Download presentation
Presentation is loading. Please wait.
Published by Hugo Jennings Modified over 5 years ago
1
OBESITY 물리작업치료전공 강권영
2
definition A state of excess adipose tissue mass BMI(body mass index)
Weight/height2(kg/m2) Overweight>25 Obesity>30
3
4
measurements BMI Waist-to-hip ratio -Abnormal>0.9(women)
Arthropometry(skin fold thickness) Densitometry(underwater weighing) CT, MRI Electrical impedence
5
Nomogram for BMI
6
prevalence Obesity(BMI>30) -14.5%(1976~1980)->22.5%(1988~1994)
Overweight(25<BMI<30) -50% of adults(>20 of age) between 1988~1991 Female>male Poor economic state
7
Physiologic regulation of energy balance
Appetite -vagal input- gut distention -hormonal signals- leptin, insulin, cortisol -metabolites- ketone, glucose Control of appetite-hypothalamus -lateral nucleus-enhance appetite -ventromedial nucleus- inhibit appetite
8
Energy balance Energy expenditure
-resting and basal metabolic rate (70%) -the energy cost of metabolizing and storing food -the thermic effect of exercise (5~10%) -adaptive thermogenesis in response chronic calorie intake- rising with increased intake (20%)
9
Etiology of obesity A chronic excess of nutrient intake relative to the level of energy expenditure Ob(obese) gene -> leptin(thin) Secreted by adipose cell. Acts through the hypothalamus. High level of leptin decrease food intake and increase energy expenditure Mutation in ob gene cause hyperphagia and diminished energy expenditure Obese people have increased level of leptin and don`t have mutation therefore they appear to have a leptin resistance
10
Other causes Cushing`s syndrome Hypothyroidism insulinoma
11
12
13
14
Complication of obesity(1)
Mortality increases Insulin resistance and type 2DM -hyperinsulinemia and insulin resistance -insulin resistance is linked to intra-abdominal fat -80% of patients with type 2DM are obese
15
Complication of obesity(2)
Reproductive disorder -men: testosterone↓, estrogen↑, hypogonadism(생식선기능감퇴증), gynecomastia(여성형 유방) -women: menstrual abnormality Cardiovascular disease -hypertension, coronary disease, congestive heart failure, stroke -waist-hip ratio is the best predictor -HDL↓, LDL and triglyceride↑
16
Complication of obesity(3)
Pulmonary disease -total lung capacity -obstructive sleep apnea Gallstone Higher mortality from cancer Osteoarthritis Venous stasis Friability of skin
17
treatment Diet Exercise Drugs Surgery others
18
Diet(1) A deficit of 7500kcal is a weight loss of 1kg
Deficit of 1000kcal/day – 1kg weight loss a week Eating 100kcal/day less for a year – 5kg weight loss Weight loss rate is greater in obese, and in men because of higher metabolic rate
19
Diet(2) Low caloric diets -800~1200kcal/day
-diet rich in fruits, vegetable, and whole grain is preferable Very low energy diets -400~600kcal/day -unsafe -45~70g of protein, 30~50g of carbohydrate, 2g of fat -contraindication: pregnancy, cancer, recent MI, cerebrovascular disease, hepatic disease, psychiatric disease
20
exercise Increase energy expenditure
Valuable means to sustain diet therapy Have effect on cardiovascular tone and blood pressure
21
drugs Subutramine(Reductil) -antidepressant
-reuptake inhibitor of norepinephrine and serotonin -suppress appetite -7% weight loss/24weeks Oristat(Xenical) -intestinal lipase inhibitor -fat malabsorption -8.7kg weight loss/year
22
Subutramine(Reductil) 금기 부작용
23
Oristat(Xenical) 효능·효과 부작용 용량·용법
24
Surgery(1) After failure of diet, exercise and drug Criteria
45kg or 100% above ideal body weight or medical condition related to refractory obesity Repeated failure of other therapeutic approaches At eligible weight for 3~5year Capability of tolerating surgery Absence of alcoholism other addiction or major psychopathology Prior clearance by a psychiatrist
25
Surgery(2) Complication -electrolyte imbalance -gallstone
-nephrolithiasis -Gastric ulcer -Hepatic dysfunction -arthritis
26
27
28
reference en.wikipedia.org/wiki/Cushing's_syndrome
en.wikipedia.org/wiki/Hypothyroidism Rimonabant: a novel selective cannabinoid-1 receptor antagonist for treatment of obesity. (includes abstract); Patel PN; Pathak R American Journal of Health-System Pharmacy, 3/1/2007; 64 (5): 481-9
Energy Balance Energy intake vs. energy output
1 Evaluation of Obesity Associate Prof. Dr. Memet IŞIK Ataturk University Medical Faculty Department of Family Medicine
Assessment of Overweight and Obesity and the Need for Weight Loss Dr. David L. Gee FCSN/PE 446 Nutrition, Weight Control & Exercise.
Energy Balance and Body Composition
ENERGY BALANCE. BMR is predicted by lean body mass (i.e. total body mass - fat mass), and varies with gender and age. Extra metabolic energy is consumed.
