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Lecture 8 Complications of Obesity

Lecture 8 Complications of Obesity. Bonnie Beezhold, PhD, MHS Assistant Professor Benedictine University. BMI-Associated Disease Risk. Additional risks: Large waist circumference (men>40 in; women >35 in) 5 kg or more weight gain since age 18-20 y Poor aerobic fitness

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Lecture 8 Complications of Obesity

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  1. Lecture 8 Complications of Obesity Bonnie Beezhold, PhD, MHS Assistant Professor Benedictine University

  2. BMI-Associated Disease Risk • Additional risks: • Large waist circumference (men>40 in; women >35 in) • 5 kg or more weight gain since age 18-20 y • Poor aerobic fitness • Specific races and ethnic groups Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. Obes Res 1998;6(suppl 2).

  3. Medical Complications of Obesity Idiopathic intracranial hypertension Pulmonary disease abnormal function obstructive sleep apnea hypoventilation syndrome Stroke Cataracts Nonalcoholic fatty liver disease steatosis steatohepatitis cirrhosis Coronary heart disease Diabetes Dyslipidemia Hypertension Severe pancreatitis Gall bladder disease Cancer breast, uterus, cervix colon, esophagus, pancreas kidney, prostate Gynecologic abnormalities abnormal menses infertility polycystic ovarian syndrome Osteoarthritis Phlebitis venous stasis Skin Gout

  4. Visceral adiposity Link between visceral fat accumulation and insulin resistance (IR) Associated with dyslipidemia - elevated plasma free fatty acids and triglyceride levels, alteration of lipoproteins http://google.com/

  5. Waist Size vs BMI and the Metabolic Syndrome Waist circumference < level 2* Waist circumference > level 2* 33.43 8-y Incidence of Metabolic Syndrome (%) 20.45 19.77 9.98 *Level 2 = waist 40 inches in men or 35 inches in women. Han TS et al. Obes Res. 2002;10:923-931.

  6. Grundy Nature Reviews Drug Discovery5, 295–306 (April 2006) | doi:10.1038/nrd2005

  7. Both Insulin Resistance and Decreased Insulin Secretion Predict the Risk of Developing Type 2 Diabetes: 7-Year Incidence Percent NeitherLowHigh Insulin secretionLowLow Insulin resistanceHighHigh BothHighLow Metabolic statusHOMA-IR I30-0min/G30-0min Haffner SM et al. Circulation. 2000;101:975-980.

  8. Relationship Between BMI and Cardiovascular Disease Mortality Men Women Relative Risk of Death Lean Overweight Obese <18.5 18.5–20.4 20.5–21.9 22.0– 23.4 23.5– 24.9 25.0– 26.4 26.5–27.9 28.0– 29.9 30.0– 31.9 32.0–34.9 35.0– 39.9 >40.0 Body Mass index Calle et al. N Engl J Med 1999;341:1097.

  9. Lipoprotein Changes with Weight Loss After 1 Year on Prescribed Diets of Differing Composition LDL, low-density lipoprotein; HDL, high-density lipoprotein. Dansiger ML, et al. JAMA. 2005;293:43-53.

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