Obesity

The Issues We have to eat Food Some don’t eat enough Some use food for coping

Eating The primary function of eating is to obtain and to store energy Food contains carbohydrates, fat, protein, minerals Digestion breaks down ingested nutrients and stores as energy Glycogen (short-term) Triglyceride (long-term)

Prevalence of Obesity

Measuring Obesity >20% of “ideal” body weight for males >30% of “ideal” body weight for females Body Mass Index Weight/(Height)2 BMI >30 = obesity

Diagnosis: Causes of Obesity Hypothyroidism Cushing's Syndrome Medications (antipsychotics,antidepressants) Other Rare causes: Prada-Willi syndrome (1/20,000) Non-pathological - 99%

Obesity Trends Among U. S Obesity Trends Among U.S. Adults (BMI > 30) BRFSS, 1991, 1995, and 2000 1991 1995 2000 No Data <10% 10%-14% 15-19% 20%

Health Risks of Excessive Fat Impaired cardiac function Hypertension, stroke, and deep vein thrombosis Increased insulin resistance in children and adults and type 2 diabetes (80% of these patients are overweight) Renal disease Sleep apnea Osteoarthritis, degenerative joint disease, gout Endometrial, prostrate. breast, colon cancers Abnormal plasma lipid and lipoprotein levels Menstrual irregularities Gallbladder disease

Not to Mention Enormous psychological burden and social stigmatization and discrimination

Pathways to Obesity Fat intake (“cafeteria” diet) Inactivity (25% get regular exercise) Metabolic issues Overeating “Thrifty genome” Alcohol intake Combinations of above

The Development of Obesity The Setpoint Model - Physiological The Positive Incentive Model – Behavioral Personal pleasure Social context Biological factors Food availability and type

Dieting Food Restriction Behavior Modification Exercise Last options – Surgery, drugs