Fuzzy logic as a decision-making support system for the indication of bariatric surgery based on an index (OBESINDEX) generated by the association between body fat and body mass index

Background: A Fuzzy Obesity Index (OBESINDEX) for use as an alternative in bariatric surgery indication (BSI) is presented. The search for a more accurate method to evaluate obesity and to indicate a better treatment is important in the world health context. BMI (body mass index) is considered the main criteria for obesity treatment and BSI. Nevertheless, the fat excess related to the percentage of Body Fat (%BF) is actually the principal harmful factor in obesity disease that is usually neglected. This paper presents a new fuzzy mechanism for evaluating obesity by associating BMI with %BF that yields a fuzzy obesity index for obesity evaluation and treatment and allows building up a Fuzzy Decision Support System (FDSS) for BSI.

Methods: Seventy-two patients were evaluated for both BMI and %BF. These data are modified and treated as fuzzy sets. Afterwards, the BMI and %BF classes are aggregated yielding a new index (OBESINDEX) for input linguistic variable are considered the BMI and %BF, and as output linguistic variable is employed the OBESINDEX, an obesity classification with entirely new classes of obesity in the fuzzy context as well is used for BSI.

Results: There is a gradual, smooth obesity classification and BSI when using the proposed fuzzy obesity index when compared with other traditional methods for dealing with obesity.

Conclusion: The BMI is not adequate for surgical indication in all the conditions and fuzzy logic becomes an alternative for decision making in bariatric surgery indication based on the OBESINDEX

The Effect of Obesity on State Health Care Expenditures: An Empirical Analysis

The purpose of this study is to examine the effects of obesity rates on per capita state health care expenditures. A two-stage least square regression model is used. In the first stage of the estimation, factors influencing obesity rates are determined. The determinants of obesity rates are outlined throughout the research process. In the second stage, the impact of obesity rates on per capita health expenditures across states is evaluated. The empirical results indicate that obesity rates do indeed have a direct effect on state health care expenditures. After reviewing the project’s results, various solutions are proposed as possible methods to slow and perhaps reverse growing obesity rates with the objective of reducing health care expenditures. The solutions offered may possibly decrease the prevalence of obesity across the nation and in turn lower per capita health care spending

Should strategies to tackle childhood obesity also focus on mental health?

Childhood obesity continues to be a concern in the UK as in many other countries. Although there has been a ‘levelling off’ of BMI recorded through the National Childhood Measurement Programme in recent years the upward trend continues in older and more deprived children. Childhood obesity has been linked to poor mental health but whether psychological and social problems are a consequence or a contributor to obesity is unknown. Childhood obesity programmes that recognise and address psychosocial problems are proving useful in addressing obesity problems but there continued support is subject to continued funding. School Nurses, by measuring children’s height and weight, can identify children at risk of obesity but this is ineffective on its own and more support and advice is needed for School Nurses on how to tackle the complex conditions surrounding childhood obesity

Obesity and diabetes mellitus association in rural community of Katana, South Kivu, in Eastern Democratic Republic of Congo : Bukavu Observ Cohort study results

Background: Factual data exploring the relationship between obesity and diabetes mellitus prevalence from rural areas of sub-Saharan Africa remain scattered and are unreliable. To address this scarceness, this work reports population study data describing the relationship between the obesity and the diabetes mellitus in the general population of the rural area of Katana (South Kivu in the Democratic Republic of the Congo). Methods: A cohort of three thousand, nine hundred, and sixty-two (3962) adults (>15 years old) were followed between 2012 and 2015 (or 4105 person-years during the observation period), and data were collected using the locally adjusted World Health Organization's (WHO) STEPwise approach to Surveillance (STEPS) methodology. The hazard ratio for progression of obesity was calculated. The association between diabetes mellitus and obesity was analyzed with logistic regression. Results: The diabetes mellitus prevalence was 2.8 % versus 3.5 % for obese participants and 7.2 % for those with metabolic syndrome, respectively. Within the diabetes group, 26.9 % had above-normal waist circumference and only 9.8 % were obese. During the median follow-up period of 2 years, the incidence of obesity was 535/100,000 person-years. During the follow-up, the prevalence of abdominal obesity significantly increased by 23 % (p < 0.0001), whereas the increased prevalence of general obesity (7.8 %) was not significant (p = 0.53). Finally, diabetes mellitus was independently associated with age, waist circumference, and blood pressure but not body mass index. Conclusion: This study confirms an association between diabetes mellitus and abdominal obesity but not with general obesity. On the other hand, the rapid increase in abdominal obesity prevalence in this rural area population within the follow-up period calls for the urgent promoting of preventive lifestyle measures

Obesity, perceived weight discrimination, and psychological well-being in older adults in England

