WHS PR Symposium - Management of Adult Obesity

8/10/2019 WHS PR Symposium - Management of Adult Obesity

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Management of Adul

ObesityDr. Margarita Ochoa-Maya, MD, CDE

Advanced Health and Wellbeing, C

!!!.AdvancedHealth"H.com


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OBESITY IS A DISEASE

Obesity afects 1 in three Americans

# out of $ adults in the %nited &tates are over!

The medical cost o OBESITY:

'et!een ()*+ 'O" to (#) 'O" /er year

Obesity is estimated to cause 111,! to deaths$yr

0une #)$1 American Medical Association and AAssociation of Clinical Endocrinologists 2AACE3reco%ni&ed OBESITY as a DISEASE


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T'E DE(I)ITIO) O( OBESIT

Obesity is:

A chronic disease

In*uenced by determinants such as:

4enetic and family history

Culture and both familial and /ersonal enviro

'ehavior and emotions Hormones

Body mass that e+ceeds a re-de.ned /

multifactorial


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OBESITY, A 0EA 20OBE3 (O0T'E )E4 3IE)I53

Obesity is a reality 6e are all acin% today, It DISEASE and it is an E2IDE3I78 5he World Health Organi6ation

5he "ational Heart, ung and 'lood nstitute of the "ational nstitutes of

5he American Medical Association

1 I) " Americans is afected by obesity, and 6

disorders #78 of Adult Americans have e9cess !eight and are obese

The re/alence o obesity has increased more9! in the ast decade


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OBESITY, A 0EA 20OBE3 (O0)E4 3IE)I53

It is estimated that more than " million Americans areby obesity

t is also estimated that this number 6ill climb to )# millionne9t 7 years

This eidemic needs to be addressed as it is a tic;bomb or the uture de/eloment o comlicationschronic illness:

m/act the biological, /sychological and s/iritual 6ellbein%individual

m/act the family unit and the community

m/act economy

m/act the utureof human:ind


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T'E I)< BET4EE) 4EI='T 3A)A=E3E=E)ETI7S, E)>I0O)3E)T A)D 'O03O)

=E)ETI7S

E)>I0O)3E)T

"5E;"A E"


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T'E I)< BET4EE) 4EI='T

3A)A=E3E)T A)D 'O03O)ES

'O03O)A DISO0DE0S I)s &yndrome

&lee/ Cycle Disorders1 &lee/ A/nea


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T'E I)< BET4EE) 4EI='T

3A)A=E3E)T A)D 'O03O)ES

'O03O)A BAA)7E IS )E7ESSA0Y (O0 'EAT'Y3AI)TE)A)7E:

7entral )er/ous System and the Brain

Cognitive choices in food

=astrointestinal System

?rom che!ing and the s/eed of eating to absor/tioelimination

0eroducti/e System

5he in@uence of E&5;O4E", ;O4E&5E;O"E and5E&5O&5E;O"E on !eight management, fertility a


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'ISTO0I7A, 75T50A A)DA0TISTI7 AS2E7TS O( OBESITY

5hroughout history of man:ind, food shortage and malnutrition habeen the recurrent theme

Ad/ances in ublic health, aired 6ith the increased amou?uality, and /ariety o ood, has had an imact on increaselon%e/ity and body si&e@

'eing under-nourished as !ell as obese has social im/lications andconnotations

7orulence and increased *esh ha/e been desirable acrothe centuries as a si%n o 6ealth

After the &econd World War, overabundance of easily accessible focou/led !ith reduced /hysical activity resulted in increased body !

Durin% the ost 6ar era, this ositi/e connotation on bein%or robustC 6as re*ected in the arts, literature, and medica

oinion o the times


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Durin% the 1th

7entury, Dr@ Tobias >enner .rst used the termOBESITY in a study ublished in 1#9!

