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  1. Obesity Jessica Phelan

  2. Defining Obesity • Overweight and obesity are terms for ranges of weight that are greater than what is generally considered healthy for a given height • Results when body fat accumulates over time as a result of chronic energy imbalance • Identifies ranges of weight that are shown to increase likelihood of certain diseases

  3. Measuring Obesity in Adults • Determined by using weight and height to calculate body mass index (BMI) • An adult with a BMI of 30 or higher is considered obese • Other methods of measuring are skinfold tests, waist circumference, calculation of waist-to-hip circumference ratios, ultrasound computed tomography, and MRIs

  4. Defining and Measuring Obesity in Children and Teens • Weight status in youth is determined using an age- and sex- specific percentile for BMI rather than the BMI categories used for adults • For children and teens obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex

  5. Stature-for-age and weight-for-age percentiles http://www.cdc.gov/growthcharts/data/set1clinical/cj41c022.pdf

  6. Body mass index-for-age percentiles http://www.cdc.gov/growthcharts/data/set1clinical/cj41c024.pdf

  7. Causes and Consequences • A variety of factors can contribute to obesity • Behavior, environment, and genetic factors may have an effect in causing someone to become obese

  8. Risk Factors for Health Topics Associated with Obesity • High blood pressure- hypertension • High LDL cholesterol- “bad” cholesterol • Low HDL cholesterol- “good” cholesterol • High triglycerides • High blood glucose (sugar) • Family history of premature heart disease • Physical inactivity • Cigarette smoking

  9. Behavior and its effect on obesity • Caloric Balance Equation: obesity results form an energy imbalance • Calorie: unit of energy supplied by food

  10. Caloric balance status • Maintaining weight= in caloric balance • Loosing weight= in caloric deficit • Gaining weight= in caloric excess • Behavior consists of choices on eating and physical activity

  11. Environment and its effect on obesity • People make choices based on their environment or community • The Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity 2001 identified action steps for locations that can affect obesity

  12. Genetics and Obesity • Genes can directly cause obesity in some disorders • Multiple genes may increase susceptibility for obesity • They do not always predict future health

  13. Other factors that contribute to obesity • Diseases such as hypothyroidism Cushing’s disease and polycystic ovary syndrome • Drugs such as steroids and some antidepressants • Lack of sleep

  14. The Dangers of Obesity • Health Consequences • Economic Consequences

  15. Health Consequences • Coronary heart disease • Type II diabetes • Endometrial, breast, and colon cancers • Hypertension • Dyslipidemia (ex: high total cholesterol) • Stroke • Liver and gallbladder disease • Sleep apnea and respiratory problems • Osteoarthritis • Gynecological problems: abnormal menses &infertility

  16. Additional Risks for Children • Obese children are at greater risk of social and psychological problems • Obese children are more likely to become obese adults • If children are overweight or obese, then obesity in adulthood is likely to be more severe

  17. Economic Consequences • Direct medical costs such as preventive, diagnostic, and treatment services related to obesity • Indirect medical costs that are related to morbidity and mortality costs • In 2008 the medical costs of obesity in the US totaled at around $147 billion

  18. Psychological and Social Effects • Emotional suffering • Feelings of unattractiveness • Stereotypes: gluttonous and/or lazy • Face prejudice and discrimination in may settings • Feelings of rejection, shame, and depression

  19. Treatment • Varies depending on level of obesity, health condition, and readiness to lose weight • Diet, exercise, behavior modification, sometimes weight loss drugs, and in extreme cases bariatric surgery • Men over 40 and women older than 50 should speak with a health care provider before beginning a vigorous physical activity program

  20. Data and Statistics

  21. Prevalence of Obesity in the US • 33.9% of US adults age 20 and over • 18.1% of adolescents age 12-19 • 19.6% of children age 6-11 • 10.4% of children age 2-5

  22. Racial and ethnic disparities in adult obesity • 31.9% among non-Hispanic white men • 37.3% among non-Hispanic black men • 35.9% among Mexican-American men • 33.0% among non-Hispanic white women • 49.6% among non-Hispanic black women • 45.1% among Mexican-American women

  23. Percent of Obese in US Adults (BMI>30)

  24. Percent of Obese in US Adults 1985

  25. Percent of Obese in 1990

  26. Percent of Obese in 1995

  27. Percent of Obese in 2000

  28. Percent of Obese in 2005

  29. Percent of Obese in 2010

  30. County Level Estimates of Obesity 2008 Age-Adjusted Estimates of the Percentage of Adults Who are Obese in VA

  31. Translational Research • The CDC’s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has a state-based nutrition and physical activity programs to prevent obesity and other chronic diseases: currently funds 25 states to address obesity • U.S. Department of Health and Human Services awarded $119 million to states to support efforts to reduce obesity, improve nutrition, and decrease smoking

  32. DNPAO Examples of Translational Research Improving Retail Access for Fruits and Vegetables • Goal is to increase the consumption of fruits and vegetables by improving access to retail venues that sell or increase availability of high-quality fruits and vegetables in underserved communities • New York Taste ‘n Take program provides a weekly bag of fresh produce to low income housing in several cities in New York. In 2008 10,00 pounds distributed and in 2010 over 69,000

  33. DNPAO Examples of Translational Research Enhanced School-Based Physical Education • Aims to increase physical activity by enhancing school-based physical education • Georgia School Fitness Assessment was conducted by the Georgia Student Health and Physical Education partnership • Conduct an assessment and provides feedback to students and parents through computer software

  34. Surveillance Systems • Behavioral Risk Factor Surveillance System • National Health and Nutrition Examination Survey • Youth Risk Behavior Surveillance System • National Health Interview Survey • Pediatric and Pregnancy Nutrition Surveillance Systems • National Collaborative on Childhood Obesity Research

  35. Obesity Resources • CDC • http://www.cdc.gov/obesity/index.html • NIH • http://health.nih.gov/topic/Obesity/FoodNutritionandMetabolism • National Heart, Lung, and Blood Institute • http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/index.htm • National Institute of Environmental Health Sciences • http://www.niehs.nih.gov/research/supported/programs/obe/index.cfm