Patient has potentially life- threatening disabilities from obesity-related chronic diseases which can only be successfully treated with bariatric surgery such as gastric bypass, LAP-BAND, etc.

IMPORTANCE OF CONTROLLING OBESITY Obesity is directly responsible for the following diseases - many of which cause over 300,000 deaths annually in the US: Cardiovascular System Cor Pulmonale (This condition is also known as right heart failure.) Congestive heart failure Enlarged heart Varicose veins Pulmonary embolism (blood clot in lungs) High blood pressure Edema (swelling usually in legs, feet and ankles) Sudden death (usually due to a heart attack) (continued on next slide)

Endocrine System Diabetes Metabolic Syndrome (formerly known as Syndrome X) Polycystic ovarian syndrome Menstrual disorders Infertility Gastrointestinal Reflux Disease (GERD) Cholelithiasis (gallstones) Hiatal Hernia Hemorrhoids Gallstones Non-alcoholic Fatty Liver Disease (can progress to scarring of the liver, cirrhosis, or liver cancer) (continued on next slide)

Kidney & Bladder Urinary Incontinence (weak bladder) Chronic Renal Failure Reproductive System Erectile Dysfunction Infertility Stillbirth Polycystic ovarian syndrome Menstrual disorders Hypogonadism (decreased production of hormones by the sex glands) (continued on next slide)

Integument System (skin) Acanthosis Nigricans (velvety, light-brown-to-black, discoloration on the neck, underarms or groin.) Cellulitis (skin infection) Carbuncles (boils) Poor wound healing Fungus infections Stretch Marks Muscles and Joints Osteoarthritis (especially in the knees and hips) Gout Low Back Pain (continued on next slide)

Nervous System Stroke Meralgia Paresthetica (numbness or pain in the outer thigh) Headache Carpal Tunnel Syndrome Dementia Respiratory System Shortness of breath Asthma Sleep Apnea (breathing stops several times during the night) Frequent respiratory infections (colds, flu, bronchitis, pneumonia) Pickwickian Syndrome (difficulty breathing which causes high levels of carbon dioxide in the blood) (continued on next slide)

Psychological Depression Low Self Esteem Body Dysmorphic Disorder Social Stigmatization Immune System Colon and rectal cancer Cancer of uterus and cervix Breast cancer Prostate cancer (continued on next slide)

Obesity also causes: Increased risk of death during surgery Increased risk of death during pregnancy Therefore, in order to decrease the risk of getting any of the above conditions, it is very, VERY important to focus on controlling obesity.

10 REASONS FOR UNCONTROLLED WEIGHT

/lllllll ll

½ lb

AT AGE 35AT AGE 55AT AGE 65

HUNGER AND APPETITE ARE NOT THE SAME. Hunger is a compelling need for food. Appetite is a desire for certain types of food.

When you are hungry, any type of food will satisfy you; your body just wants food of any kind in order to stay alive.

Appetite is the reason that OVER 99 MILLION of us are obese. A salad can satisfy our hunger; but our appetite wants cheeseburgers, milkshakes and fries!

Appetite is acquired after tasting a particular food. If the food stimulates certain chemicals that regulate pleasure (called "endorphins") in our brain, then we will be HOOKED on that particular food.

These "PLEASURABLE" foods usually contain sugar or fat. After a few years of eating calorie- rich, flavorful, fattening foods, it will be difficult to change to a more nutritious diet.

In fact, it takes 2 years for the average person to change his/her appetite so that healthy foods are actually enjoyed.

III BODY TYPES

RULER SHAPE Rulers have a fast metabolism and tend to be skinny. However, they will suddenly gain weight in the buttocks and/or stomach as their metabolism slows down, usually between years of age.

CONE Cones are built like an upside-down triangle. They have an average metabolism but a diet high in starches and sugars will cause weight gain in the chest, breasts and upper back - leading to a deposit of fat called a buffalo hump!

HOURGLASS Hourglass shapes have an athletic build with a small waist and a moderately fast metabolism. Since their fat is evenly distributed, weight gain will occur in both the upper and the lower body – especially if their diet is too low in protein.

SPOON Spoon shapes naturally have a little "extra" padding on the hips, thighs and buttocks due to a moderately slow metabolism. A diet that is high in fat will cause even more weight gain in the lower half of their bodies.

BALL Ball shapes gain fat very easily all over their bodies because they have an extremely slow metabolism. Most of their body fat is stored around the middle which can lead to serious health problems such as diabetes and heart diseases.