A Global Battle Against Obesity

1. A Global Battle Against Obesity World Health Organization will decide whether to adopt an aggressive plan outlining ways nations can combat obesity. Suggestions include limiting food advertising aimed at children, offering tax breaks and subsidies to lower prices of healthful foods, improving food labels and trying to curb added sugars to just 10% of daily calories. The plan also calls on food and beverage companies to reduce the fat, salt and sugar content in their products. The proposal has generated intense criticism from the U.S. government, and from the sugar industry, grocers, soft-drink makers and big food companies, claiming the proposal isn't supported by science. But if the World Health Organization approves the plan, consumers will see a world-wide push to help them improve their diets, including international efforts to regulate food marketing, pricing and production.

2. Consumer Health Weight Control

3. Weight Control • Basic Concepts • Extent of the Problem • Weight Loss Drugs, Products, Procedures • Suggestions for Weight Control

4. US Surgeon General Call to Action • Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity.  • Body weight is the result of genes, metabolism, behavior, environment, culture, and socioeconomic status. • Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions.

5. What is Overweight & Obese? • Height / Weight Charts • Frame Size • Body Mass Index • Lean Body Mass Index • Body Composition

6. Extent of the Problem • Healthy People 2010 • CDC

7. Physical activity Overweight and obesity Tobacco use Substance abuse Responsible sexual behavior Mental health Injury and violence Environmental quality Immunization Access to health care Leading Health IndicatorsTen Major Public Health Issues

8. Overweight and ObesityLeading Health Indicator • 7-3b10. Increase the proportion of college students who have received information on dietary behaviors and nutrition. • Baseline 32.7%, 2010 Target 55% • 19-3. Reduce the proportion of adolescents and college student who are overweight and obese. • Baseline 29.5%, 2010 Target 16% i

9. Overweight and ObesityLeading Health Indicator 7-3b1. Increase the proportion of college students who received information from their college about dietary behaviors and nutrition prevention. Targets: Baselines: Target setting method:National: Not applicableCollege: Better than the best. 32% improvement Our Campus: Better than the best. 28% improvement Data sources:National: Not applicable College: National College Health Assessment, Spring 2000Our Campus: National College Health Assessment, Spring 2000 i

10. Overweight and ObesityLeading Health Indicator 19-3. Reduce the proportion of adolescent and college students who are overweight and obese. Targets: Baselines: Target setting method:National: Better than the best. 55% improvementCollege: Better than the best. 49% improvement Our Campus: Better than the best. 51% improvement Data sources:National: 1988-1994 NHANES, CDC. College:  National College Health Assessment, Spring 2000 Our Campus: National College Health Assessment, Spring 2000 i

11. 30% 16% (2010 Target) Overweight or obese College students Overweight and ObesityLeading Health Indicator Overweight and obesity, United States,1988–94 *In those aged 6 to 19 years, overweight or obesity is defined as at or above the sex- and age-specific 95th percentile of Body Mass Index (BMI) based on CDC Growth Charts: United States. **In adults, obesity is defined as a BMI of 30 kg/m2 or more; overweight is a BMI of 25 kg/m2 or more. Source: Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey. 1988–94.

12. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1985 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman NOTE: the next slides to year 2002 advance every 2 seconds automatically.

13. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1986 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

14. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1987 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

15. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1988 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

16. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1989 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

17. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1990 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

18. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1991 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

19. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1992 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

20. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1993 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

21. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1994 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

22. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1995 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

23. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1996 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

24. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1997 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

25. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1998 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

26. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults1999 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

27. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults2000 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

28. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults2001 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman

29. No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Obesity Trends* Among U.S. Adults2002 *Obesity: BMI ≥30, or ~30 lbs overweight for 5’4” woman (*BMI 30, or ~ 30 lbs overweight for 5’4” person) Source: Behavioral Risk Factor Surveillance System, CDC

30. High blood pressure, hypertension High blood cholesterol, dyslipidemia Type 2 (non-insulin dependent) diabetes Insulin resistance, glucose intolerance Hyperinsulinemia Coronary heart disease Angina pectoris Congestive heart failure Stroke Gallstones Health Consequences

31. Cholescystitis and cholelithiasis Gout Osteoarthritis Obstructive sleep apnea and respiratory problems Some types of cancer Complications of pregnancy Poor female reproductive health (such as menstrual irregularities, infertility, irregular ovulation) Bladder control problems (such as stress incontinence) Uric acid nephrolithiasis Psychological disorders Health Consquences

32. Current Weight Loss Drugs, Products, Procedures • American Medical Association’s Today’s Health magazine • Prescriptions; injections; hypnosis; low-calorie, high fat, high protein, low carbohydrate, high carbohydrate, grapefruit, water, cabbage soup diets; diet pills; diet gum; gadgets; surgery • Much of the time “emerge defrauded” (1972)

33. Current Weight Loss Drugs, Products, Procedures • Low Carb? - South Beach Diet • The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss • The hottest diet craze in the country - The South Beach Diet.  It is not low-fat.  Nor is it low-carb.  The South Beach Diet teaches you to rely on the right carbs and the right fats.   Developed by renowned cardiologist Dr. Arthur Agatston, the South Beach Diet is a scientifically proven program that will not only help you lose weight fast - between 8 and 13 pounds in the first two weeks - but also improve your heart health.

34. Current Weight Loss Drugs, Products, Procedures • Low Carb • High Carb • Others . . . • Atkins, Ornish, Weight Watchers, Zone diet

35. ADA’s What to Ask • Promise a quick fix? • Encourage or require you to stop eating certain foods, food groups or products? • Rely on a single study as the basis for its recommendations? • Contradict recommendations of reputable health organizations? • Identify “good” and “bad” foods? • Just sound too good to be true?

36. Appropriate Weight Loss Techniques • A diet that is • individually planned to help create a deficit of 500 to 1,000 kcal/day should be an intregal part of any program • aimed at achieving a weight loss of 1 to 2 pounds per week. • Physical activity should be part of a comprehensive weight loss therapy and weight control program because it: • modestly contributes to weight loss in overweight and obese adults • may decrease abdominal fat • increases cardiorespiratory fitness • may help with maintenance of weight loss.

37. Appropriate Weight Loss Techniques • Physical activity as an integral part of weight loss therapy and weight maintenance. Initially, • moderate levels of physical activity for 30 to 45 minutes • 3 to 5 days a week, should be encouraged • accumulate at least 30 minutes or more of moderate-intensity physical activity on most, and preferably all, days of the week. • Reduced calorie diet and increased physical activity is recommended since it produces weight loss that may result in lower abdominal fat and increases in cardiorespiratory fitness.

38. Reliable Information Sources • NHLBI Clinical Guidelines • www.nhlbi.nih.gov/guidelines/obesity/ob_home.htm • Aim for Healthy Weight

39. Summary • Basic Concepts • Extent of the Problem • Weight Loss Drugs, Products, Procedures • Suggestions for Weight Control