1. Definition of obesity:
A condition characterized by excess body fat (Webster’s Dictionary)
Obesity is a chronic disease; patient and practitioner must understand that successful treatment requires a lifelong effort (NIH The Practical Guide: Identification, Evaluation, and Treatment of Overweigt and Obesity in Adults)

2. CHICAGO SCHOOLKIDS TWICE AS LIKELY TO BE OBESE
CHICAGO SUN TIMES
Wednesday December 3, 2003
CHICAGO SCHOOLKIDS TWICE AS LIKELY TO BE OBESE
An ‘astonishing’ 23% of public school pupils under 7 are overweight vs. 10% nationally

3. Overweight teen 15 – 17 years old is times more likely to be obese at 24 years old than lean teen.

4. Obesity Trends* Among U.S. Adults BRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14%

5. Obesity Trends* Among U.S. Adults BRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19%

6. Obesity Trends* Among U.S. Adults BRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19%

7. Obesity Trends* Among U.S. Adults BRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19%

8. Obesity Trends* Among U.S. Adults BRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19% ≥20%

9. Obesity Trends* Among U.S. Adults BRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19% %–24% ≥25%

10. Obesity Trends* Among U.S. Adults BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19% %–24% ≥25%

11. Obesity Trends* Among U.S. Adults BRFSS, 2006
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19% %–24% %–29% ≥30%

12. Obesity Trends* Among U.S. Adults BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% %–14% %–19% %–24% %–29% ≥30%
No Data <10% %–14% %–19% %–24% %–29% ≥30%

14. Prevalence of Overweight Among Children in the United States, National Health & Nutrition Examination Surveys,
Girls
Boys
Percent
Percent
1971 – – – – 04
Freedman et al. Obesity 14:301, Ogden et al. JAMA 295:1549, 2006

16. Physical Consequences of Childhood & Adolescent Overweight & Obesity
Sleep apnea
Pickwickian syndrome
Slipped capital epiphyses
Tibial torsion
Flat feet
Increased risk of sprains and fractures
Idiopathic intracranial hypertension
Cholelithiasis
Gastro-esophageal reflux
Menstrual abnormalities
Polycystic ovary syndrome
Hypercorticism
Left ventricular hypertrophy
Breathing Problems
Bone/Skeletal Problems
Vascular Problems
Digestive Problems
Hormonal Problems
Heart Problems

17. Actual Causes of Death in the US, 1990 & 2000
2004
JAMA 2004;291: , erratum 2005;293:293-4.

18. Wolf & Colditz Obesity Res 1998;6:97-106 Hodgson & Cohen Med Care 1999;37:994-1012
* Adjusted to 1995 dollars

19. Obesity is Caused by Long-Term Positive Energy Balance
Body Fat Stores
Energy Expenditure
Energy Intake

20. + 12 calories per day = 1 pound excess weight per year
+ 25 calories per day = 2 pounds excess weight per year
+ 125 calories per day = 10 pounds excess weight per year

21. Restaurant Portion Sizes – 1985 & Today
Bagel 3” diam. 140 kcal ” diam. 350 kcal
Turkey Sandwich kcal kcal
Coffee (whole milk & sugar) 8 oz kcal (whole milk & flavored syrup) 16 oz. 350 kcal
Blueberry Muffin 1.5 oz. 210 kcal oz kcal
Spaghetti & Meatballs 1 c kcal c kcal
Soda oz kcal oz kcal

22. Calories Burned in 30 minutes – 165 pound person
TV/computer/sitting in class 65
Sleeping
Walking
Basketball – playing in game
Basketball – shooting baskets
Swimming laps
Running, jogging

23. One pound of body fat contains 3500 calories – if you eat 500 calories more each day than you burn off you will gain one pound in a week.
Energy In must equal Energy Out to stay the same weight.

24. Westside Chicago Elementary School
6th Grade 8th Grade
Servings of chips
% of calories % %
Servings of soda
% of calories % %
Servings of milk
Servings of fruit/veg

25. What about candy? Calories
King Size Reese’s Peanut Butter Cup
King Size Baby Ruth
Twizzlers - large bag
Now ‘N Later (regular pack)
Laffy Taffy (10 pcs)

26. What about candy? Calories Hours Walking
King Size Reese’s Peanut Butter Cup hr 10min
King Size Baby Ruth hr 30min
Twizzlers - large bag hr 35min
Now ‘N Later (regular pack) hr 30min
Laffy Taffy (10 pcs) hr
Doesn’t matter where the calories come from – fat or sugar – any extra over what you burn will turn to body fat

27. The New York Times
Monday, May 25, 2005

28. USDA, Economic Research Service 2009
Sugar
USDA, Economic Research Service 2009

29. USDA, Economic Research Service 2009
Vegetable
Fruit
USDA, Economic Research Service 2009

30. USDA, Economic Research Service 2009
Whole
Total
Regular
Diet
Lower Fat/Skim
USDA, Economic Research Service 2009

31. Trends in Portion Sizes & Energy Intake for Americans,
2 years and older
NFS & NHANES
Energy Intake (kcal)
Soft drinks
144
157
193
Fruit drinks
139
152
189
French fries
188
247
256
Hamburgers
389
392
486
Portion Size (oz)
13.1
16.8
19.9
11.3
12.6
15.1
3.1
3.5
3.6
5.7
5.9
7.0
Nielsen, S. J. et al. JAMA 2003;289:

32. Relationship between Body Fatness &
Restaurant Food Consumption in Adults
Convenience sample, Boston, n=73
McCrory et al. Obes Res 1999;7:

33. Our Toxic Environment 70% more meals eaten away from home
>5000 fast food franchises in schools
70% more meals eaten away from home
Growing number of high calorie beverages
Soft drink contracts with schools (?)
Increased use of corn sweeteners
10,000 junk food ads each year
Junk food advertising - $45/person
Healthy food advertising - $1.50/person
Increased TV & video games,
Reduced emphasis on physical activity

34. Avoid fad diets and quick weight loss schemes
Healthy Tips
Avoid fad diets and quick weight loss schemes
Drink plenty of water or other low calorie beverages
Never skip meals
Get up and go! 30 minutes of activity per day