OBESITY

Dr. Angelo Smith M.D WHPL

HOMEOSTATIC MECHANISM OF FAT REGULATION

Definition•Chronic disease characterized by

accumulation of fat.

•Obesity is defined as a condition when

ideal body weight is exceeded by 20%

•Medical condition responsible for

serious co-morbidity and mortality.

•APPLE TYPE : Central or abdominal adiposity (ANDROID) increased WHR & associated with higher morbidity risk. ♂ > ♀

•PEAR TYPE : GYNOID or typical

female distribution of fat : less health

risks

Waist to hip circumferences

WHR > 0.95 (♂) & > 0.80 (♀) : increased health risk

Psychosocial consequence

•Economical impact of obesity

•Prejudice and Discrimination

•Considered lazy, incompetent and more

often absent due to illness

•Confronted with more problems at job

application : oVery few executive managers with

overweight in the US

What causes Obesity?

•Genetic predisposition

•Disruption in energy balance

•Environmental and social factors

Aetiology of obesity

LIFESTYLE

PSYCHOLOGICAL MEDICAL

GENETIC

OBESITY

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Physiology of weight gain

Energy input Energy output

Control factors

Genetic make-up

Diet

Exercise

Basal metabolism

Thermogenesis

MANAGEMENT OF OBESITY•Obesity is a serious medical condition requiring

long-term management

•Management needs to be flexible and integrate

different therapeutic approaches according to

individual patient needs including

oDietary management

oLifestyle modification

oPhysical activity

oDrug therapy

oSurgery

Spectrum of obesity management

NEED FOR REALISTIC GOALS

•Shift focus from changing appearance to improving

health

•Consider healthier weight over time - not ideal weight

•Sustained moderate weight loss of 5-10kg

(5-10% of initial body weight)

oElevated BP

oBlood sugar concentrations

oSerum triglycerides

oHDL-cholesterol levels