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Baby Boomer Bulge: Managing Obesity

Baby Boomer Bulge: Managing Obesity. Fadi Siyam M.D. Endocrinology and Diabetes. American Association of Clinical Endocrinology: Consensus Conference on Obesity. Obesity rates have soared over the past 30 years

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Baby Boomer Bulge: Managing Obesity

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  1. Baby Boomer Bulge: Managing Obesity FadiSiyam M.D. Endocrinology and Diabetes.

  2. American Association of Clinical Endocrinology: Consensus Conference on Obesity

  3. Obesity rates have soared over the past 30 years • Today , 2 out of 3 US adults are overweight or obese, and 1 out of 3 adults are obese • The impact of obesity on morbidity, mortality and health care cost is profound. Rationale for a Consensus Conference on Obesity

  4. What is Obesity? • What options are available for obesity management? • What is the optimal use of therapeutic modalities? • Can the optimal framework be cost-effective? • What are the key knowledge gaps, and how can they be filled? The five Critical Questions

  5. An unhealthy accumulation of fat mass that diminishes the quality and length of life while dramatically increasing individual, national and global health care costs. • Obesity is a disease What is Obesity?

  6. Primary= Interventions that prevent the disease from occurring. • Secondary=Interventions prior to the emergence of disease complications. • Tertiary= Interventions subsequent to the development of complications. What options are available for obesity management?

  7. Still maintains to be the cornerstone for the treatment of obesity • Includes 3 primary components: • i. healthy eating • ii. Increased energy expenditure • iii. Behavioral change Lifestyle Management

  8. DASH diet: fruits and vegetables, low fat dairy products, higher protein intake and reduced consumption of total fat and soft drinks. • Mediterranean diet: monounsaturated fat, limited intake of red meat, higher intake of legumes, fish, chicken and nuts. Dietary patterns, Macronutrient Choices and Diet Comparisons

  9. VLCD: 200-800 kcal/day • Balanced Deficit diet: reduce carbohydrates, protein and fat. • Low Glycemic Index Diets • Low Fat diet • Low Carb diet: contains < 50 gm of carbs • Low fat /high protein diet

  10. 175 minutes / week of moderately intense activity ALONGSIDE increased focus on daily lifestyle activity. Physical Activity

  11. Self monitoring of food intake and physical activity • Coping with stress and negative thoughts • Eating at regular times • Focus on the act of eating. • Frequent weighing • Refresher courses and campaigns. Behavior Modification

  12. If lifestyle interventions fail to produce weight loss after 3 to 6 months • At the outset! • Make sure there are no medications causing weight gain like diabetes medicines, antidepressants and antiepileptics Pharmacotherapy

  13. Orlistat • Lorcaserin • PHEN/TPM ER • PHEN • Bensphetamine • Phendimetrazine • Newer options… Available Medications

  14. Surgery….

  15. Choice of therapeutic modality is based on risk stratification • A multidisciplinary team can most effectively implement the program. • Stepped but rapid escalation is indicated. • Key to success also includes affordability, reimbursementand access What is the optimal use of therapeutic modalities?

  16. The answer is yes! Can the optimal framework be cost effective?

  17. Current lack of reimbursement for the treatment • Lack of health literacy and personal health education • Lack of education among health care providers What are the knowledge gaps and how can they be filled?

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