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Weight loss and belly fat loss,lose weight,lose belly fat,how to get rid of belly fat,how to burn belly fat,lose, weight, how to lose weight, weight loss
2. Introduction
Weight isgenerally stable
Food intake = Energy expenditure
Coordinated control of the hypothalamus
“Feeding”center
“Satiety” center
Food intake
Availabilityof food
Attractiveness of food
Emotional factors
5. Mechanisms of weight gain
Excess muscle – exercise
Excess fat – food intake > energy
expenditure
Excess water – fluid retention,
over hydration
6. Nature vs Narture
Genes
Fuel homeostasis
Energy expenditure
Hunger/satiety
Environment
Physical inactivity
Food
Sciocultural factors
Intrauterine
programming
7. Environment
Increased intake
Increased portionsizes
energy dense foods
High glycaemic index
foods
Softdrinks
Added sugar
Easyaccess to foods
Marketing
Decreased expenditure
Reduced exercise
Increased automation
Vehicles
Sedentary schools
Sedentaryworkplace
Elevators/Escalators
TV/Computer
8. Other causes of Weight Gain
Aging – slowed metabolism
Pregnancy
Endocrine & Other Medical Disorders
Cushing’s Syndrome
Hypothyroidism
Polycystic ovary syndrome
Hypogonadism
Some inherited diseases/genetic syndromes
11. Classification of BMI (in Kg/m2)
Underweight --BMI <18.5
Normal weight -- BMI ≥18.5 to 24.9
Overweight — BMI ≥25.0 to 29.9
Obesity — BMI ≥30
Obesity Class I — BMI of 30.0 to 34.9
Obesity Class II — BMI of 35.0 to 39.9
Obesity Class III — BMI ≥40
16. Health Risks of Obesity
Increased Morbidity
Type 2 Diabetes
Hypertension
Dyslipidemia
Coronary Heart Disease
Stroke
17. Health Risks of Obesity (Cont’d)
• Increased Morbidity
Cancer (endometrial, breast, colon)
Poor Qualityof Life
Psychosocial Dysfunction
Sleep Apnea
Osteoarthritis
Increased Mortality
18. Work up
History
Amountof gained weight
Duration of weightgain
Recent changes in diet orappetite
Rateof weight gain
Rapid weightgain – f luid retention
27. Introduction
Always ask aboutweightchange
Changeof 5% over 6 months is significant
Relative change is also important
Significantweight loss – markerof serious
illness
Persistence & periodicevaluation to identify
thecause - important
28. Mechanisms of weight loss
Increased energyexpenditure
Increased energy loss
Decreased food intake
29. Causes of weight loss
I. Involuntary with increased appetite
A. Increased energy
expenditure
Hyperthyroidism
Pheochromocytoma
Extensiveexercise
B. Increased energy loss
Diabetes Mellitus
Malabsorptionsyndromes
Chronicpancreatitis
Ulcerative colitis
Chrohn’sdisease
Celiac sprue
30. Causes of weight loss (Cont’d)
II. Involuntary with
decreased appetite
A. Medical disorders
Cancer
Infections: HIV, TB,
Endocarditis, lung
abscess, hepatitis,
chronic helminth
infection
Chronic illnesses
CHF, CLD, COPD, CKD
Endocrine diseases
Adrenal insufficiency
Hypercalcemia
GI Diseases
PUD
Strictures
Dysphagia
Diabetic gasteroparesis
Compressive mass
Infiltrating cancer
Hyperemesis gravidarum
B. Psychiatric Disorders
Depression
C. Chronic drug use
Alcohol
Metformin
Anti cancers
ART
31. Causes of weight loss (Cont’d)
III. Voluntary Weight Loss
• Diet and exercise
• Treatment of Obesity
• Anorexia Nervosa, Bulimia
32. Evaluation
• Ask About Appetite
• Food Intake
• Weight History
• Maximum Weight
• Usual Weight
• Current Weight
• Patients Underestimate/Overestimate
• Ask Family Members
41. SECOND PHASE TESTS (Cont’d)
• Blood Cultures
• 72 h stool fat
• Bone marrow biopsy
• Vitamin B12 level
• MRI of the spine
42. Conclusion
Gain & Loss in weightare importantclinical problems
Involuntarychange is a markerof serious underlying
disease
Alwaysask aboutappetite
Obesity is a seriousworld wide problemwith
increased morbidity & mortality
Persistenceand periodicevaluation is important to
reach at the underlying cause forweight loss
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