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Management of Obesity

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Ahmed Samir

on 24 October 2014

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Transcript of Management of Obesity

Management of OBESITY
from science to practice

Ass.Prof.Samir Ali Elsheikh
Department of Diabetes and metabolism

Problem
Psychology


Causes of Obesity

Diet

Sedentary lifestyle

Genetics

Social determinants


Sedentary lifestyle

Genetics

Obesity & Mood disorders
Epidemiological studies support
positive associations between BMI and mood disorders.
A recent study found increased odds of mood disorder symptoms including
major depression, dysthymia, and manic and hypomanic episodes
among obese and extremely obese persons
Autism
Parents of children with autism often worry about diet their children can be picky eaters, sensitive to certain foods

More than 30 percent of children with autism are overweight or obese, a rate that is significantly higher than in the general population.
Complications
Childhood obesity persists into adulthood

Linked to subsequent morbidity & mortality, including type 2 diabetes and cardiovascular disease

Costly--$129 billion directly attributed to obesity


Escalation in costs if development of diabetes and cardiovascular diseases

Social determinants
Obesity has become a major social and public health concern in the United States. The risk for obesity is not evenly distributed across racial/ethnic and socioeconomic groups and we know little about how obesity risk differs according to experiences in important life settings or how experiences accumulate over the life course to influence adult obesity.
Diet
Standard weight calculation formula
Body mass index (BMI)

weight (kg)/ height squared (m2).

BMI is significantly correlated with
total body fat content.

According to WHO

1.6 billion adults (over 15 years old) are overweight

400 million are obese


Projects by 2015, 2.3 billion will be overweight and 700 million obese

Energy In > Energy Out
Wholegrain varieties are better

They contain more fibres and make you feel fuller for longer.

Fruit and vegetables provide a range of nutrients including vitamins and minerals, such as folate, vitamin C, potassium and dietary fibre.

Milk and its derivative products are a rich source
of dietary calcium, also provide protein
phosphorus, vitamin A, and vitamin D.

Meat is a major source of protein, as well as iron, zinc, and vitamin B12.

Fish is a good source of protein, many vitamins and minerals.

Oily fishes like salmon are rich in long chain omega 3 fatty acids which are important for heart health.


Life Style
Modification
Behavior Change
Knowledge of nutrition, physical activity, and self.
Becoming familiar with caloric contents and energy density of foods, portion sizes, and less calorically cooking techniques.
Tricks for weight loss
The Pyramid of Health

Most obese persons wish to lose all of excess weight and return to normal weight.
This may be realistic for someone whose BMI is close to normal (26-30)

For High BMI persons, a weight loss goal should be set for a reduction of 15% from the present their baseline weight


Don't dig your grave with your own knife and fork.

The more you FRY the sooner you die!
Eating 250 kcal less per day

Leave out mayonnaise in a sandwich

Leave out dessert

Switch from soft drinks to water

Reduce portion sizes

Burning 250 calories through exercise
Walk for 30 minutes

Swimming 25 yards

Bicycling for 30 minutes
In order to lose 1 Kg of fat you need to lose 7700 Kcal

A daily caloric deficit of 500 can be done by
Wholegrain varieties are better

They contain more fibers and make you feel fuller for longer.

Fruit and vegetables provide a range of nutrients including vitamins and minerals, such as folate, vitamin C, potassium and dietary fibers.

Milk and its derivative products are a rich source
of dietary calcium, also provide protein
phosphorus, vitamin A, and vitamin D.

Meat is a major source of protein, as well as iron, zinc, and vitamin B12.

Fish is a good source of protein, many vitamins and minerals.

Oily fishes like salmon are rich in long chain omega 3 fatty acids which are important for heart health.


Saturated Vs. Unsaturated.
Saturated fat can increase blood cholesterol levels
and the chance of developing heart disease.

Saturated fat is found in such as hard cheese, cakes, biscuits, pies, pastry, cream and butter.


Foods that are high in unsaturated fats, such as vegetable oils, oily fish, avocados, nuts and seeds.
Anti-Obesity Medications
Anti-obesity medications are usually reserved for those patients who have failed diet, exercise, and behavioral interventions

Approved by the Federal Drug
Administration for weight loss in adults: appetite depressant (phentermine, sibutramine), and inhibitors of fat absorption (orlistat).

Bariatric Surgery for Obese
Medically supervised weight loss management: Failed at ≥6 months

BMI ≥40 with serious obesity-related co-morbidities

BMI ≥ 50 with less severe co- morbidities

Physiologic maturity: Attained or nearly attained

Agreement to avoiding Pregnancy: At 1 year postoperatively
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