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Obesity Pandemic Athanassios Petrotos, M.D. Surgical Specialists of Greenwich Greenwich Hospital.
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Transcript of Obesity Pandemic Athanassios Petrotos, M.D. Surgical Specialists of Greenwich Greenwich Hospital.
Obesity Obesity PandemicPandemic
Athanassios Petrotos, M.D.Athanassios Petrotos, M.D.
Surgical Specialists of Surgical Specialists of GreenwichGreenwich
Greenwich HospitalGreenwich Hospital
““Global epidemic”Global epidemic”
25% of all Americans25% of all Americans
10-20% in other parts of the globe10-20% in other parts of the globe
Steadily increasing occurrenceSteadily increasing occurrence
DefinitionDefinition
Body Mass Index = weight/height² in kg/m²Body Mass Index = weight/height² in kg/m²
Obesity is defined as a BMI>30kg/m²Obesity is defined as a BMI>30kg/m²
Overweight is defined as a BMI>25kg/m²Overweight is defined as a BMI>25kg/m²
Morbid Obesity is defined as a Morbid Obesity is defined as a BMI>40kg/m²BMI>40kg/m²
Table 1Table 1
Weight Category ‘71-’74 ‘76-’80 Weight Category ‘71-’74 ‘76-’80 ‘88-’94‘88-’94
Overweight 32% 32% 32%Overweight 32% 32% 32%Obese 10% 10% 14%Obese 10% 10% 14%Severely Obese 3% 3% 5%Severely Obese 3% 3% 5%Morbid Obesity 1% 2% 3% Morbid Obesity 1% 2% 3% ------------------------------------------------------------------------------------------------------------------------------Total population 46% 47% 54% Total population 46% 47% 54%
Current estimatesCurrent estimates
U.S.A.U.S.A.66% overweight66% overweight32% obese32% obese5% morbidly obese5% morbidly obeseWorldwideWorldwideMore than 300 million people are obese, More than 300 million people are obese,
with 2with 2billion documented as overweight, billion documented as overweight,
approximatingapproximatingthe number of starving individuals worlwide the number of starving individuals worlwide
The youth The youth
4% in children (6-11)4% in children (6-11)
6% in teenagers(12-17)6% in teenagers(12-17)
10% in girls10% in girls
11.4% in boys11.4% in boys
The youthThe youth
40% in Native Americans40% in Native Americans
30% in African Americans 30% in African Americans
30% in Hispanics30% in Hispanics
25% in Caucasians25% in Caucasians
20% in Asian Americans20% in Asian Americans
EtiologyEtiology
Exact cause is unknownExact cause is unknown Multiple factorsMultiple factors GeneticGenetic DietaryDietary EnvironmentalEnvironmental Modernization of the societyModernization of the society
EtiologyEtiology
Energy Imbalance Energy Imbalance
Axis Brain-Gut-Adipose tissueAxis Brain-Gut-Adipose tissue
Hormones: LeptinHormones: Leptin
InsulinInsulin
GhrelinGhrelin Appetite-regulating neuropeptidesAppetite-regulating neuropeptides
LEPTIN,INSULIN,GHRELLEPTIN,INSULIN,GHRELININ
LEPTINLEPTIN : :Secreted by adipocytes. Secreted by adipocytes. Reduces food intake.Reduces food intake.
INSULININSULIN: : Inhibits eating through Inhibits eating through its action in the hypothalamus but…its action in the hypothalamus but…Increase eating by decreasing the Increase eating by decreasing the blood glucose levels.blood glucose levels.
GHRELINGHRELIN:: Secreted by the stomach Secreted by the stomach and proximal small intestine. and proximal small intestine. Regulates meal initiation and satiety.Regulates meal initiation and satiety.
DIETARY FACTORSDIETARY FACTORS
Energy-dense, micronutrient poor Energy-dense, micronutrient poor foodsfoods
Sugar-sweetened beveragesSugar-sweetened beverages Portion SizePortion Size PalatabilityPalatability FiberFiber BreastfeedingBreastfeeding Eating disordersEating disorders
Obesity ComorbiditiesObesity Comorbidities
Hypertension Hypertension DyslipidemiaDyslipidemia DiabetesDiabetes Cardiac and Peripheral Vascular Cardiac and Peripheral Vascular
DiseaseDisease AsthmaAsthma Sleep ApneaSleep Apnea Obesity-Hypoventilation SyndromeObesity-Hypoventilation Syndrome
Obesity ComorbiditiesObesity Comorbidities
Back and Disk DiseaseBack and Disk Disease Peripheral OsteoarthritisPeripheral Osteoarthritis CholelithiasisCholelithiasis Gastroesophageal Reflux DiseaseGastroesophageal Reflux Disease Liver DiseaseLiver Disease Pseudotumor Cerebri and Carpal Pseudotumor Cerebri and Carpal
Tunnel SyndromeTunnel Syndrome Intertriginous Dermatitis Intertriginous Dermatitis
Obesity ComorbiditiesObesity Comorbidities
Stress IncontinenceStress Incontinence Female and Male Reproductive Female and Male Reproductive
DisordersDisorders DepressionDepression
Obesity and CancerObesity and Cancer
EsophagusEsophagus StomachStomach Liver Liver PancreasPancreas Colon and rectumColon and rectum BreastBreast UterusUterus ProstateProstate
Social Implications of Social Implications of ObesityObesity
StigmatizationStigmatization
DepressionDepression
Self-ConfidenceSelf-Confidence
Is Obesity an addiction?Is Obesity an addiction?
SummarySummary
Global phenomenonGlobal phenomenon
MultifactorialMultifactorial
All agesAll ages
Significant comorbiditiesSignificant comorbidities