Obesity and Your Daily Life

1. School of Medicine, Health Sciences and Engineering Susquehanna Township High School Lecture Series  Week 1, August 2014 Clinical Relevance of This Week’s Topic Obesity and Your Daily Life Wen Jie Zhang, MD, PhD Professor of Pathology

2. Screening for Cervical Cancer in China

11. Teaching and Learning Strategy Scientific Research Reports/Articles • Introduction/Background • Identifying a disease to study • Diagnosis, Treatment, Prevention, etc. • Materials and Methods • Mice/Patients, Reagents/Device/Tests • Results • Measurements obtained and analyzed • Discussion (and Conclusion) • The results’ meaning, significance, and conclusion(s) • References/Further Readings

12. Learning Objectives • What is obesity • Consequences of obesity • How to measure obesity • How to classify obesity • Obesity control and prevention

13. Session 1Introduction

14. Obesity – An Individual’s Challenge • Daily news in public media • Intense scientific reports • Commercial Ads on fat reduction • An Individual’s questions: • Am I overweight or obese? • What to eat/drink and what not to? • Should I be on diet? • How should I exercise to reduce weight? • Should I consult a doctor for advice?

15. Which one is your favorite?

16. More, please!

17. Should I do it ?

18. The World’s Largest McDonald’s Built on April 23, 1992 Beijing China (~Tiananmen Sq) 29 cash registers 700 seats 40,000 customers/1st Buz day

19. Buddy, Do I have a piece?

22. Definition of Obesity • A medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health risks. • Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to measure/classify underweight, overweight and obesity in adults.

23. Body Mass Index (BMI) • BMI is defined as the weight in kilograms divided by the square of the height in meters (unit=kg/m2). • Formula: BMI = mass (kg) ÷ height (m)2= kg/m2 • Example: BMI = 68.2 kg ÷ (1.7m)2 = 68.2÷ 2.89 = 23.6 kg/m2

24. Table 1: The International Classification of adult underweight, overweight and obesity according to BMI Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004.

25. “Globesity” – Obesity, A Global Issue On a worldwide scale • Nutrition improvements and excessive high energy food • Lifestyle shift (less active) • Global pandemic trends Source: WHO, Global Database on Body Mass Index

26. Characteristics of BMI • Age-independent • Same for both sexes (females may have 1.0 kg/m2 higher than females) • Population differences • May not correspond to the same degree of fatness • BMI-associated health risks may differ • Caucasians vs. Blacks vs. Asians

27. Obesity Pandemic Around the Globe 1 Percent of Adults with BMI 18.5-24.99 Source: WHO, Global Database on Body Mass Index

28. Obesity Pandemic Around the Globe 2 Percent of Adults with BMI ≥30 Source: WHO, Global Database on Body Mass Index

30. Super Obesity A "super obese" male with a BMI of 47 kg/m2: weight 146 kg (322 lb), height 177 cm (5 ft 10 in)

31. Super Obesity

32. Hands-on Laboratory WorkSession 2Materials/Subjects and MethodsSession 3Results/Observations

33. Results – Observed • BMI = 18.5-24.99 xx persons, % • BMI = 25-29.99 xx persons, % • BMI ≥ 30 xx persons, %

34. Session 4Discussion/Conclusion(s)

35. Correlation between BMI and Body Fat % Body Fat BMI

36. 3 Major Risk Factors of Obesity • Excessive food energy intake • Lack of physical activity • Genetic susceptibility • 58 genetic loci associated with obesity traits identified • >18 BMI-associated loci shared by European and East Asian ancestry populations • FTO (Fat Mass and Obesity Associated) gene • Leptin (adipo-cytokine) gene

37. Consequences of Obesity • Increased mortality • Increased health risks • Hypertension, coronary heart disease, stroke • Type 2 diabetes • Dyslipidemia • Sleep apnea and respiratory problems • Gallbladder disease • Osteoarthritis • Cancers (10 common cancers including colon, breast, endometrial) (2014 “Lancet” journal report)

38. Treatment of Obesity • Bariatric (fat reduction) surgery • Most effective • Long-term weight loss • Decreased overall mortality • Medications • Modest weight loss (2.9 kg [6.4lb]) in 1 to 4 years • Side effects concerns • Gene therapy?

39. Prevention of Obesity • Dietary change • Lower food energy diet  (long-term or permanent) • Limit weight gain more than weight loss • Physical exercise • Long-term or permanent • Limit weight gain more than weight loss

40. Session 5References/Literature(Further Readings)

41. References/Further Readings • The Obesity Society • http://www.obesity.org/ • World Health organization (WHO) Global Database on Body Mass Index • http://apps.who.int/bmi/index.jsp • The Scientific American (journal) • Popkin BM. Sci Am, 2007 Sep;297(3):88-95

42. Key Words Learned • Obesity • Body Mass Index (BMI) • Epidemic / Pandemic • Genetic susceptibility • Life expectancy • Bariatric surgery • Dietary change • Physical activity

43. Your Private Project • Based on what you have learned, figure out your daily food consumption and make yourself a plan for healthy diet and physical activities. • Measure your BMI on a fortnightly or monthly basis to monitor your body weight. • Serve as a “physician” for your family members and monitor their BMI monthly

44. The End