Obesity

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Obesity - causes, complications and management

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OBESITY Dr. Angelo Smith M.D WHPL

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HOMEOSTATIC MECHANISM OF FAT REGULATION

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Definition Chronic disease characterized by accumulation of fat. Obesity is defined as a condition when ideal body weight is exceeded by 20% Medical condition responsible for serious co-morbidity and mortality.

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APPLE TYPE : Central or abdominal adiposity (ANDROID) increased WHR & associated with higher morbidity risk. ♂ > ♀

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PEAR TYPE : GYNOID or typical female distribution of fat : less health risks

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Waist to hip circumferences WHR > 0.95 (♂) & > 0.80 (♀) : increased health risk

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Psychosocial consequence Economical impact of obesity Prejudice and Discrimination Considered lazy, incompetent and more often absent due to illness Confronted with more problems at job application : Very few executive managers with overweight in the US

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What causes Obesity? Genetic predisposition Disruption in energy balance Environmental and social factors

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Aetiology of obesity LIFESTYLE PSYCHOLOGICAL MEDICAL GENETIC OBESITY IA6

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Physiology of weight gain Energy input Energy output Control factors Genetic make-up Diet Exercise Basal metabolism Thermogenesis

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MANAGEMENT OF OBESITY Obesity is a serious medical condition requiring long-term management Management needs to be flexible and integrate different therapeutic approaches according to individual patient needs including Dietary management Lifestyle modification Physical activity Drug therapy Surgery

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Spectrum of obesity management

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NEED FOR REALISTIC GOALS Shift focus from changing appearance to improving health Consider healthier weight over time - not ideal weight Sustained moderate weight loss of 5-10kg (5-10% of initial body weight) Elevated BP Blood sugar concentrations Serum triglycerides HDL-cholesterol levels

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