Obesity

Diet and Physical Activity Therapy

By Prof.dr.ir.Faisal
The Simplified Model of abdominal obesity

2018
Compositions of whole body weight mass
 Body Fat composition%
 Male
• 20% normal
• 25% borderline
• > 25 % high
 Female
• 30-35% normal
• 35% borderline
• > 35% high

2021
Normal body composition
What is obesity?
 Definitions:
 Excessive amount of body fat in relation to lean
body mass, or Body Mass Index (BMI) of 30 or
higher (WHO).
 Body Mass Index (BMI): a measure of an adult’s
weight in relation to his or her height, specifically
the adult’s weight in kilograms divided by the
square of his or her height in meters.
Over-nutrition, Genes, Lifestyle….No exercise, diseases,
Drugs “Risk factors of global obesity”…
Prevalence as an epidemic disorder…
2008
2008
 Obesity Diagnosis
 Body mass index (BMI) weight (kg)/
height squared (m2). With a BMI of: You are considered:
Below 18.5 Underweight
 BMI is often significantly correlated 18.5 - 24.9 Healthy Weight
with total body fat content. 25.0 - 29.9 Overweight
 Ideal body weight formula = [height
30 or higher Obese
(m) x height (m)] x ideal BMI

BMI tables:
http://www.nhlbisupport.com/bmi

2018
 Obesity Diagnosis
• Obesity is further divided
into three separate classes, Obesity class BMI (kg/m2)
with Class III obesity
being the most Class I 30.0- 34.9
extreme of the three. Class II 35.0-39.9
Class III ≥ 40.0
With a BMI of: You are considered:
(Extreme Obesity)
Below 18.5 Underweight

18.5 - 24.9 Healthy Weight

25.0 - 29.9 Overweight
30 or higher Obese
Fat distribution in the body
2008
2008
Obesity in children
 The weight status calculation for children and
teens is based on the BMI-for-age charts
developed by the US Centers for Disease
Control and Prevention (CDC 2000).

 These charts are designed specifically for

children from 2 to 20 years of age.
 Healthy weight calculator
 The healthy weight calculator uses child’s height and weight, to
calculate a body mass index (BMI).

 Then plots child’s age and BMI on the chart to determine

whether the child is a healthy weight for their age.
 The calculator can also describe this as a percentile. Your child is
a healthy weight if their BMI for age and sex is from the 5th to
below the 85th percentile. A child below the 5th percentile is
below a healthy weight (underweight), and a child at the 85th
percentile and above is above a healthy weight.
Children weight status calculator
https://go4fun.com.au/why/bmi-calculator
BMI-Age graph
Waist circumference (as a measure of central
obesity)

2018
Waist/Hip ratio
Body weight status

2018
 Obesity and its complications
Being overweight/obese significantly raises one’s risk of morbidity from:

 Hypertension  Gallbladder Disease

 Dyslipidemia
 Type 2 Diabetes
 Coronary Heart Disease
 Stroke
 Osteoarthritis
 Sleep apnea
 Certain cancers
(endometrial, breast, prostate, colon)

Higher body weights are also associated

with increases in all-cause mortality.

J La State Med Soc. 2005; 156: S42-S49.

 What Causes Obesity?

 Energy imbalance over a long

period of time.
 Energy in > Energy out.
 Excess calories and lack of
physical activity.
Energy balance is like
a scale. When
calories consumed
are greater than
calories used, weight
gain is the result.
 Weight Loss & Maintenance
Strategies to Consider

Physical Activity
&
Diet Therapy

2009
Why Treat Overweight and Obesity?
Because there is strong evidence that weight
loss reduces risk factors for diabetes and
cardiovascular disease, such as:
blood pressure
serum triglycerides
total serum cholesterol
low-density lipoprotein cholesterol
blood glucose levels
 Weight Loss Programs
Any safe and effective weight-loss program should include these components:

