A holistic approach to weight management

A holistic approach to weight management

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  PROGRAMI-CAREA HOLISTIC APPROACHTO WEIGHT MANAGEMENTBY DR LEE OI WAHPENGARAH HCM
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  OverviewDefinition, Prevalence &Consequences of ObesityHealthy LifestylesAssessment of ObesityTreatments for Obesity
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  DefinitionObesity is anabnormal accumulation of body fat, usually 20 percent or more over an individual's ideal body weight.
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  Calculating BMICalculate BodyMass Index (BMI) = weight (kg)height squared (meters) Or…weight (pounds) x 703height squared (inches)
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  Definition of Overweight& ObesityUsing BMI
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  Definition of Overweight& ObesityUsing waist circumferenceWomen > 80cm
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  Men >94cmPrevalence ofObesityChildhood and adolescent obesity increased from 5% to 16% in the last 20 yearsAdulthood obesity increased from 12% to 21% in 10 years.16 million US adults with BMI over 3560 million US obese adults (BMI > 30)
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  Factors predispose toobesityGenetic – familial tendency.
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  Sex – womenmore susceptible .
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  Activity – lackof physical activity.
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  Psychogenic – emotionaldeprivation, depression .Social class – poorer classes.
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  Alcohol – problemdrinking.
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  Smoking – cessationsmoking.
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  Prescribed drugs –tricyclic derivatives.Weight Gain: How Does It Happen?Energy imbalance calories consumed not equal to calories used Over a long period of timeDue to a combination of several factorsIndividual behaviorsSocial interactionsEnvironmental factorsGenetics
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  Weight Gain: EnergyIn3500 calories = 1 pound100 calories extra per day= 36,500 extra per year= 10.4 lbs weight gainQuestion: How much is 100 calories?Answer: Not very much!1 glass skim milk, or1 banana, or1 slice cheese, or1 tablespoon butter
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  Health Consequences ofObesityMajor cause of preventable death Increase in mortality from all causesIncrease in risk for these cancersEndometriumBreastProstateColonIncrease in risk of:HypertensionDyslipidemiaDiabetes type 2Coronary artery diseaseStrokeGallbladder diseaseOsteoarthritisSleep apnea & respiratory problems
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  Health Consequences ofObesityStill doing nothing about that extra flab? Major cause of preventable death Increase in mortality from all causesIncrease in risk for these cancersEndometriumBreastProstateColonIncrease in risk of:HypertensionDyslipidemiaDiabetes type 2Coronary artery diseaseStrokeGallbladder diseaseOsteoarthritisSleep apnea & respiratory problems
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  Rosalie Bradford-200LBSThe longtimebinge-eater weighed an astounding 1,199 lb, having spent 8 years immobile in bed.She holds Guinness World Record for most weight lost by a woman.
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  I-CARE :WHAT DOWE DO?
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  Assessment Assess thepatient's readiness and willingness to lose weight:Unfortunately those who are most concerned about their weights are not necessarily those who are at the highest health risk.Those who are unable or unwilling to embark on a weight reduction program, but they are willing to take steps to avoid further weight gain or perhaps to work on other risk factors such as cigarette smoking, and they should be encouraged to do so.
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  Assessment Is heoverweight? Obese?What are his key health issues?
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  Assessment Measure BMIMeasure waistcircumference“Apple shape” body is higher risk for DM, CVD, HTNWaist larger than 40 inches for men Waist larger than 35 inches for women
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  AssessmentAssess for otherrisk factors
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  Existing high riskdisease:
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  coronary heart disease;other atherosclerotic diseases; type 2 diabetes; sleep apnea
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  Diseases associated withobesity
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  Gynecological problems; osteoarthritis;gallstones; stress incontinence
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  Cardiovascular risk factors(3 or more = high risk)
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  Cigarette smoking; Hypertension;LDL >130; HDL <35; fasting glucose = 110 to 125; family history of premature CHD; men age > 45; women age > 55
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  Other risk factors
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  Physical inactivity; elevatedserum triglycerides