Approach to Obesity

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Approach to Obesity

• DR.YOUSEF ABDULLAH AL TURKI
• MBBS,DPHC,ABFM
• Consultant Family Medicine
• Associatet professor
• King Khalid University Hospital
• College of Medicine
• King Saud University

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Scenario

• Ahmed 42 years old come to primary care clinic
  complain of bilateral joint pain for the last 6
  month.
• Weight 96 kg
• Height 162 cm
• HOW YOU WILL APPROACH AHMED?

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Calculate BMI for Ahmed?

• BMI weight (kg)/ height (m)2
• BMI for Ahmed 96/(1.62)(1.62)
• 96/2.6244
• 36.58

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Classify Obesity?

• Normal 18.5 - lt 25
• Overweight 25- lt 30
• Obesity grade 1 30- lt 35
• Obesity grade 2 35- lt 40
• Morbid obesity ?????

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How obese patient come to the clinic?

• Opportunistic health promotion
• Complication of Obesity Examples?
• Social reason
• What others?

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What are the prevalence of obesity in Saudi
Arabia?

• National Community based survey
• All different regions in K.S.A
• Adult gt 15 years
• Sample size 13177 adults( male and female).

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Results of the community survey

• BMIgt30 ???
• Male 16 Female 24
• BMI 25-30 ???
• Male 29 Female 27

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How to prevent Obesity?

• The best way to manage obesity in the community
  is to prevent it!!!
• Childhood obesity
• Weaning and feeding
• Health education

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What are the causes of obesity?

• Life styles changes Common
• dietary habits Why?!
• sedentary life
• lack of physical activity
• Genetic factors
• Secondary obesity Examples??

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Scenario

• Khalid 22 years old university student come to
  primary care clinic concern about his weight, and
  want to get drug to decrease his weight very
  soon?
• Weight 112kg height 170 cm
• How you can help Khalid to lower his weight?

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What are the Evidence based approach to decrease
the weight?

• Dietary approach
• - eat small quantity of your suitable food
• - eat fruits and vegetables
• - decrease sweet and fat
• - minimize fast food
• - avoid too much snacks
• - balance diet

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What are the Evidence based approach to decrease
the weight?

• Behavioral approach
• - start from now
• - set a realistic objective 1kg/month
• - always use small plate
• - avoid eating in front of TV
• - avoid shopping when you are hungry

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What are the Evidence based approach to decrease
the weight?

• Physical activity
• - start by increase your daily activity
• - walk for about 30 minute/ day
• - do not seat for long time in front of TV,
  play station, etc
• - choose suitable exercise for your age,
  gender, and time.
• - always think about continuity of programme to
  reach and maintain your ideal body weight for the
  rest of your life.

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Team approach

• Family involvement
• School involvement
• Health team support
• Other community related sectors

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What are the evidence of drug treatment for
obesity?

• Short term effect
• Side effects
• Need close health team supervision
• Not recommended in evidence based approach

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What are the evidence of herbal medicine for
obesity?

• The contents of herbal medicine in the
  markets????
• Side effects
• Not recommended because Lack of scientific
  evidence and possible side effect

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What are the evidence of surgical approach?

• Could be an option for morbid obesity if dietary
  and exercise approach fail after 12 month of real
  trial under health team supervision.
• Start and continue all the life time by dietary
  and behavioral approach for all patient.
• Side effect ?? discuss with patient advantages
  and disadvantages

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CONCLUSIONS

• The best way to decrease the prevalence of
  obesity is to prevent it.
• Dietary, behavioral and exercise had long term
  effects to maintain ideal body weight.
• It is important to involve entire family when
  treat obesity.

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WITH MY BEST REGARDS