Obesity

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Obesity

  1. 1. Excess body fat accumulated to the extend of causing adverse effect
  2. 2. Obesity in Asia
  3. 3. Journal of Obesity in Malaysia by University Kebangsaan Malaysia states that: 5.8% of 29,179,952-obese Number of people obese are 1,692,437 Higher rate-Malays and Indians
  4. 4.  Environmental factors  Genetic factors  Lack of sleep  Age  Gender
  5. 5. Childhood Obesity Adult Obesity
  6. 6. • Parental obesity • Prader-Willi syndrome Genetic Factors • Lack of physical activity • Sedentary lifestyle • Over eating Environmental Factors
  7. 7. Adult Obesity Excess body fat Adipose tissue is the form of tissue that fat takes in the body. Located just beneath the skin or between other organs such as the muscles and heart. Excess carbohydrates, proteins and dietary fats can be converted into fatty acids and stored as adipose tissue in the body. Too much adipose tissue on your body, it contributes to serious health complications.
  8. 8. Expansion of the adipose tissue during weight gain leads tissue undergoes a continuous remodeling process that normally maintains tissue health, but may spin out of control and lead to adipocyte death in association with the recruitment and activation of macrophages, and systemic insulin resistance.
  9. 9.  Adipose tissue located beneath the skin (subcutaneous fat), around internal organs (visceral fat), in bone marrow (yellow bone marrow) and in breast tissue.  Adipose depots in different parts of the body have different biochemical profiles.  Under normal conditions, it provides feedback for hunger and diet to the brain.  Diseased fat tissue surrounding various organs can cause illness.
  10. 10.  Aromatase which is involved in sex hormone metabolism.  TNF Alpha, IL-6 and leptin which are collectively termed „cytokines‟ and are involved in sending messages between cells.  Plasminogen activator inhibitor-1 which is involved in the clotting of blood.  Angiotensin which is involved in blood pressure control.  Adiponectin which improves the body‟s sensitivity to insulin and so helps to protect against developing type 2 diabetes.  Lipoprotein lipase and apolipoprotein E which are involved in storage and metabolism of fat to release energy.
  11. 11. Type 2 diabetes Excess body fat Difficulty sleeping extremely large waistline Heavy sweating Lack of energy Pain and soreness in joints and muscles Symptoms
  12. 12. Consequences of obesity Coronary heart disease stroke Type 2 diabetes Non alcoholic fatty liver disease (NAFLD) cancer High blood pressure
  13. 13. Body mass index BMI : BW / H2 Where :- BW = Body Weight (kilograms) H = Height (meters)  Measure waist circumference Apple shape ( risk of DM, CVD, HTN ) Waist larger than 40 inch men Waist larger than 35 inch women
  14. 14.  Overweight: BMI 25 - 29.9  Obese: BMI > 30  Obesity Class I: 30 - 34.9  Obesity Class II: 35 - 39.9  Extreme Obesity: >40
  15. 15.  Diet therapy  Increased Physical Activity  Pharmacotherapy  Behavioral Therapy  Surgery
  16. 16.  Highly ineffective rate 95 % long term failure  Often result in increase weight than before diet  Slow weight loss – stable  Rapid weight loss – gain weight  Rapid weight loss – increase risk of gallstones  Low calorie step 1 diet Women Men 1000 – 1200 kcal/day 1200-1600 kcal/day
  17. 17. Male Age 20-49 2900 calories/day 50 + 2500 calories/day Female Age 20-49 2300 calories/day 50 + 1900 calories/day Guideline Daily Amount Values Typical values Women Men Children (5-10 years) Calories 2,000 kcal 2,500 kcal 1,800 kcal Protein 45 g 55 g 24 g Carbohydrate 230 g 300g 220 g Sugars 90 g 120 g 85 g Fat 70 g 95 g 70 g Saturates 20 g 30 g 20 g Fibre 24 g 24 g 15 g Salt 6 g 6 g 4 g
  18. 18.  Integral part of weight loss  Increase activity never loss weight  Sustained activity does prevent weight regain  Reduces risk of getting HD & DM  Recommended activities
  19. 19. A) Sibutramine(Serotonin Nor-epinephrine Reuptake Inhibitor) : initial dose 10mg/day, max 20mg/day. Reduces food intake, increase HR and BP. B) Orlistat: Lipase inhibitor : 120mg PO TID. Alters metabolism, dec absorption of dietary fat.
  20. 20.  Keep a journal of diet/diary  Set spesific goals  Keep track of improvement
  21. 21. Surgery Restrictive Combined restrictive & malabsorption Vertical band gastroplasty Gastric Banding Laproscopic gastric banding Roux-en-y gastric bypass Biliopancreatic diversion
  22. 22. VBG GASTRIC BANDING (LGB)
  23. 23.  P. Thamilselvi suffered obesity for years  She had several complications due to obesity for instance;  She had difficulties of breathing while doing heaving activities  Stress and depression
  24. 24.  Thamilselvi consulted her physical dietician She started a strict diet :  Oats  Green tea  Green apple  Cut down rice intake, oily foods and food contain high fat
  25. 25. The latest Thamilselvi
  26. 26.  “Sebab mulut badan binasa” – “Body perish because of the mouth”  obesity is best tackled at home through improved self involvement, increased physical exercise, better diet and restraint from eating.
  27. 27.  Ismail MN. The nutrition and health transition in Malaysia. Public Health Nutrition 2002; 5: 191–195.  World Health Organization. Obesity: Preventing and Managing the Global Epidemic. WHO Obesity Technical Report Series no. 894. WHO: Geneva, 2000.  Ismail MN, Tan CL. Prevalence of obesity in Malaysia. In: Inoue & Zimmet (eds). The Asia–Pacific Perspective: Redefining Obesity and its Treatment. WHO(WPRO)/IASO/IOTF: Health Communications Australia, 2000 pp 10–13.  Ismail MN, Vickneswary EN. Prevalence of obesity in Malaysia: data from three ethnic populations. In: Inoue & Zimmet (eds). The Asia – Pacific Perspective: Redefining Obesity and its Treatment. WHO (WRRO)/IASO/10TF: Health Communication Australia, 2000.

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