صناع الحياة

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  • 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.
  • so as you can see something new must happen!
  • صناع الحياة

    1. 1. بسم الله الرحمن الرحيم
    2. 2. Our Agenda <ul><li>Obesity as a problem </li></ul><ul><li>Causes </li></ul><ul><li>Diagnosis. </li></ul><ul><li>How to deal. </li></ul>
    3. 3. Obesity as a Pandemic BY /Essam Adel Wahab Associated lecturer of Internal Medicine
    4. 4. Obese elsewhere
    5. 5. Rise in Childhood Obesity Bundred et al, BMJ Feb 2001
    6. 7. Animal problem
    7. 9. Most important disease states in the world? 2020 1990 Communicable Diseases Chronic Disease Injuries Source : Harvard School of Public Health
    8. 10. Obesity Trends Among U.S. Adults (BMI > 30) BRFSS, 1991, 1995, and 2000 1991 1995 2000 No Data < 10% 10%-14% 15-19%  20%
    9. 11. Global effect of Over weight <ul><li>Globally WHO estimates that: </li></ul><ul><li>58% of Diabetes mellitus, </li></ul><ul><li>21% Ischemic heart diseases, </li></ul><ul><li>4-42% of certain cancer, </li></ul><ul><li>Were attributable to BMI above 21 kg/m² </li></ul>
    10. 12. Prevalence of overweight and obesity * Obesity only
    11. 14. Over weight and Obesity among females is 54% & 48%among Male
    12. 16. Hazards of the obesity اضرار السمنة Financial costs Health problems
    13. 17. <ul><li>£2.6 billion pa, UK (1998) </li></ul><ul><li>Direct </li></ul><ul><ul><li>Co-morbidities, health service expend, prescriptions,hospitals, drugs </li></ul></ul><ul><li>Indirect </li></ul><ul><ul><li>Disability, unemployment, early retirement </li></ul></ul><ul><ul><li>18 million sick days, 40 000 lost years working life, obese die 9 years early </li></ul></ul><ul><li>Intangible </li></ul><ul><li>Loss self esteem, relationships, pain </li></ul>The Costs of Obesity
    14. 18. Burden of Obesity <ul><li>Obesity is killing around, 150.000 men and women each year. </li></ul>
    15. 19. Health Risks of Excessive Fat <ul><li>Impaired cardiac function </li></ul><ul><li>HPN, stroke, and DVD </li></ul><ul><li>Type 2 diabetes (80% of these patients are overweight) </li></ul><ul><li>Renal disease </li></ul><ul><li>Sleep apnea </li></ul><ul><li>Osteoarthritis, degenerative joint disease, gout </li></ul><ul><li>Endometrial, prostrate. breast, colon cancers </li></ul><ul><li>Abnormal plasma lipid and lipoprotein levels </li></ul><ul><li>Menstrual irregularities </li></ul><ul><li>Gallbladder disease </li></ul>
    16. 20. Physical Effects of Obesity Cardiovascular Respiratory disease Gall bladder disease Hormonal abnormalities Hyperuricaemia and gout Stroke Diabetes Osteoarthritis Cancer
    17. 21. chronic diseases result in percent of deaths worldwide... 4 50 Cardiovascular Chronic Respiratory Disease Type 2 Diabetes Cancer
    18. 22. Association of Obesity and related diseases Obesity Cancer Gall-bladder disease Kidney failure Stroke Heart failure Hyper-tension Type 2 diabetes Athero-sclerosis
    19. 23. RISK FACTORS Diabetes 2 in 10 Hypertension 1 in 4 Smoking 1 in 3 Obesity 1 in 2 Dyslipidaemia 1 in 2 Physical Inactivity 8 in 10
    20. 24. Source : Hinkle et al., CDC 1997 What matters most in health care? Lifestyle Factors Human Biology Environmental Factors Medical Care
    21. 26. Causes
    22. 30. 3 … and are caused by risk factors Tobacco Poor Diet Lack of Exercise
    23. 31. Size is every thing
    24. 32. Obesity is caused by what? <ul><li>Rare syndromes can be identified with monogenic aetiologies ( e.g.leptin deficiency) </li></ul><ul><li>Polygenic conditions can be identified with obesity as part of the syndrome (Prader-Willi syndrome ) </li></ul><ul><li>Majority of obesity is caused by an imbalance between energy consumption and energy expenditure… </li></ul>
    25. 33. Energy Expenditure Energy Intake الميزان
    26. 34. Pathways to Obesity <ul><li>Fat intake (“cafeteria” diet) </li></ul><ul><li>Inactivity (25% get regular exercise) </li></ul><ul><li>Metabolic issues </li></ul><ul><li>Overeating </li></ul><ul><li>“ Thrifty genome” </li></ul><ul><li>Combinations of above </li></ul>
