The document discusses obesity as a disease characterized by excessive fat accumulation that impairs health, driven by factors including overnutrition, genetics, and sedentary lifestyles. It highlights the global burden of obesity, including statistics showing 1.9 billion adults were overweight in 2016, and the increasing rates in both developed and developing nations. Prevention and control strategies include promoting healthier food choices, regular physical activity, and policy measures to reduce the consumption of unhealthy foods.

1. Obesity
Dr Venkatesh Karthikeyan
Department of Community and Family Medicine
AIIMS Patna
www.drvenkateshkarthikeyan.com
t.me/drvkspm

2. Contents
• What is obesity?
• Pathogenesis
• Burden
• Epidemiology of obesity
• Assessment of obesity
• Consequences of obesity
• Prevention and Control
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3. What is obesity?
• Abnormal or excessive fat accumulation in the body that may impair
health.
• A body weight higher than the expected weight for a particular age
and sex is referred to as “obesity” and “overweight”
• It is considered as a disease as well as a risk factor for other diseases
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4. Pathogenesis
• Multifactorial
• Most common cause – overnutrition
• Genetic and environmental factors plays a role
• Sedentary habits
• Junk foods
• High fat diet
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5. Burden of Obesity – Global Scenario
• In 2016, more than 1.9 billion adults aged 18 years and older were
overweight.
• Of these, over 650 million adults were obese.
• In the same year, 39% of adults aged 18 years and over were
overweight.
• Overall, 13% of the world’s adult population is obese.
• According to WHO, rates of overweight and obesity are increasing in
both developed and developing countries around the world.
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6. Burden of Obesity – Indian Scenario
• According to Global Nutritional Report 2017, prevalence of obesity
among
• Under five children is 2%
• Adolescents is 13%
• Adult males – 18% are overweight, 2% are obese
• Adult females – 22% are overweight, 5% are obese
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7. Epidemiology of obesity
• Agent factor
• Host factor
• Environment factor
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8. Agent factor - Nutrition
• Consuming more quantity of food than required amount leads to
deposition of excess fat in the body.
• QUALITY of food consumed also plays a role.
• Common contributors to obesity
• High sugar foods like ice creams and high fat food
• Protective role
• Salads, whole grains, cereals
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9. Host factors
• Age (old people > young)
• Gender (Females > Males)
• Marital status (Married > Single)
• Geographical distribution (People of Europe, US and Australia have greater risk)
• Physical inactivity (Sedentary lifestyle)
• Education (Less educated > well educated)
• Endocrine disorder (Cushing’s, PCOD, Hypothyroidism, diabetes)
• Psychological state (Stress, depression, anxiety)
• Genetics (Prader Willi Syndrome)
• Lifestyle (Binge eating, fast food, sedentary lifestyle)
• Breast feeding (Formula milk)
• Socioeconomic status (higher strata > lower strata)
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10. Environmental factors
• Seasonal variation (Winters > Summers)
• Food economics
• Social factors (Urban communities more prone to eating junk food)
• Marketing factors
• Physical environment (lack of parks, lack of walking tracks)
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11. Assessment of obesity
*Body Mass Index (Quetelet index)
BMI = Weight(kg)/Height(in meter)2
*Ponderal index = Height (cm)/ Cube root of body weight (kg)
*Broca index = Height(cm) – 100
*Corpulence index = Actual weight/Desirable weight(Should not exceed 1.2)
*Waist Hip ratio:
>1.0 in male and >0.85 in female  Abdominal fat accumulation
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12. Classification of obesity
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13. • For children under 5 years of age:
• Overweight : Weight for height greater than 2 SD above WHO Child Growth
Standards median
• Obesity : Weight for height greater than 3 SD above the WHO Child Growth
Standards median
• For children between 5 years and 19 years:
• Overweight : BMI-for-age greater than 1 SD above the WHO Growth Reference
median
• Obesity : BMI-for-age greater than 2 SD above the WHO Growth Reference
Median
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14. Consequences of obesity
• Major risk factors for
• NCDS like heart disease and stroke
• Musculoskeletal disorders like osteoarthritis knee
• Cancer of endometrium, ovary, breast, prostate, liver, gall bladder, kidney,
colon.
• Limits the ability for physical activity
• Increased incidence of premature deaths and disabilities in adulthood
• Obese children more prone for breathing difficulties, fractures,
hypertension, insulin resistance and depression.
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15. Prevention and Control
• Create enabling and supportive communities
• Choose healthier food choices
• Encourage regular physical activity
• Health education
• Encourage healthy habits
• Discourage unhealthy choices like sweetened beverages, processed
high calorie food
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16. Prevention and Control (cont.)
• Policy level decisions like higher taxes on sugar sweetened beverages
and foods
• Policy and guidelines for nutritional content of foods manufactured
• Restriction of marketing for unhealthy food items specifically
targeting children and adolescents.
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17. Prevention and Control (cont.)
• Any obesity that may have a medical basis should be referred to an
appropriate physician/specialist.
• Referrals includes suspected Diabetes, Cushing’s, hypothyroidism,
PCOD, etc.
• Suspicion should be more in individuals with typical clinical history or
strong family history of such conditions
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18. .

19. Reference
• IAPSM’s Textbook of Community Medicine
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