Download Free Medical Obesity PowerPoint Presentation

Obesity PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : The facts and figures relating to obesity...The health problems obesity can cause

Tags : Obesity,obesity symptoms,obesity treatment,Overweight,Obesity and overweight

Published on : Nov 05, 2023 | Views : 857 | Downloads : 4

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

Goring and Woodcote Medical Practice Patient Participation Group (PPG) Obesity and Self-Care 4 November 2017 Slide 1 Open Meeting
Slide 2-

Agenda PPG Notices: OCCG Primary Care Meeting – George Hotel Wallingford, 28 Nov 1830-2000 Online access to medical records –help with the “Patient Access” programme Obesity – the Primary Care perspective – Dr Andy Goode Obesity Treatments – Mr Greg Jones Questions Slide 2
Slide 3-

Goring & Woodcote Medical Practice PPG Open Meeting 4 November 2017 OBESITY Presented by Dr Andy Goode
Slide 4-

ppt slide no 4 content not found
Slide 5-

OBESITY What we are going to cover… The facts and figures relating to obesity The health problems obesity can cause How the Practice team can help patients who want to tackle their obesity problem What secondary care can offer – eg bariatric surgery
Slide 6-

Obesity – the facts Obesity represents the greatest threat to health in the developed world, with poor diet contributing to more disease than physical inactivity, smoking and alcohol combined. Obesity rates have almost doubled in the last 20 years! It is suggested that by 2050 obesity will have an annual cost to the nation of nearly £50 billion pounds. The majority of the obese adult population do not identify themselves as either obese or even very overweight.
Slide 7-

What is Obesity ? Overweight and obesity are terms that refer to an excess of body fat and they usually relate to increased weight-for-height. The most common method of measuring obesity is the Body Mass Index (BMI). In adults, a BMI of 25kg/m² to 29.9kg/m² means that person is considered to be overweight, a BMI of 30kg/m² or higher means that person is considered to be obese. This is a crude tool.
Slide 8-

(NICE) recommends the use of BMI in conjunction with waist circumference as the method of measuring overweight and obesity and determining health risks. In order to measure abdominal obesity, waist circumference is measured, and categorised into desirable, high and very high, by sex-specific thresholds. Men Desirable = Less than 94 cms (<37”) High = Between 94-102 cms (37”-40”) Very high = More than 102 cms (>40”) Women Desirable = Less than 80 cms (<31”) High = Between 80-88 cms (31”-34”) Very high = More than 88 cms (>34”)
Slide 9-

Obesity prevalence varies with age for both males and females, with the highest obesity levels in the 55-64 age group. Adult obesity: Prevalence
Slide 10-

OBESITY STATISTICS In 2015, 58% of women and 68% of men were overweight or obese. Obesity prevalence increased from 15% in 1993 to 27% in 2015. In 2015/16, over 1 in 5 children in Reception, and over 1 in 3 children in Year 6 were measured as obese or overweight.
Slide 11-

Prevalence of morbid obesity (a BMI of 40+) has more than tripled since 1993, and reached 2% of men and 4% of women in 2015.
Slide 12-

In 2015/16 there were 525,000 admissions in NHS hospitals where obesity was recorded as a contributory factor.
Slide 13-

Health problems related to obesity Hypertension High blood pressure is twice as common among obese adults as among those of a normal weight (43% of obese men and 37% of obese women, compared with 21% of men and 18% of women with BMI within the normal range).
Slide 14-

Health problems related to obesity Diabetes Number of people diagnosed with diabetes has increased by 60% in the last decade. Prevalence of diabetes (diagnosed and undiagnosed) among adults with desirable and very high waist circumference was 2% and 11% respectively.
Slide 15-

Pre-diabetes Higher risk of going on to develop diabetes than the background population. A warning alarm. Opportunity to reduce risk and change before diabetes develops. Medication can help with this but weight loss through lifestyle change really helps.
Slide 16-

Obesity – other health risks Heart disease & stroke Some cancers Depression & stress Arthritis Breathing problems, such as asthma and sleep apnoea (when a person stops breathing for short episodes during sleep)
Slide 17-

Weight loss – not a simple solution? It is widely recognised that obesity and tackling weight loss can also be heavily linked to psychological problems affecting a patient. Depression Obesity At the Practice, we can help and support patients and refer them for specialist opinion as appropriate.
Slide 18-

How can patients help themselves - diet? 26% of adults ate the recommended 5 or more portions of fruit and vegetables a day in 2015. Women (27%) were more likely to do so than men (24%). Poor diet and nutrition are recognised as major contributory risk factors for ill health and premature death.
Slide 19-