He lin:ed diet and dietary /atterns !ith obesity and disease

Durin% the 1th7entury, Dr@ 4illiam 4add I)

Durin% the year 1FG, Dr@ Burney stated that desite thesensation o hun%er 6as eltC in the stomach, it ori%inated B0AI)@

He se/arated the conce/ts of H%"4E; A"D AE55E

He stated that both doctors noted that dietary changes should be basedindividualBs uniue reuirements concerning age, gender, and activity le


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Durin% the G!th7entury the incidence and re?uency o obe

be%an to increase and become 6idesread

4ei%ht issues in 6omen 6ere addressed seci.cally by Dr@ and e/enthal in 1"9

5hey described a syndrome s/ecic to !omen characteri6ed by obesityinfertility and named it olycystic Ovarian &yndrome 2CO&3

5hey claimed CO& !as one of the leading causes of anovulatory infert

5hey also re/orted the benecial eects of !eight loss as a treatment oillness

In the 1F!Hs, 3etroolitan ie Insurance, ublished a cha6here the ideal 6ei%hts or /arious hei%hts estimated an id

nsurance com/anies reali6ed the connection bet!een !eight and lifee9/ectancy and increased /remiums for the obese and the stigma arouobesity began.


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'ISTO0I7A, 75T50A A)DA0TISTI7 AS2E7TS O( OBES In une o 19# ate 2resident Eisenho6er

created the 2residentCs 7ouncil on Youth (itn t !as a /ublic a!areness cam/aign that brought to light the increasing

/roblem !ith obesity

t !as a /ioneer for further studies that !ould address the !orld of obevarious diet and e9ercise /rograms emerged

By 1#, researchers reco%ni&ed that 6ei%ht

needed to be addressed in the settin% o aersonCs hei%ht 5he 'ody Mass nde9 2'M3 !as created

'M is a statistical calculation and inde9 !hich !ould /redictably determ/erson is obese or not based on not only their !eight but in relation to height


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4EI='T 3A)A=E3E)T A)DOBESITY I) T'E G1ST7E)T50

Obesity is the eidemic o the G1st century Obesity oses a maJor ublic health issue@5here are

increased /ersonal, familial, social, and economic costsassociated !ith obesity.

obesity is no longer a problem of adults, the rate a!hich obesity is aecting children is e9/onential, and yand younger children are being aected by obesity

The 4orld 'ealth Or%ani&ation estimates th%lobally:

More than ) billion over!eight adults that have a 'M gthan #+

Of those that are obese, $ million have a 'M greater

$.


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T'E STI=3A O( OBESIT Indi/iduals afected by 6ei%ht roblem

obesity oten ha/e to ace obstacles behealth ris;s associated 6ith obesity its

Emotional suering is one of the most /ainfbeing obese

Today, e+cess 6ei%ht is re%arded as un

and oten associated 6ith ne%ati/e ste eo/le of all ages and cultures face social

stigmati6ation, may be targeted by bullies, oby their /eers

4ei%ht is a%ain ti%htly lin;ed to social and accetance and is considered a readiscrimination@


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T'E STI=3A O( OBESIT &tigmati6ation is /resent in elementary, high school, c

the !or:/lace Over!eight students are vie!ed as self-indulgent>, la

usually e9cluded from social activities

2eer /ictimi&ation is reorted in as many as #"and 9 o boys

At least $8 of over!eight girls and #*8 of over!eigre/ort being teasedby /eers at school

Teachers reort that students aected by obesity aras untidy, more emotional, less li:ely to succeed in scmore li:ely to have family /roblems

O/er6ei%ht children are less li;ely to be accetri/ate schools and colle%e desite e?ui/alent arates and academic achie/ement


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7O)SEK5E)7ES O( 'EATA)D OBESITY BIAS

2SY7'OO=I7A E((E7TS: &hame, An9iety, o! &eesteem, oor body image, oor inter-/ersonal relationDe/ression, ost-traumatic &tress Disorder

SO7IA E((E7TS: &ocial reFection by /eers, isolationcommunity involvement, /oor uality of inter/ersonalrelationshi/s, increased divorce rate and /otential neg

im/act on family life, /otential negative im/act on deand or /oor academic outcomes.

2'YSI7A 'EAT' E((E7TS: %nhealthy !eight con/ractices, binge eating, avoidance of /hysical activityrates of inFury during /hysical eorts, less endurance /hysical activity tolerance.


