Obesity: Greatest Epidemic of the 21st Century

Dr.Murali VallipuranathanMBBS, PGD (Population Studies), MSc, MD (Community Medicine), FCCP

Consultant Community PhysicianMinistry of Health

Annual Academic Sessions of Jaffna Science Association 2016

What is the problem?

In 2014

Sri Lankan statistics 2011

• 25 % of women and 17 % of men were suffering from obesity

•  67 % of women and 81 % of men are physically inactive 

Demographic and Health Survey 2006/7

What is causing obesity?

What is obesity?

`

What are the complications of

obesity?

Childhood Obesity need to be treated

Polycystic Ovarian Syndrome

commonly associated with obesity

PCOS: Signs and Symptoms

SYMPTOMS• Menstrual irregularity• Infertility• Hirsutism, acne• Obesity

SIGNS• Hirsutism, acne• Obesity• Ovarian enlargement• Acanthosis nigricans

Acanthosis Nigricans

How doctors treat obesity?

Treatment of obesity comes into three categories:

1-behavior modification . {diet and exercise} 2-pharmacotherapy 3-surgical intervention .

Prevention of Obesity at different levels of BMI

No magic pills to reduce weight if

• Diet control is not possible • And exercises are not possible

How can I manage my obesity problem?

First step: get weighing scale and decide your target

Evidence Based Medicine

Second step

Third step: Increasing energy expenditure

exercise is very effective in preventing long term weight regain.

Aim for one hour exercise continuously a day if you want to reduce weight.

Doing 30 minute exercise each day for not increasingChildren need exercise at least one hour a day

Fourth Step: sleep well (7-9 hours/night)

Obesity Epidemic and Sleep Duration

7.56.8

9.0

0.01.02.03.04.05.06.07.08.09.0

10.0

1910 1975 2005

Sleep duration in US adults

25.2

26.9

23.0

21.0

22.0

23.0

24.0

25.0

26.0

27.0

28.0

1910 1975 2005

BMI in US adults

Sleep Deprivation/Weight Gain Linked

• Subjects with avg. 5hr./night sleep had 73% increased likelihood of obesity over those who slept 7-9 hr/night. ( Findings reported at the annual scientific meeting of the North American Society for

the Study of Obesity. Nov, 2004)• Study showed a linear relationship: reduced amounts

of sleep are associated with overweight and obesity (Arch. Intern Med, 2005;165:25-30)

Sleep Deprivation & Obesity:Potential Mechanisms

ObesitySleep Deprivation

Patel SR et al. Obesity; 2008; in press

Fifth Step: Never skip the breakfast

Breakfast:

Brain Food Improves

performance in studies

Improves physical activities

Does not contribute to overweight

Keeps you healthy

Skipping breakfast associated with obesity

High sugar breakfast causes a high sugar level which dips fast making you more hungry and you eat more sugary food

The most important meal

Sixth Step: Avoid overeating

Good eating habits Maintain hygienic habits Eat slowly, chew properly Avoid TV viewing or reading

while you eat Small frequent meals Never skip meals, specially

breakfast Don’t overeat

Seventh Step: Control Stress

Stress and Central Obesity Linked

Eighth Step: Take more vegetables and fruits

Ninth Step: Avoid fast foods and Fizzy drinks

Why is Fast Food unhealthy ? High in calorie, fat, sodium and low in

fiber which can cause Obesity, Hypertension, Heart diseases, Diabetes, Cancer

etc. Contains preservatives Choose low-calorie and low-fat meals,

snacks and desserts Have low fat or skim milk drinks.

Foods can be addictive

• Certain foods containing fats and sugar can be addictive

• Examples: fast foods and soft drinks

Industrial prediction of soft drink sale

Fast food kills

Growth of fast food outlets in 2012

• KFC started in 1995, 25 outlets at present, it will expand to 32 by end of the year

• Pizza Hut started in 1993, 24 outlets at present, it will expand to 30 by end of the year.

• Mc Donald started in 1998, 5 outlets at present, it will expand to 7 by end of the year

Tenth Step: Do abdominal exercises

Regular abdominal exercises are useful

Regular abdominal exercises (continued)

Eleventh Step: Stop methods without evidence

Most Herbal Products does not help!

Why we are still unable to reduce

weight?

Are we really ready to change ourselves?

Any questions?

Thank you