Obesity is a medical condition characterized by excessive body fat that can negatively affect health, with a global prevalence increase observed since 1990. In 2022, approximately 2.5 billion adults were overweight, and obesity rates have doubled, impacting children and adolescents significantly as well. Prevention strategies include lifestyle assessments, dietary recommendations, and regular physical activity to mitigate obesity risks.

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OBESITY
Mrs. Neelam Vashishtha
Community Health Nursing

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Definition
Obesity is a medical condition in which excess
body fat accumulates to the extent that it may
have a negative effect on health, leading to
reduced life expectancy and/or increased health
problems
Latin word “OBESUS’’ meaning fat.
BMI ≥ 30 (class–II OBESITY) GLOBALLY
BMI ≥25 (class–II OBESITY) INDIANS

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Obesity vs Overweight
Overweight
Fat
Fluid
Muscle mass
Bone
Tumors
Obesity
Fat(adipose tissue)

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Epidemiology
 In 2022, 2.5 billion adults aged 18 years and older were overweight,
including over 890 million adults who were living with obesity. This
corresponds to 43% of adults aged 18 years and over (43% of men and
44% of women) who were overweight; an increase from 1990, when 25%
of adults aged 18 years and over were overweight. Prevalence of
overweight varied by region, from 31% in the WHO South-East Asia
Region and the African Region to 67% in the Region of the Americas.
 About 16% of adults aged 18 years and older worldwide were obese in
2022. The worldwide prevalence of obesity more than doubled between
1990 and 2022.
.

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In 2022, an estimated 37 million children under the age of 5 years were
overweight. Once considered a high-income country problem, overweight is
on the rise in low- and middle-income countries. In Africa, the number of
overweight children under 5 years has increased by nearly 23% since 2000.
Almost half of the children under 5 years who were overweight or living with
obesity in 2022 lived in Asia.
Over 390 million children and adolescents aged 5–19 years were overweight
in 2022. The prevalence of overweight (including obesity) among children
and adolescents aged 5–19 has risen dramatically from just 8% in 1990 to
20% in 2022. The rise has occurred similarly among both boys and girls: in
2022 19% of girls and 21% of boys were overweight.
While just 2% of children and adolescents aged 5–19 were obese in 1990 (31
million young people), by 2022, 8% of children and adolescents were living
with obesity (160 million young people).

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Epidemiology Cont.
There is 12-25 % prevelance in India.
Maximum obese children in the world in China.
India is on Second position for obesity in children in the
world.
Highest obesity approx. 61% in the world is in Nauru country.
Obesity is preventable.

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7 OBESITY INDICES
 BMI (epidemiological indicator) :- 18.5-22.9 (Indians)
 Broca’s index :- Ht (cm)-100 IDEAL Wt
 Lorentz Formula :- Ht (cm)-100 - (Ht (cm)-150/2 or 4)
 Corpulence Index :-
Actual Wt/Desired Wt >1.2 (excess Wt)
permissible Upper range
 Waist hip ratio :- girth of waist/girth of hip
>0.85 Male
>0.80 Femaale

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Measurement of obesity
 BMI
 Waist hip ratio
 Skin fold thickness(sites- Mid triceps,Biceps, Subscapular,
suprailliac)
Herpenden Calliper
Male > 40 - fat accumaulation
Female > 50 - fat accumaulation
 Air displacement Plethysmography
 Total body electrical conductivity

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Types of obesity

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1. Inactivity Obesity
It is no secret that a lack of physical activity can
cause you to become overweight. In this type of
obesity, once-strong parts of the body quickly
gain fat and become unhealthy.

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2. Food Obesity
If you overeat, and particularly if you
overindulge in unhealthy foods, you may suffer
from food obesity.
Excessive sugar intake can also cause food
obesity, which may lead to accumulation of fat
around the middle part of the body.

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3. Anxiety Obesity
Anxiety or depression can often lead to
overeating and accumulation of fat in the
body, since the body must constantly survive in
fight-or-flight mode.
To treat this type of obesity, you must control
your anxiety.
Common treatments include medication, a
decrease in caffeine intake.

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4. Venous Obesity
Venous circulation is one obesity cause that is
genetic in nature, rather than habitual in nature.
if anyone in your family suffers from venous
circulation, you run the risk of the same
condition.
This type of obesity is particularly common in
pregnancy.
Exercise is the best solution for this problem.

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5. Gluten Obesity
You are likely no stranger to the many health
problems that gluten can cause. In fact, gluten
can actually cause obesity.
This type of weight gain is most common in
women.
It is often spotted during periods of hormonal
change, like puberty, pregnancy, and
menopause.

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6. Atherogenic Obesity
People whose fat tends to accumulate in the
stomach area often suffer from atherogenic
obesity.
This is a particularly dangerous condition since it
can affect your other organs and lead to
breathing problems.
It is extremely important to avoid drinking
alcohol if you have atherogenic obesity.

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16 Several factors are responsible for
obesity
Behavioral and lifestyle factors
Diseases
Mental illness
Genetics

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17 Behavioral and lifestyle factors
Unhealthy dietary patterns
Less physical inactivity
Medication use
Easy availability of fast food
Unfavorable physical activity environment
Less education and skills
Food marketing and promotion

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18 Behavioral and lifestyle factors
1. Diet
A diet high in simple carbohydrates.
Carbohydrates increase blood glucose levels,
which in turn stimulate insulin release by the
pancreas, and insulin promotes the growth of fat
tissue and can cause weight gain.