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(A7TO0S TO BE 7O)SIDE0ED 4ADD0ESSI)= T'E OBESITY E2ID

4enetics

arenting and family life

sychological s:ills of theindividual and the family

Gno!ledge and education

about food, health andhealth /revention

&ocioeconomic status

&

hys

Cultural inchoices

?amilial inavailabi

Who /re/aresthe


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T'E 0OE O( 3O)EY A)DOBESITY o!er-cost foods ma:e u/ a greater /ro/ortio

diet of lo!er-income individuals In 5@S@ Deartment o A%riculture L5SDA

studies, emale reciients o ood assista

More energy-dense diets

Consumed fe!er vegetables and fruit Were more li:ely to be obese

2Darmon ", Dre!no!s:i A1 Does social class /redict diet uality AmI+1))+J)))+, #I3.


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7'ID'OOD OBESITY

The o/erall re/alence ochildhood obesity continued toincrease durin% the .rst hal othis decade:

in #1 )*8

in #*1 )+8

in #)#1 #)8

7hildho

)on-'

#8 in boys #

3e+ic

##8 in boys )

)on-'

)L8 average fo

2Harris GM, 4ordon-arsen , Chantala G, %dry ;1 ongitudinal trendsdis/arities in leading health indicators from adolescence to young ad

ediatr Adolesc Med )L1+*JI), #L3


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2'YSI7A A7TI>ITY A)DOBESITY

eo/le tend to model the /hysical activity of thei E9ercise habits follo! familial clusters

4ith increasin% a%e the trend demonstrateshysical acti/ity decreases

ncreased television, com/uter, and internet vi

times Decreased slee/ time is associated !ith increa

obesity rates


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BODY 7O32OSITIO): In order to measurebody, 6e need to understand its comon

The body is comosed o: Muscle tissue

?at tissue

Connective 5issue

&:eletal bones and teeth

'rain and nerves

Contents of digestive tract, including intestinal gas, air in thurine, lym/h, and blood.

3ost o the human body is made u o 6ater@ 5he cells arof L7-K8 !ater by !eight. 5herefore, it isnBt sur/rising that mhuman bodyBs !eight !ill have a tight re/resentation to their to!eight.


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T'E DI((E0E)T


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T'E B3I 7E)TE0ED DE(I)ITIO)O( 4EI='T A)D OBESITY

n the )Kth century the 'elgian statistician Dr. Adol/he Nuetelet

develo/ed the body mass inde9

'M-based denition is easy to use and it is /articularly conveniestatistical /ur/oses and use in research.

5he most commonly used denitions, established by the World HOrgani6ation 2WHO3 in )KK+ and /ublished in the year # /rovcurrent classication of obesity based on the 'M.

2OTE)TIA 2IT(AS: t considers !eight and height yet it does not consider &HAE

gnores EA" 'ODP MA&& as a measure of M%&CE MA&& and 'ODP ?A/ercentage as !ell as WA5E; WE4H5 and !ater retention


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BODY 3ASS I)DEN7ASSI(I7ATIO)BODY 3ASS I)DEN 7ASSI(I7ATIO)

Q)I.7 %nder!eight

)I.7 J #*.K "ormal !eight

#7. J #K.K 2#+3 Over!eight

$. J $*.K CA&& O'E&5P

$7. J $K.K CA&& O'E&5P

R *. CA&& O'E&5P

&ome modications to the WHO denitions have been made by /articsurgical literature brea:s do!n class obesity into further categoriesvalues are still dis/uted. 2&turm ; 20uly #+3. Sncreases in morbid ob#J#7S. ublic Health )#) 2+31 *K#JL.3


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BODY 7O32OSITIO) A)AYSISEssential Body (at The ercenta%e o essential at is G9 in men, and 1!1" in

There is no sin%le ideal ercenta%e o body at or e/eryone, it individuali6ed and the levels of body fat vary based on se9 and age as and :ind of /hysical activity

5he American Council on E9ercise 2not an oTcial government agency3 average /ercentages dier according to the s/ecied grou/s and categ

