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Obesidad
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Obesidad

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  • Based on the NHANES III data, about 55 percent of adults, or an estimated 97 million adults, in the United States are overweight or obese, a condition that substantially increases their risk for hypertension, dyslipidemia, type 2 diabetes, stroke, coronary heart disease, osteoarthritis, gallbladder disease, sleep apnea and respiratory problems, and endometrial, breast, prostate, and colon cancers. Higher body weight is also associated with increases in all-cause mortality. Obese individuals may also suffer from social stigmatization and discrimination.
  • 13 Xenical Slide Kit August 1998 Section 1 13 Slide 13: Consequences of obesity The slide illustrates the most common co-morbidities and risk factors associated with obesity. These range from type 2 diabetes, osteoarthritis, cancer of the breast and prostate, major cardiovascular disease, stroke and respiratory disease to gallstones and gout. In short, obesity predisposes patients to a variety of diseases and, accordingly, should be considered by the medical profession as a serious, potentially life-threatening condition rather than an affliction brought on by lack of self-control.
  • The recommendation to treat overweight and obesity is based not only on the evidence that shows overweight is associated with increased morbidity and mortality, but also on RCT evidence that weight loss reduces risk factors for disease. Thus, weight loss may help control diseases worsened by overweight and obesity and may also decrease the likelihood of developing these diseases. Some benefits associated with weight loss include the following: Decreased cardiovascular risk. Decreased glucose and insulin levels. Decreased blood pressure. Decreased LDL-cholesterol and triglycerides and increased HDL-cholesterol. Decreased severity of sleep apnea. Reduced symptoms of degenerative joint disease. Improved gynecological conditions.
  • The recommendation to treat overweight and obesity is based not only on the evidence that shows overweight is associated with increased morbidity and mortality, but also on RCT evidence that weight loss reduces risk factors for disease. Thus, weight loss may help control diseases worsened by overweight and obesity and may also decrease the likelihood of developing these diseases. Some benefits associated with weight loss include the following: Decreased cardiovascular risk. Decreased glucose and insulin levels. Decreased blood pressure. Decreased LDL-cholesterol and triglycerides and increased HDL-cholesterol. Decreased severity of sleep apnea. Reduced symptoms of degenerative joint disease. Improved gynecological conditions.
  • BMI is the measure of choice as a practical indicator of the severity of obesity. It can be calculated in a variety of ways: Weight in kilograms (kg) divided by height in meters squared (m 2 ). Using pounds and inches: weight (pounds)/height (inches) 2  703, (1 lb = 0.4536 kg), (1 in. = 2.54 cm = 0.0254 m). (A patient should be weighed with shoes off and clad only in a light robe or undergarments.) From existing tables. BMI is a direct measure based on height and weight, regardless of gender. The limitations of BMI are that BMI overestimates body fat in persons who are very muscular and can underestimate body fat in persons who have lost muscle mass (e.g., the elderly). Also, since the presence of excess fat in the abdomen is an independent predictor of risk factors and morbidity, waist circumference should also be measured. A high waist circumference is associated with an increased risk for type 2 diabetes, dyslipidemia, hypertension, and CVD in patients with a BMI in a range between 25 and 34.9 kg/m 2 . High-risk waist circumference in men is defined as >102 cm (>40 in.) and in women, it is >88 cm (>35 in.).
  • In addition to measuring the patient’s BMI and waist circumference, one needs to assess the presence of concomitant CVD risk factors or comorbidities. Some obesity-associated diseases (e.g., CHD, type 2 diabetes) and risk factors (e.g., hypertension, high blood cholesterol) place patients in a very high-risk category for subsequent mortality. These diseases require aggressive modification of risk factors in addition to their own clinical management. Other obesity-associated diseases are less lethal, but still require appropriate clinical therapy. Overweight and obesity also aggravate several cardiovascular risk factors (e.g., triglycerides, physical inactivity). Identifying these risk factors is required as a guide to the intensity of the clinical intervention used to treat the weight problem.
  • 9 Xenical Slide Kit August 1998 Section 1 9 Slide 9: Aetiology of obesity The aetiology of obesity is complex and involves the interplay of medical, genetic, psychological and lifestyle-associated factors. The relative importance of each of these factors has yet to be determined but, from available evidence, it is clear that none operate in total isolation. Although the genetic factors may control the disposition towards obesity, environmental and lifestyle factors have a profound influence. Similarly, psychological factors, particularly binge eating by young women in Western countries and the consequences of endocrine disorders (e.g. Cushing’s Syndrome) play a significant role in certain individuals. Likewise, the side-effects of certain drugs (e.g. corticosteroids, tricyclic antidepressants and valproate) may lead to Peso accumulation.
