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Obesity

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LIFE STYLE

DISEASES
DR TESSY MATHEW
​Introduction:
• Obesity is defined by the World Health
Organization (WHO) as “abnormal or excessive
fat accumulation that presents a risk to
health".
• Obesity causes significant health, economic
and social burdens every year.
• Obesity is when a person is carrying too much
body fat for their height and sex. A person is
considered obese if they have a body mass
index (BMI) of 30 or greater.
Prevalance
As per July 2019
Facts:
• At least 2.8 million people die
each year as a result of being
overweight or obese.

• Obesity is one of the leading


causes of many chronic diseases
including: heart disease, liver
disease, diabetes, several types of
cancers, and others.
• According to WHO, 2.7 billion adults worldwide
will suffer from overweight and obesity by 2025.
What are the causes
Exc
es sive
TODAY’S TEEN
Less
physical
activity

This means that the calories they eat are not getting burnt off

as energy. Instead, the extra calories are stored as fat.


PATHOPHYSIOLOGY
OF
OBESITY
Excess adipose tissue increases available triglyceride stores
Breakdown of TG lead to overabundance of circulating
fatty acids

OBESITY
Increased fatty acids

Increases hepatic
DIABETES Insulin resistance triglyceride synthesis &
production of VLDL

Loss of
vasodilatory effect
of insulin hypercholesterolemia

Preserved sodium
reabsorption

HYPERTENSI
ON
DIABETES MELTUS (DM)
• Obesity causes stress in a system of cellular
membranes called endoplasmic reticulum
(ER), which in turn causes the ER to suppress
the signals of insulin receptors, which then
leads to insulin resistance
NON ALCOHOLIC FATTY LIVER DISEASE
(NAFLD)
• Non-alcoholic fatty liver disease (NAFLD) refers
to a group of conditions where there is
accumulation of excess fat in the liver of
people who drink little or no alcohol
CANCER
SOCIAL STIGMATIZATION
• Social stigma is the extreme disapproval of a
person or group on socially characteristic
grounds that are perceived, and serve to
distinguish them, from other members of
a society
SLEEP APNEA
• Sleep apnea is a potentially serious sleep
disorder in which breathing stops for 10
seconds or more and starts
• In obesity, it is associated with soft tissue of
the mouth and throat. During sleep, when
throat and tongue muscles are more relaxed,
this soft tissue occlude the airway to become
blocked.
Normal airway Obstructive sleep apnea
Air Air

