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Name of the CONDITION: Obesity DEFINITION: Obesity is having a high amount of extra body fat.

[1] DIAGNOSIS: body mass index (BMI) > 30 kg/m2, where BMI equals weight in kilos di vided by height in meters squared.[1] MORBIDITY: Morbid obesity is having BMI >35 or experiencing obesity-related heal th conditions, such as high blood pressure or diabetes. Your chance of dying is significantly increased with a BMI at this level.[2] MORTALITY: Large-scale American and European studies have found that mortality risk is lowest at a BMI of 2025 kg/m2[3][4] in non-smokers and at 2427 kg/m2 in cu rrent smokers, with risk increasing along with changes in either direction.[5][6 ] A BMI above 32 has been associated with a doubled mortality rate among women o ver a 16-year period.[7] RISKS: There are many risks and complications with obesity. Physical consequences incl ude: Increased risk of heart disease High blood pressure Diabetes Breathing problems Trouble sleeping [8] Persistence - Although not an immediate consequence, the risk of childhood obesi ty persisting into adulthood is important, as there are serious medical complica tions associated with being an overweight adult. The risk persistence depends on the child's age, gender, and degree of overweight. Studies indicate that 25% of overweight preschool children versus 80% of overweight adolescents will become obese adults. Adolescent girls, in particular, appear to have a greater risk tha n boys. Additionally, the more overweight a child is at any age, the likelihood of obesity persisting into adulthood is higher. [10] POPULATIONS AT RISK AND SUBGROUPS:

One out of every six adolescents is overweight, and one out of every three is at risk.[12] Since the 1980s, the proportion of overweight children has steadily increased.[1 2] Obesity rates vary by race/ ethnicity.[13] For adolescents ages 12 to 19, non-Hispanic black girls and Mexican-American boy s have the highest rates of obesity, 29.2 percent and 26.7 percent respectively. Non-Hispanic white boys and girls have the lowest rates of obesity at 16.7 perc ent and 14.5 percent respectively.[13] Childhood obesity was found to be highest in the Southeast, with eight of the 10 states with the highest rates of childhood obesity being in this region.[14]

CAUSES: Obesity develops from a sedentary lifestyle of overeating and lack of ex ercise. >> Neuroendocrines Obesity originating in the hypothalamus.

Cushing Illness (high levels of cortisol). Hypothyroidism (low levels of thyroids). Policystic ovary syndrome. Growth hormone deficiency.

>> Medicamental Tricyclic anti depressives have shown an increase in fat and an important weigh t gain, thus presenting an obesity condition. Long corticoid treatments have shown an increase in fat and in weight also pres enting obesity.[15] >> High Caloric Nutrition Intake of more calories than our bodies require definitely cause the caloric ba lance to accumulate and for every 7,500 calories that our body accumulates the w eight gain is 1 KG which leads to obesity.[15] >> Psychological Recent discoveries have transformed the theory that psychological causes can in crease obesity and now consider the psychological changes in obesity as the cons equence, not as the cause. Perhaps the most damaging aspects of being overweight are psychological a feelin g of inferiority, self-consciousness and shyness, a sense of being unattractive and a lack of confidence.[15] INCIDENCE IN EGYPT: In a cross-sectional survey, made in 2010 where pupils were recruited from 2 pri maries, 2 preparatory and 2 secondary schools This case study uses studies of the status of hypertension among Egyptians cover ing the period from 1987 to 2005 WHAT WORKS BEST FOR THE PREVENTION OF OBESITY AMONG ADOLSCENTS? -Regular Exercise: e.g. 20 minutes jogging per day -Proper Nutrition: US Guidelines: Calorie Needs For Teenagers Teenage Girls Age Average Calorie Needs Each Day 11-14 years 2200 calories 15-18 years 2200 Teenage Boys Age Average Calorie Needs Each Day 11-14 years 2500 15-18 years 3000 Breakfast is the most important meal Eating should be at regular intervals. Unsaturated fats are recommended. Make junk food healthy. E.g. replace chees with paneer or low fat chees, add ple nty of vegetables -Combine TV watching with physical activity like stationary bicycling or spot jo gging. References: 1. Widmaier EP, Raff H and Strang K. T. Vanders Human Physiology: The Mechan isms of Body Function. 9th edition. Regulation of organic metabolism, growth and energy balance. 2003 2. What is morbid obesity? http://www.urmc.rochester.edu/hh/services-center s/bariatrics/morbid-obesity.cfm 3. Berrington de Gonzalez A, Hartge P, Cerhan JR, et al.(December 2010). " Body-Mass Index and Mortality among 1.46 Million White Adults". N. Engl. J. Med.

363 (23): 22119.doi:10.1056/NEJMoa1000367. PMC 3066051.PMID 21121834. 4. Whitlock G, Lewington S, Sherliker P, et al. (March 2009). "Body-mass in dex and cause-specific mortality in 900 000 adults: collaborative analyses of 57 p rospective studies". Lancet 373 (9669): 108396. doi:10.1016/S0140-6736(09)60318-4 . PMC 2662372. PMID 19299006. 5. ^ Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW (October 1999). "Body-mass index and mortality in a prospective cohort of U.S. adults". N. Engl. J. Med. 341 (15): 1097105. doi:10.1056/NEJM199910073411501.PMID 10511607. 6. ^ Pischon T, Boeing H, Hoffmann K, et al. (November 2008). "General and abdominal adiposity and risk of death in Europe". N. Engl. J. Med. 359 (20): 210 520.doi:10.1056/NEJMoa0801891. PMID 19005195. 7. Manson JE, Willett WC, Stampfer MJ, et al. (1995). "Body weight and mort ality among women". N. Engl. J. Med. 333 (11): 67785. doi:10.1056/NEJM19950914333 1101.PMID 7637744. 8. http://www.aacap.org/cs/root/facts_for_families/obesity_in_children_and_ teens 9. http://obesity.dietxnutrition.com/childhood-obesity-causes-and-heart-dis ease/ 10. Travers SH, Obesity in children, http://www.evpeds.com/pedwebarticle9.as p?tArticleId=834&tGo=Go 11. http://www.iaso.org/iotf/ 12. Wang, Youfa; Beydoun, May A. 2007. The Obesity Epidemic in the United St ates Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-Regression Analysis. Epidemiologic Reviews 29(1): 6 -28. 13. Ogden, Gynthia L.; Carroll, Margaret D.; Curtin, Lester R.; Lamb, Molly M.; Flegal, Katherine M. 2010. Prevalence of High Body Mass Index in U.S. Childr en and Adolescents, 2007-2008. Journal of the American Medical Association 303(3 ): 242-249. 14. Levi, Jeffrey; Vinter, Serena; Richardson, Liz; St. Laurent, Rebecca; Se gal, Laura. 2009. F as in Fat: How Obesity Policies Are Failing in America. Wash ington, DC: Robert Wood Johnson Foundation. 15. http://www.obesidad.net/english2002/default.htm 16. Nayera El-morsy Hassan, Safaa T. Zaki, Azza Gabr and Hala ElGindi. Diet quality in Egyptian obese children and adolscents.2010;6(10). 17. http://www.fao.org/docrep/009/a0442e/a0442e09.htm 18. http://www.weight-loss-center.net/calorie-needs-teens.html

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