The Obesity/Diabetes Epidemic:
Adiposopathy & ‘Obesity’- The New Disease!
Weight Management in Obesity and DM:
Emphasis on New Medical Therapies
Part 1
Stan Schwartz MD, FACP, FACE
Private Practice, Ardmore
Obesity Program
Cardiometabolic Diabetes Center and Affiliate,
Main Line Health System
Emeritus, Clinical Associate Professor
University of Pennsylvania
Outline
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Epidemiology and Economics of obesity/diabetes
Perspectives on Obesity
Consequences of Obesity, Prediabetes, Obesity
Obesity/ Diabetes Risk Factors,
Obesity/ Diabetes Onset can be Prevented or Delayed – Early Risk
Identification and Intervention.
• Medical Benefits to Weight Loss
• Treatment– Basics, Generalities
– Obesity
• Lifestyle- Diet , Activity, Behavior
• Medications
– Weight Control, WEIGHT REDUCTION in DIABETES
Metabolically Healthy Obese
Yes, but…Healthy Obese= OXYMORON
Are Metabolically
Healthy Overweight
and Obesity Benign
Conditions?:
NO!!
THUS=
OXYMORON
Meta-analyses of various clinical
characteristics, by metabolic–body mass
index categories.
Data shown as weighted mean difference
compared with metabolically healthy normalweight persons (reference). To convert
cholesterol, triglyceride, and glucose values
to traditional units (mg/dL), divide by 0.0259,
0.0113, and 0.0555, respectively. HOMA-IR =
Homeostasis Model Assessment of Insulin
Resistance.* P < 0.05.
Date of download:
Ann Intern Med. 2013;159(11):758-769. doi:10.7326/0003-4819-159-11-201312030-00008
12/14/2013
Copyright © American College of Physicians. All rights reserved.
Medical Complications of Obesity
Pulmonary disease
abnormal function
obstructive sleep apnea
hypoventilation syndrome
Nonalcoholic fatty liver disease
steatosis
steatohepatitis
cirrhosis
Gall bladder disease
Gynecologic abnormalities
abnormal menses
infertility
polycystic ovarian syndrome
Osteoarthritis
Idiopathic intracranial hypertension
Stroke
Cataracts
Coronary heart disease
Diabetes
Dyslipidemia
Hypertension
Severe pancreatitis
Cancer
breast, uterus, cervix
colon, esophagus, pancreas
kidney, prostate
Skin
Metabolic
Non-metabolic
Gout
Phlebitis
venous stasis
Outline
•
•
•
•
•
Epidemiology and Economics of obesity/diabetes
Perspectives on Obesity
Consequences of Obesity, Prediabetes, Obesity
Obesity/ Diabetes Risk Factors,
Obesity/ Diabetes Onset can be Prevented or Delayed – Early Risk
Identification and Intervention.
• Medical Benefits to Weight Loss
• Treatment– Basics, Generalities
– Obesity
• Lifestyle- Diet , Activity, Behavior
• Medications
– Weight Control, WEIGHT REDUCTION in DIABETES