Obesity assessment

Pro Academy 01098484656 1

Anatomy

Causes

Patient evaluation
Pro Academy 01098484656 2
 Anatomy

Size and Number of Fat Cells

• Hypertrophic Obesity
• Hypercellular Obesity

Fat Distribution
• Subcutaneous versus visceral fats
• Lipodystrophy
Pro Academy 01098484656 3
 Size and Number of Fat Cells
Hypertrophic Obesity
• Enlarged fat cells tend to correlate with an android or
truncal fat distribution and are often associated with
metabolic disorders such as glucose intolerance,
dyslipidemia, hypertension, and coronary artery
disease.
Hypercellular Obesity
• An increased number of fat cells usually occurs when
obesity develops in childhood.
• Increased numbers of fat cells may also occur in adult
life and this is to be expected when the body mass
index (BMI) is >40 kg/m2

Pro Academy 01098484656 4

Pro Academy 01098484656 5
 Fat Distribution
• Subcutaneous vs visceral fats
– Measuring fat distribution in subcutaneous vs
visceral compartments is important because
• Visceral fat predicts development of health risks better
than total body fat.

Pro Academy 01098484656 6

Pro Academy 01098484656 7
Lipodystrophy

Pro Academy 01098484656 8

 Causes
Neuroendocrine Obesity
• Hypothalamic Obesity
• Cushing’s Syndrome
• Hypothyroidism
• Polycystic Ovary Syndrome
• Growth Hormone Deficiency

Cessation of Smoking

Sedentary Lifestyle

Diet
Pro Academy 01098484656 9
Hypothalamic Obesity

Pro Academy 01098484656 10

Pro Academy 01098484656 11
Hypothyroidism

Pro Academy 01098484656 12

Polycystic Ovary Syndrome

Pro Academy 01098484656 13

Growth Hormone Deficiency

Pro Academy 01098484656 14

Cessation of Smoking

Pro Academy 01098484656 15

Sedentary Lifestyle

Pro Academy 01098484656 16

 Diet

Eating fast Sugar-

food outside sweetened Snacking
of the home beverage

Lower cost of
energy-dense “Supersizing”
foods

Pro Academy 01098484656 17

 Patient evaluation

Interview

Physical Measurements

Labs

Plan
Pro Academy 01098484656 18
History
• Have you gained 20 or more lb (10 kg) since age 20?
• Are members of your family overweight?
• Do your parents or grandparents have diabetes?
Endocrine
• Do you have diabetes?
• Do you take thyroid hormone?
• For women: Do you have normal menstrual periods?
Activity
• Do you exercise regularly?
Disease
• Do you have gallstone or gallbladder disease ?
• Do you fall asleep easily during the day?
• Do you have high blood pressure?
Medications
• Do you take medications regularly? If so, specify
Psychiatric
Pro Academy 01098484656 19
• Are you depressed?
 Physical Measurements

Weight Height BMI

WC WHR

Pro Academy 01098484656 20

 Weight measurement
• Patients should be asked to
– Remove any outer garments such as
• Coats,
• Cardigans and
• Their shoes,
• Empty their pockets before stepping
onto the scales.
• No coins
• No metals
Pro Academy 01098484656 21
 Height measurement
Height measurement technique
• Stand straight with their back to
the stadiometer
• Top of head touching
– but not pressing against the rule.
• Arms relaxed with feet slightly
apart

Pro Academy 01098484656 22

 Waist circumference
• Provides information about
– Distribution of body fat
– Risk for conditions.
Technique:
• Correct position
• Bony landmarks in which case placing the tape
at the level of the belly button is recommended.

Pro Academy 01098484656 23

Waist/hip ratio

Pro Academy 01098484656 24

 Labs

Plasma Plasma
Glucose Lipids

Thyroid
Cancer
function test
Pro Academy 01098484656 25
Pro Academy 01098484656 26
Thyroid function test

Pro Academy 01098484656 27

 Cancer

Prostate-
Mammography Specific
Antigen (PSA)

Pro Academy 01098484656 28

 Plan

Do Patient &
Is the Patient
Doctor Have
Ready to Lose
Realistic
Weight?
Expectations?

Pro Academy 01098484656 29

Inbody

Pro Academy 01098484656 30

 Measuring weight
using beurer balance
1. Switching on the scale
• Press the button on the control unit. 0.0 kg
appears on the display.
2. Diagnostics
• Switch the device on and select your user
number from 1 to 10 by pressing the right-
hand button .

Pro Academy 01098484656 31

 Measuring weight
using beurer balance
• Stand still with your weight
distributed evenly on both legs.
Please note that there must be
no skin contact between feet,
legs, calves and thighs.
• Otherwise the measurement
will not be performed correctly.
• To prevent skin contact, you can
wear, for example, a lightweight
pair of trousers.
Pro Academy 01098484656 32
 Precautions for inbody use
1. Perform the analysis on an empty stomach
2 - Perform the analysis after you enter the bathroom
3 - Do not exercise before the analysis
4 - Make sure you stand on your feet 5 minutes before the
measurement, because sitting or lying down changes the
distribution of water in the body.
5 - Do not analyze after the sauna or consultation
6 - For women, do not take the analysis during the menstrual
cycle, due to increased water retention.
7. Measure at a temperature of 20 ° C to 25 ° C
8 - Each time take the measurement in the same conditions
and time and the same clothes.

Pro Academy 01098484656 33

 Dr. Salah Darwish, BCNSP, Dr. Ahmed Mahmoud, BCNSP,
SNN SNN
Obesity management Obesity management
professional professional
Mobile : Mobile :
01065396906 01004954331
Mail : Mail :
Dr.salahdarwish@gmail.com ahmed.mahmoud.0987@gmail.co
m
facebook :
facebook :
Salah Darwsih
Ahmed Mahmoud
Facebook page :
Facebook page :
Nutrition by ahmed and salah
Nutrition by ahmed and salah

copyrights by nutrition by ahmed and salah 2017 34