2. Obesity
• Defined as abnormal or excessive fat accumulation
that presents a risk to health.
• BMI of >
30
• Eating more in combination with reduced activity
levels has resulted in a tendency for the sustained
deposition of fat.
o T
he fundamental cause of obesity and overweight is an energy
imbalance between calories consumed and calories expended.
3. Obesity
• an increased intake of
energy-dense foods
• a decrease in physical
activity due to the
o increasingly sedentary nature of
many forms of work,
o changing modes of transportation
o increasing urbanization
4. Obesity Facts from WHO
• Worldwide obesity has
more than doubled since
1980.
• I
n 2008;
o 1.5 billion adults, 20 and older, were
overweight.
• Overall, more than one in
ten of the world’s adult
population was obese.
5. Obesity Facts from WHO
• Nearly 43 million children
under the age of five
were overweight in 2010.
6. Obesity Facts from WHO
• Overweight and obesity are
linked to more deaths
worldwide than
underweight.
• At least 2.8 million adults die
each year as a result of
being overweight or obese.
8. Body Mass Index
• A crude population measure of
obesity isthe body massindex
(BMI)
• Accountsfor differences in body
composition by defining the level
of adiposity according to the
relationship of weight to height.
• A person’s weight (in kilograms)
divided by the square of hisor her
height (in metres).
BMI=(weight in kg)/(height in meters)2
9. Body Mass Index
• While it does not directly measure body fat,
it ismore accurate at approximating degree
of body fatness than weight alone.
• Allows comparisons both within and
between populations.
10. Disadvantage of BMI
• Very muscular individuals
often fall into the
overweight category
o Muscle isdenser than fat, it weighs
more.
o Using BMIto assess their weight may
result in overestimating their true level
of body fat.
11. Other measurements
• Measure midway between the
top of iliac crest and tip of
lowest rib.
• Hip circumference should be
measured around the widest
portion of the buttocks
Measurement Male Female
Waist
circumference
> 35 inches > 31 inches
Waist to hip
ratio
> 0.95 > 0.8
12. Adipose
• Functions as the major storage site for
fat in the form of triglycerides
o Our major fuel store is adipose triacylglycerol
(triglyceride)
o if we eat more food than we require for our energy
needs, the excess fuel is stored (mainly in our adipose
tissue), and we gain weight
• Energy ingested as fat beyond that
needed for current energy demands is
stored in adipose tissue.
• Inaddition, carbohydrate and protein
consumed in the diet can be converted
to fat
13.
14. Adipose
• T
he average 70-kg man has
approximately 15 kg stored
triacylglycerol, which
accounts for approximately
85%of histotal stored
calories.
15. Adipose
• When triacylglycerols are
deposited in adipocytes, the
cells initially show a modest
increase in size
• When itsmaximal size is
reached, it divides.
• Fat cells, once gained, are
NEVER LOST
.
• T
hus, when an obese individual
losesweight, the size of the fat
cells is reduced, but the number
of fat cells isnot affected.
• The observation that fat cells are
never lost emphasizes the
importance of preventing
obesity in the first place.
16. Anatomic differences in fat
deposition
• Android - Excess fat located in the
central abdominal area of the body
o waist to hip ratio of more than
• 0.8 for women
• 1.0 for men
• Gynoid - Fat distributed in the lower
extremities around the hips or
gluteal region
o waist to hip ratio of less than
• 0.8 for women
• 1.0 for men
17. Android
• isassociated
with a greater
risk for:
o Hypertension
o insulin
resistance
o Diabetes
o Dyslipidemia
o coronary heart
disease
vs. Gynoid
• isrelatively
benign
healthwise, and
iscommonly
found in
females.
• Fat deposits are
presumably
energy reserves
to support
demands of
pregnancy and
lactation
18. 1 cup Veg
16 kcal
1 cup Rice
200 kcal
1 cup Ice cream
267 kcal
1 cup Mayonnaise
720 kcal
19.
20. CASE
• Height:5’8” (172.72cm)
• Weight: 250lbs (113.6kg)
• Physical Activity: Sedentary
• BMI:113.6/1.72=39.3 (Obese
class I
I
)
22. Patients’ Ideal Body Weight and Caloric
Requirement
• (IBW) T
annhausers
Method
o (172.72kg –100kg) –10%
o 72.72 - 7.272
o 65.5kg ~66kg
• T
otal Caloric
Requirement
o 66kg x 30=1980 kcal
o 2000 kcal
• Actual wt/ I
BW
113.6kg/66kg= 172%
The patients’ wt is72%above
his IBW
• Corrected Body Weight (CBW)
– [(Actual BW –IBW) x25%]+ IBW
– [(113.6–66) x 0.25]+ 66
– [47.6 x 0.25]+ 66
– 11.9 + 66
– 77.9kg ~ 78kg
• Total Caloric Requirement
– 78kg x 30= 2340 kcal
– 2350 kcal
