1. Obesity By Amr S. Moustafa, M.D.; Ph.D.

2.  Historical keywords  Objectives  Definition  Apple-Vs Pear-shaped  Causes and associated Factors  Hormonal effects  Metabolic Aspects  Management Outlines

3. Historical keywords Obesity: Latin obesus: one who has become plump through eating Thomas Venner (1620) First medical recognition of obesity Occupational hazard of the genteel classes control by balancing diet, sleep,.. X X

4. Ibn Hubal Al-Baghdady (1121- 1213) Kitab Al-Mukhtarat fit-Tibb Ibn El-Nefis (1207 – 1288) Al-Mujaz Fit-Tibb Mohamed ibn Zakaria Al-Razi (841-926) Al-Hawi Fit-Tibb Ibn Sina (980 - 1037) Canon in Medicine Islamic civilization: “Obesity 1000 years ago”

5. The 18 th and 19 th centuries: Corpulence Vs obesity William Banting’s pamphlet (1863) “A letter on corpulence addressed to the public” The 20 th century: Obesity associated diseases The 10 th – 13 th centuries: First medical recognition by Islamic Scientists Thomas Venner (1620) Occupational hazard of the genteel classes Historical keywords: Obesity “Revised”

6. Objectives Prevalence: Obese > Undernourished Recent Epidemic Childhood Obesity Morbidity: Strong at young age (< 55 Y) Mortality: Unfit lean Vs Fit overweight

7. Recent US Obesity Epidemic

8. Objectives Prevalence: Obese > Undernourished Recent Epidemic Childhood Obesity Morbidity: Strong at young age (< 55 Y) Mortality: Unfit lean Vs Fit overweight

9. Morbidity Risk for obese Men and Women

10. The Metabolic Syndrome Risk factorDefining level Abdominal obesity (waist circumference) Men>40 in Women>35 in Plasma triacylglycerols≥150 mg/dl Plasma HDL-C Men<40 mg/dl Women<50 mg/dl Blood pressure≥130/85 mmHg Fasting plasma glucose≥110 mg/dl

11. Objectives Prevalence: Obese > Undernourished Recent Epidemic Childhood Obesity Morbidity: Strong at young age (< 55 Y) Mortality: Unfit lean Vs Fit overweight

13.  Objectives  Definition  Apple-Vs Pear-shaped  Causes and associated Factors  Hormonal effects  Metabolic Aspects  Management Outlines

14. Definition Obesity is Disorder of Body Regulatory Systems Excess Body Fat Assessment:  Body Mass Index (BMI)  Waist to Hip ratio (WHR)  Waist Circumference (WC)

15. WHR > 0.8 W > 1.0 M WHR < 0.8 W < 1.0 M Obesity Visceral Vs Peripheral

16.  Objectives  Definition  Apple-Vs Pear-shaped  Causes and associated Factors  Hormonal effects  Metabolic Aspects  Management Outlines

17. Obesity Causes & Associated Factors Genetic: Complex Polygenic Environmental and Behavioral Signaling: Hormonal Neurologic Psycological

18. Hypertrophic and Hyperplastic Fat cells

19. Set-Point for BW Regulation

20. Obese Identical Twins

21. Obesity Signaling

22. Leptin and Obesity

23. The Role of Adipokines in Atherosclerosis

24. The Link between Obesity, Insulin Resistance and Atherosclerosis

25. Non-Diabetic, Obese and Insulin Resistant

26. Obesity Insulin Resistance Lipotoxicity

27.  Objectives  Definition  Apple-Vs Pear-shaped  Causes and associated Factors  Hormonal effects  Metabolic Aspects  Management Outlines

28. Treatment of Obesity Orlistat Vs Surgery

29. Summary

30. Conclusions & Recommendation Obesity is a risk factor Morbidity Mortality Prevention is better than treatment Change life style Physical activities Food habits: Quantity and Quality