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Obesity Dr Thomas Fox SpR Endocrinology Royal Cornwall Hospital
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition of obesity Body Mass Index  (kg/m 2 ) Category <18.5 Underweight 18.5-25 Healthy weight 25-30 Overweight 30-35 Grade 1 obese 35-40 Grade 2 obese >40 Grade 3 obese
BMI ,[object Object],[object Object],[object Object],[object Object]
Waist circumference ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A global epidemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
Health Survey England 2005 (HSE) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gender, age and obesity in UK ,[object Object],[object Object],[object Object]
 
 
 
Ethnicity and Obesity rates BMI>30kg/m 2   (UK) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Social class and obesity ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of obesity - food ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Percentage change in amount of food and energy contained between 1985-95 in Australia
Between 1985-95 in Australian children (Magarey  et al  2005) ,[object Object],[object Object],[object Object],[object Object]
Australian National Nutritional Survey of Children 1995 - snapshot ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of obesity – physical activity (HSE 2005) ,[object Object],[object Object]
Influence of genetic and environmental factors on prevalence of type 2 diabetes (Schulz LO  et al  2006)   Arizona Pima Indians N=888 Mexican Pima Indians n-=223 Mexicans N=193 BMI  (kg/m 2 ) 34.6 25.1 25.8 Calorie   intake  (kcal/day) 1751 2458 2593 Lipid intake  (%) 36.3 26.3 25.6 Physical activity  (hr/week) 7 27 27 Prevalence TIIDM (%) 38.1 7.1 2.6
“ It’s my metabolism Doctor” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leptin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacological causes of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endocrine causes of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cushing’s syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cushings and obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exogenous glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prader-Willi syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laurence-Moon syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health effect of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aims of weight loss ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diet ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Low calorie diets ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Very low calorie diets ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Low carbohydrate diets ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Samaha  et al,  NEJM 2003 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Meta-analysis: the effect of dietary counselling for weight loss. Dansinger ML  et al  2007 ,[object Object],[object Object],[object Object]
Exercise ,[object Object],[object Object],[object Object],[object Object]
 
Exercise ,[object Object],[object Object]
Pharmacotherapy ,[object Object],[object Object],[object Object],[object Object]
Sibutramine  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Orlistat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bariatric surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Roux-en-Y ,[object Object],[object Object],[object Object]
 
Adjustable vertical banding gastroplasty ,[object Object],[object Object]
 
Swedish Obese Subjects ,[object Object],[object Object],[object Object],[object Object],[object Object]
SOS 10 years ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Banding vs RYGB ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Obesity and diabetes ,[object Object],[object Object],[object Object]
 
Prevalence of diabetes 2008 ,[object Object],[object Object],[object Object],[object Object]
Glycaemic control and exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weight gain in treatment of diabetes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sulphonylureas ,[object Object],[object Object]
Pioglitazone ,[object Object],[object Object]
Newer therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GLP-1 ,[object Object],[object Object],[object Object],[object Object],[object Object]
DPP-4 inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GLP-1 agonists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incretin levels and effect are markedly increased 1 month following Roux-en-Y gastric bypass surgery in obese patients with type II diabetes ( Laferere et al  2007) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Obesity summary ,[object Object],[object Object],[object Object],[object Object]

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Obesity

  • 1. Obesity Dr Thomas Fox SpR Endocrinology Royal Cornwall Hospital
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  • 4. Definition of obesity Body Mass Index (kg/m 2 ) Category <18.5 Underweight 18.5-25 Healthy weight 25-30 Overweight 30-35 Grade 1 obese 35-40 Grade 2 obese >40 Grade 3 obese
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  • 25. Influence of genetic and environmental factors on prevalence of type 2 diabetes (Schulz LO et al 2006) Arizona Pima Indians N=888 Mexican Pima Indians n-=223 Mexicans N=193 BMI (kg/m 2 ) 34.6 25.1 25.8 Calorie intake (kcal/day) 1751 2458 2593 Lipid intake (%) 36.3 26.3 25.6 Physical activity (hr/week) 7 27 27 Prevalence TIIDM (%) 38.1 7.1 2.6
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