Weight Problems
Overweight Adults – UK %
70
60
50
40
Male
Female
30
20
10
0
1980
Erens & Primatesta 1999
1997
Obese Adults – UK %
20
18
16
14
12
10
8
6
4
2
0
Male
Female
1980
Erens & Primatesta 1999
1997
Rise in Childhood Obesity - UK
25
20
15
Overweight
Obese
10
5
0
1989
1998
Bundred et al, BMJ Feb 2001
WHO classification of obesity
BMI = weight(kg)/height(m)2
WHO Classification
BMI
Risk of Death
Underweight
Below 18.5
Low
Healthy weight
18.5-24.9
Average
Overweight (grade 1 obesity)
25.0-29.9
Mild increase
Obese (grade 2 obesity)
30.0-39.0
Moderate/severe
Morbid/severe obesity(grade 3) 40.0 and above
Very severe
World Health Organisation. Obesity: Preventing and Managing the Global Epidemic. Geneva: WHO,
1997 [3]
Three people have the following
heights: 1.65m; 1.73 m; 1.85m
They each have a BMI of 30.
Calculate their body masses.
1.65m = 81.7 kg
1.73m = 89.8 kg
1.83m = 100.5 kg
Body fat distribution
Apple shaped obesity
Women
cm
>88 cm (80cm) = Increased risk
Men
>102 cm (90cm) = Increased risk
Lean MEJ et al. Lancet; 1998; 351:853-6
Waist Measurement or BMI?
Causes of Obesity
Energy
Intake
Energy
Expenditure
nutritional, activity levels, endocrine,
genetic, drugs
The Costs of Obesity




£4.6 billion pa, UK (2007)
Direct
 Death, health service expend, drug prescription
charges, hospital costs,
Indirect
 Disability, unemployment, early retirement
 18 million sick days, 40 000 lost years working
life, obese die 9 years earlier
Intangible
 Loss self esteem, relationships, pain
Physical Effects of Obesity
Stroke
Respiratory disease
Gall bladder disease
Cardiovascular
Diabetes
Osteoarthritis
Hormonal abnormalities
gout
Cancer
Benefits of 10% Weight Loss
Mortality
>20% fall in total mortality
>30% fall in diabetes related deaths
>40% fall in obesity related deaths
Blood pressure
fall of 10mmHg systolic and
diastolic pressure
Diabetes
50% fall in fasting glucose
Lipids
10% dec. total cholesterol
15% dec. in LDL
30% dec. in triglycerides
8% inc. in HDL
Jung 1997
Obesity in practice







GP average has 2000 patients
800 overweight adults BMI > 25
320 obese adults BMI > 30
16 morbidly obese adults BMI > 40
30% increase appointments and
prescriptions in last 10 years
95% will see GP in 5 years
130 will die of the disease each year
Men and their
trousers



50% of men wear their trousers too tight
 only 10% admit to it
45% of men thought they were overweight
30% hated their stomach most of all
Prof Steven Gray, NTU, 1999
Men and weight loss



Men are reluctant to seek medical advice to lose
weight, until after they have developed a medical
problem
Less than one fifth GP or hospital obesity clinic
patients are male
Women are the driving force behind men’s health
Is this man too big for his trousers…?
What about this man..?
Or this one..?
Fat bloke my arse
The perfect male..?
…and the perfect female??
WHO April 2001
“Obesity cannot be prevented or managed
solely by governments (or health
professionals). The food industry, the
media, communities and individuals need to
work together so that the environment is
less conducive to weight gain”
Copy this table, and make a list of
practical things each group could do
to tackle obesity:
Government Food
Industry
Media
Individual
LDL and HDL formation
Identify
stages
1-5
Atherosclerosis
Collagen fibre
Platelet
Plaque
Red cells
Cholesterol
Risk of CHD increases if:
Blood cholesterol
 Blood LDLs
 Blood HDL


> 5 mmol dm-3
> 3 mmol dm-3
< 1 mmol dm-3
Ratio of HDL:LDL should be 4:1 or better
Worked examples
What is meant by the
‘prevalence’ of a disease? (1)

Prevalence means

“The number of people in a population with
that disease.”
Q. “What is the prevalence of
obesity in England in 2007” (2)
(answer from data in table or graph)
 In England in 2007, 17% of men and 21%
of women were estimated as being obese
(BMI > 30)

Q. “What are the main ‘risk
factors’ for CHD?” (4)
Diet rich in saturated fatty acids
 Lack of exercise (low PAL)
 BMI > 30 ( obese)
 Heredity
 Hypertension ( high BP)

Q. “How does a high salt diet
lead to hypertension?” (4)
Salt in the blood lowers water potential
 Water is drawn into blood from tissues by
osmosis
 Blood volume increases
 Heart needs to work harder to pressurise
this volume of blood

What happens when Energy Intake is
lower than expenditure…?
Anorexic or fashion victim?
True
‘Starvation’ – a
disease called
MARASMUS.
What
symptoms can
you see?
Very thin
(skeletal)
Papery skin
Weak and
Miserable
Still world-wide malnutrition…WHY?
Kwashiorkor
Give three
recognisable
signs of
kwashiorkor.
Prep – A4 essay for next week:
Explain the term ‘malnutrition’
 You must include the 4 PEM diseases:
 Anorexia, Obesity, Marasmus, Kwashiorkor
