OBESITY
Overview of the
disease
Obesity is a complex
disease involving having too
much body fat.
Obesity isn't just a cosmetic
concern. It's a medical problem
that increases the risk of many
other diseases and health
problems.
What CAUSES obesity?
Certain health conditions can also
Common specific causes of lead to weight gain, which may lead
obesity include: to obesity. These include:
● genetics ● metabolic syndrome
● growing older ● polycystic ovary syndrome
● not sleeping enough (PCOS)
● high stress ● Prader-Willi syndrome
● pregnancy ● Cushing syndrome
● hypothyroidism (underactive
thyroid)
● osteoarthritis (OA)
CLINICAL MANIFESTATION
The most obvious symptom is the increase in weight, therefore the
symptoms that may be presented arise from this increase in weight that,
among others, may be:
● difficulty in sleeping
● back and/or joint pains
● excessive sweating
● intolerance to heat
● infections in skin folds
● fatigue
● depression
● feeling of shortness of breath (dyspnoea)
SIGNS OF OBESITY
● Acanthosis nigricans
● stretch marks
● Swelling and varicose veins in the lower limbs.
● Body Mass Index (BMI) greater than 30 kg/m2.
● Waist circumference greater than 94 cm in men
and 88 cm in women.
● High blood pressure level > 140/90 mmHg.
PATHOPHYSIOLOGY
The pathogenesis of obesity involves
regulation of calorie utilization, appetite, and
physical activity, but have complex
interactions with availability of health-care
systems, the role of socio-economic status,
and underlying hereditary and environmental
factors.
ASSESSMENT and DIAGNOSTIC FINDINGS
● taking your health history
● a general physical exam
● calculating your BMI
● measuring your waist size
● checking for other health problems
Other more accurate measures of body fat and where body fat is located
include:
● skinfold thickness tests
● waist-to-hip comparisons
● dual energy radiographic absorptiometry (DEXA) scans
● other screening tests, such as ultrasounds, CT scans, and MRI scans
A doctor may also order certain tests to help diagnose
obesity-related health risks. These may include:
● blood tests to examine cholesterol and glucose levels
● liver function tests
● diabetes screening
● thyroid tests
● heart tests, such as an electrocardiogram (ECG or
EKG)
COMPLICATIONS
Many of the complications of obesity can reduce the quality of life and also
shorten the lifespan. The consequences of obesity include the following:
● gastroesophageal reflux
● cardiovascular disorders ● liver disorders
● diabetes mellitus ● gallbladder disease
● certain cancers ● reproductive system
● sleep apnea disorders
● metabolic syndrome ● urologic problems
● Osteoarthritis ● skin disorders
● tendon and fascial disorders ● social, economic, and
psychological problems
MEDICAL MANAGEMENT
● medication - appetite suppressants can intercept some of the pathways to
your brain that affect your hunger.
Common FDA-approved drugs for treating obesity include:
● Orlistat (Xenical®, Alli®)
● Benzphetamine (Didrex®, Regimex®) ● dietary changes
● Bupropion-naltrexone (Contrave®) ● increased activity
● Semaglutide (Wegovy®) ● behavioral therapies
● Cellulose and citric acid (Plenity®) ● weight loss surgery
● Lisdexamfetamine dimesylate (Vyvanse®) ○ Bariatric
● Phentermine-topiramate (Qsymia®) Surgery
SURGERIES
Types of weight loss surgery include:
● Gastric bypass surgery: In this procedure, a surgeon creates a small
pouch at the top of your stomach that connects directly to your small
intestine. Food and liquids go through the pouch and into the intestine,
bypassing most of the stomach. It’s also known as Roux-en-Y gastric
bypass (RYGB) surgery.
● Laparoscopic adjustable gastric banding (LAGB): LAGB separates
your stomach into two pouches using a band.
● Gastric sleeve surgery: This procedure removes part of your stomach.
● Biliopancreatic diversion with duodenal switch: This procedure
removes most of your stomach.
PREVENTION
● Choosing healthier foods (whole grains, fruits and
vegetables, healthy fats and protein sources) and
beverages.
● Limiting unhealthy foods (refined grains and sweets,
potatoes, red meat, processed meat) and beverages (sugary
drinks)
● Increasing physical activity
● Limiting television time, screen time, and other “sit time”
● Improving sleep
● Reducing stress
GERONTOLOGIC CONSIDERATIONS
Obese older adults are more likely to be severely disabled and
require the assistance of another person than those who are not
obese (Center on an Aging Society, 2003). Older adults who are
obese are more likely to suffer from persistent and chronic
symptoms of illness, and to report symptoms of depression.
In patients over 65, the increase in chronic diseases associated
with aging reduces physical activity and exercise capacity,
making it more difficult for elderly persons to lose weight.
