Etiologies of obesity

• An exceedingly complex group of diseases and probably should

be characterized as a syndrome.

• Simply overeating does not result in long-term obesity.

• More than 350 genes or gene markers have been identified

that are associated with obesity.

• The etiologies that contribute to obesity include dietary and

exercise patterns, endocrine and metabolic diseases, and
drugs.
 Medical Consenquences of Obesity and
Benefit of Weight Loss
• Increasing risk for developing numerous medical problems.

• Accounts for significant mortality, particularly when the

body mass index exceeds 30 kg/m2.

• The association between type 2 diabetes mellitus with a

cluster of disorders known as Syndrome X or the insulin-
resistance syndrome.

• Weight loss can improve health status.

Obesity rates in Malaysia (Adult): Third National Health
and Morbidity Survey (NHMS III) 2006

Percentage

29%

Overweight
Obese
57% Normal

14%
Obesity rates in Malaysia (Adult): Second National
Health and Morbidity Survey (NHMS II) 1996.

Percentage

17%
4%
Overweight
Obese
Normal

79%
Comparison obesity rates in Malaysia (Adult)

Normal

Column1
NHMS II
Obese

Overweight

0.00% 20.00% 40.00% 60.00% 80.00% 100.00%

 Obesity rates in Malaysia (Children): Third National
Health and Morbidity Survey (NHMS III) 2006

• The prevalence of overweight among children

was 5.4%.

• Overweight among boys (6.0%) compared to

girls (4.7%).

• overweight children in urban areas (6.3%) was

higher than that observed for rural areas (4.0%).
Obese Patients With Binge-Eating Disorder
• The ingestion of large amounts of food with an associated
sense of loss of control over when, what, or the amount
one is eating without the regular compensatory behaviors.

• Distinct entity and disordered eating associates with

psychiatric comorbidity; rapid eating, eating until
uncomfortably full, eating large amounts when one is not
hungry, eating alone because of embarrassment over the
amount eaten, and feelings of disgust, depression, or guilt
after overeating.
Obese Patients With Binge-Eating Disorder

• Treatment should be of an eating disorder.

Cognitive behavioral, interpersonal, and
dialectical behavior therapy can be effective.

• Therapy proceeds through three stages over

months.

• Pharmacotherapy, particularly with

antidepressants, is useful.