BE FITNESS&HEALTHY

1. Dr. Gad Allah Modawe, PhD
Assistant Proforessor of Biochemistry

2. • Obesity occurs when energy intake from
food and drink consumption is greater than
energy expenditure through the body
metabolism and physical activity over ametabolism and physical activity over a
prolonged period, resulting in the
accumulation of excess body fat .

3. energy
intake from
food and
drinkdrink
energy expenditure
through
metabolism and
physical activity

5. Causes of obesity :
• 1-Lack of energy balance :
• Energy balance means that energy IN
equals energy OUT .

6. 2-An inactive sedentary life

8. • 3-Environmental factors : fast foods, and
lack of access to healthy foods .

9. • Lack of sidewalk,

10. • 4-Genes and family history .

11. • 5-Hormonal disturbances : Hypothyroidism,
Cushing syndrome, and Polycystic ovarian
syndrome .

12. Hypothyroidism

13. • 6-Medicines : Corticosteroids ,
Antidepressant, and Seizure medicine .

14. • 7-Emotional factors : Some people eat more
than usual when they are bored, angry or
stressed.

15. • 1-Lack of energy balance
• 2-An inactive sedentary life
• 3-Environmental factors : Lack of sidewalk,
fast foods
• 4-Genes and family history .
• 5-Hormonal disturbances : Hypothyroidism,• 5-Hormonal disturbances : Hypothyroidism,
Cushing syndrome.
• 6-Medicines : Corticosteroids ,
Antidepressant, and Seizure medicine .
• 7-Emotional factors : stress.

16. Indicies of obesity :
• 1- Relative weight =
patient weight .
standard weight based on the patient height.

18. 2-Body mass index (BMI )
• It means weight ( kg ) / height ( m 2.)
• WHO classified the weight according to body
mass index (BMI) into:
 BMI <18.5 %. Under weightBMI <18.5 %. Under weight
 BMI 19-24.9 % Normal weight
 BMI 25-29.9 % Overweight
 BMI 30-35 % Obesity class I .
 BMI 35.0-39.9 %. Obesity class II
 BMI > 40 % Obesity class III

20. 3- Skin folds:
• Skin fold thickness is indicating obesity if
exceed 25 mm in women, normally from 10-20
mm or 20 mm in men, normally 7-18mm.

21. 4- Circumferences:
• the waist-hip ratio (WHR ).
• The waist circumference is the narrowest
circumference below the rib cage and above
the umbilicus.the umbilicus.
• The hip circumferences the largest
circumferences at the posterior extension of
the buttocks.

23. • A waist circumference of greater than 102 cm
in men and 88 cm in women is a risk factor
for insulin resistance, diabetes mellitus and
cardiovascular disease.cardiovascular disease.
• WHR exceeds 0.85 for female and 0.90
for male indicate predominant abdominal fat
distribution

24. Indicies of obesity
• 1- Relative weight
• 2- Body mass index (BMI )
• 3- Skin folds• 3- Skin folds
• 4- Circumferences: the waist-hip ratio

25. Weight management
1.Primary prevention of excess weight gain
2.Weight loss (usually completed within three to
six months).
3.Prevention of weight regain (from three to
six months onwards).

26. Prevention of excess weight gain :

29. Prevention of excess weight gain :
• 1-Reduce the intake of energy gain foods
(animal fats and sugar drink )
 2-Select low energy foods (whole grain
cereals, vegetables, fruits )
 3-Reduce consumption of fast foods

30.  4-Reduce alcohol intake.
 5-Increase the physical activity and avoid
sedentary life .

31. Weight loss :
 1-Dietary interevention : reduce a 600
Kcal/day

35. • 2-Physical activity : 225 - 300 min/ week
which is equal to 1.800 - 2500 Kca/week.

36.  3-Pharmacological treatment : Orlistat
reduces the absorption of energy dense
foods by inhibiting gastric and pancreatic
lipase.

37. 4-Bariatric surgery
• especially in patients with BM > 35 Kg/m2
and those who have severe comorbidities .

38. Weight loss :
 Dietary interevention
 Physical activity
 Pharmacological treatment. Pharmacological treatment.
• Bariatric surgery

39. Health benefits of weight loss :
 reduced blood pressure.
 improved lipid profiles.
 improved glycaemic control. improved glycaemic control.
• lowered all-cause, cancer and diabetes
mortality in some patient groups
• reduced osteoarthritis-related disability.

40. Case
• A female complains of type 2 diabetes
mellitus, her weight was 121 kg and her
height was 161 cm.
• A.Calculate the BMI for her.• A.Calculate the BMI for her.
• B.Comment on her BMI.
• C.How to manage this case?
• D.Mention investigation that must be done?

41. A.Calculate the BMI for her.
• BMI =weight ( kg ) / height ( m 2.)
• BMI= 121 / ( 1.61 2)=46.7

42. B.Comment on her BMI.
• Her BMI= 46.7 %.
• The patient is obesity class III as BMI > 40 %

43. C. How to manage this case?
1.Primary prevention of excess weight gain
• 1-Reduce the intake of animal fats and sugar
drink
 2-Select low energy foods (whole grain 2-Select low energy foods (whole grain
cereals, vegetables, fruits )
 3-Reduce consumption of fast foods
 4-Reduce alcohol intake.
 5-Increase the physical activity and avoid
sedentary life .

44. 2- Weight loss
a-Dietary interevention : reduce a 600 Kcal/day
b-Physical activity : 225 - 300 min/ weekb-Physical activity : 225 - 300 min/ week
c-Pharmacological treatment : Orlistat
d-Bariatric surgery
3-Prevention of weight regain

45. D. Mention investigation that must be
done?
• Investigations for diabetes:
• Glycosylated haemeglobin HbAlc: to monitor
the long-term control of diabetes within 6-8the long-term control of diabetes within 6-8
weeks.
• Fructosamine: It is indicated for follow up
control of diabetes with 2-4 weeks.

46. • Investigations for detect causes of obesity:
• Level of thyroxin hormone and adrenal gland
hormone for exclude hypothyroidism and
Cushing syndrome.Cushing syndrome.

47. • Investigations for diabetes and obesity
complications:
 Microalbuminuria (for incipient diabetic
nephropathy).nephropathy).
 Serum creatinine (in established renal disease).
 Lipids ( because of the risk of
atherosclerosis).
 Cancer biomarkers if suspected.