Preventing Obesity

Question 1

Is being overweight or underweight more common globally?

Answer 1

Overweight = 65% of the worlds population live in countries where overweight and obesity kill more people than being underweight

Question 2

What are some of the morbidity issues associated with being overweight or obese?

Answer 2

Obesity doubles the odds of being unable to live a normal active life

Question 3

What is the effect of severe obesity on life expectancy?

Answer 3

Leads to death 8-10 years sooner than in those of normal weight = with every extra 15kg risk of early death increases by about 30%

Question 4

What are the medical issues associated with being overweight or obese?

Answer 4

Stroke, idiopathic intracranial hypertension, pulmonary disease, cataracts, pancreatitis, diabetes, dyslipidaemia, hypertension, no-alcoholic fatty liver disease, gynaecological abnormalities, gall bladder disease, osteoarthritis, cancer, phlebitis, gout

Question 5

What BMI range carries the lowest health risk?

Answer 5

BMI of 21-22 = normal weight

Question 6

What does a BMI of 22-25 carry a risk of?

Answer 6

BMI > 22 = 3x risk of diabetes
BMI > 23 = CHD mortality increased
BMI of 25 = 8x risk of diabetes, 2x risk of CHD

Question 7

What does a BMI of 28-32 carry a risk of?

Answer 7

BMI of 28 = presentation of NIDDM
BMI of 30 = 40x risk of diabetes
BMI > 32 = all causes of mortality doubled

Question 8

What are the health impacts of having a BMI >39?

Answer 8

BMI of 39 = cancer risk doubled

BMI >= 40 = incompatible with normal life

Question 9

What are some features of persistent obesity in men?

Answer 9

Odds ratio is 4.8, not significantly associated with any adverse adult outcomes measures

Question 10

What are some features of persistent obesity in women?

Answer 10

Odds ratio 4.7, predicted higher risk of never having been gainfully employed and not having a current partner

Question 11

What is classed as normal weight?

Answer 11

BMI of 18.5-24.9

Question 12

What BMI is classed as being overweight?

Answer 12

25-29.9

Question 13

What are the different classes of obesity?

Answer 13

Class I (mild) = BMI of 30-34.9
Class II (moderate) = BMI of 35-39.9
Class III (severe) = BMI of 40 or above

Question 14

In what ethnic groups are the ranges for being overweight and obese different?

Answer 14

South Asians, Chinese, Japanese, Black Africans and Afro-Caribbeans = overweight at BMI >23, obese at BMI > 27.5

Question 15

What are the weight centiles in children (aged 2-18)?

Answer 15

Median is 50th centile, <85th centile used for populations
<91st centile is healthy range
91st centile is overweight, 98th centile is obese, 99.6th centile is severely obese

Question 16

What sub-groups are at high risk of developing obesity?

Answer 16

Socioeconomically deprived, rapid weight gainers, obese children (or children with obese parents), post-obese, pregnant, smoking quitters, genetic markers of susceptibility, physical inactive

Question 17

What factors interact to cause obesity?

Answer 17

Heritability = 60% of weight variance
Genetic mutations/polymorphisms = <5% of weight variance
Environment

Question 18

What are some obesity drivers?

Answer 18

Increased supply of cheap, palatable and energy dense food, increased access and convenience of food, increased marketing, decreased access to physical activity opportunities

Question 19

What are the major sub-systems that cause someone to become obese?

Answer 19

Societal influences, individual psychology, food production and consumption, individual activity, activity environment, biology

Question 20

What aspects of the consumer food environment are being targeted for improvement?

Answer 20

Processed food composition, food availability, pricing strategies, informational and promotional environment is more consistent with dietary advice

Question 21

How are food systems being targeted to reduce obesity?

Answer 21

Incentives to produce, distribute and sell healthier products
Opportunities for producers to enter alternative marketing channels for healthier products

Question 22

How can consumer attitudes be changed?

Answer 22

Through education and building skills

Question 23

In what groups is obesity more common?

Answer 23

With increasing age (up until age 75) and deprivation (especially women and children)

Question 24

What are the obesity prevention targets?

Answer 24

Decrease energy intake and sedentary behaviour

Increase physical activity

Question 25

What is the prevalence of obesity?

Answer 25

1/5 of P1 children are overweight or obese, increasing to 2/3 by adulthood

Question 26

What is the role of doctors in preventing obesity?

Answer 26

Set a good example, supports those around you, speak out publicly, know how to recognise obesity, raise healthy weight with patients, be able to explain facts to patients, be aware of support available to patients