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Causes, Consequences and Tackling obesity.

Causes, Consequences and Tackling obesity. . Professor Paul Gately Carnegie Weight Management Leeds Metropolitan University. What is overweight ?. This boy is 3 years, 3 weeks old. Is his BMI-for-age - below the 5 th percentile? - 5 th to <85 th percentile: normalweight?

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Causes, Consequences and Tackling obesity.

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  1. Causes, Consequences and Tackling obesity. Professor Paul Gately Carnegie Weight Management Leeds Metropolitan University

  2. What is overweight ? • This boy is 3 years, 3 weeks old. • Is his BMI-for-age • - below the 5th percentile? • - 5th to <85th percentile: normalweight? • - >85th to <95th percentile: overweight? • - >95th percentile: • obese? Photo from UC Berkeley Longitudinal Study, 1973

  3. BMI BMI Boys: 2 to 20 years BMI BMI Plotted BMI-for-Age Measurements: Age=3 y 3 wks Height=100.8 cm (39.7 in) Weight=18.6 kg(41 lb) BMI=18.3 BMI-for-age=>95th percentile = obese

  4. BMI distribution curves over time Probability density O/WT OBESE Body Mass Index (kg/m2) Source: Rose, G. (1991) .

  5. Changes in prevalence

  6. Idiopathic intracranial hypertension Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Stroke Cataracts Nonalcoholic fatty liver disease Steatosis Steatohepatitis cirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Severe pancreatitis Gall bladder disease Cancer breast, uterus, cervix colon, esophagus, pancreas kidney, prostate Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Osteoarthritis Phlebitis venous stasis Skin Gout Why is this a concern? Source: www.obesityonline.org

  7. Psycho social factors12-year old girls and boys

  8. Fat-teasing in boys & girls (Murphy & Hill, 2003) * ** ** ** **

  9. Toxic or obesogenic environment Obesity is a normal response to an abnormal environment • side-effect of technological advances • reflects natural human preferences (eg easy, convenient, fast, low effort, value for money) • key factors • energy-saving machines, passive recreation • energy-dense foods & drinks, large portion sizes

  10. FOOD Strong signals to eat Weak signals to stop Increased availability Eating is rewarding No viable alternatives Eating well is high status ACTIVITY Weak activity signal Strong signals to stop Reduced availability Inactivity is rewarding Inactivity is a viable alternative Inactivity is high status Biological and cultural mismatches to the modern environment

  11. Where should the focus be?

  12. NORMAL WEIGHT OVERWEIGHT Health costs ↑ 20% Gately (2007)

  13. OBESE Health costs ↑ 50% Gately (2007)

  14. OBESE +++ Health costs ? Min ↑100% Gately (2007)

  15. Is policy having an impact on weight change?

  16. Results of process research Comments on exercise: “I prefer to do sports than watch TV, just don’t get the chance, I’m too fat.” “I don’t like walking or running its boring, just never do it.” “I like doing sports, because I’m having fun with friends.” Potential of extended schools and PESSCL? “I would get laughed at it I turned up for an afterschool sports club, they are not for kids like me” “After I lost weight and got fitter I felt more like joining in PE and clubs”

  17. Broadcast

  18. Carnegie Curriculum Behaviour Change Theory & Tools

  19. Carnegie Weight Management

  20. Skill based exercise *** *** *** *** *** P<0.001 pre to post

  21. Self Perception Profile for Children (SPPC) ** ** ** Source: Walker et al. (2002) ** (P<0.01)

  22. Long term results of residential programme

  23. Community club outcomes

  24. Impact of obesity interventions on participants 1 Very little published evidence on the effectiveness of whole-school obesity interventions in the UK. What exists is not overwhelmingly positive

  25. Comparative attributes of obesity interventions

  26. Carnegie Weight Management The Grange Headingley Campus Leeds Metropolitan University Leeds LS6 3QS Tel. +441138123579 p.gately@leedsmet.ac.uk www.carnegieweightmanagement.com

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