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19 Behavioral and lifestyle factors
1. Diet Cont.
Frequency of eating. The relationship between
frequency of eating (how often you eat) and
weight is somewhat controversial

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20 Behavioral and lifestyle factors
2. Sedentary lifestyle
Physical inactivity. Sedentary people burn fewer
calories than people who are active. The
National Health and Nutrition Examination
Survey (NHANES) showed that physical inactivity
was strongly correlated with weight gain in both
sexes.

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21 Behavioral and lifestyle factors
3.Medications
Medications associated with weight gain include
certain antidepressants, anticonvulsants, some
diabetes medications, certain hormones such as
oral contraceptives, and most corticosteroids.
Weight gain may also be seen with some high blood
pressure medications and antihistamines.

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22 Diseases
Many diseases like
Cushing’s disease
Polycystic ovary syndrome
Thyroid and other endocrine disorders

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23 Mental illnesses
Depression
Eating disorders

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24 Genetics
A person is more likely to develop obesity if one
or both parents are obese.
Genetics also affect hormones involved in fat
regulation.
For example, one genetic cause of obesity is
leptin deficiency.

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25 Health consequences of obesity
According to CDC obesity affects almost all organ
systems and creates adverse health effects.
1. Hypertension
2. Dyslipidemia
3. Type 2 diabetes
4. Coronary heart disease
5. Stroke

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26 Health consequences of obesity Cont.
6. Gallbladder disease
7. Osteoarthritis
8. Sleep apnea, obesity related asthma
9. Endometrial, breast, colon, liver cancers
10.Low quality of life
11.Mental illness
12.Chronic pain

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Prevention

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28 Primary Prevention
Lifestyle Assessment Related to Obesity Risk
Assess BMI at least annually, monitor for
increasing BMI.
Review dietary and physical activity habits in
addition to sleep duration
Review other obesity risk factors such as medical
co-morbidities, familial obesity, medication use,
and lack of nutrition knowledge and/or skills for
food preparation.

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29 Primary Prevention Cont.
Counseling and Approaches
Discuss weight control interventions for
overweight patients to prevent the progression
to obesity
Encourage a self-management approach
including setting goals for healthy lifestyle habits

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30 Primary Prevention Cont.
Physical Activity and Exercise
Encourage adults and children to engage in
regular physical activity and decrease
sedentary activity.

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31 Physical Activity Recommendations
with Definitions and Examples
A. Children & Adolescents
Minimum of one hour of active play and other
activities daily that include moderate-or vigorous-
intensity aerobic physical activity, muscle-
strengthening activities, and bone-strengthening
activities

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32 Physical Activity Recommendations
with Definitions and Examples Cont.
B. Adults
Aerobic exercise – either or a combination of:
1. At least 150 minutes of moderate-intensity
exercise weekly.
2. At least 75 minutes of vigorous-intensity exercise
weekly.

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33 Physical Activity Recommendations
with Definitions and Examples Cont.
B. Adults
For additional health benefits, also consider:
1. Strength/resistance exercises 2-3 days/week
2. Neuromotor exercise (balance, agility, and
coordination) 2-3 days/week
3. Flexibility exercises ≥ 2 days/week

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34 Physical Activity Recommendations
with Definitions and Examples Cont.

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35 Primary Prevention Cont.
Diet and Eating
1. Promote consumption of a variety of nutritious
foods.
2. Recommend avoidance of high calorie foods
and sugar sweetened beverages.

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36 Primary Prevention Cont.
Diet and Eating
3. Encourage and support breastfeeding during
infancy
4. Encourage families to create a healthful eating
environment that is responsive to hunger and
fullness cues

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37 Primary Prevention Cont.
Diet and Eating
5. Discuss ways to access affordable healthy
foods
6. Promote family meals and limited eating out
and fast food
7. Limit children’s screen time and exposure to
food and beverage marketing

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38 Primary Prevention Cont.
5-2-1-0 (Quick Summary for Children and
Adolescents)
5 or more servings daily of fruits and vegetables.
2 hours or less of screen time daily (Keep
TV/computer out of bedroom. No screen time
under the age of 2.)
1 hour or more daily of physical activity
0 sugary drinks – more water & low fat milk

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39 Primary Prevention Cont.
Sleep
Promote age-appropriate sleep durations.
Children:
Preschoolers (3-5 years: 11-13 hours),
School-aged (5-12 years: 10-11 hours)
Adolescents and Adults:
Adolescents (12-18 years): 9-10 hours),
Adults: 7-8 hours

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40 Secondary Prevention
1. Annual assessment of BMI should be recorded
and discussed with patients.
2. Annual assessment of BMI should be recorded
and discussed with patients.
3. indicating increased risk for developing
obesity.

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41 Secondary Prevention Cont.
General goals of weight management in obese
persons are:
1. Reduce body weight
2. Sustain weight loss by minimizing risk of weight
gain
3. Prevent further weight gain.

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