SlideShare une entreprise Scribd logo
1  sur  81
Obesity Dr Thomas Fox SpR Endocrinology Royal Cornwall Hospital
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition of obesity Body Mass Index  (kg/m 2 ) Category <18.5 Underweight 18.5-25 Healthy weight 25-30 Overweight 30-35 Grade 1 obese 35-40 Grade 2 obese >40 Grade 3 obese
BMI ,[object Object],[object Object],[object Object],[object Object]
Waist circumference ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
A global epidemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
Health Survey England 2005 (HSE) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gender, age and obesity in UK ,[object Object],[object Object],[object Object]
 
 
 
Ethnicity and Obesity rates BMI>30kg/m 2   (UK) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Social class and obesity ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of obesity - food ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Percentage change in amount of food and energy contained between 1985-95 in Australia
Between 1985-95 in Australian children (Magarey  et al  2005) ,[object Object],[object Object],[object Object],[object Object]
Australian National Nutritional Survey of Children 1995 - snapshot ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of obesity – physical activity (HSE 2005) ,[object Object],[object Object]
Influence of genetic and environmental factors on prevalence of type 2 diabetes (Schulz LO  et al  2006)   Arizona Pima Indians N=888 Mexican Pima Indians n-=223 Mexicans N=193 BMI  (kg/m 2 ) 34.6 25.1 25.8 Calorie   intake  (kcal/day) 1751 2458 2593 Lipid intake  (%) 36.3 26.3 25.6 Physical activity  (hr/week) 7 27 27 Prevalence TIIDM (%) 38.1 7.1 2.6
“ It’s my metabolism Doctor” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Leptin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pharmacological causes of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Endocrine causes of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cushing’s syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cushings and obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Exogenous glucocorticoids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prader-Willi syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laurence-Moon syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health effect of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Management of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aims of weight loss ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diet ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Low calorie diets ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Very low calorie diets ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Low carbohydrate diets ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Samaha  et al,  NEJM 2003 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Meta-analysis: the effect of dietary counselling for weight loss. Dansinger ML  et al  2007 ,[object Object],[object Object],[object Object]
Exercise ,[object Object],[object Object],[object Object],[object Object]
 
Exercise ,[object Object],[object Object]
Pharmacotherapy ,[object Object],[object Object],[object Object],[object Object]
Sibutramine  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Orlistat ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bariatric surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Roux-en-Y ,[object Object],[object Object],[object Object]
 
Adjustable vertical banding gastroplasty ,[object Object],[object Object]
 
Swedish Obese Subjects ,[object Object],[object Object],[object Object],[object Object],[object Object]
SOS 10 years ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Banding vs RYGB ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Obesity and diabetes ,[object Object],[object Object],[object Object]
 
Prevalence of diabetes 2008 ,[object Object],[object Object],[object Object],[object Object]
Glycaemic control and exercise ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Weight gain in treatment of diabetes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Insulin ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sulphonylureas ,[object Object],[object Object]
Pioglitazone ,[object Object],[object Object]
Newer therapies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GLP-1 ,[object Object],[object Object],[object Object],[object Object],[object Object]
DPP-4 inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GLP-1 agonists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Incretin levels and effect are markedly increased 1 month following Roux-en-Y gastric bypass surgery in obese patients with type II diabetes ( Laferere et al  2007) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Obesity summary ,[object Object],[object Object],[object Object],[object Object]

Contenu connexe

Tendances

Diagnosis and management of obesity
Diagnosis and management of obesityDiagnosis and management of obesity
Diagnosis and management of obesityegyfellow
 
Management Of The Morbidly Obese
Management Of The Morbidly ObeseManagement Of The Morbidly Obese
Management Of The Morbidly Obesenels1937
 
Medical treatment of obesity 2016
Medical treatment of obesity 2016Medical treatment of obesity 2016
Medical treatment of obesity 2016rloewens
 
Obesity Metabolic Syndrome
Obesity Metabolic SyndromeObesity Metabolic Syndrome
Obesity Metabolic SyndromeEneutron
 
Metabolic Syndrome and Obesity
Metabolic Syndrome and ObesityMetabolic Syndrome and Obesity
Metabolic Syndrome and Obesitymeducationdotnet
 
