Obesity

• Obese individuals are at higher risk for developing type 2 diabetes, hypertension, heart disease, stroke, certain cancers (breast, colon), gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and mental health disorders.
• Patients with android obesity have a greater risk for developing hypertension, coronary artery disease, stroke, and type 2 diabetes, than patients who have gynoid obesity, also called the "pear-shaped" body.
• The U.S. Preventive Services Task Force (USPSTF) recommends that all adults with BMIs in excess of 30 kg/m² be advised to engage in multi-component behavioral interventions that include setting weight loss goals, improving lifestyle behaviors (e.g., diet habits, physical activity), addressing barriers to change, considering use of adjunctive pharmacotherapy agents, and self-monitoring and strategizing ongoing lifestyle changes aimed at a healthy weight.
• These interventions are called intensive behavioral therapy.
• Patients with obesity may have other diagnostic laboratory studies done to screen for cardiovascular diseases, such as cholesterol and triglycerides.
• Treatment of obesity generally includes lifestyle modification, pharmacologic management, and nonsurgical or surgical interventions.
• The first approach used to treat obesity consists of lifestyle modification aimed at weight loss and then weight maintenance.
• The USPSTF notes that modest weight loss of 5% total body weight can be associated with significant clinical improvements and benefits to patients with obesity.
• The most effective behavioral interventions are those considered high intensity; consisting of 12 to 24 sessions annually, which may include individual counseling sessions between the primary provider and patient, group nutrition education sessions, and physical activity sessions, to name a few.
• Obesity is the most important risk factor for obstructive sleep apnea (OSA), particularly among older men.
• In some instances, obesity may be secondary to other diseases or disorders, such as hypothyroidism or Cushing's syndrome.
• Obesity is defined by the World Health Organization as an "abnormal or excessive fat accumulation that may impair health" (WHO, 2018, p. 1).
• The presence of a variant mutation of the FTO gene is associated with more daily meals, snacks, and fat and sweet intake.
• Hunting for scarce food sources during prehistoric times consumed a lot of energy, and food sources were not abundant.
• Obesity results from a metabolic imbalance, characterized by an excess of caloric consumption relative to caloric expenditures.
• The "thrifty gene" hypothesis has come under scrutiny in recent years, as human genome sequencing research findings suggest that a far more complex genetic explanation may be responsible for the recent global obesity pandemic.
• The "thrifty gene" hypothesis suggests that the human genome was sequenced during times when finding and storing food sources expended more energy than during contemporary times.
• Research has identified 79 syndromes and 31 genes that cause obesity through monogenic (single gene) mutations and polygenic (multiple gene) mutations as well as gene-environment interactions.
• Storing fat to provide energy sources during times of food scarcity was a physiologic adaptive response to these environmental challenges.
• Most people who are predisposed to obesity are thought to have a collection of several genetic mutations from more than 700 possible mutated genes that each can contribute to several pounds of additional body fat.
• Certain processed and high caloric foods that contain fructose corn syrup, simple sugars, or trans fats, are hypothesized to be obesogenic because they are associated with food cravings consonant with other type of addictive cravings.
• Dysfunctional adipose tissue cells release biochemical mediators that cause chronic inflammatory changes, which can lead to a multitude of diseases, including heart disease, hypertension, and type 2 diabetes.
• Having at least one different genetic mutation can strongly predispose people who have ready access to food sources to having obesity.
• Being overweight or having obesity is the primary reason why young American adults are excluded from military service.
• The causes of obesity are complex and multifactorial, and include behavioral, environmental, physiologic, and genetic factors.
• Obesity is associated with a 2- to 6-year decrease in overall life expectancy when coupled with metabolic disease or another chronic illness.
• Average annual health care expenditures for Americans with obesity are $3429 higher per person than for those Americans without obesity.
• Obesity alone does not decrease a person's lifespan.
• It is estimated that annual health care costs tied to obesity are approximately $190 billion.
• Obesity is associated with morbidity and mortality from numerous other diseases.
• As body mass index (BMI) increases, so does the overall risk of cancer and risk for death from cancer; obesity is responsible for up to 90,000 deaths from cancer annually.
• These increases in body fat cause adiposopathy, a dysfunction of adipose tissue, which promotes the development of metabolic, biomechanical, and psychosocial diseases and disorders.
• Having obesity increases the likelihood of having type 2 diabetes by 10-fold and the likelihood of having either asthma or hypertension by nearly fourfold.
• Obesity incurs a greater overall risk of mortality.
• While there are certain demographic groups who seem to be at risk for obesity and while there are notable familial patterns of obesity, identification of risk factors that specify odds of being diagnosed with obesity is not as clearly elucidated as those for other diseases.
• Obesity is a chronic, relapsing disease characterized by an excessive accumulation of body fat and weight gain.
• The economic burden of obesity to American society extends beyond limiting young adults with obesity from pursuing military service commitments.
• Adults with obesity are twice as likely to eventually be diagnosed with Alzheimer's disease than those adults who maintain a normal weight.
• The American Medical Association (AMA) House of Delegates in 2013 officially resolved that obesity should be diagnosed and treated as a disease (AMA, 2013).
• Older adults with higher BMIs had more evidence of cognitive dysfunction compared to their normal weight counterparts.