Primary Care Clinic In Service Training OBESITY

What is obesity More than just a few extra pounds The heavy accumulation of fat in your body to such a degree that it rapidly increases your risk for diseases that can damage your health and knock years off your life, such as heart disease and diabetes. The body fat may be equally distributed around the body or concentrated on the stomach( apple shape) or the hips and thighs ( pear shape)

When are you obese The body mass index (BMI) is used to determine whether a patient is obese or if his weight is within the normal range. You are obese when your BMI is 30 or above. You are morbidly obese when your BMI is above 40. BMI compares your weight against your height. If you do not have a BMI calculator, you can calculate it as follows - Take your weight(kg) and divide it by the square of your height - Weight 80kg, height 1.7m - Multiply your height by itself. 1.7x1.7=2.89 - Divide your weight by this figure - 80kg / 2.89 = 27.7kg/m2 - The BMI is 27.7

How common is obesity Around one in 4 men and one in 3 women are obese. Slightly more women than men are obese, but in the last 10 years there has been a greater increase under men. Stomach obesity (apple shape) is the most common type of obesity. Obesity is rapidly increasing in young people and children. Around 1 in 3 children between the age of 2 and 15 are overweight. What problems can obesity cause Psychologically, being overweight can affect your body image and damage your self-esteem. In some cases it can cause social anxiety and depression. Common physical problems include: Difficulty breathing Difficulty in walking and running Increased sweating

Back pain and pain in the knees and ankles Skin conditions such as acne. Gallstones

The following medical conditions are also more common in obese people than in people with a normal weight: Hypertension High cholesterol Cardiovascular diseases, - arteriosclerosis, MI, stroke Type 2 Diabetes Some types of cancer What Causes obesity? Obesity can be hereditary. Genetic factors can affect appetite, the rate at which you burn energy(metabolic rate), and how the body stores fat. Even if your genes make weight gain more likely, it is not inevitable that you will be overweight. Obesity develops from: Over eating Irregular meals Lack of daily physical activity It is lifestyle that determines how the genes develop. Our lifestyles have changed rapidly. Obesity has trebled since 1980. Since then ready availability of convenience foods and car journeys instead of walking to work or school are examples of how our lifestyles has changed. How is obesity treated? Initially suggestion of weight loss through change in diet and increase in physical exercise. Clinical guidelines for weight loss are between 5 10kg in 3 months. Dietitian can give nutritional advice, also what products to buy and how to prepare food in a healthy way. They can design a weight loss plan for each individual. Increased physical activity help to burn excess fat and loose weight. Our bodies need a certain amount of energy each day. Excess energy is stored as fat. By eating fewer calories than your body need and exercising more, you are forcing your body to use existing fat stores for energy. Medical treatment Medication is usually only considered if changes to the diet and lifestyle are not effective. Orlistat (Xenical), and Sibutramine (Reductil) are 2 medications available for weight loss. Xenical reduces the amount of fat that is absorbed from the GIT Common side effects can include: Headache, diarrhea, flatulence, oily fatty stools. Reductil Acts on the serotonin and noradrenalin in the brain and make you feel fuller for longer. Common side effects: Loss of appetite, constipation, dry mouth and problem sleeping.

Weight reduction surgery Considered if you are morbidly obese or if you have a BMI that range from 35 to 40 and you are at risk obesity related diseases. Gastric binding Also called lap banding limits the capacity of the stomach so you feel full after eating a small amount of food. Surgery is reversible. Gastric Bypass Is permanent surgery that reduces the length of the digestive tract and stop food from being absorbed. Gastric balloon insertion A balloon is inserted into your stomach via your mouth with a endoscope. Liquid or air is then pumped into the balloon so it partially fills the stomach, this create a feeling of fullness. The balloon is usually removed after 6 months Complications of weight loss surgery Usual risks of surgery, long term digestive problems such as nausea, heartburn, vomiting, diarrhea. After surgery your body absorbs less food, but it will also absorb less vitamins and nutrients. This means you are at greater risk for diseases caused by vitamin and mineral deficiency such as anemia and osteoporosis. 14 facts about obesity 1. It is a chronic condition like diabetes or heart disease 2. It wont go away by itself, and cant be treated quickly 3. You are defined as obese if you are 20% above normal body weight due to fat. 4. You may not look obese but falling into this category causes health risks. 5. Your genes may explain some of your excess weight but not all. 6. There is a healthy weight range for everyone, find yours. 7. Your basic body shape is inherited, but your lifestyle determines your health. 8. Even small amounts of weight loss result in big health improvements. 9. The only way to attain a healthy weight is to find a plan and stick to it for life. 10. You must develop your own plan that is flexible and keeps you happy 11. More money is spent on treatment and not enough on prevention in health systems. 12. A Canadian study showed that 83% of doctors are less likely to examine obese patients. 13. 64% of parents with overweight children say that the doctor didnt mention any thing about their child loosing weight. 14. Liposuction amongst teens has tripled in the last year. Summary While plenty of diets and slimming products claim to offer quick fixes, obesity is not something that can be cured or brought under control within a few weeks.

Treatment like diet and exercise may have to continue for years. The greater challenge is to achieve a way of life that maintains weight and reduces the chances of gaining it again. The only way to achieve this is by permanently changing your eating and exercise habits. The real secret to weight loss can be found in your motivation and mind set.

CHANGE YOUR LIFESTYLE!