 Healthy eating plans that reduces caloric intake

 Regular physical activity and/or exercise instruction
 Tips on healthy behavior
 Slow and steady weight loss of about 1 to 2 pounds a week
 Medical care if needed
 A plan to keep the weight off after you have lost it
Physical Activity
 Types of Physical Activity
 Occupational work
 Carpentry, construction, waiting tables, farming

 Household chores
 Washing floors or windows, gardening

 Leisure time activities

 Walking, skating, biking, swimming, playing,
dancing, softball, tennis, football,
aerobics
Health Benefits of Physical Activity
(prevention & management)
 Benefits of Physical Activity
Regular physical activity is good for overall health .
 Physical activity decreases the risk for:
 Colon cancer
 Diabetes
 High blood pressure

 Physical activity also helps to:

 Helps in weight loss and weight maintenance
 Contribute to healthy bones, muscles, and joints
 Helpful for the prevention of overweight and
obesity.

2009
CDC
 How Much Physical Activity a
Day?
The 2005 Dietary Guidelines for Americans recommend the following for adults:

To reduce the risk of chronic diseases in adulthood:

Engage in at least 30 minutes of moderate-intensity physical activity,
above usual activity, at work or home on most days of the week.

To prevent weight gain in adulthood:

Engage in approximately 60 minutes of moderate- to vigorous-intensity activity
on most days of the week while not exceeding caloric intake
requirements.

To sustain weight loss in adulthood:

Participate in at least 60 to 90 minutes of daily moderate- to vigorous-intensity
physical activity while not exceeding caloric intake requirements. (Some may
need to contact your doctor before participating in this level of activity.

Dietary Guidelines for Americans

 How many calories you burn while
walking?

100 calories are nearly burned per

mile (1.6km) for 90 kg person and
65 calories for 60 kg person….

2018
Factors of physical activity effect
 Body weight mass.
 Distance of activity.
 Intensity of activity.

2018
 How Many Calorie Am I Burning?
Calories burned/hour of activity
Activity 100 lb 150 lb 200 lb
Bicycling, 6 mph 160 240 312
Bicycling, 12 mph 270 410 534
1. Jogging, 7 mph 610 920 1,230
Jumping rope 500 750 1,000
Running, 5.5 mph 440 660 962
Running, 10 mph 850 1,280 1,664
Swimming, 25 yds/min 185 275 358
Swimming, 50 yds/min 325 500 650
Tennis singles 265 400 535
Walking, 2 mph 160 240 312
Walking, 3 mph 210 320 416
Walking, 4.5 mph 295 440 572

American Heart Association

 Before Beginning an Exercise Program
You should check with your doctor before beginning an exercise program if you:

 Are a man older than age 40 or  Have had joint replacement surgery
a woman older than age 50
 Smoke
 Have had a heart attack
 Are overweight or obese
 Have a family history of heart-related
problems before age 55  Tale medication to manage a
chronic condition
 Have heart, lung, liver or kidney disease
 Have an untreated joint or muscle
 Feel pain in your chest, joints, or muscles
injury, or persistent symptoms after
during physical activity
a joint or muscle injury
 Have high blood pressure, high  Are pregnant
cholesterol, diabetes, arthritis,
osteoporosis, or asthma  Unsure of your health status.

2018

Mayo Clinic
Eating for Weight Loss
 A Healthy Diet
The 2005 Dietary Guidelines for Americans defines a healthy diet as one
that::
 Emphasizes fruits, vegetables, whole grains, fat-free or low-fat milk, & milk products.
 Includes lean meats, poultry, fish, beans, eggs, and nuts.
 Low in saturated fats, trans fats, cholesterol, salt (sodium), and less added sugars.

 According to the American Heart Association, the maximum amount of added sugars you
should eat in a day are- Men: 150 calories per day (37.5 grams or 9 teaspoons) .
Women: 100 calories per day (25 grams or 6 teaspoons).

Sodium intake to less than 2,300 mg per day—that's equal to about 1 teaspoon of salt.