Airway is open and Airway is blocked and air


air moves through dos not move through
OSTEO ARTHRITIS
• Being overweight increases the load placed on
the joints such as the knee, which increases
stress and could possibly hasten the
breakdown of cartilage.
Overweight women have nearly 4 times the
risk of knee OA; for overweight men the risk
is 5 times greater.
Joint with
Normal joint increased pressure
force due to obesity
CLINICAL
FEATURES
OF
OBESITY
CENTRAL NERVOUS SYSTEM
• Mild cognitive impairment (attention, learning, and
memory deficits; impairments in decision making),
• Increased risk of dementia and Alzheimer’s disease
• Mood disorders including anxiety and depression
• Stroke
CARDIOVASCULAR SYSTEM
• Hypertension
• Increased risk for CAD or CHF
• Arrhythmias
• Coagulopathy
• Dyslipidemia
GASTRO INTESTINAL SYSTEM
• Gall bladder stones
• Pancreatitis
• Abdominal hernia
• Fatty liver and liver failure
• Acidity and heart burn
ENDOCRINE SYSTEM
• Insulin resistance
• Hypothyroidism
• Cushing’s syndrome
PULMONARY SYSTEM
• Shortness of breath
• Asthma
• Dyspnea on exertion
• Obstructive pulmonary apnea
MUSCULOSKELETAL SYSTEM
• Osteo arthritis
• Gout
REPRODUCTIVE SYSTEM
• Hypogonadism
• Menstrual irregularities
• Poly Cystic Ovarian disease
Dietary Changes
• https://youtu.be/OLoVC-eYpNs
Dietary Changes
• Cutting calories. The key to weight loss is
reducing how many calories you take in. The
first step is to review your typical eating and
drinking habits to see how many calories you
normally consume and where you can cut back.
You and your doctor can decide how many
calories you need to take in each day to lose
weight, but a typical amount is 1,200 to 1,500
calories for women and 1,500 to 1,800 for men.
• Feeling full on less. Some foods — such as
desserts, candies, fats and processed foods
— contain a large amount of calories for a
small portion. In contrast, fruits and
vegetables provide a larger portion size
with fewer calories. By eating larger
portions of foods that have fewer calories,
you reduce hunger pangs, take in fewer
calories and feel better about your meal,
which contributes to how satisfied you feel
overall.
• Making healthier choices. To make your
overall diet healthier, eat more plant-based
foods, such as fruits, vegetables and whole-
grain carbohydrates. Also emphasize lean
sources of protein — such as beans, lentils and
soy — and lean meats. If you like fish, try to
include fish twice a week. Limit salt and added
sugar. Eat small amounts of fats, and make
sure they come from heart-healthy sources,
such as olive, canola and nut oils
• Restricting certain foods. Certain diets limit
the amount of a particular food group, such as
high-carbohydrate or full-fat foods. Ask your
doctor which diet plans have been found
effective and which might be helpful for you.
Drinking sugar-sweetened beverages is a sure
way to consume more calories than you
intended, and limiting these drinks or
eliminating them altogether is a good place to
start cutting calories.
• Meal replacements. These plans suggest that
you replace one or two meals with their
products — such as low-calorie shakes or meal
bars — and eat healthy snacks and a healthy,
balanced third meal that's low in fat and
calories. In the short term, this type of diet
can help you lose weight. Keep in mind that
these diets likely won't teach you how to
change your overall lifestyle, though, so you
may have to keep this up if you want to keep
Exercise & Activity
• Exercise. People with obesity need to get at
least 150 minutes a week of moderate-
intensity physical activity to prevent further
weight gain or to maintain the loss of a
modest amount of weight. To achieve more-
significant weight loss, you may need to
exercise 300 minutes or more a week. You
probably will need to gradually increase the
amount you exercise as your endurance and
fitness improve.
• Keep moving. Even though regular aerobic
exercise is the most efficient way to burn
calories and shed excess weight, any extra
movement helps burn calories. Making simple
changes throughout your day can add up to
big benefits. Park farther from store
entrances, rev up your household chores,
garden, get up and move around periodically,
and wear a pedometer to track how many
steps you actually take over the course of a
Behavioral change
• Counseling. Talking with a mental health
professional can help you address emotional
and behavioral issues related to eating.
Therapy can help you understand why you
overeat and learn healthy ways to cope with
anxiety. You can also learn how to monitor
your diet and activity, understand eating
triggers, and cope with food cravings.
Counseling can be one-on-one or in a group.
More-intensive programs — those that
• Support groups. You can find camaraderie and
understanding in support groups where others
share similar challenges with obesity. Check
with your doctor, local hospitals or
commercial weight-loss programs for support
groups in your area.
Prescription weight-loss
medication
• Your doctor may recommend weight-loss
medication if other diet and exercise programs
haven't worked and you meet one of these
criteria:
• Your body mass index (BMI) is 30 or greater
• Your BMI is greater than 27, and you also have
medical complications of obesity, such as
diabetes, high blood pressure or sleep apnea
• Anti-obesity medications approved by the
Food and Drug Administration (FDA) include:
• Orlistat (Alli, Xenical)
• Lorcaserin (Belviq)
• Phentermine and topiramate (Qsymia)
• Bupropion and naltrexone (Contrave)
• Liraglutide (Saxenda, Victoza)
Endoscopic procedures for weight
loss
Weight-loss surgery

• You have extreme obesity (BMI of 40 or


higher)
• Your BMI is 35 to 39.9, and you also have a
serious weight-related health problem, such
as diabetes or high blood pressure
• You're committed to making the lifestyle
changes that are necessary for surgery to work
• Gastric bypass surgery. In gastric bypass
(Roux-en-Y gastric bypass), the surgeon
creates a small pouch at the top of your
stomach. The small intestine is then cut a
short distance below the main stomach and
connected to the new pouch. Food and liquid
flow directly from the pouch into this part of
the intestine, bypassing most of your stomach.
• Adjustable gastric banding. In this procedure,
your stomach is separated into two pouches
with an inflatable band. Pulling the band tight,
like a belt, the surgeon creates a tiny channel
between the two pouches. The band keeps
the opening from expanding and is generally
designed to stay in place permanently.
• Biliopancreatic diversion with duodenal
switch. This procedure begins with the
surgeon removing a large part of the stomach.
The surgeon leaves the valve that releases
food to the small intestine and the first part of
the small intestine (duodenum). Then the
surgeon closes off the middle section of the
intestine and attaches the last part directly to
the duodenum. The separated section of the
intestine is reattached to the end of the
• Gastric sleeve. In this procedure, part of the
stomach is removed, creating a smaller
reservoir for food. It's a less complicated
surgery than gastric bypass or biliopancreatic
diversion with duodenal switch.

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