Lecture 9-Obesity

Question 1

define obesity- WHO

Answer 1

excess fat accumulation in adipose tissue- extent that health may be impaired

Question 2

BMI

Answer 2

weight in kg/height in metres squared

Question 3

BMI for overweight and obesity

Answer 3

overweight- 25-30
obesity- >30 (1)
class II- >35
class III- >40

Question 4

limitations of BMI

Answer 4

doesn’t take into account muscle mass at individual level, not at population level

Question 5

why is waist circumference measured?

Answer 5

metabolically active fat

Question 6

double burden

Answer 6

low and middle income countries- overnutrition alongside undernutrition

Question 7

nutrition transition

Answer 7

obesity common from women–>men
higher socioeconomic status –>low socio economic status
more prevalence in children

Question 8

global prevalence of obesity

Answer 8

increase started in rich world but now everywhere except sub saharan africa

Question 9

australian adults obesity prevalence peaks?

Answer 9

at 55-64 then decreases

Question 10

healthy survivor effect

Answer 10

people who are obese throughout their life not making it into older years

Question 11

percentage of overweight/obese adults in australia

Answer 11

62.8%- normal to be overweight

Question 12

prevalence of obesity gradual or sudden?

Answer 12

steady gradual increase not sudden

Question 13

3.5 year old victorian children

Answer 13

prevalence of overweight/obesity decreased

- positive effects, first generation to come out

Question 14

socio-economic differences in obesity

Answer 14

higher prevalence for most disadvantaged (especially women), decreases as you get to least disadvantaged

Question 15

obesity and self-reported chronic diseases prevalence

Answer 15

1. diseases of circulatory system
2. mental/behavioural problems
3. T2D
4. IHD
5. cerebrovascular disease

Question 16

hypertension and obesity

Answer 16

triple for obese people compared to underweight

Question 17

dyslipidemia

Answer 17

almost double for obese compared to underweight

Question 18

type 2 diabetes and obesity

Answer 18

quite uncommon to have T2D in healthy weight,
quite common if you are obese
-higher prevalence in obese men compared to women

Question 19

biomarkers to diagnose T2D

Answer 19

fasting plasma glucose

HbA1C level

Question 20

obesity and economic consequences

Answer 20

productivity losses
health care costs
decreased quality of life
- costs borne both by individual and society

Question 21

indirect costs

Answer 21

absenteeism, government subsidies

Question 22

direct costs

Answer 22

GPs, health services, weight loss interventions, pharmaceuticals

Question 23

4 explanations for obesity epidemic

Answer 23

1. energy imbalance
2. genes and environment
3. potential influences on population prevalence
4. foresight causal map

Question 24

energy imbalance

Answer 24

level of individual

• overnutrition and underactivity
• NOT driven us to be obese society (need to see how its changed in last 30 years)

Question 25

genes interacting with environment

Answer 25

certain genes make more susceptible to obesity in certain environment
-NOT driven obese society

Question 26

potential influences on population prevalence

Answer 26

international factors–>national/regional–>community locality–>work/school/home–>individual

e. g. public transport, manufactured/imported food- community
e. g. globalisation of markets, media–>international

Question 27

foresight causal map

Answer 27

centre is energy balance

• around drivers of obesity
  e. g. food production/consumption, physical activity, social/ individual psychology

Question 28

3 levels of obesity prevention

Answer 28

1. universal/public health/primary intervention
2. selective prevention
3. targeted prevention

Question 29

public health/ primary intervention

Answer 29

prevent weight gain across population- all members of community

Question 30

selective prevention

Answer 30

identify groups/individuals at risk, prevent further weight gain, promote weight loss

Question 31

targeted prevention

Answer 31

identify those with existing weight problems, prevent downstream consequences e.g. diseases

Question 32

select committee into obesity- children in most points

2 reasons

Answer 32

• primary prevention, childrens rates not yet high in australia
• politically palatable- children are innocent, help them

Question 33

approaches to addressing obesity

agent–>structural

Answer 33

agent- individual makes choice

structural- individual choice removed e.g. school canteen

Question 34

approaches to addressing obesity

micro–>macro

Answer 34

micro- schools, worksites, homes

macro- national, state, community e.g. sugar tax

Question 35

community based interventions

Answer 35

• healthy choices easy choices, healthier community environment, tailored to local context
  time frames- need at least 3 years to see effect
• prevention measured in generations

Question 36

systems based community interventions

Answer 36

importance of linkages, relationships, feedback loops, interactions amongst systems parts

• identify elements of community system that promote or prevent obesity
• points of intervention
• use existing resources to combat
• feedback, shared understanding

Question 37

policy interventions

Answer 37

most policies happen outside health care system e.g. transport, taxation, education
-focus on government policy at all 3 levels plus international agreements

Question 38

sugar tax

Answer 38

reformulation to drive food companies to change what’s in their products

Question 39

8 critical actions

Answer 39

1. toughen TV restriction
2. food reformulation targets
3. health star ratings
4. active transport
5. public health education campaigns
6. 20% health levy on sugar drinks
7. national obesity taskforce
8. monitor diet, physical activity, weight