MyPyramid: http://mypyramid.gov/
Weight loss:
Goals for Weight
Management of Weight Lost
 Calorie Deficit
Needed For Weight Loss
 A calorie deficit of no more than 500 kcal/day.

 This can be achievable through the combination of diet + exercise.

 An example of how to create a calorie deficit of 500 kcal/day through diet + exercise
would be: eating 250 kcal less per day, along with burning 250 calories through exercise

2018
 Calorie Deficit
Needed For Weight Loss

A caloric deficit of 500 can be done by:

 Eating 250 kcal less per day:  burning 250 calories through exercise:
 Leave out mayonnaise in a  Walking
sandwich  Swimming
 Leave out dessert  Bicycling
 Switch from soft drinks to water  Running
 Reduce portion sizes

2018
 Goals for Weight Loss
And Management
 The initial goal of weight loss therapy is to reduce body
weight by approximately 10 percent from baseline.
Once this goal is achieved, then further weight loss can be
attempted, if necessary.

 A reasonable time line for a 10 percent reduction in body

weight is 6 months.

 Experience reveals that lost weight is usually regained

unless a weight maintenance program, consisting of diet
therapy, physical activity and behavior therapy, is
continued indefinitely.
2018
 Goals for Weight Loss
And Management
 For overweight individuals with BMIs in the typical range of 27 to 35 kg/m2, a decrease
of 300 to 500 kcal/day will result in weight losses of about ½ to 1 lb per week.

 A 10 percent weight loss could be achieved within 6 months.

 For more severely obese individuals (BMI > 35), deficits of up to 500 to 1,000 kcal/day
will lead to weight losses of about 1 to 2 lb per week.

 A 10 percent weight loss could be achieved within 6 months.

2018
 Goals for Weight Loss
And Management
 After 6 months of weight loss treatment, the individual should be assessed.

 If no further weight loss is needed, then the current weight should be maintained.

 Sustained physical activity is particularly important in the prevention of weight regain.

 If further weight loss is desired, another attempt at weight reduction can be made.

2018
 References
 Centers for Disease Control and Prevention (CDC):
Prevalence of Overweight and Obesity Among Adults: U.S., 2003-2004. Available at:
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese03_04/overwght_adult_03.htm
 Womenshealth.gov. Physical Activity. Available at:
http://www.womenshealth.gov/pub/steps/Physical%20Activity.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Do You Know the Health Risks of Being Overweight? Available at:
http://win.niddk.nih.gov/publications/health_risks.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Statistics Related to Overweight and Obesity. Available at:
http://win.niddk.nih.gov/statistics/index.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight and Waist Measurement: Tools for Adults. Available at:
http://win.niddk.nih.gov/publications/tools.htm

2009
 References
 Bellanger T, Bray G. Obesity related morbidity and mortality. J La State Med Soc.
2005; 156: S43-49.
 National Heart, Lung, and Blood Institute (NHLBI). Clinical Guidelines on the
Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
Available at: http://www.nhlbi.nih.gov/guidelines/obesity/ob_exsum.pdf
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Choosing a Safe and Successful Weight-loss Program. Available at:
http://win.niddk.nih.gov/publications/choosing.htm
 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Weight Loss for Life. Available at: http://win.niddk.nih.gov/publications/for_life.htm
 Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence.
2006; CMAJ; 174(6): 801-809.

2009
 References
 Dietary Guidelines for Americans 2005. Available at:
http://www.health.gov/dietaryguidelines/dga2005/recommendations.htm
 American Heart Association (AHA). Physical Activity Calorie Use Chart.
Available at: http://www.americanheart.org/presenter.jhtml?identifier=756
 American Cancer Society (ACS). Exercise Counts. How Many Calories Will Your
Activity Burn? Available at:
http://www.cancer.org/docroot/PED/content/PED_6_1x_Calorie_Calculator.asp
 Mayo Clinic. Exercise: When To Check With Your Doctor First. Available at:
http://www.mayoclinic.com/health/exercise/SM00059

2018
 Thank you!!

2018