Fasted growing cause of preventable illness and death in the US, second to smoking.
Obesity vs. Overweight
Obesity is specific to being overweight due to excess FAT
BMIs that indicate obesity and overweight
Overweight 25-30. Obese I 30-35. Obese II 35-40. Obese III 40+.
What populations can BMI be misleading in?
Athletes (overweight but far from obese), short people, older people (lose muscle mass as age) and women
Regional fat distribution standards when assessing obesity?
Waist:Hip ratio in men = >1 women >0.85. Waist circumference in men > 40 and > 35 in women
High risk groups for obesity
Age 40-60. Women w/multiple pregnancies. African American/Hispanic women. Low SES.
What is at the root of the comorbidities that come with obesity?
Endocrine function of adipose tissue is amplified.
Military FM physicians attitudes
Tend to be positive towards obese patients, contrary to civilians
Causes of obesity
Genetics (resting metabolic rate), gluttony (fast food, soft drinks), lazy (automation and decreased physical activity), psychological (emotional eating, boredom), illness (depression) and drugs (steroids)
Why people get fatter as they lose and gain and lose and gain weight
They lose fat and muscle but never gain back the muscle and gain more fat.
Why do you gain fat without knowing it?
How do you treat obesity?
Assess and manage. Teach prevention (pregnancy, activity, nutrition). Set reasonable goals (small behavior changes).
Goals for weight loss and weight management
Reduce weight, maintain lower weight, prevent further gain
Healthy amount of weight loss
2lb/month, however, behavior change should be your main focus
Foods to eat when trying to lose weight
Complex carbs (fruits, veggies, whole grains)
When to use surgery or pharmacotherapy for obesity
BMI > 30 w/risk factors for disease.