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              Obesity
Evolution – Costs - Origins – Remedies
     By Valerie Orsoni (Founder of LeBootCamp.com)
All rights reserved © 2013



Evolution of the BMI (1850-2012)
BMI
  33



  31



  29



  27



  25



  23



  21



  19



  17

   1840   1860   1880   1900   1920   1940   1960   1980   2000   2020        2040
All rights reserved © 2013




                   42% obese
72% unhealthy weight



                36% obese
54% unhealthy weight


                               in millions




  Adults only
Cost of
                                                                         All rights reserved © 2013




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


 $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
All rights reserved © 2013



                        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)
All rights reserved © 2013



Obesity Metrics
All 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 consumed
  from 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]
All rights reserved © 2013



         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
All rights reserved © 2013



                        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.
All rights reserved © 2013



                        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
All rights reserved © 2013



           Remedies: Lifestyle Changes
                Eliminate calorie-            Introduce a varied
                   counting and                 nutritional diet
1st step
                 restrictive diet        +   which draws from all
                    approaches                   food groups


               1 small change per day:
                                             Replace monotonous
2nd step         Daily small changes
                  yield better results   +      gym with daily
                                             integrative exercises
                   (Berkeley study)


                                              Empower individuals
                       Address                with real information
                  emotional/mental
3rd step
               issues which contribute   +           on the
                                              body, nutrition, and
                  greatly to obesity                 fitness
All rights reserved © 2013



             Remedies: Lifestyle Changes
                  Encourage mindful
                                              Educate and inform
                   home cooking vs.
4th   step
                  oversized fast-food     +   on healthy fast-food
                                                    options
                       portions


                  Combat powerful
                                                Offer unlimited
5th step         advertising for quick-
                      fix weight          +   support (affordable
                                              personal coaching)
                    loss methods



                    Organize healthy
6th step
                  living communities      +     Monitor daily
All rights reserved © 2013



                 Remedies: Surgery
Restrictive 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.
All rights reserved © 2013




          LeBootCamp
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Presentation on the Obesity Epidemic - Stanford Hospital - March 2013

  • 1. All rights reserved © 2013 Obesity Evolution – Costs - Origins – Remedies By Valerie Orsoni (Founder of LeBootCamp.com)
  • 2. All rights reserved © 2013 Evolution of the BMI (1850-2012) BMI 33 31 29 27 25 23 21 19 17 1840 1860 1880 1900 1920 1940 1960 1980 2000 2020 2040
  • 3. All rights reserved © 2013 42% obese 72% unhealthy weight 36% obese 54% unhealthy weight in millions Adults only
  • 4. Cost of All rights reserved © 2013 Obesity Increase A 6% obesity increase from 2012 to 2030 will lead to:  $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
  • 5. All rights reserved © 2013 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)
  • 6. All rights reserved © 2013 Obesity Metrics
  • 7. All 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 consumed from 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]
  • 8. All rights reserved © 2013 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
  • 9. All rights reserved © 2013 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.
  • 10. All rights reserved © 2013 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
  • 11. All rights reserved © 2013 Remedies: Lifestyle Changes Eliminate calorie- Introduce a varied counting and nutritional diet 1st step restrictive diet + which draws from all approaches food groups 1 small change per day: Replace monotonous 2nd step Daily small changes yield better results + gym with daily integrative exercises (Berkeley study) Empower individuals Address with real information emotional/mental 3rd step issues which contribute + on the body, nutrition, and greatly to obesity fitness
  • 12. All rights reserved © 2013 Remedies: Lifestyle Changes Encourage mindful Educate and inform home cooking vs. 4th step oversized fast-food + on healthy fast-food options portions Combat powerful Offer unlimited 5th step advertising for quick- fix weight + support (affordable personal coaching) loss methods Organize healthy 6th step living communities + Monitor daily
  • 13. All rights reserved © 2013 Remedies: Surgery Restrictive 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.
  • 14. All rights reserved © 2013 LeBootCamp 1.2 million members For more information on LeBootCamp go to http://www.LeBootCamp.com Facebook page: http://www.facebook.com/lebootcamp Twitter: http://www.twitter.com/lebootcamp

Notas del editor

  1. http://www.voxeu.org/article/100-years-us-obesity
  2. http://www.economiematin.fr/les-experts/item/208-etats-unis-probleme-societe-obesite-poids-coutStyletelegraphique
  3. Figures for state obesity: http://www.cdc.gov/obesity/data/adult.html
  4. http://www.everydayhealth.com/weight/outdoor-fast-food-ads-linked-to-obesity.aspx?xid=tw_everydayhealth_sfProcessed foods > Global market for machinery and equipment used in food processing expected to be worth $45+ billion by 2015 [Global Industry Analysts]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. [Centers for Disease Control and Prevention study, 2013]Unstructured meal times >Fast food > Adults average of 11.3% of daily calories consumedfrom fast food in 2007-2010 [CDC survey, 2013]Snacking > The average American eats 4.9 snacks and meals daily -- a 29% increase since the 1970s [2011 study published in PLoS Medicine]Ubiquity of food > “Food is everywhere you turn. It’s in pharmacies, in hardware stores.” [Thomas Farley, NYC Health Commissioner]
  5. http://ucsdnews.ucsd.edu/newsrel/soc/07-07ObesityIK-.aspContagion: Arizona State University researchers published online May 5 in the American Journal of Public Health“http://www.sciencedaily.com/releases/2011/05/110505160953.htm30 min in a car = + 3% risk n obesity
  6. http://www.neatorama.com/2010/09/09/the-history-of-diets/