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Obesity
Evolution – Costs - Origins – Remedies
By Valerie Orsoni (Founder of LeBootCamp.com)

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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

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42% obese
72% unhealthy weight
36% obese
54% unhealthy weight
in millions
Adults only

4. Cost of
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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

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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 Metrics

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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]

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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.

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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- 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

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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

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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.

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