Presentation on the Obesity Epidemic - Stanford Hospital - March 2013

ObesityEvolution – Costs - Origins – Remedies

By Valerie Orsoni (Founder of LeBootCamp.com)

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Evolution of the BMI (1850-2012)

1840 1860 1880 1900 1920 1940 1960 1980 2000 2020 204017

19

21

23

25

27

29

31

33BMI

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72% unhealthy weight

54% unhealthy weight

42% obese

36% obese

in millions

Adults only

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Cost of Obesity Increase

$190 billion in annual medical costs due to obesity, double earlier estimates

$5,530 more per year in medical costs for a worker with a BMI above 40

Obesity responsible for 32% of all medical costs in 2030 vs. 21% in 2012

Airlines spending: $5 billion to cater for heavier passengers (over 2 decades)

$285,000/y/company spent on obesity related lack of productivity and absenteeism

$4 billion / year for additional gasoline as cars carry heavier passengers

A 6% obesity increase from 2012 to 2030 will lead to:

Mayor Bloomberg says

costs of treating obesity

will ‘bury all of us’

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Obesity Metrics The medical costs for people who are obese are $1,429 higher than those of

normal weight

Non Hispanic blacks have a 49.5% obesity rate vs. 31% in non Hispanic whites

400,000 premature deaths per year in the USA

7% of non obese children become obese adults

77% of obese children become obese adults

Fattest state: Mississippi (34.9% - entire population)

Leanest state: Colorado (20.7% - entire population)

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Obesity MetricsAll rights reserved © 2013

Nutritional Origins of Obesity Processed foods (high GI of foods)

Portion sizes average US restaurant meal now 4X larger than it was in the 1950s; average hamburger was 3.9 oz, now 12+ ounces; average French fries was 2.4 oz, now 7 oz; average soda was 7 oz to 40 oz

Unstructured meal times

Fast food. Adults average of 11.3% of daily calories consumedfrom fast food in 2007-2010

Snacking. The average American eats 4.9 snacks and meals daily -- a 29% increase since the 1970s!

Ubiquity of food. “Food is everywhere you turn. It’s in pharmacies, in hardware stores.” [Thomas Farley, NYC Health Commissioner]

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Lifestyle Origins of Obesity Sedentary lifestyle: major changes due to labor-saving technologies

The rise of the culture of consumption

Automobile way of life 620h/year in commute = 35 lbs

Introduction of radio - TV - computer - video games 8.5h in front of a screen / day

Social clustering of obesity/thinness

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Remedies: Diets 1087: First ever recorded diet: England’s first King William I.

1830: Graham Diet

1863: Banting Diet (the first recorded low carb diet)

1879: First artificial sweetener (saccharine)

1900’s: Fletcherism

1920: Jean Nidetch (founder, Weight Watchers)

1977: Slim-Fast®

70’s and 80’s: The Mayo Clinic Diet

80’s: High-protein diets

90’s – now: Paleo, vegan, raw, tubes, etc.

80% of dieters regain

all lost weight

Weight loss market size: $12 billion

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Remedies: Drugs• Alli (Orlistat, originally Xenical): reduces intestinal fat absorption

• Metformin (Glucophpage): reduces blood glucose levels

• Byetta (Exenatide): reduces blood glucose levels

• Qsymia (Phentermine/Topiramate): appetite suppressant

• Belviq (Lorcaserin): appetite suppressant

• Symlin (Pramlintide): controls blood glucose; currently being tested in non-diabetics as a treatment for obesity

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Remedies: Lifestyle Changes

Eliminate calorie-counting and

restrictive diet approaches

Introduce a varied nutritional diet

which draws from all food groups

1st step +

2nd stepReplace monotonous

gym with daily integrative exercises

3rd stepAddress

emotional/mental issues which contribute

greatly to obesity

Empower individuals with real information

on the body, nutrition, and fitness

+

+

1 small change per day: Daily small changes yield better results

(Berkeley study)

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Remedies: Lifestyle Changes

Encourage mindful home cooking vs.

oversized fast-food portions

Educate and inform on healthy fast-food

options4th step +

5th stepOffer unlimited

support (affordable personal coaching)

6th step Organize healthy living communities

Monitor daily

+

+

Combat powerful advertising for quick-

fix weight loss methods

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Remedies: SurgeryRestrictive Surgery (ie. sleeve gastrectomy; adjustable gastric

banding surgery): Removal or closure of a section of the stomach to limit the amount of food it can hold and cause a feeling of fullness

Malabsorptive Surgery (ie. gastric bypass): Shortening the length of the small intestine, and/or changing where it connects to the stomach to limit the amount of food that is completely digested or absorbed

Combination of Restrictive & Malabsorptive Procedures (ie. Roux-en-Y Gastric Bypass Surgery, “gold standard”): tend to produce more weight loss than either procedure does on its own. Studies show that after 10 to 14 years, patients on average have only gained back 10-13% of the lost weight.

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