Obesity Pathophysiology functional changes associated with or resulting from disease injury or symptoms and the scientific study of such changes Ex What s going on What s changing with the people or disease process of the body Pathogenesis development of morbid condition of the disease Result of the disease More specifically the cellular events of the reactions and other pathological mechanisms occurring in the development of this disease Ex comorbidities with actual disease Epidemiology the study of the disease origin or the spread of the disease Etiology the cause of the disease Ex What caused the disease to physically occur What is Obesity an excess buildup of adipose tissue or fat Proportion of body weight composed of adipose tissue percent body fat that exceeds a range that is considered healthy Assessments for Measuring Body Fat All tests are timely Must have experience Most clinicians not trained for these tests Skinfold is the only one everyone might be able to use Contrast o Weigh somebody and measure height Easy and quick equipments available And can tell if someone is obese or not Skinfold Test measures the thickness of subcutaneous fat Distribution of body fat will be based on age and sex Must know age group and gender when conducting skinfold test No real agreement on where to measure the body fat Easy to make large errors especially with people who are obese Not a great method for measuring body fat If only option something you can trend like baseline level If doing skinfold consistently can be affective If administering test on someone huge margin of error Underwater Weighing Useful but unlikely to conduct Bioelectrical Impedance method that sues the passage of electrical current through the body to determine the proportion of fat to lean body mass Different portions of fat and lean mass that causes differing speeds of transitions throughout the body Converted to potential proportions of lean and fat tissue Not super accurate effective Cheaper more convenient option Air displacement plethysmography Dual energy x ray absorptiometry Body Mass Index BMI establishes reasonable correlation for the portions between weight and height Not direct measure of body fat Reasonable people with high BMI more adipose tissue for people who are obese and are skewed toward being full of adipose tissue Box in book 14 3 calculating BMI to classify adults Ex Body builder o Can t use BMI because muscle weighs more than fat Not likely have high BMI if have dense skeletons Relatively good measure of fat Measure for BMI o kg m2 o weight in pounds x 703 height in inches 2 Classification of BMI Underweight 18 5 Normal 18 5 24 9 Overweight 25 29 9 Obesity class 1 30 34 9 Obesity class 2 35 39 9 Extreme obesity class 3 40 Increase in mortality in overweight people 25 29 9 Increase in huge mortalities and commodities in grade 1 3 obesity 30 40 Body Fat Distributions Abdominal or Central Usually in males but not excluselivey in males Apple or android shape Risks o Having abdominal or central fat is a lot more difficult for the body in associated with comorbidities because of areas of holding the fat which is abdominal and chest areas o Where organs are o Likely to have more problems with heart disease or hypertensions o Cardiovascular disease or heart disease more prevalent here Lower body Usually in females Pear and gynoid shape Risks Epidemiology of obesity Obesity is an epidemic Usually associated where populations wasn t westernized Average weight of body weight of adults children s increased WHO use terms as globosity Describing global epidemic of obesity Not is it just happening in western cultures but everywhere as well Other terms epidemic o Used in context of infectious disease o Can be applied to adverse effects as well According to WHO Prevalence ranges from 5 of the population in China japan and certain African countries to 75 of the population in urban Samoa US at 60 overweight or obese Texas has an obesity problem Obesity in the US From 1976 1980 to 1999 2002 the percentage of obesity increased from 15 31 US at 60 overweight or obese Obesity in children o 1 3 of infants in westernized societies are too heavy o b w 6 15 in school children and 20 30 in adolescent is obesity o 80 of obese adolescent becomes obese adults and are fatter to those who prevalence became obese as adults Race Ethnicity Prevalence in females is highest in non Hispanic black females 48 8 Non Hispanic white females 30 7 Mexican American females not a lot of research and obesity factor Prevalence among Adult males are varied Socioeconomic Status The higher the status the lower the prevalence of obesity Income below poverty level 34 7 prevalence of obesity Income 200 more poverty level 28 7 Fast food joints everything has sugar besides diet coke Obesity increases with age until 60 65 and decreases after 65 Over 65 start to die or don t eat as much 40 64 have a prevalence in obesity increase Age Etiology of Obesity Obesity develops when chronic energy intake exceeds energy expenditure Heterogeneous group of disorders obesity Etiology of obesity is elusive because it can be a result of many different things Not just one thing multitude of issues Obesity Can be caused by Medical disorders rare o Cushing syndrome o Hypothyroidism growing in prevalence doesn t make you obese o Prater willy syndrome Non normative eating patterns o Night eating syndrome consumption of eating 25 of energy intake in evening meals and on to the next morning o Binge eating Medical Treatments o Physiatrist medications cause to eat more or store fat easily o Steroids o Anti diabetic agents or meds o 14 6 medical condition and pharm logical to cause obesity Stop smoking gain 9 11 additional pounds in ten years Genetics o Large appetite o Resting energy expenditure o Taste preferences o Body efficiency and storing energy o Multiple genes involved to cause obesity Obesogenic environment toxic food environment o Definition promoting or encouraging development of obesity high energy foods and discouraging physical activities with high carbohydrates and fat o Food low in cost energy dense large portions readily available o Huge cost in the US o Diet o Physical activity o Culture o Situational o Likely cause of obesity o 14 5 environmental changes o Average Energy consumption increases Average consumption of energy in past years have increased 1971 1974 men 2450 kcals women 1542 kcals 1999 2000 men 2618kcals women 1877 kcals Lack of energy