1. Nationwide epidemic of obesity
A. Epidemiology Update
Nationwide epidemic of obesity
Content Points:
A 2001 telephone survey of 195,005 adults >18 years found that the prevalence of obesity (as defined by a body mass index [BMI] >30 kg/m2) is 21%.1 This represents a 74% increase in the prevalence of obesity observed in a similar survey conducted in 1991.
As shown, the rise in obesity is a nationwide phenomenon.
The reduction in lifespan attributable to obesity by the age 40 years is 7.1 years in women and 5.8 years in men (based on life-table analysis of Framingham Heart Study data).2
1 Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, JAMA. 2003;289:76-79.
2 Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, for NEDCOM, the Netherlands Epidemiology and Demography Compression of Morbidity Research Group. Obesity in adulthood and its consequences for life expectancy: A life-table analysis. Ann Intern Med. 2003;138:24-32.

2. Nationwide epidemic of obesity Content Points:
A 2001 telephone survey of 195,005 adults >18 years found that the prevalence of obesity (as defined by a body mass index [BMI] >30 kg/m2) is 21%.1 This represents a 74% increase in the prevalence of obesity observed in a similar survey conducted in 1991.
As shown, the rise in obesity is a nationwide phenomenon.
The reduction in lifespan attributable to obesity by the age 40 years is 7.1 years in women and 5.8 years in men (based on life-table analysis of Framingham Heart Study data).2
1 Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, JAMA. 2003;289:76-79.
2 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(suppl 1):S5-S20.

3. Obesity accelerates coronary atherosclerosis in men Content Points:
The Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study evaluated the relation of obesity to atherosclerosis in persons dying of noncardiovascular causes.1 Specimens were obtained from the right coronary and left anterior descending arteries of 2133 men and 688 women aged 15 to 34 years.
In men, fatty streak surface area increased with an increase in body mass index (BMI, P = ) but there was no significant association with panniculus thickness (P = ).
In women with a thick panniculus, there was a trend for larger fatty streak surface area with increasing BMI (P = ).
In men, raised lesion area increased with increasing BMI independent of pannicular thickness (P = ).
In women, neither BMI nor pannicular thickness was associated with raised lesion area.
These data show that obesity is associated with accelerated atherosclerosis in adolescent and young adult men. The investigators speculate that the lack of association in young women may be due to a slower rate of progression of atherosclerosis in women. Another proposed explanation is that women may be less likely to have central obesity, which is more strongly related to cardiovascular (CV) risk than non-central obesity
1 McGill HC, McMahan A, Herderick EE, Zieske AW, Malcom GT, Tracy RE, Strong JP, for the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Obesity accelerates the progression of coronary atherosclerosis in young men. Circulation. 2002;105;

4. CV disease: Patients at risk Content Points:
According to current American Heart Association (AHA) statistics, 105 million Americans have high cholesterol, and 50 million have high blood pressure (BP).1
In addition, data from the Third National Health and Nutrition Examination Survey show that the CV metabolic syndrome, a predisposing factor to development of diabetes and CV disease, has an overall prevalence of 23.7% among US adults >20 years of age.2 Thus, an estimated 47.7 million adults in this country have this condition (based on 2002 population estimates).
Finally, as discussed in a previous slide, there are an estimated 18 million individuals with diagnosed diabetes and a further 8 million with undiagnosed diabetes.3,4
There are so many patients at risk that one death from CV disease occurs every 33 seconds.1
1 American Heart Association. Heart Disease and Stroke Statistics-2003 Update. Dallas, Tex: American Heart Association; 2002.
2 Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the Third National Health and Nutrition Examination Survey. JAMA. 2002;287:
3 Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, JAMA. 2003;289:76-79.
4 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes melitus. Diabetes Care. 2003;26(suppl 1):S5-S20.