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. Grading

  1. BMI 25 to 30: Overweight
  2. BMI 30 to 35: Class 1 Obesity
  3. BMI 35 to 40: Class 2 Obesity
  4. BMI >40: Class 3 Obesity (Severe Obesity)

IV. 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

VI. Diagnosis: Obesity

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

VIII. Worksheets

  1. Dietician in the Box
    1. PreventEdWeightLoss2Sjm.htm

IX. 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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