5he leanest athletes ty/ically com/ete at levels of about LJ)$8 for mefor !omen, the a/era%e erson has a at le/el o G or men an6omen

DES70I2TIO) 4O3E) 3E)

Atheletes )*-#8 L-)$8

?itness #)-#*8 )*-)+8

Obese $#8 U #78 U


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4AIST TO 'I2 0ATIO (AT DIST0IB5TIO): the !ay in !hich the fat is distributed in

has an in@uence on the ris: of disease

4AIST TO 'I2 0ATIO: Measurements of the !aist and of the observing their relationshi/ is an anthro/ometric measuremendetermine central obesity - fat in the abdominal region and the

5his measure has been !idely used in research and has been sho!com/arable and sometime better than 'M in its /o!er to /redict tmetabolic abnormalities such as ty/e diabetes and cardiovascula

5he !aist to hi/ ratio is commonly used in clinical /ractice and

used to /redict future medical /roblems and com/lications of o 3easurements that ha/e increased ris; o diabetes, car

disease, and $ or other serious illness in men and 6ome

3E) 4O3E)

Waist Circumference R* inches R$7 inches

Waist to Hi/ ;atio R). R.I


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T'E I)< BET4EE) OBESITY A)=E)ES 4ei%ht roblems and obesity are a conse?uence o

interlay bet6een a ersonCs o6n %enetic redisositand the en/ironment in 6hich it li/es@ These actorsafect multile %enes@

5o loo: at genes associated !ith being or becoming obes4enes that regulate a//etite, genes res/onsible for

metabolism and energy balance

As o G!!#, more than F1 sites on the human%enetic code 6ere lin;ed to the de/eloment oobesity

articularly if the environment !as conducive to activa

the genetic /redis/osition. En/ironment has beenassociated 6ith a F!-! in/ol/ement in the

de/eloment o obesity@


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T'E I)< BET4EE) OBESITY A)=E)ES I)'E0ITA)7E 2ATTE0)S:5o identify genetic abnormalities th

/resent in the form of obesity

4E"E5C C%&5E;& A;5C%A; 4E"E A'"O;MA5E&

The Pthrity %ene hyothesisQ: t /ostulates that humanevolution has had /eriods of famine, alternating !ith /eriods ofabundance.

5his may ma:e /eo/le /rone to obesity. During /eriods ofabundance, there is a /redis/osition to store energy and

/romote obesity, and this !ould /rove advantageous in/re/aring for the times to come.

Once a society or culture established a stable food su//ly, !create an e/idemic in obesity.


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=E)ETI7 SY)D0O3ES O(OBESITY 4E ESTABIS'ED =E)ETI7 SY)D0O3ES: Early onset of se

obesity, !hen a child younger than ) years of age has a 'M grethan 5H;EE standard deviations above normal

+8 harbor single locus mutation

SY)D0O3I7 OBESITY1 obesity associated !ith a genetic disord

Do6n Syndrome 2Do!n syndrome is not al!ays associated !obesity, yet it increases the ris: for obesity3

2rader-4illi syndrome

'ardet-'iedl syndrome

Cohen syndrome

Aya6i syndrome

MOMO syndrome


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=E)ETI7 SY)D0O3ES O(OBESITY Other %enes associated 6ith obesity include:

etin De.ciency 2OMM )L*)L ocus +$).$3

etin 0ecetor De.ciency 2OMM L)+ ocus )/$)3

2ro-hormone 7on/ertase-1 De.ciency 2OMM LK77 ocus 7

2ro-oio-melanocortin De.ciency 2OMM LK+$* ocus #/#$.$3

3elanocortin -F 0ecetor L37F0M 2olymorhism 2OMM )777*)I##3


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3ETABOIS3: T'E I)< BET4E'O03O)ES A)D 4EI='T 3etabolism is the act o maintainin% lie throu%h the u

ener%y t is a collection of chemical reactions that allo! organism

re/roduce, and maintain its structure and relate to their e

Anabolism: creation and /roduction of energy sources tand used later

7atabolism: brea:ing do!n and using u/ energy

3etabolic rate:5he heat that is liberated during metabolicreactions

7alorieLsM: A unit of measure that denes the uantity of enfrom dierent foods or e9/anded by dierent functions of the

