Definition%20of%20obesity:

1
Definition of obesity A condition characterized
by excess body fat (Websters
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 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
20 times more likely to be obese at 24
years old than lean teen.
4
Obesity Trends Among U.S. AdultsBRFSS, 1987
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
5
Obesity Trends Among U.S. AdultsBRFSS, 1991
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
6
Obesity Trends Among U.S. AdultsBRFSS, 1993
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
7
Obesity Trends Among U.S. AdultsBRFSS, 1995
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519
8
Obesity Trends Among U.S. AdultsBRFSS, 1998
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 20
9
Obesity Trends Among U.S. AdultsBRFSS, 2001
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
10
Obesity Trends Among U.S. AdultsBRFSS, 2004
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 25
11
Obesity Trends Among U.S. AdultsBRFSS, 2006
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
12
Obesity Trends Among U.S. AdultsBRFSS, 2010
(BMI 30, or 30 lbs. overweight for 5 4
person)
(BMI 30, or 30 lbs. overweight for 5 4
person)
No Data lt10 1014
1519 2024 2529
30
No Data lt10 1014
1519 2024 2529
30
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Prevalence of Overweight Among Children in the
United States, National Health Nutrition
Examination Surveys, 1971 - 2002
Girls
Boys
Percent
Percent
1971 74 1976 80 1988 94 1999 04
Freedman et al. Obesity 14301,2006 Ogden et
al. JAMA 2951549, 2006
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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
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Actual Causes of Death in the US, 1990 2000
www.cdc.gov, 2004
JAMA 20042911238-45, erratum 2005293293-4.
18
Wolf Colditz Obesity Res 1998697-106
Hodgson Cohen Med Care
199937994-1012
Adjusted to 1995 dollars
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Obesity is Caused by Long-Term Positive Energy
Balance
Body Fat Stores
Energy Expenditure
Energy Intake
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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 6
diam. 350 kcal Turkey Sandwich 320 kcal
820 kcal Coffee (whole milk sugar) 8
oz. 45 kcal (whole milk flavored
syrup) 16 oz. 350 kcal Blueberry Muffin 1.5
oz. 210 kcal 4 oz. 500 kcal Spaghetti
Meatballs 1 c. 500 kcal 2 c. 1025
kcal Soda 8 oz. 100 kcal 20
oz. 250 kcal
22
Calories Burned in 30 minutes
165 pound person TV/computer/sitting in
class 65 Sleeping 40 Walking
95 Basketball playing in game
300 Basketball shooting baskets
165 Swimming laps
300 Running, jogging
250
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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 4
3 of calories
25
20 Servings of soda 3
2.5 of calories
16
15 Servings of milk 1
1 Servings of
fruit/veg 1.5
1
25
What about candy?
Calories King Size Reeses Peanut Butter
Cup 420 King
Size Baby Ruth
480 Twizzlers - large
bag 490
Now N Later (regular pack) 280 Laffy
Taffy (10 pcs) 380

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What about candy? Calories Hours
Walking King Size Reeses Peanut Butter Cup
420 2hr 10min King
Size Baby Ruth
480 2hr 30min Twizzlers
- large bag
490 2hr 35min Now N Later
(regular pack) 280 1hr
30min Laffy Taffy (10 pcs) 380
2hr Doesnt matter where the calories come
from fat or sugar any extra over what you
burn will turn to body fat
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The New York Times Monday, May 25, 2005
28
Sugar
USDA, Economic Research Service 2009
29
Vegetable
Fruit
USDA, Economic Research Service 2009
30
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
1977-78 1989-91 1994-96
Energy Intake (kcal) Energy Intake (kcal) 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) Portion Size (oz) Portion Size (oz)
Soft drinks 13.1 16.8 19.9
Fruit drinks 11.3 12.6 15.1
French fries 3.1 3.5 3.6
Hamburgers 5.7 5.9 7.0
Nielsen, S. J. et al. JAMA 2003289450-453.
32
Relationship between Body Fatness Restaurant
Food Consumption in Adults Convenience sample,
Boston, n73
McCrory et al. Obes Res 19997564-71.
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• Our Toxic Environment
• gt5000 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

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• 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