Obesity – Review

Case 2 Family Medicine – Jumat, 11/09/2020

Obesity –Definition
 An increase in body weight beyond the BMI: indeks sederhana untuk klasifikasi overweight dan
limitation of skeletal and physical obesitas pada orang dewasa.
requirement, as the result of an excessive
accumulation of fat in the body
(Dorland’s Medical Dictionary).
 Chronic disease characterized by an
increase of body fat stores (European
Guidelines for Obesity Management in
Adults).
 Penumpukan lemak yg berlebihan akibat
ketidakseimbangan asupan energi
(energy intake) dengan energi yg
dibutuhkan (energy expenditure) dalam
waktu lama (WHO, 2002)
Obesity –Definition (cont.)
Other obesity terms
 Exogenous obesity (alimentary o.,
simple o.)
 Endogenous obesity
 Android obesity (abdominal o.,
viseral o.)
 Gynecoid obesity (gynoid o.)
 Adult-onset obesity (hypertrophic o.)
 Life-long obesity (hyperplastic-
hypertrophic o.)
Epidemiology
Obesity has reached epidemic proportions globally, with at least 2.8M people
dying each year as a result of being overweight or obese. Once associated with
high-income countries, obesity is now also prevalent in low- and middle-
income countries. (WHO, 2020)
1975 2016
Both overweight
Overweight and obesity have Overweight
- Men: 20% shown a marked - Men: 39%
- Women: <23% increase over the - Women: 39%
Obesity past 4 decades. Obesity
- Men: 3% - Men: 11%
- Women: 6% - Women: 15%
*overweight = BMI≥25 kg/m2; obese = BMI ≥30 kg/m2
Epidemiology –Indonesia
Dewasa (18+) Anak (5-12 tahun)
Overweight: 13,5% Overweight: 18,8%
Obese: 28,7% Obese: 10,8%
Etiology

No single cause.
Obesity arisen from a myriad contributing factors.

The fundamental cause of obesity and overweight is an energy imbalance between calories
consumed and calories expended. Globally, there has been:
 An increased intake of energy-dense foods that are high in fat and sugars, and
 An increase in physical inactivity due to the increasingly sedentary nature of many forms of
work, changing modes of transportation, and increasing urbanization.
Risk Factors

Changes in dietary and physical activity are often result of environmental and social
changes. Every aspect of the environment in which children are conceived, born and
raised contribute to their risk of becoming overweight or obese.

Individual-Level Environmental
Interpersonal Factors
Factors Factors
Risk Factors (cont.)

Individual-Level Factors

Non-modifiable risk factors Modifiable risk factors

a. Family history a. Knowledge
b. Genetics b. Attitude and beliefs
- Gene mutations (leptin, ghrelin)
c. Diet and physical activity-related
- Very few
behaviors
c. Others: age, gender, and d. Psychological disturbances
race/ethnicity.
Risk Factors (cont.)

Interpersonal Factors Environmental Factors

a. Social Networks a. Food and Physical Activity

b. Cultural Factors (diet n PA) Environments
(urban, less available, marketing)
b. Workplaces and Schools

There are wide variety of individual, interpersonal, and environmental factors that may
play a role in the development of obesity. When counseling patients on techniques for
weight management, all of these factors should be carefully examined.
References
 Dorland’s Medical Dictionary
 European Guidelines for Obesity Management in Adults, 2015
 Obesity Facts; Childhood Obesity Facts; Obesity and Overweight (WHO articles)
 Taking Action on Childhood Obesity (WHO)
 Paolicelli, Courtney Winston 2016. Nutrition and Dietetics Practice Collection. Momentum Press Health.
 Obesity and Overweight (https://ourworldindata.org/obesity)
 Epidemi Obesitas (Kemenkes RI, fact sheet)
 Google images.