The Obesity/Diabetes Epidemic: Perspectives, Consequences, Prevention, Treatment

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The Obesity/Diabetes EpidemicPerspectives,
Consequences,Prevention, Treatment

• Stan Schwartz MD, FACP, FACE
• Private Practice, Ardmore
• Obesity Program
• Cardiometabolic Diabetes Center and Affiliate,
• Main Line Health System
• Emeritus, Clinical Associate Professor
• University of Pennsylvania

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The Obesity/Diabetes EpidemicPerspectives,
Consequences,Prevention, Treatment
Part 2

• Stan Schwartz MD, FACP, FACE
• Private Practice, Ardmore
• Obesity Program
• Cardiometabolic Diabetes Center and Affiliate,
• Main Line Health System
• Emeritus, Clinical Associate Professor
• University of Pennsylvania

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Outline

• Epidemiology and Economics of obesity/diabetes
• Perspectives on Obesity
• Consequences of Obesity, Prediabetes, Obesity
• Obesity/ Diabetes Risk Factors,
• Obesity/ Diabetes Onset can be Prevented or
  Delayed Early Risk Identification and
  Intervention.
• Medical Benefits to Weight Loss
• Treatment-CDCs diabetes prevention program and
  other Evidence-Based Interventions-
• Basics,
• Next Lecture in Series

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Perspectives on Obesity

• Moral problem?
• NOT- Must not blame an individual for issues
  they cannot have complete control over- ie
  Their genes!
• Psychological problem? Aesthetic problem?
• culture based- self perception/esteem
• Medical problem!
• Public health problem! Increased Societal
  Cost

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Cultural Defintions Change Over Time
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Components of Total Daily Energy Expenditure
8
8
17
32
75
60
Sedentary person (1800 kcal/d)
Physically active person (2200 kcal/d)
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Obesity Is Caused by Long-Term Positive Energy
Balance

• Fat
• stores

Energy expenditure

Energy intake
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Cumulative Effect of Small Daily Errors in Energy
Balance on Body Fat Mass
Leads to 100 cal/ day 1 lb/m rule And
patients are NOT pigging out
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Regulation of Body Weight

• Genes confer the potential for obesity.
• Environment determines whether and to what extent
  the potential is realized.

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Thrifty Genes Contribute to Morbid Obesity

• Genetic factors account for 80 percent of a
  persons tendency to develop obesity.
• These thrifty genes are designed to protect us
  from starvation by allowing us to store large
  amounts of energy in the form of fat when food is
  abundant.
• This is the first time in human history that food
  has been so abundant.
• The age-old advantage of thrifty genes has been
  influenced by our unique environment to cause
  disease.

Kaplan L. Body Weight Regulation and Obesity.
Journal of Gastrointestinal Surgery
20037(4)443-451.
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