Ener%y balance: the dierence bet!een the amount of caloand the amount of calories the body uses


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3ETABOIS3: T'E I)< BET4E'O03O)ES A)D 4EI='T

The relationshi bet6een metabolic rates, ener%y ba6ei%ht chan%es is /ery comle+@

Hormones are inherently attached to the !ord metabolism

metabolism is tightly lin:ed to body !eight, body function a/erformance

'ormones, roteins, and other chemicals are crucial

controllin% ener%y e+enditure, ood inta;e, and bod 5he brain centers regulate energy e9/enditure and tissues t

the body by communicating !ith the gastrointestinal systemtissue, and muscles to control energy e9/enditure and ener

6e cannot redict the efect o alterin% only one oactors on body 6ei%ht as a 6hole


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(A7TO0S T'AT I)(5E)7E E)EEN2E)DIT50E

0estin% 3etabolic 0ate: contributes V+8 of daily energy e9/en/hysical activity contributes 7-)83 J 5his means that a signicant energy usage and consum/tion is 9ed3

The ener%y cost of metaboli6ing and storing food

The temerature efect of the body during rest, illness and e9erc

Adati/e thermo%enesis:5he ada/tation of tem/erature and enregulation ha//ens in the bro!n fat>

'ro!n fat uses stored energy to create heat and therefore /romotes !e

White fat stores energy in the form of li/ids 2fat molecules3

5he balance bet!een !hite fat and bro!n fat is being actively investiga

We do :no! that bro!n fat decreases !ith age, and the balance bet!eeres/onse to chronic caloric inta:e as !ell as genetic /redis/osition


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I)(5E)7ES I) (OOD 7'OI7ES

Indi/idual 2reerence: e9/osure, /ast e9/eriences, tradition

Social In*uences: cultural shared beliefs and values, mar:et 7ultural 2reerenceand identity !ithin a grou/

0eli%ious 2reerences and Holidays

Economic In*uences on aordability and allocation of mone

En/ironmental in*uences:

Social: /arental, school and !or: environment

Internal: emotions and feelings, boredom

Biolo%ical en/ironment: llness, /uberty, menstrual cycleaging

2olitical In*uences: ta9ation, industriali6ed farming, subsidilabeling


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)O50IS'3E)T A)D T'EDI((E0E)7ES 4'E) DIS75SSI)

OBESITY "ourishment is the food or other substances needed for grhealth and /revention of disease. 3alnutrition is 6hen a erson does not ha/e a diet t

contains the ri%ht amount o nutrients or is unable tabsorb them rom the %astrointestinal tract@

oor nutrition can also refer to under-nutrition> !hich mea

/erson is not getting enough nutrients, des/ite adeuate inof calories.

5his ha//ens !hen a /erson consumes a lot of em/ty calories!ithout good nutritional value.


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OBESITYSI=)S O( 5)DE0-)5T0ITIO) I)75DE: Wea: muscles, decreased muscle mass

Chronic fatigue, chronic muscle soreness

o! mood, de/ression, @at aect, and the o//osite suddenirritability and mood changes

ncrease in illnesses and infections due to an altered immustate

Decreased healing of s:in

Changes in hair te9ture, uality and color


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OBESITY(A7TS: $ /ercent of American diets fall short of such common /lant-derived nutrmagnesium,


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4%5 "5E4;5P A"D O'E&5P


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=5T I)TE=0ITY A)D OBESITY

Disru/tion of gut lining

m/ro/er absor/tion

n@ammation

ermeable gut- "D'

?ood ntolerances

?ood Allergies


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T'E I)< BET4EE) 'O03O)ES4EI='T Body 6ei%ht is re%ulated by hormones and the ner/ous sys

6hich to%ether they orchestrate a balance bet6een ener%y

ener%y e+enditure 5nder normal circumstances:

When a /erson is overfed, a//etite !ould fall and energy e9/enditure

When a /erson is food de/rived, a//etite increases and energy e9/end

f this e9uisite balance is disturbed, !eight imbalance and obesity ensues.