How can patients help themselves – diet Start a diet – which one ? – how big is a normal portion ? 5:2 diet, Paelo diet, Cambridge diet, South Beach diet See our portion size plates at the Practice Join a slimming group - which one ? Weightwatchers, Slimming World OR Come to the Practice and see Nicky our HCA who has a special interest in supporting patients through weight loss
Slide 20-

How can patients help themselves – activity ? In 2015/16, 26% of adults were classified as inactive (fewer than 30 minutes physical activity a week). Less active and less fit people have a greater risk of developing high blood pressure. Physical activity can reduce your risk for type 2 diabetes. Studies show that physically active people are less likely to develop coronary heart disease than those who are inactive.
Slide 21-

How can patients help themselves – activity Join a local Gym or exercise at home! Go for a walk! Walking is simple, free, and one of the easiest ways to get more active, lose weight and become healthier. You don't have to walk for hours. A brisk 10-minute daily walk has lots of health benefits and counts towards your recommended 150 minutes of weekly exercise Join the local Goring Gap Health Walks! Go for a swim! Join a dance class! Anything to get you moving and hopefully having fun!
Slide 22-

How can we help patients in primary care Help and support patients who want to lose weight and become more active Monitor their progress Refer patients to weight loss and activity programmes
Slide 23-

Medication Orilstat Can only be continued if causing weight loss Affects absorption of fat from the gut Causes diarrhoea GLP-1 agonist Medication (injection) that we can use in diabetic patients to improve blood glucose control and fortuitously causes some weight loss in certain patients.
Slide 24-

Options in secondary care We can refer patients to secondary care so that they can discuss options such as weight loss surgery, also called bariatric or metabolic surgery, which is sometimes used as a treatment for people who are very obese. It can lead to significant weight loss and help improve many obesity-related conditions, such as type 2 diabetes or high blood pressure. But it's a major operation and in most cases should only be considered after trying to lose weight through a healthy diet and exercise.
Slide 25-

What are the Treatments for Obesity Mr Greg Jones Consultant Upper GI & Bariatric Surgeon Royal Berkshire NHS Foundation Trust
Slide 26-

What I will cover Secondary care treatment options Non-surgical weight loss Bariatric surgery Secondary treatment options for diabetics What surgery involves Outcomes from surgery
Slide 27-

Model of Care in the UK Tier 4 - Specialised Complex Obesity Services (including bariatric surgery) Tier 3 - Multi-disciplinary team obesity service to provide an intensive level of input to patients. Tier 2 - Primary Care with Community Interventions Tier 1 - Primary Care and Community Advice
Slide 28-

BMI
Slide 29-

BMI
Slide 30-

Tier 3 weight loss Up to 77,000 people in West Berkshire. Not currently available Who gets priority?
Slide 31-

BMI
Slide 32-

Tier 3 referral BMI > 50 (consider surgery as primary therapy) BMI > 40 BMI > 35 + Obesity related co-morbidity BMI 30 – 34.9 with recent onset type 2 diabetes Lower BMI in recent onset diabetes in Asian population
Slide 33-

Obesity related disease
Slide 34-

Obesity related disease
Slide 35-

Obesity related disease
Slide 36-

Obesity related disease
Slide 37-

Obesity related disease
Slide 38-

Obesity related disease Diabetes High blood pressure Heart disease Sleep apnoea Arthritis High cholesterol Polycystic Ovaries Asthma
Slide 39-

Tier 3 weight loss Dietician Psychologist Physician / GP Trainer
Slide 40-

ppt slide no 40 content not found
Slide 41-

Tier 3 results Also: Increase in exercise Increase in quality of life Improvement in diabetes More likely to have their “5 a day”
Slide 42-

Tier 3 results BUT: Weight regain at 2-4 years Not available locally MOST health gains with 10% weight loss Results are around 8% weight loss
Slide 43-

BMI
Slide 44-

Tier 3 for Type 2 diabetics Structured programme 1. Active loss – 800KCal food eplacement 2. Re-introduction 3. Sustain For BMI 28-35 Type 2 DM Dr Theingi Aung - RBH
Slide 45-

Tier 4 Royal Berkshire Hospital BMI > 50 (consider surgery as primary therapy) BMI > 40 BMI > 35 + Obesity related co-morbidity BMI 30 – 34.9 with recent onset type 2 diabetes Lower BMI in recent onset diabetes in Asian population
Slide 46-

