assessment of obesity
DESCRIPTION
Assessment of Obesity biochemistryTRANSCRIPT
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Assessment of Obesity
MARYAM JAMILAH BINTI ABDUL HAMID082013100002
IMS BANGALORE
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Learning Outcome
• Definition of obesity
• Assessment of obesity
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Obesity
A medical condition in which excess body
fat has accumulated to the extent that it
may have a negative effect on health,
leading to reduced life expectancy
and/or increased health problems.
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Assessment of Obesity
• Body mass index (BMI)
• Anatomic differences in fat deposition
• Biochemical differences in regional fat
depots
• Size and number of fat cells
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a) Obesity Index/Body Mass Index (BMI)
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a) Obesity Index/Body Mass Index (BMI)A measure of relative weight based on an individual's mass andheight W
H2
W = Weight (kg)H = Height (m)or BMI= (weight in lb)/(height in inches)2 × 703
Nearly 2/3 of American adults are overweight and more than 1/3 are obese
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1 stone = 14 pounds = 6.35 kg
1 kg = 2.2 pounds
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• BMI is accurate most of the time
• However may overestimate or underestimate body fat.
• Does not distinguish between body fat and muscle mass, which weighs more than fat.
• Many NFL players have been labelled "obese" because of their high BMI, when they actually have a low percentage of body fat
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b) Anatomic differences in fat deposition
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b) Anatomic differences in fat deposition• It has a major influence on associated
health risks• Excess fat located in the central
abdominal area of the body is called android, “apple-shaped,” or upper body obesity(greater risk for hypertension, insulin resistance, diabetes, dyslipidemia, and coronary heart disease)
• Waist to hip ratioWomen > 0.8 Men > 1.0
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• In contrast, excess fat in the lower extremities around
the hips or gluteal region is call gynoid, “pear-shaped,”
or lower body obesity
• Waist to hip ratio
Women < 0.8
Men < 1.0
• Commonly found in females (lower risk metabolic
disease)
• Some experts feel that the waist-to-hip ratio is better
than BMI as predictor of myocardial infarction
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80-90% of fat stored in subcutaneous depots (under the skin,abdominal & lower body region)10-20% of fat stored in visceral depots (omental& mesenteric)
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c) Biochemical differences in regional fat depots
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• Men tend to accumulate the readily mobilizable
abdominal fat, they generally lose weight more readily
than women do
• Substances released from abdominal fat are absorbed via
the portal vein and, thus, have direct access to the liver
• Fatty acids taken up by the liver may lead to insulin
resistance and increased synthesis of triacylglycerols,
which are released as very-low-density lipoprotein (VLDL)
• By contrast, free fatty acids from gluteal fat enter the
general circulation, and have no preferential action on
hepatic metabolism
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i. Abdominal fat cells
• much larger
• higher rate of fat
turnover
• adipocytes are
hormonally more
responsive than fat cells
in the legs and buttocks
ii. Lower body fat cells
• much smaller
• lower rate of fat
turnover
• adipocytes are
hormonally less
responsive than fat
cells in abdominal
c) Biochemical differences in regional fat depots
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d) Number of fat cells
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Hypertrophic and hyperplastic
changes thought to occur in severe
obesity
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• When triacylglycerols are deposited in
adipocytes, the cells initially show a modest
increase in size
• However, the ability of a fat cell to expand is
limited, and when its maximal size is reached,
it divides
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• Most obesity is, therefore, thought to involve
an increase in both the number and size of
adipocytes
• Fat cells, once gained, are NEVER LOST
• Thus, when an obese individual loses weight,
the size of the fat cells is reduced, but the
number of fat cells is not affected
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• An obese individual, with increased numbers
of adipocytes, will have to reduce the size of
those fat cells in order to normalize fat stores
• These individuals will be in the doubly
abnormal state of having too many, too small
fat cells
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• Formerly obese patients have a particularly
difficult time maintaining their reduced body
weight
• The observation that fat cells are never lost
emphasizes the importance of preventing
obesity in the first place
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• Assessments of obesity are described
Conclusion
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References
• Lippincott’s Illustrated Reviews: Biochemistry, 4th edition
• DM Vasudevan, Biochemistry Textbook for Medical Students
• http://health.howstuffworks.com/wellness/diet-fitness/weight-loss/bmi3.htm
• http://en.wikipedia.org/wiki/Obesity
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