Approach to a patient of obesity
Approach to a patient of obesityApproach to a patient of obesity
Approach to a patient of obesityDrVeereshDhanni
 
Diabesity (Diabetes and Obesity)
Diabesity (Diabetes and Obesity)Diabesity (Diabetes and Obesity)
Diabesity (Diabetes and Obesity)simplyweight
 
Obesity and diabetes [autosaved]
Obesity and diabetes [autosaved]Obesity and diabetes [autosaved]
Obesity and diabetes [autosaved]Asrar Zakari
 
Managment of Diabesity (Obesity in diabetes mellitus)
Managment of Diabesity (Obesity in diabetes mellitus) Managment of Diabesity (Obesity in diabetes mellitus)
Managment of Diabesity (Obesity in diabetes mellitus) Tarek Al 3reeny
 
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?InsideScientific
 

Tendances (20)

Diagnosis and management of obesity
Diagnosis and management of obesityDiagnosis and management of obesity
Diagnosis and management of obesity
 
Management Of The Morbidly Obese
Management Of The Morbidly ObeseManagement Of The Morbidly Obese
Management Of The Morbidly Obese
 
Obesity
ObesityObesity
Obesity
 
Medical treatment of obesity 2016
Medical treatment of obesity 2016Medical treatment of obesity 2016
Medical treatment of obesity 2016
 
Obesity Metabolic Syndrome
Obesity Metabolic SyndromeObesity Metabolic Syndrome
Obesity Metabolic Syndrome
 
Obesity
ObesityObesity
Obesity
 
Managment of obesity
Managment of obesityManagment of obesity
Managment of obesity
 
Obesity, prevalence, risk factors, approach to management- Dr Shahjada Selim
Obesity, prevalence, risk factors, approach to management- Dr Shahjada SelimObesity, prevalence, risk factors, approach to management- Dr Shahjada Selim
Obesity, prevalence, risk factors, approach to management- Dr Shahjada Selim
 
Obesity
ObesityObesity
Obesity
 
Metabolic Syndrome and Obesity
Metabolic Syndrome and ObesityMetabolic Syndrome and Obesity
Metabolic Syndrome and Obesity
 
Obesity
ObesityObesity
Obesity
 
Approach to a patient of obesity
Approach to a patient of obesityApproach to a patient of obesity
Approach to a patient of obesity
 
Obesity
ObesityObesity
Obesity
 
Diabesity (Diabetes and Obesity)
Diabesity (Diabetes and Obesity)Diabesity (Diabetes and Obesity)
Diabesity (Diabetes and Obesity)
 
Obesity
ObesityObesity
Obesity
 
Obesity and diabetes [autosaved]
Obesity and diabetes [autosaved]Obesity and diabetes [autosaved]
Obesity and diabetes [autosaved]
 
Managment of Diabesity (Obesity in diabetes mellitus)
Managment of Diabesity (Obesity in diabetes mellitus) Managment of Diabesity (Obesity in diabetes mellitus)
Managment of Diabesity (Obesity in diabetes mellitus)
 
Obesity
ObesityObesity
Obesity
 
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?
Anti-Obesity Pharmacotherapy: Where are we now? Where are we going?
 
Obesity
ObesityObesity
Obesity
 

En vedette (20)

Obesity Presentation
Obesity PresentationObesity Presentation
Obesity Presentation
 
Obesity
ObesityObesity
Obesity
 
Obesity
ObesityObesity
Obesity
 
Power point obesity
Power point obesityPower point obesity
Power point obesity
 
Presentation on the Obesity Epidemic - Stanford Hospital - March 2013
Presentation on the Obesity Epidemic - Stanford Hospital - March 2013Presentation on the Obesity Epidemic - Stanford Hospital - March 2013
Presentation on the Obesity Epidemic - Stanford Hospital - March 2013
 
Obesity - India
Obesity - IndiaObesity - India
Obesity - India
 
Childhood Obesity Presentation
Childhood Obesity PresentationChildhood Obesity Presentation
Childhood Obesity Presentation
 
