Obesity

Definition
Obesity and over weight are terms commonly used to
describe individuals with increased body fat or increase
in adiposity (weight gain).

 The worldwide prevalence of obesity is 13 %.

 11 % of the men and 15 % of the women in the world are
obese.
 38% of the men and 40 % of the women are overweight.
 Worldwide, there are more individuals with obesity than
individual who are underweight.
 Definition
 The World Health Organization (WHO) classifies according to
categories of BMI, body weight into underweight (BMI < 18.5
kg/m2) , normal weight (BMI 18.5-24.9 kg/m2), overweight and

obesity

 The correct definition of overweight is (BMI 25-29.9) kg/m2.

 The correct definition of obesity is BMI > 30 kg/m2.

 BMI of 40 kg/m2 is associated with a decreased life expectancy

of around 10 years.
 Causes
Weight gain is due to an imbalance between energy intake and energy
expenditure.

1- Highest fat intake.

2- Consumption of energy – dense food and drink’s high in fat and sugar.

3- Alcohol promotes weight gains

4- Decreasing physical activity

5- Family and genetic predisposition.

6- Certain drugs many contribute to weight gain e.g. corticosteroids,

sulphonylureas, tricyclic anti- resents.

7- Endocrine causes are rare.

 Assessment of Obesity
1-Qualitative assessment ‘distribution of adiposity’
location of fat in different parts of the body’.

2- Quantitative assessment

a)Relative body weight (R.W.):

b) Body mass index (BMI):
c) Waist circumference:
d) Skin fold test:
Relative weight:
It is measured as
body weight (Kg) /
the desirable weight
(Kg), then Output
multiplied by the
100.

Ideal RW is supposed to
be 100.
 Body Mass Index
-BMI is computed using the following formula:
BMI = Weight (kg)/ Height (m²)
-Evidence shows that high BMI (obesity level) is
associated with type 2 diabetes & high risk of
cardiovascular morbidity & mortality
-Ex :Patient Wight is 90 kg and Hight 160 cm ,Calculate
BMI ?
Answer: BMI = 90 / (1.6) 2 = 35.1 ( obese grade 2 )
 BMI (WHO - Classification)

 BMI < 18.5 = Under Weight

 BMI 18.5-24.9= Healthy weight range
 BMI 25-30 = Overweight (grade 1
obesity)
 BMI >30-40 = Obese (grade 2 obesity)
 BMI >40 =Very obese (morbid or
grade 3 obesity)
 Waist circumference
• Waist circumference is measured at the
level of the umbilicus.
The subject stands erect with relaxed
abdominal muscles, arms at the side, and
feet together.
The measurement should be taken at the
end of a normal expiration.
 Waist circumference
Waist circumference predicts mortality better than any
other anthropometric measurement.

It has been proposed that waist measurement alone

can be used to assess obesity.
MALES FEMALE
(obesity) >102cm >88cm
Waist/Hip Ratio
 Skin fold test
• It is one of common method determining body fat Percentage
• The assessor, using forefinger and the thumb ,grasps and lifts the subcutaneous
tissue and skin from underlying muscle .

• Places the pincers of skin fold caliper, applying a constant pressure.

• Holds this position for 3-4 seconds .
• Take three measurement for accuracy.
• Provides the actual skin fold thickness in mm.

Normal skin fold thickness

 20 mm in man.
 30 mm in women
 Skin fold test is usually used in infants and young children.
Skin fold test
Thickness of skin over the middle of triceps muscle is measured in
millimeters by special device.
 Risk of obesity (complications):
1. It increases mortality

2. Type 2 diabetes mellitus.

3. Hypertension and stroke.

4. Hyperlipidaemias.

5. Coronary heart disease and hypertension.

6. Gallstones.

7. Arthritis of the hip, Knee and foot.

8. Breathlessness, sleep apnea.

9. Infertility, hirsutism.

10. Pregnancy complications, perinatal mortality, pre- eclampsia, gestational diabetes, pre- term
labour, deep vein thrombosis.

11. Stress incontinence and abdominal hernia.

12. Psychological: depression.

13. Social: disability on low-income, reduced employment prospects.

 Prevention and control:
The prevention and control of obesity depends on behavioral
modification including the following issues:

1) Self-monitoring using a food diary.

2) Need for long-term lifestyle change.

3) Need to modify eating habits.

4) Need to assess present exercise level and ideas to increase

this if necessary.

5) Separation of eating from other activities level and ideas

to increase this if necessary.
 Prevention and control:
6. Planning of daily food intake.

7. Possibility of changes to individual eating style.

8. Identification of the causes of negative emotions

and stress.

9. Dealing with situations that interfere with every

day food choices e.g. eating out, holidays, family
pressure and cost.
 Prevention and control:
A high protein content and low GI is more

effective for weight maintenance after weight

loss in adults, to induce weight loss in children

and had a favorable effect on risk markers for

type 2 diabetes and cardiovascular diseases.

 Prevention and control:
Bariatric surgery is used for obesity treatment

and it decreases the incidence of type 2

diabetes in obese individuals after surgery by

about 80-90%.