PA and Obesity

PA and Obesity - PA and Obesity Chapter 8 Overweight and...

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PA and Obesity Chapter 8 Overweight and obesity excess body fat resulting from a positive energy balance Obesity chronic disease that develops from an interaction of a person’s genotype, the environment, and the person’s dietary and physical inactivity habits Health Risks of Overweight and Obese o Hypertension moderately obese have double risk o Hypercholesterolemia BMI > 40 have 2x risk of high cholesterol o Type 2 diabetes moderately obese have triple risk o CHD o Gallbladder disease o Osteoarthritis o Cancer uterus, prostate, breast, colon o Stroke o 1 year reduction in life-expectancy Major Health Risk o Bouchard estimates that obesity is underlying cause of 20% of all deaths in Canada o Causes 75% of diabetes cases Magnitude of Problem o World overweight 1.1 billion same as underweight Increasing even in developing countries Majority in Germany, Russia, US, USA o USA Adults ~55% overweight (and 23% of those obese) 4-decade trend increasing exponentially Obesity doubled in recent decade only 12% were obese 10 yrs ago 2000-2001: 19.8 20.9% reaching epidemic status $118 billion (12% of health care budget) Obesity and overweight #2 leading cause of preventable death (after smoking) Prevalence o 33% Canadians 20-64 yrs overweight o 15% Canadians 20-64 yrs obese o Aged 20-24 yrs 21% overweight and 8% obese o Aged 55-64 yrs 40% overweight and 19% obese o Obesity rate tripled in recent decades o Overweight and obesity-related death rate has increased more in Eastern Canada BMI Canadian Adults (1994/05 - 2000/01) BMI Category Proportion Underweight <18.5 kg/m 2 3% Normal 18.5 – 24.9 49% Overweight 25.0 – 29.9 33% Obese 30.0 – 39.9 15% Vs. US adults: 35% overweight + 27% obese BMI Canadian Children o 7-13 yr olds in 2001 Obese and overweight proportion of population increased to 1.5-5.0x what it was in 1981 Rate of obesity in girls 2% to 10% Rate of obesity in boys 9% to 20% More US subgroups
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o Sex higher prevalence in men o Youth 13% Greater rise in African American and Hispanic than White 21.5% and 21.8% vs. 12.3% o Black and Mexican American women, Native American adults higher prevalence o Lower formal education and lower income Higher mean BMI and prevalence of overweight and obesity Treatment o Dietary intervention with obesity Mean weight loss 10kg in 18weeks Regain without sustained PA 2/3 in 1 year and all in 3-5yrs o Medication sibutramine only drug approved by FDA for long-term use o NIH clinically accepted approaches PA low-cal and lower-fat diets, behavior therapy, pharmacotherapy, surgery 6 month target 10% loss of BW Negative balance of 300-500kcal/day for BMI of 27-35 losses of 0.5-1lb/ week 500-1000kcal/day for BMI >35 to achieve goal After 6 months Loss rate slows to plateau due to RMR that accompanies
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PA and Obesity - PA and Obesity Chapter 8 Overweight and...

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