Obesity
ObesityObesity
Obesity
 
Nutritional diseases (Obesity and starvation)
Nutritional diseases (Obesity and starvation)Nutritional diseases (Obesity and starvation)
Nutritional diseases (Obesity and starvation)
 
Obesity
ObesityObesity
Obesity
 
Obesity Pp
Obesity PpObesity Pp
Obesity Pp
 
Obesity
Obesity Obesity
Obesity
 
Obesity
ObesityObesity
Obesity
 
Obesity.ppt
Obesity.pptObesity.ppt
Obesity.ppt
 
Childhood Obesity
Childhood ObesityChildhood Obesity
Childhood Obesity
 
Obesity proposal
Obesity  proposalObesity  proposal
Obesity proposal
 
Obesity and physiotherapy
Obesity and physiotherapyObesity and physiotherapy
Obesity and physiotherapy
 
Obesity
ObesityObesity
Obesity
 
Obesity
ObesityObesity
Obesity
 
Obesity management
Obesity managementObesity management
Obesity management
 

Similaire à Obesity

Controversies in type 2 diabetes mellitus
Controversies in type 2 diabetes mellitusControversies in type 2 diabetes mellitus
Controversies in type 2 diabetes mellitusPratap Tiwari
 
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...George S. Ferzli
 
P488 obesity
P488 obesityP488 obesity
P488 obesitymjpol
 
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan Lifestyle
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan LifestyleReversing Diabetes Naturally Therapeutic Effects Of A Vegan Lifestyle
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan LifestyleJen King
 
Endocrinology of the bariatric surgical patient
Endocrinology of the bariatric surgical patientEndocrinology of the bariatric surgical patient
Endocrinology of the bariatric surgical patientMatthew Brackman
 
SCOPE School Dublin - David Heber
SCOPE School Dublin - David HeberSCOPE School Dublin - David Heber
SCOPE School Dublin - David Heber_IASO_
 
Topic 5_MNT Weight Managementeducation.pptx
Topic 5_MNT Weight Managementeducation.pptxTopic 5_MNT Weight Managementeducation.pptx
Topic 5_MNT Weight Managementeducation.pptxsyaril1
 
PCOS- Is obesity a concern
PCOS- Is obesity a concernPCOS- Is obesity a concern
PCOS- Is obesity a concernSujoy Dasgupta
 
Obesity - Etiopathogenesis, Clinical features, Advances in Management
Obesity - Etiopathogenesis, Clinical features, Advances in ManagementObesity - Etiopathogenesis, Clinical features, Advances in Management
Obesity - Etiopathogenesis, Clinical features, Advances in ManagementChetan Ganteppanavar
 
Nutrition in renal patient
Nutrition in renal patientNutrition in renal patient
Nutrition in renal patientFarragBahbah
 
Nutrition in renal patient
Nutrition in renal patientNutrition in renal patient
Nutrition in renal patientFarragBahbah
 
Weight loss among metabolically healthy obese men and women: harmful or benef...
Weight loss among metabolically healthy obese men and women: harmful or benef...Weight loss among metabolically healthy obese men and women: harmful or benef...
Weight loss among metabolically healthy obese men and women: harmful or benef...PeterJaniszewski
 
obesity and fertility implications
obesity and fertility implicationsobesity and fertility implications
obesity and fertility implicationsPranay Phukan
 

Similaire à Obesity (20)

Obesity
ObesityObesity
Obesity
 
Weightma2
Weightma2Weightma2
Weightma2
 
Controversies in type 2 diabetes mellitus
Controversies in type 2 diabetes mellitusControversies in type 2 diabetes mellitus
Controversies in type 2 diabetes mellitus
 
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...
Surgery for Obesity Duodeno-Jejunal Bypass forType 2 Diabetes in Non-Obese - ...
 
