La obesidad se produce cuando existe un exceso de grasa corporal depositada, generalmente como resultado de un desequilibrio entre la ingesta calórica y el gasto energético. Esto puede conducir a varios problemas de salud como enfermedades cardíacas, diabetes y cáncer. La obesidad se puede evaluar mediante el índice de masa corporal y la medición de la cintura, y se recomienda modificar el estilo de vida a través de una dieta balanceada y ejercicio regular para prevenir y tratar la obesidad y sus complicaciones.
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
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
Editor's Notes
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.