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OBESITY AND THE REGULATION OF BODY WEIGHT

OBESITY AND THE REGULATION OF BODY WEIGHT. OBESITY: A Huge Public Health Problem. Definition of obesity: BMI > 30 Definition of overweight : BMI > 25. BMI = weight (kg)/ height 2 (m). Obesity Trends* Among U.S. Adults BRFSS, 1985.

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OBESITY AND THE REGULATION OF BODY WEIGHT

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  1. OBESITY AND THE REGULATION OF BODY WEIGHT

  2. OBESITY: A Huge Public Health Problem Definition of obesity: BMI>30 Definition of overweight: BMI >25 BMI = weight (kg)/ height2 (m)

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

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

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

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

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

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

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

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

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

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

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

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

  15. 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%

  16. 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%

  17. 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%

  18. 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%

  19. 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%

  20. 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%

  21. 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%

  22. 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%

  23. Obesity Trends* Among U.S. AdultsBRFSS, 2005 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  24. Obesity Trends* Among U.S. AdultsBRFSS, 2006 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  25. Obesity Trends* Among U.S. AdultsBRFSS, 2007 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  26. Obesity Trends* Among U.S. AdultsBRFSS, 2008 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  27. Obesity Trends* Among U.S. AdultsBRFSS, 2009 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  28. Obesity Trends* Among U.S. AdultsBRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

  29. Global burden of obesity (lower) and overweight (upper) Global burden of obesity in 2005 and projections to 2030 T Kelly, W Yang, C-S Chen, K Reynolds and J He. Int. J. Obesity 32:1431-1437, 2008.

  30. www.cdc.gov/nccdphp/dnpa/obesity/trend/index.htm

  31. Increasing childhood obesity worldwide Source: WHO

  32. Obesity is a risk factor for: • Type 2 diabetes • Hypertension • Atherosclerosis • Some types of cancer • Asthma • Gall bladder problems • Fertility problems • Osteoarthritis • Sleep disordered breathing • Gastroesophageal reflux

  33. Prevalence of type 2 diabetes by BMI From: Handbook of obesity, Marcel Dekker Inc, 2004

  34. 1990 1995 2001 Diabetes Trends* Among Adults in the U.S.,(Includes Gestational Diabetes)BRFSS, 1990,1995 and 2001 Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286:10.

  35. Global burden of diabetes Data source: WHO

  36. What’s my BMI?

  37. What’s my BMI? About 30.5 (based on height of 1.87 m and weight of 107 kg)

  38. Normal BMI doesn’t necessarily mean normal body fat A. Romero-Corral et al, Eur. Heart J. 31:737-746, 2010

  39. A. Romero-Corral et al, Eur. Heart J. 31:737-746, 2010

  40. The locus of adipose tissue deposition matters Metabolic problems Android Gynoid From: Diabetes2bfree.com

  41. Body fat increases disease risk in normal weight subjects A. Romero-Corral et al, Eur. Heart J. 31:737-746, 2010

  42. All cause mortality From: Berrington de Gonzalez et al, New Engl. J. Med. 363:2211-2219, 2010

  43. Risk factors for the development of obesity • Genetics • twin studies • animals can be bred for fatness • there are inbred strains of mice and rats that are spontaneously obese • whole genome wide genetic studies have identified several genes associated with obesity • Environment • Animals on a high fat diet gain weight • Human who live in other cultures gain weight when they move to the US or other places with a Western diet • Animals born to obese mothers tend to also become obese • Exposure to certain environmental agents (bisphenol A) increases the risk of obesity • Amount of sleep affects weight gain

  44. Wildtype (C57BL/6J) Ob/Ob

  45. Risk factors for the development of obesity • Genetics • twin studies • animals can be bred for fatness • there are inbred strains of mice and rats that are spontaneously obese • whole genome wide genetic studies have identified several genes associated with obesity • Environment • Animals on a high fat diet gain weight • Human who live in other cultures gain weight when they move to the US or other places with a Western diet • Animals born to obese mothers tend to also become obese • Exposure to certain environmental agents (bisphenol A) increases the risk of obesity • Amount of sleep affects weight gain

  46. Risk factors for the development of obesity • Genetics • twin studies • animals can be bred for fatness • there are inbred strains of mice and rats that are spontaneously obese • whole genome wide genetic studies have identified several genes associated with obesity • Environment • Animals on a high fat diet gain weight • Human who live in other cultures gain weight when they move to the US or other places with a Western diet • Animals born to obese mothers tend to also become obese • Exposure to certain environmental agents (bisphenol A) increases the risk of obesity • Amount of sleep affects weight gain

  47. Short sleep duration increases BMI From: Taheri et al, PLoS Med 3:e62, 2004

  48. Sleep and Obesity • Elevations of BMI are observed in subjects who sleep fewer than • 6 h per night • Childhood sleeping problems predict adult BMI • Experimental acute sleep curtailment increases hunger and appetite • especially for energy rich foods • -Mice in which circadian rhythms are disrupted become obese • More than 33% of adolescents get less sleep than recommended

  49. Major obstacles to obesity control • Genetic programming to store energy • Abundance of energy-dense foods • Poor adherence to calorie restriction • Poor sleep • Sedentary lifestyle • Inadequate built environment to promote physical activity • Cost of exercise programs/equipment • No effective drugs to combat obesity • High cost and risks of bariatric surgery Cancer Prev Res; 5(11); 1260–72. Julie Kasperzyk lecture notes from 11/12

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