P488 obesity
P488 obesityP488 obesity
P488 obesity
 
obesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndromeobesity diabetes and metabolic syndrome
obesity diabetes and metabolic syndrome
 
Obesity2
Obesity2Obesity2
Obesity2
 
Metabolic surgery
Metabolic surgeryMetabolic surgery
Metabolic surgery
 
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan Lifestyle
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan LifestyleReversing Diabetes Naturally Therapeutic Effects Of A Vegan Lifestyle
Reversing Diabetes Naturally Therapeutic Effects Of A Vegan Lifestyle
 
Endocrinology of the bariatric surgical patient
Endocrinology of the bariatric surgical patientEndocrinology of the bariatric surgical patient
Endocrinology of the bariatric surgical patient
 
SCOPE School Dublin - David Heber
SCOPE School Dublin - David HeberSCOPE School Dublin - David Heber
SCOPE School Dublin - David Heber
 
Topic 5_MNT Weight Managementeducation.pptx
Topic 5_MNT Weight Managementeducation.pptxTopic 5_MNT Weight Managementeducation.pptx
Topic 5_MNT Weight Managementeducation.pptx
 
PCOS- Is obesity a concern
PCOS- Is obesity a concernPCOS- Is obesity a concern
PCOS- Is obesity a concern
 
Obesity - Etiopathogenesis, Clinical features, Advances in Management
Obesity - Etiopathogenesis, Clinical features, Advances in ManagementObesity - Etiopathogenesis, Clinical features, Advances in Management
Obesity - Etiopathogenesis, Clinical features, Advances in Management
 
Obesity
ObesityObesity
Obesity
 
Nutrition in renal patient
Nutrition in renal patientNutrition in renal patient
Nutrition in renal patient
 
Nutrition in renal patient
Nutrition in renal patientNutrition in renal patient
Nutrition in renal patient
 
Obesity
ObesityObesity
Obesity
 
Weight loss among metabolically healthy obese men and women: harmful or benef...
Weight loss among metabolically healthy obese men and women: harmful or benef...Weight loss among metabolically healthy obese men and women: harmful or benef...
Weight loss among metabolically healthy obese men and women: harmful or benef...
 
obesity and fertility implications
obesity and fertility implicationsobesity and fertility implications
obesity and fertility implications
 

Plus de PeninsulaEndocrine

Endocrine disease in pregnancy
Endocrine disease in pregnancyEndocrine disease in pregnancy
Endocrine disease in pregnancyPeninsulaEndocrine
 
Primary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling casesPrimary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling casesPeninsulaEndocrine
 
Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2PeninsulaEndocrine
 
Hypogonadism and testosterone replacement
Hypogonadism and testosterone replacementHypogonadism and testosterone replacement
Hypogonadism and testosterone replacementPeninsulaEndocrine
 
Erectile dysfunction in diabetes
Erectile dysfunction in diabetesErectile dysfunction in diabetes
Erectile dysfunction in diabetesPeninsulaEndocrine
 
ADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionPeninsulaEndocrine
 
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionDCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionPeninsulaEndocrine
 
DCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationDCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationPeninsulaEndocrine
 

Plus de PeninsulaEndocrine (20)

Gestational diabetes
Gestational diabetesGestational diabetes
Gestational diabetes
 
Endocrine disease in pregnancy
Endocrine disease in pregnancyEndocrine disease in pregnancy
Endocrine disease in pregnancy
 
Diabetes in pregnancy
Diabetes in pregnancyDiabetes in pregnancy
Diabetes in pregnancy
 
Hypoglycaemia in older people
Hypoglycaemia in older peopleHypoglycaemia in older people
Hypoglycaemia in older people
 
Diabetes in the elderly
Diabetes in the elderlyDiabetes in the elderly
Diabetes in the elderly
 
Primary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling casesPrimary hyperaldosteronism - arterial venous sampling cases
Primary hyperaldosteronism - arterial venous sampling cases
 
Calcium metabolism handout
Calcium metabolism handoutCalcium metabolism handout
Calcium metabolism handout
 
Calcium metabolism handout
Calcium metabolism handoutCalcium metabolism handout
Calcium metabolism handout
 
Kallmann syndrome
Kallmann syndromeKallmann syndrome
Kallmann syndrome
 
Kallmann syndrome
Kallmann syndromeKallmann syndrome
Kallmann syndrome
 
Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2Hypogonadism and testosterone replacement part 2
Hypogonadism and testosterone replacement part 2
 
Hypogonadism and testosterone replacement
Hypogonadism and testosterone replacementHypogonadism and testosterone replacement
Hypogonadism and testosterone replacement
 
