Obesity

Statistics 60% of U.S. population are overweight This figure has doubled since $75 billion spent per year due to obesity 100, ,000 deaths each year due to obesity Pediatric obesity has reached epidemic proportions.

Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults BRFSS, 1986 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1987 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1988 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1989 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1990 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%

Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults BRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19%

Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults BRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% ≥20

Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14%15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

(*BMI  30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14%15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) Obesity Trends* Among U.S. Adults BRFSS, 2002

Obesity Trends* Among U.S. Adults BRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14%15%–19% 20%–24% ≥25%

Obesity Trends* Among U.S. Adults BRFSS, 2004 No Data <10% 10%–14%15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

Obesity Trends* Among U.S. Adults BRFSS, 1991, 1996, 2004 (*BMI 30, or about 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25% 2004

Obesity with research controls

Obesity Prevalence Rates Over Time, Controlling for Race/Gender/Education

Epidemic Increase in Pediatric Obesity, 1980s-present

Promising Research Using Control Groups JAMA (1999) “Reducing Children’s Television Viewing to Prevent Obesity: A Randomized, Controlled Trial”

Promising Research Using Control Groups, JAMA Context Some observational studies have found an association between television viewing and child and adolescent adiposity. Objective To assess the effects of reducing television, videotape, and video game use on changes in adiposity, physical activity, and dietary intake. Design Randomized controlled school-based trial conducted from September 1996 to April Setting Two socio-demographically and scholastically matched public elementary schools in San Jose, Calif. Participants Of 198 third- and fourth-grade students, who were given parental consent to participate, 192 students (mean age, 8.9 years) completed the study. Intervention Children in 1 elementary school received an 18-lesson, 6-month classroom curriculum to reduce television, videotape, and video game use. Main Outcome Measures Changes in measures of height, weight, triceps skinfold thickness, waist and hip circumferences, and cardiorespiratory fitness. The primary outcome measure was body mass index, calculated as weight in kilograms divided by the square of height in meters. Results Compared with controls, children in the intervention group had statistically significant relative decreases in body mass index (intervention vs control change: to kg/m2 vs to kg/m2, respectively; adjusted difference kg/m2 [95% confidence interval {CI}, to -0.17]; P=.002), triceps skinfold thickness (intervention vs control change: to mm vs to mm, respectively; adjusted difference, mm [95% CI, to -0.54]; P=.002), waist circumference (intervention vs control change: to cm vs to cm, respectively; adjusted difference, cm [95% CI, to -1.33]; P<.001), and waist-to-hip ratio (intervention vs control change: 0.83 to 0.83 vs 0.82 to 0.84, respectively; adjusted difference, [95% CI, to -0.01]; P<.001). Relative to controls, intervention group changes were accompanied by statistically significant decreases in children's reported television viewing and meals eaten in front of the television. There were no statistically significant differences between groups for changes in high-fat food intake, moderate-to-vigorous physical activity, and cardiorespiratory fitness. Conclusions: Reducing television, videotape, and video game use may be a promising, population- based approach to prevent childhood obesity.

Obesity: diet, exercise, and GENES Malcolm Gladwell, “The Pima Paradox,” pp. 8-9: Claude Bouchard, professor of social and preventive medicine (Laval University, Quebec City) – one group of men of similar height, weight and life style and overfed them by 1,000 calories/per day, six days a week, for 100 days. The avg. weight gain was 18 pounds, BUT the range was 9-26 pounds. role of “evolutionary history” (p. 9): those Pima that survived centuries ago did so for a reason that has enormous consequences for the Pima Indians of today