    27. 35. Or, in simple terms <ul><li>… We are eating too much and doing too little exercise </li></ul>
    28. 37. Diagnosis
    29. 40. Body fat distribution Apple shaped obesity Women >88 cm (80cm) = Increased risk Men >102 cm (90cm) = Increased risk cm
    30. 42. Waist Measurement or BMI?
    31. 43. WHO criteria for Over weight and Obesity <ul><li>Overweight = BMI of 25-29 Kg/ m² </li></ul><ul><li>Obesity = BMI of  30 kg/ m² </li></ul>
    32. 44. How to deal ???
    33. 45. WHO <ul><li>“ Obesity cannot be prevented or managed solely by governments (or health professionals). The food industry, international agencies, the media, communities and individuals need to work together so that the environment is less conducive to weight gain” </li></ul>
    34. 46. Excuses <ul><li>Governments : “Food is the responsibility of the individual” </li></ul><ul><li>Doctors: “Diabetes is a disease, but obesity is compatible with a long and happy life” </li></ul><ul><li>Scientists: “Obesity is genetic” </li></ul><ul><li>Rich individuals: “I only eat lettuce” </li></ul><ul><li>Poor individuals: “The best value meal I can find is fast food” </li></ul>Nonsense! Nonsense! Nonsense! Nonsense! True!
    35. 47. Role of Media
    36. 48. Food is advertised, and marketed. Choices depend on availability Governments have a responsibility for food standards and labelling
    37. 49. Los Angeles 25 th Nov 2003
    38. 51. What we need <ul><li>Health education </li></ul><ul><li>Role of media. </li></ul><ul><li>Public organization. </li></ul><ul><li>Role of health providers. </li></ul><ul><li>Role of person. </li></ul>
    39. 53. The Plane <ul><li>Food Restriction. </li></ul><ul><li>Behavior Modification. </li></ul><ul><li>Exercise. </li></ul><ul><li>Last options – Surgery, drugs. </li></ul>
    40. 56. Success in weight management? Starting weight Time Natural course of weight gain Increasing success Body weight (kg) Weight loss phase Weight maintenance phase years months
    41. 58. <ul><li>Heads of state: Not in focus </li></ul><ul><li>Health ministries: Inadequate capacity and budget </li></ul><ul><li>WHO: Has tried for 48 years </li></ul><ul><li>Academic health centres: Not a priority </li></ul><ul><li>International donors: Only for HIV/AIDS (tobacco) </li></ul><ul><li>Private-public partnerships: All on infectious diseases </li></ul><ul><li>Global NGOs: No support </li></ul><ul><li>Media: Little </li></ul><ul><li>Pharmaceutical industry: Major contribution?????????????????????? </li></ul>Who is responsible for policy response to Obesity?
    42. 59. Multiple stakeholder interventions can be effective <ul><li>Cigarette smoking </li></ul><ul><ul><li>high taxation </li></ul></ul><ul><ul><li>Advertising ban </li></ul></ul><ul><ul><li>Prevention of smoking in public places </li></ul></ul><ul><ul><li>Health campaigns to stop smoking </li></ul></ul><ul><ul><li>Transport smoking bans </li></ul></ul><ul><ul><li>Campaign groups </li></ul></ul><ul><ul><li>Health warnings on packets </li></ul></ul>
    43. 60. Raising community awareness (Eat less – Walk more): <ul><li>Since obesity is the major risk factor, not only for diabetes, but also for hypertension and cardiovascular diseases, it is essential to create awareness in the community about obesity, the risk factors involved and the importance of a healthy lifestyle, including intake of fewer calories and more physical activity. </li></ul>
    44. 61. NEGLECTING OVERWEIGHT-OBESITY IS A disaster
    45. 62. “ All segments of the society must unite across the world to provide a global obesity
    46. 63. <ul><li>NO MATTER HOW FAR YOU HAVE GONE ON THE WRONG ROAD, JUST TURN BACK </li></ul><ul><li>TURKISH PROVERB </li></ul>
    47. 64. <ul><li>عن صالح بن يحيى بن المقدام : سمعت رسول الله صلى الله عليه وسلم يقول : ( ما ملأ آدمي وعاءً شراً من بطن، حسبك يا ابن آدم لقيمات يقمن صلبك ، فإن كان لا بد ، فثلث طعام ، وثلث شراب ، وثلث نفس . صدق رسول الله </li></ul>

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