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School Nurse and Adolescent Obesity: Understanding the disease for effective prevention

School Nurse and Adolescent Obesity: Understanding the disease for effective prevention

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School Nurse and Adolescent Obesity: Understanding the disease for effective prevention

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  1. School Nurse and Adolescent Obesity: Understanding the disease for effective prevention Manish Singh MD Adjunct Assistant Professor of Surgery UTHSC San Antonio . Texas Medical Director, Advanced Laparoscopic and Bariatric Surgery Doctors Hospital at Renaissance Bariatric and Metabolic Institute Edinburg .Texas

  2. No disclosures

  3. Objectives 1. Understanding obesity as disease. 2. Debunking various myths surrounding obesity 3. Differentiating between prevention and treatment of obesity 4. Understanding Various methods of management of obesity.

  4. Myself • Born and Medical School in India .

  5. Surgery Residency at St Agnes Hospital, Baltimore. ( 2004-2010)

  6. Fellowship in Advanced Laparoscopy and Bariatrics at Cleveland Clinic , Cleveland. (2011)

  7. Obesity is a Disease.

  8. Prevention vs Treatment

  9. Obesity is… …a disease of excess fat storage with a number of associated diseases, known as co-morbidities. It is also… • multi-factorial (many different factors can cause obesity) • life-long • progressive • potentially life-threatening • costly

  10. Many factors influence obesity OBESITY

  11. BMI As a Vital Sign: A Guide to the Treatment of Morbid Obesity l July 28, 2014 l 15

  12. Weight Classification by BMI

  13. Definition of Pediatric Obesity

  14. Prevalence of Overweight (>95th%ile)

  15. Prevalence of Overweight (>95th%ile)

  16. Prevalence of Overweight (>95th%ile)

  17. Prevalence of Overweight (>95th%ile)

  18. Boys 6-11 Disparities of Risk % Non-Hispanic White Non-Hispanic Black Mexican-American

  19. Girls 6-11 Disparities of Risk % Non-Hispanic White Non-Hispanic Black Mexican-American

  20. Disparities of Risk Girls 12-19 Boys 12-19 % % Non-Hispanic White Non-Hispanic Black Mexican-American

  21. Disparities of Risk • Epidemiological data suggest that minority children from lower socioeconomic strata have an almost 1 in 2 chance of being overweight or obese (Mei et al., 1998; National Center for Health Statistics, 2001)

  22. Why is Obesity in Children of Particular Concern? • Linear relationship between degree of overweight and medical morbidity in children. • Very high adolescent BMI has been associated with 30-40% higher adult mortality compared with medium BMI. • Severely overweight children have a greater probability of becoming overweight adults than mildly or moderately obese children do.

  23. Tracking BMI-for-Age from Birth to 18 Yearswith Percent of Overweight Children Who Are Obese at Age 25 Whitaker et al. NEJM:1997;337:869-873

  24. The Levels Of Obesity What does obesity look like?*based on female 5’4” tall Normal Weight (BMI 19 to 24.9) Overweight(BMI 25 to 29.9) Obese (Class I)(BMI 30 to 34.9) Obese (Class II)(BMI 35 to 39.9 ) Morbidly Obese(BMI 40 or more) 152# BMI 26 175# BMI 30 205# BMI 35 234# BMI 40 130# BMI 22

  25. Obesity Is Rising At An Alarming Rate Sturm R, Pub Health, 2007

  26. Obesity Trends* Among U.S. AdultsBRFSS, 1985 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  27. Obesity Trends* Among U.S. AdultsBRFSS, 1986 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  28. Obesity Trends* Among U.S. AdultsBRFSS, 1987 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  29. Obesity Trends* Among U.S. AdultsBRFSS, 1988 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  30. Obesity Trends* Among U.S. AdultsBRFSS, 1989 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  31. Obesity Trends* Among U.S. AdultsBRFSS, 1990 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14%

  32. Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  33. Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  34. Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  35. Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  36. Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  37. Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

  38. Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

  39. Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

  40. Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

  41. Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20%

  42. Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  43. Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  44. Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

  45. Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%