Obesity Pandemic

1
Obesity Pandemic

• Athanassios Petrotos, M.D.
• Surgical Specialists of Greenwich
• Greenwich Hospital

2
Global epidemic

• 25 of all Americans
• 10-20 in other parts of the globe
• Steadily increasing occurrence

3
Definition

• Body Mass Index weight/height² in kg/m²
• Obesity is defined as a BMIgt30kg/m²
• Overweight is defined as a BMIgt25kg/m²
• Morbid Obesity is defined as a BMIgt40kg/m²

4
Table 1

• Weight Category 71-74 76-80
  88-94
• Overweight 32 32
  32
• Obese 10 10
  14
• Severely Obese 3 3
  5
• Morbid Obesity 1 2
  3
• --------------------------------------------------
  -------------
• Total population 46 47
  54

5
Current estimates

• U.S.A.
• 66 overweight
• 32 obese
• 5 morbidly obese
• Worldwide
• More than 300 million people are obese, with 2
• billion documented as overweight, approximating
• the number of starving individuals worlwide

6
The youth

• 4 in children (6-11)
• 6 in teenagers(12-17)
• 10 in girls
• 11.4 in boys

7
The youth

• 40 in Native Americans
• 30 in African Americans
• 30 in Hispanics
• 25 in Caucasians
• 20 in Asian Americans

8
Etiology

• Exact cause is unknown
• Multiple factors
• Genetic
• Dietary
• Environmental
• Modernization of the society

9
Etiology

• Energy Imbalance
• Axis Brain-Gut-Adipose tissue
• Hormones Leptin
• Insulin
• Ghrelin
• Appetite-regulating neuropeptides

10
LEPTIN,INSULIN,GHRELIN

• LEPTIN Secreted by adipocytes. Reduces food
  intake.
• INSULIN Inhibits eating through its action in
  the hypothalamus butIncrease eating by
  decreasing the blood glucose levels.
• GHRELIN Secreted by the stomach and proximal
  small intestine. Regulates meal initiation and
  satiety.

11
DIETARY FACTORS

• Energy-dense, micronutrient poor foods
• Sugar-sweetened beverages
• Portion Size
• Palatability
• Fiber
• Breastfeeding
• Eating disorders

12
Obesity Comorbidities

• Hypertension
• Dyslipidemia
• Diabetes
• Cardiac and Peripheral Vascular Disease
• Asthma
• Sleep Apnea
• Obesity-Hypoventilation Syndrome

13
Obesity Comorbidities

• Back and Disk Disease
• Peripheral Osteoarthritis
• Cholelithiasis
• Gastroesophageal Reflux Disease
• Liver Disease
• Pseudotumor Cerebri and Carpal Tunnel Syndrome
• Intertriginous Dermatitis

14
Obesity Comorbidities

• Stress Incontinence
• Female and Male Reproductive Disorders
• Depression

15
Obesity and Cancer

• Esophagus
• Stomach
• Liver
• Pancreas
• Colon and rectum
• Breast
• Uterus
• Prostate

16
Social Implications of Obesity

• Stigmatization
• Depression
• Self-Confidence
• Is Obesity an addiction?

17
Summary

• Global phenomenon
• Multifactorial
• All ages
• Significant comorbidities