Obesity and Diet Therapy Overview

Obesity and Diet Therapy

• Obesity is the excess accumulation of fatty tissue.
• Body Mass Index (BMI) is used to diagnose obesity.
  • BMI = Weight (kg) / Height (m)²
  • Example: 150 kg / (1.72 m)² = 50 BMI
• BMI classifications:
  • <18.5: Underweight
  • 18.5-24.9: Normal weight
  • 25.0-29.9: Overweight
  • 30.0-34.9: Class I obesity
  • 35.0-39.9: Class II obesity
  • ≥40.0: Class III obesity
• BMI is not applicable in all cases:
  • Athletes and weightlifters (high muscle mass)
  • Pregnant and lactating women
  • Children
• Alternative Methods for Measuring Body Fat:
  • Triceps skin fold thickness (using calipers): >19-18mm (males), >25-26mm (females)
  • Waist circumference: >102cm (males), >88cm (females)
  • Waist-to-Hip Ratio: <0.9 (males), <0.8 (females) considered normal, otherwise considered obesity.
• Measuring Tools: Calipers, measuring tape.
• Growth charts are used to determine obesity among children.
• Method for estimating body fat percentage (Deurenberg equation):
  • Body fat percentage = 1.2(BMI) + 0.23(age) – 10.8(sex) – 5.4.
  • Age in years. Sex: 1 (male), 0 (female).
  • Standard error of 4%, accounts for approximately 80% of the variation.
• Percentage of body fat definitions:
  • Men: >25%, 21–25% is borderline.
  • Women: >33%, 31–33% is borderline.
• Location of fat: Abdominal/visceral fat is larger, less numerous, and easier to respond to dieting, in contrast to hip fat which requires more effort.
• Factors Influencing Obesity:
  • Energy imbalance (calories in vs. calories out)
  • Hormonal disturbances (hypothyroidism, insulin resistance, leptin resistance, ghrelin)
  • Genetic factors
  • Physiological factors (hunger/satiety imbalance)
  • Psychological factors
  • Birth control pills
  • Increased intake of soft drinks, fried foods, and fast foods
  • Pregnancy and lactation
• Control of Food Intake:
  • Leptin resistance causes feelings of hunger.
• Short-term health problems related to obesity: High blood pressure, high cholesterol, high triglycerides.
• Long-term health problems related to obesity: Arthritis, cardiovascular disease, diabetes, gallbladder disease.
• Obesity Treatment:
  • Before starting a diet, assess height, weight, skin thickness, waist circumference, and use lipid profile, thyroid hormones tests, blood sugar and kidney function.
  • Dietary therapy (hypocaloric diet, high protein diet, high-fiber diet)
  • Dietary advices: Decrease energy dense food and beverages, smaller portions, avoid extra and unhealthy snacks, avoid skipping breakfast or eating late. Energy restriction is essential but should be individually evaluated based on dietary habits, physical activities, co-morbidities, and previous dieting attempts.
  • Healthy meal planning – Adequate, balanced, variety. Carb: 45-55%, Protein: 20-25%, Fat: <25% of total calories.
  • Side effects of severe caloric restriction; hypotension, decrease in muscle mass, easy fatigability, cold intolerance, dry skin, hair loss, menstrual irregularity, cholecystitis.
  • High-fiber/Low-carb diets, and Mediterranean diets; CHO: 50%, Fats: 35%, Protein: 15% (Avoid processed, fatty meats).
  • Ketogenic diet: Very low carb, high fat diet. The body enters ketosis, burning fat for energy, resulting in significant reductions in blood sugar and insulin levels. Fat: 55–60%, Protein: 30–35%, CHO: 5–10%.
  • Behavior modification: Describing behavior, replace with new behaviors, use techniques to control behavior, reward success, change eating habits (triggers to binge eating, plate size reduction)
  • Exercise behaviors: Aerobic, flexibility, and strength/resistance training.
  • Surgery (gastric sleeve, gastric bypass, gastric balloon) for high BMI (>40), comorbidity issues or diet resistance.
• How to avoid obesity: drink lots of water, eat 5–6 small meals every 3–4 hours, eat foods with high fiber content, drink healthy drinks (avoid soda), don’t take more than 3 tsp sugar/day and 3 tsp oil/day, reduce sodium intake, avoid preserved and processed foods, walk 30 min a day.
• Eating habits: intake = expenditure, for a stable weight and live to eat, intake > expenditure, for weight gain.

This quiz explores the concepts of obesity, including its definition, diagnosis through Body Mass Index (BMI), and the classification of obesity levels. It also discusses alternative methods for measuring body fat and the importance of considering various populations when assessing obesity. Join us to test your knowledge on obesity management and dietary therapy!