  • 9 Xenical Slide Kit August 1998 Section 1 9 Slide 9: Aetiology of obesity The aetiology of obesity is complex and involves the interplay of medical, genetic, psychological and lifestyle-associated factors. The relative importance of each of these factors has yet to be determined but, from available evidence, it is clear that none operate in total isolation. Although the genetic factors may control the disposition towards obesity, environmental and lifestyle factors have a profound influence. Similarly, psychological factors, particularly binge eating by young women in Western countries and the consequences of endocrine disorders (e.g. Cushing’s Syndrome) play a significant role in certain individuals. Likewise, the side-effects of certain drugs (e.g. corticosteroids, tricyclic antidepressants and valproate) may lead to Peso accumulation.
  • The recommendation to treat overweight and obesity is based not only on the evidence that shows overweight is associated with increased morbidity and mortality, but also on RCT evidence that weight loss reduces risk factors for disease. Thus, weight loss may help control diseases worsened by overweight and obesity and may also decrease the likelihood of developing these diseases. Some benefits associated with weight loss include the following: Decreased cardiovascular risk. Decreased glucose and insulin levels. Decreased blood pressure. Decreased LDL-cholesterol and triglycerides and increased HDL-cholesterol. Decreased severity of sleep apnea. Reduced symptoms of degenerative joint disease. Improved gynecological conditions.
  • The recommendation to treat overweight and obesity is based not only on the evidence that shows overweight is associated with increased morbidity and mortality, but also on RCT evidence that weight loss reduces risk factors for disease. Thus, weight loss may help control diseases worsened by overweight and obesity and may also decrease the likelihood of developing these diseases. Some benefits associated with weight loss include the following: Decreased cardiovascular risk. Decreased glucose and insulin levels. Decreased blood pressure. Decreased LDL-cholesterol and triglycerides and increased HDL-cholesterol. Decreased severity of sleep apnea. Reduced symptoms of degenerative joint disease. Improved gynecological conditions.
  • Transcript

    • 1. OBESIDAD
    • 2. OBESIDAD ALIMENTACION ALIMENTOS INSULINA Tools 2a: ## EJERCICIO OOOOOOOOOOOOOOOOOOOOOOOOOO Obesidad es un estado patológico, donde existe un exceso de gordura depositado en el organismo, por encima de los padrones considerados normales para la edad, sexo y altura. Debido principalmente a que hay un desequilibrio entre la ingesta de alimentos (cantidad y calidad) y el gasto calórico que uno realiza (ejercicio/actividad física). R.B.I
    • 3. Consecuencias de la obesidad Factores de riesgo cardiovascular T. respiratorios T. cardíacos T. de vesícula biliar Anomalías hormonales Hiperuricemia y gota Accidente cerebrovascular Diabetes Osteoartritis Cáncer R.B.I
    • 4. • Menos del 10 % de los niños son o seran obesos cuando ambos padres son delgados. • 50 % de los niños son obesos cuando uno de los padres es obeso. • 80 % de los niños son obesos cuando ambos padres son obesos. • Los hábitos alimentares familiares también influyen en el aparecimiento de obesidad. • Las personas obesas ingieren una cantidad mayor de alimentos que las personas de peso normal, lo cual puede estar asociado a situaciones de ansiedad, angustia o OBESIDAD FAMILIA INFANCIA R.B.I
    • 5. OBESIDAD La obesidad se ha convertido en un problema de salud que debe ser identificado a tiempo por el médico, para iniciar la evaluación y realizar el tratamiento multidisciplinar de la persona obesa o con sobrepeso. Aproximadamente 97 millones de americanos tienen sobrepeso o son obesos. R.B.I
