Discussing the magnitude of obesity problem globally and in Sri Lanka, define obesity, list the complications of obesity in different age groups, treatment and prevention of obesity in simple terms but with scientific evidence.

1. Obesity: Greatest Epidemic of the 21st
Century
Dr.Murali Vallipuranathan
MBBS, PGD (Population Studies), MSc, MD (Community Medicine), FCCP
Consultant Community Physician
Ministry of Health
Annual Academic Sessions of Jaffna Science Association 2016

2. What is the problem?

3. In
2014

5. Sri Lankan statistics 2011
• 25 % of women and 17 %
of men were suffering from
obesity
• 67 % of women and 81 %
of men are physically
inactive

6. Demographic and Health Survey 2006/7

7. What is causing obesity?

10. What is obesity?

11. `

14. What are the
complications of obesity?

17. Childhood Obesity need to be treated

18. Polycystic Ovarian Syndrome
commonly associated with obesity

19. PCOS: Signs and Symptoms
SYMPTOMS
• Menstrual irregularity
• Infertility
• Hirsutism, acne
• Obesity
SIGNS
• Hirsutism, acne
• Obesity
• Ovarian enlargement
• Acanthosis nigricans

20. Acanthosis Nigricans

21. How doctors treat
obesity?

22. Treatment of obesity comes into three categories:
1-behavior modification .
{diet and exercise}
2-pharmacotherapy
3-surgical intervention .

23. Prevention of Obesity at different levels of
BMI

24. No magic pills to reduce weight if
• Diet control is not possible
• And exercises are not possible

25. How can I manage my
obesity problem?

26. First step: get weighing scale and
decide your target

28. Evidence Based Medicine

29. Second step

30. Third step: Increasing energy
expenditure
exercise is very effective in preventing long term weight
regain.
Aim for one hour exercise continuously a day if you
want to reduce weight.
Doing 30 minute exercise each day for not increasing
Children need exercise at least one hour a day

31. Fourth Step: sleep well
(7-9 hours/night)

33. Obesity Epidemic and Sleep Duration
7.5
6.8
9.0
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
1910 1975 2005
Sleep duration in US adults
25.2
26.9
23.0
21.0
22.0
23.0
24.0
25.0
26.0
27.0
28.0
1910 1975 2005
BMI in US adults

34. Sleep Deprivation/Weight Gain Linked
• Subjects with avg. 5hr./night sleep had 73% increased
likelihood of obesity over those who slept 7-9 hr/night.
( Findings reported at the annual scientific meeting of the North American Society for
the Study of Obesity. Nov, 2004)
• Study showed a linear relationship: reduced amounts
of sleep are associated with overweight and obesity
(Arch. Intern Med, 2005;165:25-30)

35. Sleep Deprivation & Obesity:
Potential Mechanisms
ObesitySleep
Deprivation
Patel SR et al. Obesity; 2008; in press

36. Fifth Step: Never skip the breakfast

37. Breakfast:
 Brain Food
 Improves
performance in
studies
 Improves physical
activities
 Does not
contribute to
overweight
 Keeps you healthy
 Skipping breakfast associated
with obesity
 High sugar breakfast causes a
high sugar level which dips fast
making you more hungry and
you eat more sugary food
The most important meal

39. Sixth Step: Avoid overeating

41. Good eating habits
 Maintain hygienic habits
 Eat slowly, chew properly
 Avoid TV viewing or reading while
you eat
 Small frequent meals
 Never skip meals, specially
breakfast
 Don’t overeat

42. Seventh Step: Control Stress

43. Stress and Central Obesity Linked

44. Eighth Step: Take more vegetables and
fruits

46. Ninth Step: Avoid fast foods and Fizzy
drinks

47. Why is Fast Food unhealthy ?
 High in calorie, fat, sodium and low in fiber
which can cause
Obesity, Hypertension, Heart diseases, Diabetes, Cancer etc.
 Contains preservatives
 Choose low-calorie and low-fat meals,
snacks and desserts
 Have low fat or skim milk drinks.

48. Foods can be addictive
• Certain foods containing
fats and sugar can be
addictive
• Examples: fast foods
and soft drinks

49. Industrial prediction of soft drink sale

50. Fast food kills

51. Growth of fast food outlets in 2012
• KFC started in 1995, 25 outlets at present, it will
expand to 32 by end of the year
• Pizza Hut started in 1993, 24 outlets at present, it will
expand to 30 by end of the year.
• Mc Donald started in 1998, 5 outlets at present, it will
expand to 7 by end of the year

52. Tenth Step: Do abdominal exercises

53. Regular abdominal exercises are useful

54. Regular abdominal exercises (continued)

55. Eleventh Step: Stop methods without
evidence

56. Most Herbal Products does not help!

57. Why we are still unable
to reduce weight?

58. Are we really ready to change
ourselves?

59. Any questions?