Obesity - Community medicine, PSM, SPM

This powerpoint covers the following subtopics:

What is obesity?
Pathogenesis
Burden
Epidemiology of obesity
Assessment of obesity
Consequences of obesity
Prevention and Control

1. Obesity Dr Venkatesh Karthikeyan Department of Community and Family Medicine AIIMS Patna www.drvenkateshkarthikeyan.com t.me/ drvkspm

2. Contents What is obesity? Pathogenesis Burden Epidemiology of obesity Assessment of obesity Consequences of obesity Prevention and Control 18-11-2021 Obesity 2

3. What is obesity? Abnormal or excessive fat accumulation in the body that may impair health. A body weight higher than the expected weight for a particular age and sex is referred to as “obesity” and “overweight” It is considered as a disease as well as a risk factor for other diseases 18-11-2021 Obesity 3

4. Pathogenesis Multifactorial Most common cause – overnutrition Genetic and environmental factors plays a role Sedentary habits Junk foods High fat diet 18-11-2021 Obesity 4

5. Burden of Obesity – Global Scenario In 2016, more than 1.9 billion adults aged 18 years and older were overweight. Of these, over 650 million adults were obese. In the same year, 39% of adults aged 18 years and over were overweight. Overall, 13% of the world’s adult population is obese. According to WHO, rates of overweight and obesity are increasing in both developed and developing countries around the world. 18-11-2021 Obesity 5

6. Burden of Obesity – Indian Scenario According to Global Nutritional Report 2017, prevalence of obesity among Under five children is 2% Adolescents is 13% Adult males – 18% are overweight, 2% are obese Adult females – 22% are overweight, 5% are obese 18-11-2021 Obesity 6

7. Epidemiology of obesity Agent factor Host factor Environment factor 18-11-2021 Obesity 7

8. Agent factor - Nutrition Consuming more quantity of food than required amount leads to deposition of excess fat in the body. QUALITY of food consumed also plays a role . Common contributors to obesity High sugar foods like ice creams and high fat food Protective role Salads, whole grains, cereals 18-11-2021 Obesity 8

9. Host factors Age (old people > young) Gender (Females > Males) Marital status (Married > Single) Geographical distribution (People of Europe, US and Australia have greater risk) Physical inactivity (Sedentary lifestyle) Education (Less educated > well educated) Endocrine disorder (Cushing’s, PCOD, Hypothyroidism, diabetes) Psychological state (Stress, depression, anxiety) Genetics (Prader Willi Syndrome) Lifestyle (Binge eating, fast food, sedentary lifestyle) Breast feeding (Formula milk) Socioeconomic status (higher strata > lower strata) 18-11-2021 Obesity 9

10. Environmental factors Seasonal variation (Winters > Summers) Food economics Social factors (Urban communities more prone to eating junk food) Marketing factors Physical environment (lack of parks, lack of walking tracks) 18-11-2021 Obesity 10

11. Assessment of obesity *Body Mass Index ( Quetelet index) BMI = Weight(kg)/Height(in meter) 2 *Ponderal index = Height (cm)/ Cube root of body weight (kg) *Broca index = Height(cm) – 100 *Corpulence index = Actual weight/Desirable weight (Should not exceed 1.2) *Waist Hip ratio: >1.0 in male and >0.85 in female  Abdominal fat accumulation 18-11-2021 Obesity 11

12. Classification of obesity 18-11-2021 Obesity 12

13. For children under 5 years of age: Overweight : Weight for height greater than 2 SD above WHO Child Growth Standards median Obesity : Weight for height greater than 3 SD above the WHO Child Growth Standards median For children between 5 years and 19 years: Overweight : BMI-for-age greater than 1 SD above the WHO Growth Reference median Obesity : BMI-for-age greater than 2 SD above the WHO Growth Reference Median 18-11-2021 Obesity 13

14. Consequences of obesity Major risk factors for NCDS like heart disease and stroke Musculoskeletal disorders like osteoarthritis knee Cancer of endometrium, ovary, breast, prostate, liver, gall bladder, kidney, colon. Limits the ability for physical activity Increased incidence of premature deaths and disabilities in adulthood Obese children more prone for breathing difficulties, fractures, hypertension, insulin resistance and depression. 18-11-2021 Obesity 14

15. Prevention and Control Create enabling and supportive communities Choose healthier food choices Encourage regular physical activity Health education Encourage healthy habits Discourage unhealthy choices like sweetened beverages, processed high calorie food 18-11-2021 Obesity 15

16. Prevention and Control (cont.) Policy level decisions like higher taxes on sugar sweetened beverages and foods Policy and guidelines for nutritional content of foods manufactured Restriction of marketing for unhealthy food items specifically targeting children and adolescents. 18-11-2021 Obesity 16

17. Prevention and Control (cont.) Any obesity that may have a medical basis should be referred to an appropriate physician/specialist. Referrals includes suspected Diabetes, Cushing’s, hypothyroidism, PCOD, etc. Suspicion should be more in individuals with typical clinical history or strong family history of such conditions 18-11-2021 Obesity 17

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19. Reference IAPSM’s Textbook of Community Medicine 18-11-2021 Obesity 19