II. Epidemiology

  1. Prevalence: 33% US adults age 20 to 74 are obese
  2. Trends
    1. Obesity Prevalence has increased 8% since 1980
    2. Obesity Prevalence has increased 54% ages 6-11 years
  3. Patients gain 1 pound per year after age 25

III. Pathophysiology: Fat expands in 2 ways

  1. Fat Cell Number
    1. Fat cell number does not decrease with weight loss
    2. Increases 5 fold until age 22 years
    3. Increase continues with nutritional excess
    4. Non-obese person has 25-30 billion fat cells
    5. Obese person has 260 billion cells
  2. Fat Cell Size
    1. Fat cell size reduces with weight loss
    2. Adults fill existing fat cells when they over eat

V. Diagnosis: Obesity

  1. Men: 20% over estimated Ideal Weight
  2. Women: 30% over estimated Ideal Weight

VII. Worksheets

  1. Dietician in the Box
    1. PreventEdWeightLoss2Sjm.htm

VIII. Research: Obesity Gene (ob)

  1. Ob expression
    1. Feeding turns on rat adipocytes via Insulin
    2. Inhibit Neuropeptide Y synthesis at appetite center
    3. Neuropeptide Y
      1. Decreases thermogenesis
      2. Increases Insulin and appetite
  2. Ob gene function: Produces Leptin (protein)
    1. Leptin uppresses appetite in rats
    2. Leptin increases thermogenesis in rats
    3. Leptin decreases Insulin levels in rats
  3. References
    1. Saladin (1995) Nature 377:527-9 [PubMed]
    2. Stephens (1995) Nature 377:530-2 [PubMed]
    3. Pelleymounter (1995) Science, 269(5223):540-3 [PubMed]

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Ontology: Obesity (C0028754)

Definition (MEDLINEPLUS)

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active.

Being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you are obese, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Definition (NCI_NCI-GLOSS) A condition marked by an abnormally high, unhealthy amount of body fat.
Definition (NCI_CTCAE) A disorder characterized by having a high amount of body fat.
Definition (NCI) Having a high amount of body fat (body mass index [BMI] of 30 or more).
Definition (CSP) excessively high accumulation of body fat or adipose tissue in relation to lean body mass; the amount of body fat (or adiposity) includes concern for both the distribution of fat throughout the body and the size of the adipose tissue deposits; individuals are usually at high clinical risk because of excess amount of body fat (BMI greater than 30).
Definition (MSH) A status with BODY WEIGHT that is grossly above the acceptable or desirable weight, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
Concepts Disease or Syndrome (T047)
MSH D009765
ICD9 278.00
ICD10 E66 , E66.9
SnomedCT 5476005, 154776002, 190963004, 414916001, 414915002
LNC LA6301-1
English Obesity, Obesity, unspecified, OBESITY, obesity (diagnosis), obesity, Obesity NOS, Obesity [Disease/Finding], obese, adiposity, Obesity, NOS, Obesity [Ambiguous], Obese, Obese (finding), Obesity (disorder)
French OBESITE, Obésité, non précisée, Obésité
Portuguese OBESIDADE, Obesidade NE, Obesidade
Spanish OBESIDAD, Obesidad no especificada, obesidad (trastorno), obesidad, obeso (hallazgo), obeso, Obesidad
Dutch obesitas niet-gespecificeerd, Vetzucht, niet gespecificeerd, zwaarlijvigheid, Adipositas, Vetzucht
German Fettleibigkeit, unspezifisch, ADIPOSITAS, Adipositas, nicht naeher bezeichnet, Adipositas, Fettsucht, Obesitas
Italian Obesità, non specificata, Obesità
Japanese 肥満, 肥満、詳細不明, ヒマン, ヒマンショウサイフメイ
Swedish Fetma
Czech obezita, Obezita, blíže neurčená, Obezita, otylost
Finnish Lihavuus
Russian OZHIRENIE, ОЖИРЕНИЕ
Korean 상세불명의 비만, 비만
Polish Otyłość
Hungarian Obesitas, nem meghatározott, Obesitas
Croatian Gojaznost, Pretilost
Norwegian Fedme

Ontology: Overweight (C0497406)

Definition (CHV) BMI 25
Definition (CHV) BMI 25
Definition (NCI_NCI-GLOSS) Being too heavy for one's height. Excess body weight can come from fat, muscle, bone, and/or water retention. Being overweight does not always mean being obese.
Definition (MSH) A status with BODY WEIGHT that is above certain standard of acceptable or desirable weight. In the scale of BODY MASS INDEX, overweight is defined as having a BMI of 25.0-29.9 kg/m2. Overweight may or may not be due to increases in body fat (ADIPOSE TISSUE), hence overweight does not equal "over fat".
Concepts Sign or Symptom (T184)
MSH D050177
ICD9 278.02
ICD10 E66.3
SnomedCT 238131007, 23495001
English OVERWEIGHT, overweight (diagnosis), overweight (physical finding), overweight, Overweight [Disease/Finding], clinical overweight, Patient overweight, Overweight (finding), Overweight, overweight (BMI<30), Overweight (BMI 25-30)
Japanese 過体重, カタイジュウ
Swedish Övervikt
Czech nadváha, Nadváha
Finnish Ylipaino
French Surplus de poids, Excédent de poids, Excès de poids, Surcharge pondérale, Surpoids
Russian VES IZBYTOCHNYI, ВЕС ИЗБЫТОЧНЫЙ
Croatian Not Translated[Overweight]
Polish Nadwaga
Hungarian Túlsúly
Norwegian Overvekt
Spanish paciente con peso alto, paciente con sobrepeso, sobrepeso (hallazgo), sobrepeso, Sobrepeso
Dutch Overgewicht, overgewicht
Portuguese Excesso de peso, Sobrepeso
German Uebergewicht, Übergewicht
Italian Sovrappeso