Time line of assessment of RBH Obesity pathway for surgery
Slide 47-

Royal Berkshire Hospital Surgical Team: 3 consultant surgeons supported by 8 junior doctors Consultants: See each others patients Before and after surgery Operate on patients seen by other consultant May operate together
Slide 48-

Stomach and intestinal tract
Slide 49-

Operations Intra-Gastric Balloon Gastric Band Sleeve Gastrectomy Gastric Bypass
Slide 50-

Gastric Balloon
Slide 51-

Gastric Balloon Day case procedure Endoscopy - camera passed down gullet into stomach General Anaesthetic Balloon is size of 2 cans of Coke
Slide 52-

Gastric Balloon 20-30% excess weight loss at 6 months Need to be removed / replaced after 6 months Feeling sick and vomiting common early on after the procedure.
Slide 53-

Gastric Band
Slide 54-

Gastric Band Arrive morning of Surgery General Anaesthetic 5 small cuts (0.5-1cm)– KEYHOLE surgery Takes 1 hour Day surgery
Slide 55-

Works by Dividing the stomach with inflatable band Adjustable to reach goal Restricts amount you can eat Stimulates nerves telling the brain you are full
Slide 56-

Benefits Safest, simplest procedure Day case surgery “reversible” 50-60% excess weight loss No major nutritional problems Good long term evidence that it works
Slide 57-

Problems Least amount of excess weight loss Less effect on other medical problems Less likely to cure/benefit diabetes May take some time to achieve best fill of the band Band slippage/erosion Further surgery 30%
Slide 58-

Gastric Bypass
Slide 59-

Gastric bypass Arrive morning of surgery General Anaesthetic 5 small (1cm) cuts – KEYHOLE surgery Takes 1.5 hours 2 nights stay, 60% have 1 night stay 2 week liquid diet
Slide 60-

Robotic Gastric Bypass Royal Berkshire – only place in the UK
Slide 61-

Works by Reducing the stomach to the size of your thumb. Reducing the amount you can eat Separating most of the stomach from food Changes the hunger hormones so you feel less hungry Re-arranging the small bowel Changes the hunger hormones so you feel full These hormone changes help cure diabetes
Slide 62-

Benefits Most excess weight loss (70-80%) Best for helping other medical problems Highest cure for diabetes Long term evidence (20 years)
Slide 63-

Problems More early complications than Band (although very few) Longest operation Re-arrangment of Anatomy Small risk of leak Nutritional supplements (tablet and injection) and blood tests required.
Slide 64-

Sleeve Gastrectomy
Slide 65-

Sleeve Gastrectomy
Slide 66-

Sleeve Gastrectomy Arrive morning of surgery General Anaesthetic 5 small (1cm) cuts – KEYHOLE surgery Takes 1 hour 2 nights stay Water day of operation Liquids day after surgery
Slide 67-

Works by Reduces amount you can eat as stomach is now one 5th of its original size Removes the part of stomach from food that triggers hormone release Changes the hunger hormones so you feel less hungry Food enters the small bowel quicker Changes the hunger hormones so you feel full These hormone changes help cure diabetes
Slide 68-

Benefits Weight loss starts from time of surgery Loose 50-70% of excess weight over 2 years Cure or reduce need for diabetes medicines No re-arrangement of anatomy Less complicated than bypass
Slide 69-

Problems Not reversible Risk of weight regain if “stretching of sleeve” 15% do not loose expected weight Leak Heart burn Newer procedure, only have 10 year data
Slide 70-

UK Outcomes
Slide 71-

UK Diabetes
Slide 72-

Diabetes Prevention
Slide 73-

Risk of Dying
Slide 74-

Day to day living Improves activity and exercise Most able to walk 3 flights of stairs Back to work Back to hobbies
Slide 75-

14% of deaths from cancer in men & 20% of deaths in women are due to overweight and obesity Hospital visits for all cause cancer 1 in 50 Bariatric surgery patients 1 in 12 similar non-surgery patients Breast cancer even more reduced. Cancer
Slide 76-

Quality of life Looked at for 25 years after bypass Improvement seen from 5-25 years
Slide 77-

Summary Surgery Safe Best weight loss results Best results for other medical problems Keyhole surgery Non-Surgical Limited Long term results not impressive
Slide 78-

Referrals NHS – Royal Berkshire Hospital Consult your GP for referral Private – Spire Dunedin Same Surgeons and team 0118 958 7676 DunedinHospBariatrics@spirehealthcare.com
Slide 79-

Questions? Slide 79