1. Obesity and Your Daily Life
School of Medicine, Health Sciences and Engineering
Susquehanna Township High School
Lecture Series  Week 1, August 2014
Clinical Relevance of This Week’s Topic
Obesity and Your Daily Life
Wen Jie Zhang, MD, PhD
Professor of Pathology

2. Screening for Cervical Cancer in China

11. Teaching and Learning Strategy
Scientific Research Reports/Articles
Introduction/Background
Identifying a disease to study
Diagnosis, Treatment, Prevention, etc.
Materials and Methods
Mice/Patients, Reagents/Device/Tests
Results
Measurements obtained and analyzed
Discussion (and Conclusion)
The results’ meaning, significance, and conclusion(s)
References/Further Readings

12. Learning Objectives What is obesity Consequences of obesity
How to measure obesity
How to classify obesity
Obesity control and prevention

13. Session 1 Introduction

14. Obesity – An Individual’s Challenge
Daily news in public media
Intense scientific reports
Commercial Ads on fat reduction
An Individual’s questions:
Am I overweight or obese?
What to eat/drink and what not to?
Should I be on diet?
How should I exercise to reduce weight?
Should I consult a doctor for advice?

15. Which one is your favorite?

16. More, please!

17. Should I do it ?

18. The World’s Largest McDonald’s Built on April 23, Beijing China (~Tiananmen Sq) cash registers seats ,000 customers/1st Buz day

19. Buddy, Do I have a piece?

22. Definition of Obesity
A medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health risks.
Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to measure/classify underweight, overweight and obesity in adults.

23. Body Mass Index (BMI)
BMI is defined as the weight in kilograms divided by the square of the height in meters (unit=kg/m2).
Formula: BMI = mass (kg) ÷ height (m)2 = kg/m2
Example: BMI = 68.2 kg ÷ (1.7m)2
= 68.2÷ 2.89 = 23.6 kg/m2

24. Principal cut-off points Additional cut-off points
Table 1: The International Classification of adult underweight, overweight and obesity according to BMI
Classification
BMI (kg/m2)
Principal cut-off points
Additional cut-off points
Underweight
<18.50
     Severe thinness
<16.00
     Moderate thinness
     Mild thinness
Normal range
Overweight
≥25.00
     Pre-obese
     Obese
≥30.00
          Obese class I
          Obese class II
          Obese class III
≥40.00
Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.

25. “Globesity” – Obesity, A Global Issue
On a worldwide scale
Nutrition improvements and excessive high energy food
Lifestyle shift (less active)
Global pandemic trends
Source: WHO, Global Database on Body Mass Index

26. Characteristics of BMI
Age-independent
Same for both sexes (females may have 1.0 kg/m2 higher than females)
Population differences
May not correspond to the same degree of fatness
BMI-associated health risks may differ
Caucasians vs. Blacks vs. Asians

27. Obesity Pandemic Around the Globe 1
Percent of Adults with BMI
Source: WHO, Global Database on Body Mass Index

28. Obesity Pandemic Around the Globe 2
Percent of Adults with BMI ≥30
Source: WHO, Global Database on Body Mass Index

30. Super Obesity
A "super obese" male with a BMI of 47 kg/m2: weight 146 kg (322 lb), height 177 cm (5 ft 10 in)

31. Super Obesity

32. Hands-on Laboratory Work Session 2 Materials/Subjects and Methods Session 3 Results/Observations

33. Results – Observed BMI = 18.5-24.99 xx persons, %

34. Session 4 Discussion/Conclusion(s)

35. Correlation between BMI and Body Fat

36. 3 Major Risk Factors of Obesity
Excessive food energy intake
Lack of physical activity
Genetic susceptibility
58 genetic loci associated with obesity traits identified
>18 BMI-associated loci shared by European and East Asian ancestry populations
FTO (Fat Mass and Obesity Associated) gene
Leptin (adipo-cytokine) gene

37. Consequences of Obesity
Increased mortality
Increased health risks
Hypertension, coronary heart disease, stroke
Type 2 diabetes
Dyslipidemia
Sleep apnea and respiratory problems
Gallbladder disease
Osteoarthritis
Cancers (10 common cancers including colon, breast, endometrial) (2014 “Lancet” journal report)

38. Treatment of Obesity Bariatric (fat reduction) surgery Medications
Most effective
Long-term weight loss
Decreased overall mortality
Medications
Modest weight loss (2.9 kg [6.4 lb]) in 1 to 4 years
Side effects concerns 
Gene therapy?

39. Prevention of Obesity Dietary change Physical exercise
Lower food energy diet  (long-term or permanent)
Limit weight gain more than weight loss
Physical exercise
Long-term or permanent

40. Session 5 References/Literature (Further Readings)

41. References/Further Readings
The Obesity Society
World Health organization (WHO) Global Database on Body Mass Index
The Scientific American (journal)
Popkin BM. Sci Am, 2007 Sep;297(3):88-95

42. Key Words Learned Obesity Body Mass Index (BMI) Epidemic / Pandemic
Genetic susceptibility
Life expectancy
Bariatric surgery
Dietary change
Physical activity

43. Your Private Project
Based on what you have learned, figure out your daily food consumption and make yourself a plan for healthy diet and physical activities.
Measure your BMI on a fortnightly or monthly basis to monitor your body weight.
Serve as a “physician” for your family members and monitor their BMI monthly

44. The End