Obesity - causes, complications and management.

1. OBESITY
Dr. Angelo Smith M.D
WHPL

2. HOMEOSTATIC MECHANISM OF FAT
REGULATION

6. 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.

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

10. •PEAR TYPE : GYNOID or typical
female distribution of fat : less health
risks

11. Waist to hip circumferences
WHR > 0.95
(♂) & > 0.80
(♀) :
increased
health risk

12. 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

16. What causes Obesity?
•Genetic predisposition
•Disruption in energy balance
•Environmental and social factors

17. Aetiology of obesity
LIFESTYLE
PSYCHOLOGICAL MEDICAL
GENETIC
OBESITY
IA6

20. Physiology of weight gain
Energy input Energy output
Control factors
Genetic make-up
Diet
Exercise
Basal metabolism
Thermogenesis

27. 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

42. Spectrum of obesity management

43. 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