OBESITY AND OVERWEIGHT

Presented by
 OBESITY
We are going to talk about...
 Obesity facts and details
 Health issues Obesity can cause.
 How does the practice staff help people who are trying to
overcome their obesity?
 What secondary care can offer – e.g bariatric surgery
 Obesity – the realities
Obesity is the most serious health issue in developing countries, with
a poor diet causing more illness than lack of physical activity,
tobacco, and alcohol together.
In the past 20 years, obesity prevalence have nearly doubled!

According to estimates Obesity is expected to cost the country about

£50 billion a year by 2050.
The large percentage of obese adults do not consider themselves to
be obese or even somewhat overweight.
 What is Obesity ?
Overweight and obesity are concepts for having too
much body fat, and they commonly refer to having too
much weight for one's height. Obesity is most
commonly measured using the
Body Mass Index (BMI).
Adults with a BMI of 25kg/m2 to 29.9kg/m2 are
considered overweight, whereas those with a BMI of
30kg/m2 or higher are considered overweight. This is a
really basic method.
 The National Institute for Health and Clinical Excellence (NICE) suggests
using BMI in combination with waist circumference to measure
overweight and obesity and determine health risks. Waist circumference
is calculated and classified into reasonable, extreme, and extremely high
levels of abdominal obesity using intimate relations thresholds.
Men
Below 94 cm (37”) is desirable.
Approximately 94 and 102 cm (37” and 40”)
Over 102 cm (>40”) is considered very high.
Women
Below 80 cm (31”) is desirable.
Approximately 80 and 88 centimeters (31” and 34”)
Over 88 cm (>34”) is considered very high.
BMI
Height Overweight Obese I Obesity II Obesity III
BMI 25-30 BMI 30-35 BMI 35-40 BMI 40+

5’3 10 st. 1 12 st. 2 14 st. 2 16 st. 2

5’6 11 st. 1 13 st. 4 15 st. 8 17 st. 11

5’9 12st. 0 14 st. 6 16 st. 12 19 st. 4

6’0 13st. 2 15 st. 11 18 st. 6 21 st. 1

6’3 14 st. 5 16 st. 1 20 st. 2 23 st. 0

 Adult obesity: Prevalence
Obesity prevalence varies by age among
both females and males, well with 55-64
age range having the highest obesity rates.
 OBESITY STATISTICS

• In 2020, 58 percent of women and 68 percent of

men were overweight and obese, according to
the American Heart Association.
• Obesity prevalence has risen from 15% in 1993 to
27% in 2020.
• About 1 in 5 children in Nursery and over 1 in 3
children from Year 6 were overweight or obese in
2019/2020.
 Since 1993, the prevalence of extreme
obesity (a BMI of 40 or higher) has about
tripled reaching 2% of males and 4% of
females in 2020.
 Health problems related to
obesity
Hypertension
Obese people have double the risk of health
problems as those of average weight (43 percent
of obese men and 37 percent of obese women,
compared with 21 percent of men and 18
percent of women with BMI within the normal
range).
Obesity and overweight related
health issues
Diabetes
In the last century, the signs and symptoms associated
with diabetes has risen by 60%.Diabetes is very
prevalent.(diseases that have been diagnosed and
those that have not been diagnosed)among adults who
have desirable traits as well as a very high
overweight 2% and 11%, accordingly.
 Pre-diabetes
• In comparison to the general population,
there is a higher chance of developing
diabetes.
• The  warning bell.
• Until diabetes progresses, there is a tool to
prevent risk and make changes.
• Medication helps, but losing weight through a
lifestyle change is far more effective.
 Other health risks
 Stroke and heart attack
 Some tumours.
 Depression and stress.
 Arthritis is a disease that affects the joints.
 Asthma and sleep problems are examples of
respiratory disorders (when a individual
discontinues breathing for short period
during sleep)
Weight loss – not a simple solution?
 Obesity and weight loss are generally acknowledged to be strongly related
to psychological issues that impact patients.
Depression

Obesity

 At the Practice, we can help and support patients and refer them for
specialist opinion as appropriate.
 What is the best way for patients
to improve themselves - diet?
In 2020, 26% of adults consumed the suggested
5 or more servings of fruits and vegetables per
day. Women (27%) were far more likely than
males to do just that (24%).Bad diet and health
have long been recognized as significant
contributory lifestyle factors for illness and
death.
How can patients help themselves – diet
and activity
• Start a diet - which one? - how big is a normal portion?
5:2 diet, Paelo diet, Cambridge diet, South Beach
diet
See our portion size plates at the Practice
• Join a slimming group - which one ?
Weightwatchers, Slimming Worl
weekly physical activity of less than 30 minutes
• Go for a swim and Join a dance class!
Walk!
Running is an easy, cost-free way becoming more involved, lose weight, and
improve your health. You are not required to walk for long periods of time. A
short 10-minute morning walk has many medical benefits and contributes
against your physical fitness target is 150 minutes.
Time line of assessment of Obesity
pathway for surgery
• Medical MDT (Endocrinologist, Specialist dietician, clinical psychologist) BSN-group sessions
Baseline

• 3 months life style groups sessions (Specialist dietician, clinical psychologist)

6-months
• Medical investigations & treatment of Co-morbidities; 1:1 section for intensive input-selective patient

• Review by medical MDT clinic (notes) review

10-12 • medical review, weight target, patient engagement to programme, Low calorie diet pathway
months

• Surgical MDT: Medical team, Surgeons & Anaesthetics

12-18
months

• Drop in clinics, Band adjustments, Group supports, Medical reviews

Follow-up
 How can we help patients in
primary care
1. Help and support patients who want to lose weight and become more
active
2. Monitor their progress
3. Refer patients to weight loss and activity programmes
4. We can refer patients to secondary care so that they can discuss options
such as Weight loss surgery that also known as bariatric or metabolic
surgery is a form of surgery that is often used to treat patients who are
severely overweight.
5. It will help patient in lose weight and improve a variety of obesity-
related conditions like type 2 diabetes and high blood pressure.
6.  However, it is a major procedure that should be regarded only after
trying to lose the weight by a balanced exercise and diet.
 References
• Clinical guidelines on the identification, evaluation, and
treatment of overweight and obesity in adults: The evidence
report. (1998). PsycEXTRA Dataset.
https://doi.org/10.1037/e565682010-001
• Must, A. (1999). The Disease Burden Associated With
Overweight and Obesity. JAMA, 282(16), 1523.
https://doi.org/10.1001/jama.282.16.1523
• Krebs, N. F., Himes, J. H., Jacobson, D., Nicklas, T. A., Guilday,
P., & Styne, D. (2007). Assessment of Child and Adolescent
Overweight and Obesity. Pediatrics, 120(Supplement 4).
https://doi.org/10.1542/peds.2007-2329d
Thank You