Aetite is in*uenced by sycholo%ical actors, cultural ac

amilial beha/iors 'ormones that ha/e efects on the brain, the %astrointestin

the ancreas, the li/er and the adrenal %lands include:

A22ETITE STI35ATO0S: le/tin, insulin, glucose, :etones, cortisol, gP, cholecysto:inin, neuro/e/tide P, MCH, Ag;, Ore9in, Endocannabino

A22ETITE 7O)T0OE0S: M&H, CA;5, 4-), and &erotonin

T'E I)< BET4EE) T'E B0AI) (OOD


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T'E I)< BET4EE) T'E B0AI), (OOD'EAT': hormones that ma;e the con

Si%ht , smell, te+ture and en/ironment are all sensed by the brain .rst

The brain reares the body or ood, anticiate and desire ood "otice the dierence bet!een H%"4E;, AE55E A"D &A5E5P and MOOD

?ood stimulates the /leasure and re!ard centers of the brain

Ener%y balance re?uires an ability o the brain to detect the status oener%y stores and match ener%y inta;e 6ith e+enditure

T'E =57OSE BAA)7I)= 'Y2OT'ESIS: nsulin and 4lucagon

T'E (AT BAA7I)= 3ODE: e/tin, 4hrelin, Adi/onectin,

T'E )5T0IE)T 3ODE: 4astrointestinal absor/tion, hormones and function oindividual organs1 4astrin, Cholecysto:inin,


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=AST0OI)TESTI)A 'O03O)E

5he gastrointestinal tract secretes hormones that control of feeding athey have a direct access to the brain

7'OE7YSTO


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'O03O)ES (0O3 T'E ADI2OSETISS5E E2TI):

3ade by the Adiocyte to communicate to the brain abo

ener%y stores crosses the blood-brain barrier Eects on the hy/othalamus, brain stem, and feeding and

centers 2


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'O03O)ES (0O3 T'E ADI2OSETISS5E ADI2O)E7TI): adiocyte comlement-related roteinC

5he adi/onectin gene 2AM)3 has been ma//ed to chromosome $#+

3ade by the Adiocyte to communicate to the brain aboener%y stores DOES )OT cross the blood-brain barrier

&5M%A5E& E"E;4P E=E"D5%;E

;ED%CE& ?OOD "5AGE

E"HA"CE& "&%" &E"&5


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SEE2 OBESITY A)D 7'0O)I)ESS Slee deri/ation has a direct and ne%ati/e imact on a er

health, their 6or;, and 6or; erormance

Decreases the ability to concentrate

m/acts inter/ersonal relationshi/s and limit social interactions and acti

5here are more than + slee/ disorders described in the medical literatu

(acts about Slee related Disease:

&lee/ /roblems account for an estimated ()L billion in medical costs eacause lost /roductivity at !or: Jarge indirect costs

At least * million Americans suer from chronic, long-term slee/ disord

) in $ /eo/le in the %nited &tates has used some :ind of a slee/ aid

roblems li:e stro:e and asthma attac:s tend to occur more freuently dnight and early morning, /erha/s due to changes in hormones, heart rathormonal shifts of the circadian rhythm.

"eurons that control slee/ interact closely !ith the immune system, thude/rivation is associated !ith immune /roblems.

2SY7'OO=I7A 7A5SES O( 4


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2SY7'OO=I7A 7A5SES O( 4DISO0DE0S

Obesity is one of the nationBs fastest-gro!ing and most troubling h/roblems today

Emotions are tightly lin:ed to eating, and for that matter, under-eand overeating

What !e do and donBt do often results from ho! !e thin: and feel- strean9iety

%nless a /erson is able to ma:e the reali6ation that their emotions

lin:ed to their a//etite and !hat they eat, and address these emo!ith healthy co/ing s:ills, serious health /roblems may be aconseuence of emotional eating.

EATI)= DISO0DE0S


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EATI)= DISO0DE0S Hormones are closely lin:ed to a//etite, mood, and im/ulse control, !hic

all altered in /eo/le !ith eating disorders

A)O0ENIA )E0>OSA: eo/le !ith anore9ia nervosa have a distorted boimage that causes them to see themselves as over!eight even !hen thedangerously thin.

