weight management pathophysiology risk assess

Gout osteoarthritis osteoarthritis type 2 diabetes

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Unformatted text preview: or The about $175 per person -- for obesity through Medicare and Medicaid programs Medicare Health Problems Associated with Excess Body Fat • • • • • • Surgical risk Lung (pulmonary) Lung disease disease Sleep apnea HTN CVD Bone and joint Bone disorders (gout, osteoarthritis) osteoarthritis) • • • • • • • Type 2 diabetes Gallstones Cancers (breast, colon, Cancers pancreas, gallbladder) pancreas, Infertility Pregnancy- difficult Pregnancydelivery delivery Reduced agility Early death NHANES III Prevalence of Hypertension* According to BMI BMI <25 BMI 25-<27 50 BMI 27-<30 BMI > 30 41.9 37.8 Percent 40 32.7 20 27.7 27 30 22.1 15.2 14.9 10 0 Men *Defined as mean systolic blood pressure ≥ 140 mm Hg, mean diastolic ≥ 90 mm Hg, or currently taking antihypertensive medication. Brown C et al. Body Mass Index and the Prevalence of Hypertension and Dyslipidemia. Obes Res. 2000;8:605-619. Women Obesity and Diabetes Risk Incidence of New Cases per 1,000 Person-Years 100 80 60 40 20 0 <20 20-25 25-30 30-35 BMI Levels Knowler WC et al. Am J Epidemiol 1981;113:144-156. 35-40 >40 Weight Gain and Diabetes Risk Weight Change Since Age 21 <5 kg 25 5-10 kg 11+ kg Relative Risk 21.1 20 15 9.1 10 6.3 5 1.0 3.6 2.5 1.0 5.3 2.1 0 <22 22-23 Body Mass Index at Age 21 Adapted from Chan JM et al. Diabetes Care 1994;17:960-969. 24+ Metabolic Syndrome Criteria* Three or more of the following abnormalities: Three • Waist circumference >102 cm (40 inches) in men Waist and > 88 cm (35 inches) in women and • Serum triglycerides of at least 150 mg/dL • High density lipoprotein level <40 mg/dL in men High and <50 mg/dL in women and • Blood pressure >=135/85 mm/hg • Serum glucose >=110 mg/dl • Includes 47 million US residents (27.7% of the Includes population population *ATP III Guidelines. National Cholesterol Education Program, 2001 Polycystic Ovary Syndrome (PCOS) • • • • • Endocrine disorder characterized by Endocrine hyperandrogenism and insulin resistance hyperandrogenism Associated with android obesity Affects 5-10% of reproductive age women Erratic menstrual periods, chronic anovulations Erratic resulting in multiple ovarian cysts; infertility, acne, hirsutism and alopecia acne, Increased risk of heart disease, type 2 diabetes, Increased reproductive cancers reproductive Management of PCOS • • • Symptom oriented, as etiology is unclear Individualized diet and exe...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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