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Obesity and Your Daily Life Wen Jie Zhang, MD, PhD Professor of Pathology School of Medicine, Health Sciences and Engineering Susquehanna Township High School Lecture Series Week 1, August 2014 Clinical Relevance of This Weeks Topic

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Screening for Cervical Cancer in China

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Teaching and Learning Strategy Scientific Research Reports/Articles Introduction/Background Identifying a disease to study Diagnosis, Treatment, Prevention, etc. Materials and Methods Mice/Patients, Reagents/Device/Tests Results Measurements obtained and analyzed Discussion (and Conclusion) The results meaning, significance, and conclusion(s) References/Further Readings

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Learning Objectives What is obesity Consequences of obesity How to measure obesity How to classify obesity Obesity control and prevention

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Session 1 Introduction

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Obesity An Individuals Challenge Daily news in public media Intense scientific reports Commercial Ads on fat reduction An Individuals questions: Am I overweight or obese? What to eat/drink and what not to? Should I be on diet? How should I exercise to reduce weight? Should I consult a doctor for advice?

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Which one is your favorite?

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More, please!

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Should I do it ?

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The Worlds Largest McDonalds Built on April 23, 1992 Beijing China (~Tiananmen Sq) 29 cash registers 700 seats 40,000 customers/1st Buz day

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Buddy, Do I have a piece?

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Definition of Obesity A medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health risks. Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to measure/classify underweight, overweight and obesity in adults.

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Body Mass Index (BMI) BMI is defined as the weight in kilograms divided by the square of the height in meters (unit=kg/m 2 ). Formula: BMI = mass (kg) height (m) 2 = kg/m 2 Example: BMI = 68.2 kg (1.7m) 2 = 68.2 2.89 = 23.6 kg/m 2

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Table 1: The International Classification of adult underweight, overweight and obesity according to BMI ClassificationBMI (kg/m 2 ) Principal cut-off points Additional cut-off points Underweight18 BMI-associated loci shared by European and East Asian ancestry populations FTO (Fat Mass and Obesity Associated) gene Leptin (adipo-cytokine) gene

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Consequences of Obesity Increased mortality Increased health risks Hypertension, coronary heart disease, stroke Type 2 diabetes Dyslipidemia Sleep apnea and respiratory problems Gallbladder disease Osteoarthritis Cancers (10 common cancers including colon, breast, endometrial) (2014 Lancet journal report)

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Treatment of Obesity Bariatric (fat reduction) surgery Most effective Long-term weight loss Decreased overall mortality Medications Modest weight loss (2.9 kg [6.4 lb]) in 1 to 4 years Side effects concerns Gene therapy?

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Prevention of Obesity Dietary change Lower food energy diet (long-term or permanent) Limit weight gain more than weight loss Physical exercise Long-term or permanent Limit weight gain more than weight loss

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Session 5 References/Literature (Further Readings)

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References/Further Readings The Obesity Society http://www.obesity.org/ http://www.obesity.org/ World Health organization (WHO) Global Database on Body Mass Index http://apps.who.int/bmi/index.jsp http://apps.who.int/bmi/index.jsp The Scientific American (journal) Popkin BM. Sci Am, 2007 Sep;297(3):88-95

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Key Words Learned Obesity Body Mass Index (BMI) Epidemic / Pandemic Genetic susceptibility Life expectancy Bariatric surgery Dietary change Physical activity

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Your Private Project Based on what you have learned, figure out your daily food consumption and make yourself a plan for healthy diet and physical activities. Measure your BMI on a fortnightly or monthly basis to monitor your body weight. Serve as a physician for your family members and monitor their BMI monthly

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The End