 10.4 lbs weight gain Question: How much is 100 calories? Answer: Not very much! 1 glass skim milk, or 1 banana, or 1 slice cheese, or 1 tablespoon butter

Slide 12 :

Evolving Pathology More in and less out = weight gain More out and less in = weight loss Hypothalamus control center for hunger and satiety Endocrine disorder where are the hormones?

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Leptin Protein hormone secreted by adipocytes Levels correlate with lipid content of cells Leptin acts on the hypothalamus to reduce hunger and to stimulate energy expenditure

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Ghrelin Hormone secreted in the stomach Acts on the hypothalamus to stimulate appetite Levels peak just before meals and drop afterward

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Bad News for Dieters Leptin Dieting decreases leptin levels Reducing metabolism, stimulating appetite Ghrelin Levels in dieters are higher after weight loss The body steps up ghrelin production in response to weight loss The higher the weight loss, the higher the ghrelin levels

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Health Consequences of Obesity Major cause of preventable death Increase in mortality from all causes Increase in risk for these cancers Endometrium Breast Prostate Colon Increase in risk of: Hypertension Dyslipidemia Diabetes type 2 Coronary artery disease Stroke Gallbladder disease Osteoarthritis Sleep apnea & respiratory problems

Slide 17 :

Treatment Approach A multi-faceted approach is best Diet Physical activity Behavior change “A” Recommendation

Slide 18 :

Treatment Approach Initial goal: 10% weight loss Significantly decreases risk factors Rate of weight loss 1 to 2 pounds per week Reduction of caloric intake 500-1000 per day Slow weight loss is more stable Rapid weight loss is almost always followed by weight gain Rapid weight loss increases risk for gallstones & electrolyte abnormalities

Slide 19 :

Treatment Approach Aim for 4 - 6 months of weight loss effort Most people will lose 20 to 25 pounds After 6 months, weight loss is more difficult Ghrelin & Leptin are at work! Changes in resting metabolic rate Energy requirements decrease as weight decreases Diet adherence wavers Set goals for weight maintenance for next 6 months, then reassess.

Slide 20 :

Dietary Therapy Weight reduction with dietary treatment is in order for virtually all patients with a BMI 25-30 who have comorbidities and for all patients over BMI 30. Strategies of dietary therapy include teaching about calorie content of different foods, food composition (fats, carbohydrates, and proteins), reading nutrition labels, types of foods to buy, and how to prepare foods.

Slide 21 :

How Much is 1200 Calories? Could you stick to 1200 per day? 1 Big Mac (580) 1 SMALL Fries (210) 1 SMALL shake (430)

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Weight Maintenance: How Much Should People Eat? Varies widely Some averages, below

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Physical Activity Physical activity should be an integral part of weight loss Physical activity alone is less successful than a combined diet & exercise program Increased activity alone does not decrease weight Sustained activity does prevent weight regain Reduces risk for heart disease & diabetes

Slide 24 :

Physical Activity Start slowly Many obese people live sedentary lives Avoid injury Early changes can be activities of daily living Increase intensity & duration gradually Long-term goal 30 to 45 minutes or more of physical activity 5 or more days per week Burn 1000+ calories per week

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