Erectile dysfunction in diabetes
Erectile dysfunction in diabetesErectile dysfunction in diabetes
Erectile dysfunction in diabetes
 
The role of the podiatrist
The role of the podiatristThe role of the podiatrist
The role of the podiatrist
 
The diabetic foot
The diabetic footThe diabetic foot
The diabetic foot
 
ADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with interventionADVANCE - Type 2 diabetes - vascular risk with intervention
ADVANCE - Type 2 diabetes - vascular risk with intervention
 
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with interventionDCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
DCCT/EDIC - Type 1 diabetes - cardiovascular risk with intervention
 
DCCT - Hypoglycemia
DCCT - HypoglycemiaDCCT - Hypoglycemia
DCCT - Hypoglycemia
 
DCCT overview
DCCT overviewDCCT overview
DCCT overview
 
DCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtrationDCCT – intensive diabetes therapy and glomerular filtration
DCCT – intensive diabetes therapy and glomerular filtration
 

Dernier

Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsGfnyt
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Dipal Arora
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiAlinaDevecerski
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomdiscovermytutordmt
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipurparulsinha
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...narwatsonia7
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableDipal Arora
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiLow Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiSuhani Kapoor
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escortsvidya singh
 

Dernier (20)

Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual NeedsBangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
Bangalore Call Girl Whatsapp Number 100% Complete Your Sexual Needs
 
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
Russian Call Girls in Delhi Tanvi ➡️ 9711199012 💋📞 Independent Escort Service...
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ooty Just Call 9907093804 Top Class Call Girl Service Available
 
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
Best Rate (Guwahati ) Call Girls Guwahati ⟟ 8617370543 ⟟ High Class Call Girl...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls DelhiRussian Escorts Girls  Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
Russian Escorts Girls Nehru Place ZINATHI 🔝9711199012 ☪ 24/7 Call Girls Delhi
 
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel roomLucknow Call girls - 8800925952 - 24x7 service with hotel room
Lucknow Call girls - 8800925952 - 24x7 service with hotel room
 
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls JaipurCall Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
Call Girls Service Jaipur Grishma WhatsApp ❤8445551418 VIP Call Girls Jaipur
 
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
Top Rated Bangalore Call Girls Mg Road ⟟ 8250192130 ⟟ Call Me For Genuine Sex...
 
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bareilly Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
 
Chandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD availableChandrapur Call girls 8617370543 Provides all area service COD available
Chandrapur Call girls 8617370543 Provides all area service COD available
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service KochiLow Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
Low Rate Call Girls Kochi Anika 8250192130 Independent Escort Service Kochi
 
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore EscortsCall Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
Call Girls Horamavu WhatsApp Number 7001035870 Meeting With Bangalore Escorts
 

Obesity

  • 1. Obesity Dr Thomas Fox SpR Endocrinology Royal Cornwall Hospital
  • 2.
  • 3.
  • 4. Definition of obesity Body Mass Index (kg/m 2 ) Category <18.5 Underweight 18.5-25 Healthy weight 25-30 Overweight 30-35 Grade 1 obese 35-40 Grade 2 obese >40 Grade 3 obese
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.  
  • 10.  
  • 11.  
  • 12.
  • 13.
  • 14.  
  • 15.  
  • 16.  
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Percentage change in amount of food and energy contained between 1985-95 in Australia
  • 22.
  • 23.
  • 24.
  • 25. Influence of genetic and environmental factors on prevalence of type 2 diabetes (Schulz LO et al 2006) Arizona Pima Indians N=888 Mexican Pima Indians n-=223 Mexicans N=193 BMI (kg/m 2 ) 34.6 25.1 25.8 Calorie intake (kcal/day) 1751 2458 2593 Lipid intake (%) 36.3 26.3 25.6 Physical activity (hr/week) 7 27 27 Prevalence TIIDM (%) 38.1 7.1 2.6
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.  
  • 40.  
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.  
  • 48.
  • 49.  
  • 50.
  • 51.
  • 52.
  • 53.  
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.  
  • 61.
  • 62.  
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.  
  • 69.
  • 70.
  • 71.
  • 72.
  • 73.
  • 74.
  • 75.
  • 76.
  • 77.
  • 78.
  • 79.
  • 80.
  • 81.