A Global Battle Against Obesity World Health Organization will decide whether to adopt an aggressive plan outlining ways nations can combat obesity. Suggestions include limiting food advertising aimed at children, offering tax breaks and subsidies to lower prices of healthful foods, improving food labels and trying to curb added sugars to just 10% of daily calories. The plan also calls on food and beverage companies to reduce the fat, salt and sugar content in their products. The proposal has generated intense criticism from the U.S. government, and from the sugar industry, grocers, soft-drink makers and big food companies, claiming the proposal isn't supported by science. But if the World Health Organization approves the plan, consumers will see a world-wide push to help them improve their diets, including international efforts to regulate food marketing, pricing and production.

Consumer Health Weight Control

Basic Concepts Extent of the Problem Weight Loss Drugs, Products, Procedures Suggestions for Weight Control

US Surgeon General Call to Action Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity. Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status. Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions.

What is Overweight & Obese? Height / Weight Charts Frame Size Body Mass Index Lean Body Mass Index Body Composition

Extent of the Problem Healthy People 2010 CDC

Leading Health Indicators Ten Major Public Health Issues 1. Physical activity 2. Overweight and obesity 3. Tobacco use 4. Substance abuse 5. Responsible sexual behavior 6. Mental health 7. Injury and violence 8. Environmental quality 9. Immunization 10. Access to health care

Overweight and Obesity Leading Health Indicator 7-3b10. Increase the proportion of college students who have received information on dietary behaviors and nutrition. Baseline 32.7%, 2010 Target 55% Reduce the proportion of adolescents and college student who are overweight and obese. Baseline 29.5%, 2010 Target 16% 

Overweight and Obesity Leading Health Indicator 7-3b1. Increase the proportion of college students who received information from their college about dietary behaviors and nutrition prevention. Targets: Baselines: Target setting method: National: Not applicable College: Better than the best. 32% improvement Our Campus: Better than the best. 28% improvement Data sources: National: Not applicable College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 NationalDNCCollege32.5%Our Campus34.8% NationalDNCCollege55%Our Campus55% 

Overweight and Obesity Leading Health Indicator Reduce the proportion of adolescent and college students who are overweight and obese. Targets: Baselines: Target setting method: National: Better than the best. 55% improvement College: Better than the best. 49% improvement Our Campus: Better than the best. 51% improvement Data sources: National: NHANES, CDC. College: National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 National11%College29.5%Our Campus29.1% National5%College16%Our Campus16% 

Overweight and Obesity Leading Health Indicator *In those aged 6 to 19 years, overweight or obesity is defined as at or above the sex- and age-specific 95th percentile of Body Mass Index (BMI) based on CDC Growth Charts: United States. **In adults, obesity is defined as a BMI of 30 kg/m 2 or more; overweight is a BMI of 25 kg/m 2 or more. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey. 1988–94. 30% 16% (2010 Target) Overweight or obese College students Overweight and obesity, United States,1988–94

Obesity Trends* Among U.S. Adults 1985 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman No Data <10% 10%–14% 15%–19% 20%–24% ≥25% NOTE: the next slides to year 2002 advance every 2 seconds automatically.

Obesity Trends* Among U.S. Adults 1986 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1987 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1988 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1989 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1990 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1991 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1992 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1993 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1994 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1995 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1996 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1997 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1998 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 1999 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 2000 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Obesity Trends* Among U.S. Adults 2001 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Source: Behavioral Risk Factor Surveillance System, CDC (*BMI  30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults 2002 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

Health Consequences High blood pressure, hypertension High blood cholesterol, dyslipidemia Type 2 (non-insulin dependent) diabetes Insulin resistance, glucose intolerance Hyperinsulinemia Coronary heart disease Angina pectoris Congestive heart failure Stroke Gallstones

Health Consquences Cholescystitis and cholelithiasis Gout Osteoarthritis Obstructive sleep apnea and respiratory problems Some types of cancer Complications of pregnancy Poor female reproductive health (such as menstrual irregularities, infertility, irregular ovulation) Bladder control problems (such as stress incontinence) Uric acid nephrolithiasis Psychological disorders

Current Weight Loss Drugs, Products, Procedures American Medical Association’s Today’s Health magazine Prescriptions; injections; hypnosis; low-calorie, high fat, high protein, low carbohydrate, high carbohydrate, grapefruit, water, cabbage soup diets; diet pills; diet gum; gadgets; surgery Much of the time “emerge defrauded” (1972)

Current Weight Loss Drugs, Products, Procedures Low Carb? - South Beach Diet The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss The hottest diet craze in the country - The South Beach Diet. It is not low-fat. Nor is it low-carb. The South Beach Diet teaches you to rely on the right carbs and the right fats. Developed by renowned cardiologist Dr. Arthur Agatston, the South Beach Diet is a scientifically proven program that will not only help you lose weight fast - between 8 and 13 pounds in the first two weeks - but also improve your heart health.

Current Weight Loss Drugs, Products, Procedures Low Carb High Carb Others... Atkins, Ornish, Weight Watchers, Zone diet

ADA’s What to Ask Promise a quick fix? Encourage or require you to stop eating certain foods, food groups or products? Rely on a single study as the basis for its recommendations? Contradict recommendations of reputable health organizations? Identify “good” and “bad” foods? Just sound too good to be true?

Appropriate Weight Loss Techniques A diet that is individually planned to help create a deficit of 500 to 1,000 kcal/day should be an intregal part of any program aimed at achieving a weight loss of 1 to 2 pounds per week. Physical activity should be part of a comprehensive weight loss therapy and weight control program because it: modestly contributes to weight loss in overweight and obese adults may decrease abdominal fat increases cardiorespiratory fitness may help with maintenance of weight loss.

Appropriate Weight Loss Techniques Physical activity as an integral part of weight loss therapy and weight maintenance. Initially, moderate levels of physical activity for 30 to 45 minutes 3 to 5 days a week, should be encouraged accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. Reduced calorie diet and increased physical activity is recommended since it produces weight loss that may result in lower abdominal fat and increases in cardiorespiratory fitness.

Reliable Information Sources NHLBI Clinical Guidelines Aim for Healthy Weight

Summary Basic Concepts Extent of the Problem Weight Loss Drugs, Products, Procedures Suggestions for Weight Control