إشراف الدكتور : يوسف التركي محمد الشمراني عامر الملوقي منتصر المنصوري منتصر المنصوري عبدالباقي السبعي وليد العنزي عبدالعزيز السعران.
Endocrine System 2. Part 2: Metabolism Overweight or obesity Adiposity Central obesity B.M.I. above normal Body fat greater than normal Abnormal distribution.
Weight Management Overweight and Underweight Copyright 2005 Wadsworth Group, a division of Thomson Learning.
Energy Balance & Body Composition Nutrition, Weight, and Health.
Chapter 8 Energy Balance and Body Composition. Bomb Calorimeter How Do We Know How Much Energy Comes From A Food? Calorimetric Values versus Physiological.
Chapter 14: Energy Balance and Body Composition
Overweight and Obesity for Teens and Adults. Definitions for Teens and Adults Overweight: An adult who has a BMI between 25 and 29.9 Obese: An adult who.
OBESITY. A medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life.
Obesity M.A.Kubtan MD - FRCS M.A.Kubtan1. 2 Pulmonary Disease Fatty Liver Disease Orthopedic Disorders Gallbladder Disease Psychological Impact.
Endocrine Block | 1 Lecture | Dr. Usman Ghani
CHAPTER 8 ENERGY BALANCE AND BODY COMPOSITION. ENERGY BALANCE Excess energy is stored as fat Fat is used for energy between meals Energy balance: energy.
الجامعة السورية الخاصة كلية الطب البشري قسم طب المجتمع
OBESITY.
Energy Balance Susan Algert Indirect calorimetry Measuring energy use without measuring heat production O2 uptake and CO2 output Doubly labeled water.
Copyright © 2006 Pearson Education, Inc., publishing as Benjamin Cummings Weight Management Achieving and Maintaining a Healthful Body Weight 5/9/07.
Similar presentations
© 2024 SlidePlayer.com Inc.
All rights reserved.
玻璃钢生产厂家玻璃钢佛像雕塑供应芜湖玻璃钢雕塑设计制作玻璃钢仿真大象雕塑菏泽泡沫玻璃钢景观雕塑玻璃钢 雕塑定做山东公园玻璃钢雕塑设计海口定做玻璃钢雕塑厂家浮雕汉白玉玻璃钢雕塑河南节庆商场美陈多少钱黑色玻璃钢花盆厂家批发濮阳玻璃钢人物雕塑价格报价广东玻璃钢仿真雕塑厂玻璃钢人物雕塑封开玻璃钢造型雕塑广东玻璃钢卡通动物雕塑定制天津户外玻璃钢雕塑设计晋城太湖石玻璃钢景观雕塑厂家春季美陈商场安徽公园玻璃钢雕塑定制武汉小区玻璃钢雕塑生产厂家商场购物中心美陈商场装饰玻璃钢卡通雕塑要求吉安玻璃钢雕塑批发濮阳玻璃钢景观雕塑定做价格河北创意玻璃钢雕塑设计郑州专业玻璃钢人物雕塑定做价格商场开业美陈哪家机构口碑好商场装饰 美陈安徽商业街玻璃钢雕塑威海玻璃钢海豚雕塑定制香港通过《维护国家安全条例》两大学生合买彩票中奖一人不认账让美丽中国“从细节出发”19岁小伙救下5人后溺亡 多方发声单亲妈妈陷入热恋 14岁儿子报警汪小菲曝离婚始末遭遇山火的松茸之乡雅江山火三名扑火人员牺牲系谣言何赛飞追着代拍打萧美琴窜访捷克 外交部回应卫健委通报少年有偿捐血浆16次猝死手机成瘾是影响睡眠质量重要因素高校汽车撞人致3死16伤 司机系学生315晚会后胖东来又人满为患了小米汽车超级工厂正式揭幕中国拥有亿元资产的家庭达13.3万户周杰伦一审败诉网易男孩8年未见母亲被告知被遗忘许家印被限制高消费饲养员用铁锨驱打大熊猫被辞退男子被猫抓伤后确诊“猫抓病”特朗普无法缴纳4.54亿美元罚金倪萍分享减重40斤方法联合利华开始重组张家界的山上“长”满了韩国人?张立群任西安交通大学校长杨倩无缘巴黎奥运“重生之我在北大当嫡校长”黑马情侣提车了专访95后高颜值猪保姆考生莫言也上北大硕士复试名单了网友洛杉矶偶遇贾玲专家建议不必谈骨泥色变沉迷短剧的人就像掉进了杀猪盘奥巴马现身唐宁街 黑色着装引猜测七年后宇文玥被薅头发捞上岸事业单位女子向同事水杯投不明物质凯特王妃现身!外出购物视频曝光河南驻马店通报西平中学跳楼事件王树国卸任西安交大校长 师生送别恒大被罚41.75亿到底怎么缴男子被流浪猫绊倒 投喂者赔24万房客欠租失踪 房东直发愁西双版纳热带植物园回应蜉蝣大爆发钱人豪晒法院裁定实锤抄袭外国人感慨凌晨的中国很安全胖东来员工每周单休无小长假白宫:哈马斯三号人物被杀测试车高速逃费 小米:已补缴老人退休金被冒领16年 金额超20万