Objective To examine whether the adverse effect of obesity on psychological well-being can be explained by weight discrimination. Methods The study sample included 5056 older (≥50 y) men and women living in England and participating in the English Longitudinal Study of Ageing. Participants reported experiences of weight discrimination in everyday life and completed measures of quality of life (CASP-19 scale), life satisfaction (Satisfaction With Life Scale), and depressive symptoms (eight-item CES-D scale). Height and weight were objectively measured, with obesity defined as BMI ≥30 kg/m2. Mediation analyses were used to test the role of perceived weight discrimination in the relationship between obesity and each psychological factor. Results Obesity, weight discrimination, and psychological well-being were all significantly inter-related. Mediation models revealed significant indirect effects of obesity through perceived weight discrimination on quality of life (β = −0.072, SE = 0.008), life satisfaction (β = −0.038, SE = 0.008), and depressive symptoms (β = 0.057, SE = 0.008), with perceived weight discrimination explaining approximately 40% (range: 39.5-44.1%) of the total association between obesity and psychological well-being. Conclusions Perceived weight discrimination explains a substantial proportion of the association between obesity and psychological well-being in English older adults. Efforts to reduce weight stigma in society could help to reduce the psychological burden of obesity

Childhood Obesity and Familial Hypercholesterolemia: Genetic Diseases that Contribute to Cardiovascular Disease

Childhood obesity occurs as the result of an imbalance between caloric intake and energy expenditure. Genetic risk factors for obesity have become an area of research due to its permanency. Mutated genes such as Fat Mass and Obesity Associated (FTO), Leptin (LEP), Leptin Receptor (LEPR), Melanocortin 4 Receptor (MC4R), Adiponectin C1Q and Collagen Domain Containing (ADIPOQ), Proprotein Convertase Subtilisin/Kexin Type 1 (PCSK1), and Peroxisome Proliferator-Activated Receptor Gamma (PPARG) all contribute to the development of childhood obesity. In the presence of high cholesterol caused by obesity, the genetic condition known as familial hypercholesterolemia is exacerbated. Familial hypercholesterolemia is caused by a mutation in the following genes: Low Density Lipoprotein Receptor (LDLR), Apolipoprotein B (APOB), Low Density Lipoprotein Receptor Adaptor Protein 1 (LDLRAP1), and the Proprotein Convertase Subtillisin/Kexin Type 9 (PCSK9). Familial hypercholesterolemia and childhood obesity both contribute to elevated serum cholesterol levels resulting in the accelerated progression of atherosclerosis in children. Another sequela of hypercholesterolemia, atherosclerosis, is an arterial disease that contributes to the development of cardiovascular disease in children. Nurses play a prominent role in the prevention of childhood obesity through education within the community and school setting. As a result of childhood obesity and familial hyperlipidemia, both genetically-linked, cardiovascular disease has become prevalent in the pediatric population

Circulating SIRT1 inversely correlates with epicardial fat thickness in patients with obesity

Background and aim: Obesity is increasing worldwide and is related to undesirable cardiovascular outcomes. Epicardial fat (EF), the heart visceral fat depot, increases with obesity and correlates with cardiovascular risk. SIRT1, an enzyme regulating metabolic circuits linked with obesity, has a cardioprotective effect and is a predictor of cardiovascular events. We aimed to assess the relationship of EF thickness (EFT) with circulating SIRT1 in patients with obesity. Methods and results: Sixty-two patients affected by obesity and 23 lean controls were studied. Plasma SIRT1 concentration was determined by enzyme-linked immunosorbent assay (ELISA). EFT was measured by echocardiography. Body mass index (BMI), waist circumference, heart rate (HR), blood pressure, and laboratory findings (fasting glucose, insulin, HbA1c, cholesterol, and triglycerides) were assessed. SIRT1 was significantly lower (P = 0.002) and EFT was higher (P < 0.0001) in patients with obesity compared with lean controls. SIRT1 showed a negative correlation with EFT and HR in the obesity group (rho = -0.350, P = 0.005; rho = -0.303, P = 0.008, respectively). After adjustment for obesity-correlated variables, multiple linear regression analysis showed that EFT remained the best correlate of SIRT1 (beta = -0.352, P = 0.016). Conclusions: Circulating SIRT1 correlates with the visceral fat content of the heart. Serum SIRT1 levels might provide additional information for risk assessment of coronary artery disease in patients with obesity. (C) 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved

Defining Obesity: An Argument for the Social Environment Perspective

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, are largely ignored. The traditional, medicalized narrative is the dominant narrative in U.S. society today. As a result, policy initiatives aimed at reducing the prevalence of obesity focus on changing individuals’ behaviors. One such initiative is to tax sugar-sweetened beverages (SSBs). The idea is to deter individuals from buying sugary drinks and steer them towards healthier options. In this paper, I use an SSB tax policy in order to examine how obesity is defined, measured, and viewed by different groups in American society. Furthermore, I argue that the traditional narrative of obesity is flawed and contributes to unnecessary negative stigma of the obese. In contrast, I will show that social factors play the most important role in the growing trend towards larger and heavier bodies. Therefore, policy initiatives aimed at reducing obesity should focus on reducing social disparities in society