5hey tend to be /erfectionistic, and often refuse to eat, e9ercise com/ulsivelydevelo/ unusual habits such as refusal to eat in /ublic or in front of others. Annervosa is usually associated !ith signicant !eight loss, and can even cause from starvation.

B5I3IA )E0>OSA: eo/le !ith bulimia nervosa eat e9cessive uantitielater /urge their bodies of the food and calories they Fust consumed and

5hey use /rolonged fasting, la9atives, enemas, or diuretics, thro! u/ 2vomit3 oe9cessively e9ercise. 5hese acts are often done in secrecy and are associated feelings of disgust and shame as they binge, soon to be relieved of the tensionnegative emotions once their stomachs are em/ty again or /urge.

EATI)= DISO0DE0S


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EATI)= DISO0DE0S

BI)=E EATI)= DISO0DE0: eo/le !ith binge eating disorder e9/erience fre/isodes of out-of-control eating.

5he dierence bet!een bulimia and binge eating is that binge eaters do not /urgebodies of the e9cess calories consumed.

eo/le !ith bulimia are often im/ulsive and eat to overcome /sychic /ain and esca/roblems in their day-to-day lives.

A study of obese /eo/le !ith binge eating /roblems found that more than half alsohistory of maFor de/ression.

Additional research sho!s that obese !omen !ith binge-eating disorder !ho e9/eteasing about their a//earance later develo/ed body dissatisfaction and de/ressio

Bin%e eatin% is characteri&ed by:

;ecurrent e/isodes of eating during a discrete /eriod of time 2at least # days a !eea L month /eriod

Eating uantities of food that are larger than most /eo/le !ould eat during a similaamount of time

A sense of lac: of control during the e/isodes of e9cessive eating

Emotions of guilt or distress follo!ing the e/isodes of e9cessive eating

(EE =OOD A)D ST0ESS


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(EE =OOD A)D ST0ESS'O03O)ES Brain chemicals can rimarily in*uence emotions 5hese hormones are the :ey /layers that control a//etite a

hunger- f out of balance, they may get triggered to stimulae9cessive eating

'ormones that hel us eel %ood:

&erotonin, Do/amine, 4amma-amino butyric acid 24A'A

Endor/hins, Acetylcholine, 5yrosine, "itric o9ide

'ormones associated 6ith stress: Adrenaline, E/ine/hrine, "ore/ine/hrine

Cortisol1 corticosterone

nsulin

"euro/e/tide P

(OOD OBSESSIO) A)D (OOD


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(OOD OBSESSIO) A)D (OODADDI7TIO) 7omulsi/e o/ereatin% is real, it haens and it is /ery hard t

f a /erson is overtly /reoccu/ied !ith food and feels that sometimes out of control, :no!ing that there is a light at the end of the tunnel is

As hysician, identiyin% this roblem is /ery diRcult

5here is a lot of shame and denial around this /roblem and it is very hard the /erson does not ac:no!ledge this is ha//ening

An unhealthy relationshi/ !ith food hard to diagnose, it lac:s diagnostic c

n fact, there are guidelines that a//ly for substance addiction, /rocess addisordered eating in general, yet a!areness and the ability to start a conv

diTcult 5al:ing about it /romotes education about healthier eating, /romotes hea

those !ho choose unhealthy lifestyles and at high ris: for obesity, and thofor their obesity /roblems.

?ood addiction is one of the /ro/osed causes of the obesity e/idemic &tates, and around the !orld.

3EDI7ATIO)S A)D S50=E0Y 5S


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T0EAT OBESITY 20ES70I2TIO) 3EDI7ATIO) (O0 T'E T0EAT3E)T O( OBESI

ME5?O;M"

D-* "H'5O;& A"D 4-) A"AO4&

HE"5E;M"E

HE"5E;M"E A"D 5OAMA=- N&MA

O;CA&E;"- 'E


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N%E&5O"&

5HA"G PO%Margarita Ochoa-Maya, MD

Documents

WHS PR Symposium - Management of Adult Obesity