Obesity

Background and Overview

• Considered BMI of 30+
• Not DSM disorder, but may be a consequence
• Statistics
  • In 2008, 33.8% of adults in the United States were obese; 37.5% in 2010
  • Mortality rates
  • Close to those associated with smoking
  • Increasing more rapidly in children/teens
  • Obesity also growing rapidly in developing countries

Obesity and Disordered Eating Patterns

• Obesity and night eating syndrome
  • Occurs in 7 to 19% of treatment seekers
  • Occurs in 55% of individuals seeking bariatric surgery
  • Consume 1/3+ of daily calories after dinner
  • Get up during the night to eat
  • Patients are wide awake and do not binge eat
  • Often not hungry, skip breakfast the next morning
• Causes
  • Obesity is related to technological advancement
  • Promotes inactive, sedentary lifestyle
  • Genetics account for about 30% of obesity cases
  • Psychosocial factors contribute as well
  • More likely to be obese if people in close social circles are also obese

Obesity Treatment

• Efficacy
  • Moderate success with adults
  • Greater success with children and adolescents
  • Recent study suggests that the combination of restricted calorie intake, increased physical activity, and behavior therapy tends to lead to more weight loss than any of these components on their own
• Treatment progression – from least to most intrusive options
• First step: Self-directed weight loss programs
• Second step: Commercial self-help programs
• Third step: Behavior modification programs
• Last step: Bariatric surgery