    • 6. PREVALENCIA DE DIABETES - HIPERTENSION Y OBESIDAD EN 4 CIUDADES DE BOLIVIA (1998) Primera Encuesta Nacional de Diabetes y factores de riesgo asociados: hipertensión y obesidad. Estudio realizado por las Sociedades de Endocrinología y Cardiología, OPS y Min. de Salud (1998-2000) EL ALTO LA PAZ COCHABAMBA SANTA CRUZ 2,7 5,7 9,2 10,7 CIUDAD DIABETES HIPERTENSION OBESIDAD 11,4 19,1 18,5 22,8 21,1 18,8 17,3 30,3 R.B.I
    • 7. DATOS SOBRE EXCESO DE PESO Y OBESIDAD • La prevalencia de obesidad en todo el mundo está aumentando alcanzando proporciones epidémicas, tanto en países desarrollados como en vías de desarrollo. • El 80% de las personas muestra sobrepeso en el momento del diagnóstico de DM tipo 2. La obesidad es el principal factor modificable de riesgo de desarrollar diabetes tipo 2. • El exceso de peso es hoy la afección médica más común en la infancia. • La obesidad puede reducir la esperanza de vida de las R.B.I
    • 8. DATOS SOBRE EXCESO DE PESO Y OBESIDAD • Los adolescentes con sobrepeso tienen una probabilidad de un 70% de convertirse en adultos obesos. • Se calcula que al menos la mitad de todos los casos de DM tipo 2 se eliminaría si se pudiese prevenir el aumento de peso en adultos. • Las intervenciones en el estilo de vida (cambio de dieta y actividad física moderada) pueden reducir el riesgo de desarrollar DM tipo 2 en un 60%. R.B.I
    • 9. PARAMETROS PARA EVALUAR LA OBESIDAD • INDICE DE MASA CORPORAL • MEDICION DE CINTURA • APARATOS ANALIZADORES DE LA COMPOSICION CORPORAL R.B.I
    • 10. INDICE DE MASA CORPORAL (IMC) PESO (kg) ALTURA (m2 ) IMC = Clasificación Tipo de obesidad IMC = kg/m2 Bajo peso < 18.5 Normal 18.5 – 24.9 Sobrepeso 25 – 29.9 Obesidad I 30 – 34.9 II 35 – 39.9 Obesidad extrema o morbida III ≥ 40.0 R.B.I
    • 11. PESO (kg) ALTURA (m2 ) IMC = Ejemplo, individuo con: peso: 99 kg altura: 1,70 m 99 kg 99 kg (1,70)2 2,89 IMC = = 34 La importancia del IMC reside en el hecho de que las personas con IMC > 30 presentan mayor riesgo de presentar enfermedades cardiovasculares o diabetes. = R.B.I
    • 12. Evaluación de la Obesidad y sobrepeso Medidas de la circunferencia de la cintura Riesgo cardiovascular Elevado: • Hombres > 94 cm • Mujeres > 80 cm Alto riesgo: • Hombres >102 cm • Mujeres > 88 cm R.B.I
    • 13. Determinar el estado de riesgo Evaluar: • Enfermedades presentes: Diabetes tipo 2, problemas para dormir (falta de aire). • Otras enfermedades asociadas a la obesidad, por ej. Problemas ginecológicos, osteoartritis • Factores de riesgo cardiovascular: tabaquismo, hipertensión, LDL elevado, HDL bajo, intolerancia al azúcar, historia familiar. • Otros factores de riesgo: – Inactividad física – Trigliceridos elevados (>200 mg/dL) R.B.I
    • 14. CAUSAS DE LA OBESIDAD ESTILO DE VIDA F. PSICOLÓGICOS F. MEDICOS F. GENÉTICOS OBESIDAD R.B.I
    • 15. QUE PODEMOS MODIFICAR? ESTILO DE VIDA F. PSICOLÓGICOS F. MEDICOS F. GENÉTICOS OBESIDAD SI R.B.I
    • 16. BENEFICIOS QUE SE OBTIENEN AL DISMINUIR DE PESO • Disminuye el riesgo cardiovascular • Disminuye los niveles de azucar e insulina en la sangre. • Disminuye la presión arterial • Disminuye los niveles de las fraciones del colesterol (LDL/trigliceridos) y aumenta el R.B.I
    • 17. BENEFICIOS QUE SE OBTIENEN AL DISMINUIR DE PESO • Disminuye los problemas de respiración al dormir. • Reduce los síntomas de dolor y molestias en las articulaciones. • Mejora las condiciones ginecológicas. R.B.I
    • 18. Leonardo da Vinci- 1503 Fernando Botero - Siglo 20 Dra. Roxana Barbero GRACIAS POR SU ATENCION

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