Obesity is defined using body mass index and is increasing in prevalence globally. It is caused by an energy imbalance where caloric intake exceeds energy expenditure, and is influenced by both environmental and genetic factors. Obesity is associated with numerous health complications and increases the risk of conditions like diabetes, cardiovascular disease, hypertension, certain cancers, and early mortality. Treatment involves lifestyle modifications like diet and exercise as well as pharmaceutical options and surgery for severe obesity.

1. Obesity
Presented By-Dr Santosh M Narayankar

2. Increased adipose tissue
Chronic disease
Increasing in prevalence.
Epidemic

3. Definition
• Body Mass Index - as tool

6. Waist Circumference
Waist circumference best correlates with DM,HTN & Dyslipdaemia

7. BMI in Indian Population

10. Prevalence

11. Etiology
Energy imbalance
Environ
mental
factors
Host
agents

14. Environmental Factors

15. Intrauterine factors
Maternal diabetes
Maternal smoking
Intrauterine nutrition

16. Neonatal environment
Breast-fed for
>3 months
Decreases
Future risk
obesity

17. Adiposity Rebound

19. Drugs

20. Diet And Physical activity
High
caloric
intake
Low
physical
activity
Obesity

21. Smoking
Smokers have low body weight than
non smokers
Thermogenic
Decreases hunger

22. Viruses
Obese
Higher
antibody levels
to adenovirus
(AM-36)

23. Microbiome

24. Lean –
bacteriodetes
Obese -
Firmicutes

25. Host Agents

26. Genetic Causes
Melanocortin Gene(MC-4) -6%
Leptene gene
Pro-opiomelanocortin gene
(POMC)
Agouti Gene

27. Pathology & Pathophysiology

29. Complications & Consequences

30. Diabetes
Risk of
diabetes
BMI
>30kg/m2

32. Dyslipidamia
Low
HDL
High
TG
level

33. Cardiovascular Diseases
Increase in BMI
of 1.1kg/m2
Increases major
CV disease by 6%
Also increases risk of heart failure and atrial
fibrillation

34. Hypertension
• 44-51% over weight individuals
• Increased risk of heart failure

35. Kidney disease
Focal segmental
glomerulusclerosis -
2%
Increased risk of
stones
Risk factor for ESRD

36. GI & Liver diseases
Cholelithiasis NAFLD GERD

37. Cancers
• Men-Risk of Colon, Rectum, GB.
• Women-Reproductive systems, GB,Breast.

38. Endocrine Effects
PCOS
Infertility
Insulin Resistance
Hypogonadism
Gyaenecomastia

39. • Increased risk of community acquired
pneumonia

41. Diseases ass0ciated with
increased fat mass
OSA
Osteoarthritis
Stretch marks/Striae
Acanthosis nigricans
Psychosocial dysfunction

42. Death

43. Weight loss benefits

44. Evaluation

45. Algorithm for obesity evaluation by NHLBI

46. Laboratory studies
Serum lipids
Glucose
Hs-CRP
Other tests based risk factors noted at
history

47. Treatment

48. Realism is an
important aspect
of treatment.
Target of at least
10% weight loss-
success

50. Principal determinant of weight loss-adherence to
diet, not the specific diet itself

51. Lifestyle Modification

53. Orlistat
120 mg three times daily
Inhibits enzymatic action of pancreatic
lipase
Side effects - Fecal incontinence,anal
leakage,bloating,borborgyami &fat soluble
vitamin defeciency.

55. Lorcaserin
5-HT 2c receptor agonist
10mg twice daily
Adverse events-headache,
nausea,dizziness.
No cardiac side effects

59. Drugs Approved For Other
Indication Other Than Obesity
• Metformin
• GLP-1 Agonists-Exenatide & Liraglutide
• Pramilintide
• Bupropion
• Zonisamide

60. Thank You

61. Surgical And
Endoscopic
Management of
Obesity