The document summarizes the evolution and costs of obesity, its nutritional and lifestyle origins, and potential remedies including diets, drugs, lifestyle changes, and surgery. It provides data on the rising rates of obesity and associated costs over time. Fast food consumption, large portion sizes, and sedentary lifestyles are identified as contributing factors. Common diets, drugs approved to treat obesity, and the benefits of lifestyle modifications, mindful home cooking, and bariatric surgery are outlined as potential remedies.

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Obesity
Evolution – Costs - Origins – Remedies
By Valerie Orsoni (Founder of LeBootCamp.com)

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Evolution of the BMI (1850-2012)
BMI
33
31
29
27
25
23
21
19
17
1840 1860 1880 1900 1920 1940 1960 1980 2000 2020 2040

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42% obese
72% unhealthy weight
36% obese
54% unhealthy weight
in millions
Adults only

4. Cost of
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Obesity Increase
A 6% obesity increase from 2012 to 2030 will lead to:
 $190 billion in annual medical costs due to obesity, double earlier estimates
 $5,530 more per year in medical costs for a worker with a BMI above 40
 Obesity responsible for 32% of all medical costs in 2030 vs. 21% in 2012
 Airlines spending: $5 billion to cater for heavier passengers (over 2 decades)
 $285,000/y/company spent on obesity related lack of productivity and absenteeism
 $4 billion / year for additional gasoline as cars carry heavier passengers

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Obesity Metrics
 The medical costs for people who are obese are $1,429 higher than those of
normal weight
 Non Hispanic blacks have a 49.5% obesity rate vs. 31% in non Hispanic whites
 400,000 premature deaths per year in the USA
 7% of non obese children become obese adults
 77% of obese children become obese adults
 Fattest state: Mississippi (34.9% - entire population)
 Leanest state: Colorado (20.7% - entire population)

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Obesity Metrics

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Nutritional Origins of Obesity
 Processed foods (high GI of foods)
 Portion sizes average US restaurant meal now 4X larger than it was in the 1950s;
average hamburger was 3.9 oz, now 12+ ounces; average French fries was 2.4
oz, now 7 oz; average soda was 7 oz to 40 oz
 Unstructured meal times
 Fast food. Adults average of 11.3% of daily calories consumed
from fast food in 2007-2010
 Snacking. The average American eats 4.9 snacks and meals daily -- a 29% increase
since the 1970s!
 Ubiquity of food. “Food is everywhere you turn. It’s in pharmacies, in hardware
stores.” [Thomas Farley, NYC Health Commissioner]

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Lifestyle Origins of Obesity
 Sedentary lifestyle: major changes due to labor-saving technologies
 The rise of the culture of consumption
 Automobile way of life
620h/year in commute = 35 lbs
 Introduction of radio - TV - computer - video games
8.5h in front of a screen / day
 Social clustering of obesity/thinness

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Remedies: Diets
 1087: First ever recorded diet: England’s first King William I.
 1830: Graham Diet
 1863: Banting Diet (the first recorded low carb diet)
 1879: First artificial sweetener (saccharine)
 1900’s: Fletcherism
 1920: Jean Nidetch (founder, Weight Watchers)
 1977: Slim-Fast®
 70’s and 80’s: The Mayo Clinic Diet
 80’s: High-protein diets
 90’s – now: Paleo, vegan, raw, tubes, etc.

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Remedies: Drugs
• Alli (Orlistat, originally Xenical): reduces intestinal fat absorption
• Metformin (Glucophpage): reduces blood glucose levels
• Byetta (Exenatide): reduces blood glucose levels
• Qsymia (Phentermine/Topiramate): appetite suppressant
• Belviq (Lorcaserin): appetite suppressant
• Symlin (Pramlintide): controls blood glucose; currently being tested in non-
diabetics as a treatment for obesity

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Remedies: Lifestyle Changes
Eliminate calorie- Introduce a varied
counting and nutritional diet
1st step
restrictive diet + which draws from all
approaches food groups
1 small change per day:
Replace monotonous
2nd step Daily small changes
yield better results + gym with daily
integrative exercises
(Berkeley study)
Empower individuals
Address with real information
emotional/mental
3rd step
issues which contribute + on the
body, nutrition, and
greatly to obesity fitness

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Remedies: Lifestyle Changes
Encourage mindful
Educate and inform
home cooking vs.
4th step
oversized fast-food + on healthy fast-food
options
portions
Combat powerful
Offer unlimited
5th step advertising for quick-
fix weight + support (affordable
personal coaching)
loss methods
Organize healthy
6th step
living communities + Monitor daily

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Remedies: Surgery
Restrictive Surgery (ie. sleeve gastrectomy; adjustable
gastric banding surgery): Removal or closure of a section of the
stomach to limit the amount of food it can hold and cause a feeling of
fullness
Malabsorptive Surgery (ie. gastric bypass): Shortening the
length of the small intestine, and/or changing where it connects to the
stomach to limit the amount of food that is completely digested or
absorbed
Combination of Restrictive & Malabsorptive Procedures
(ie. Roux-en-Y Gastric Bypass Surgery, “gold standard”): tend
to produce more weight loss than either procedure does on its own.
Studies show that after 10 to 14 years, patients on average have only
gained back 10-13% of the lost weight.

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