Obesity is defined as abnormal or excessive fat accumulation that presents a risk to health. The fundamental cause is an energy imbalance between calories consumed and expended. Worldwide obesity has more than doubled since 1980. Overweight and obesity are linked to more deaths than underweight. Body mass index (BMI) is a crude measure of obesity that accounts for differences in body composition by relating weight to height. Waist circumference and waist-to-hip ratio are also used to measure obesity. Excess calories are stored as triglycerides in adipose tissue, and fat cells once gained are never lost. Central abdominal fat carries greater health risks than lower body fat. Lifestyle changes aimed at balancing calorie intake with expenditure through diet and

1. OBESITY
Zagada, T
imothy M.

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.

7. • Obesity ispreventable.
How can we measure obesity?

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

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

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
)

21. Patients Actual Caloric
Intake
• CHO: 590g
• CHON: 135g
• Fat: 115g
X 4 = 2360 kcal
X 4 = 540 kcal
X 9 =1035 kcal
3935 Kcal

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

23. Caloric Distribution
• CHO- 55-70%
• CHON- 10-15%
• Fat- 20-30%
• CHO: 2350 x 60%
=1410 kcal
• Fat: 2350 x 30%
=705 kcal
• CHON: 2350 x 10%=235 kcal ÷ 4
÷ 4 = 350g
= 60g
÷ 9 = 80g

24. Energy and Nutrient Requirements
Actual
• Calorie: 3935 Kcal
• CHO: 590g
• CHON: 135g
• FAT: 115g
Required
• Calorie :2350 kcal
• CHO: 350g
• CHON: 60g
• FAT: 80g