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Source: Chen JT, Sheehan AH, Yanovski JA, Calis KA. Obesity. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=133894259. Accessed May 16, 2017.
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Many neurotransmitters and neuropeptides stimulate or depress brain’s appetite network, impacting total calorie intake.
Net balance of energy ingested relative to energy expended over time determines degree of obesity.
Adrenergic stimulation activates lipolysis in fat cells and increases energy expenditure in adipose tissue and skeletal muscle.
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Prevalence.
Varies by sex among racial and ethnic minorities in the United States.
Increases with age until eighth decade.
Increased with lower socioeconomic class and educational achievement.
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Sedentary lifestyle.
Association with other obese individuals.
Lower socioeconomic status.
Lower educational achievement.
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CLINICAL PRESENTATION
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BMI >25, calculated as weight (kg) divided by square of height (m2).
Waist circumference (WC) >40 inches (102 cm) for men and >35 inches (89 cm) for women (narrowest circumference between the last rib and top of iliac crest)
Both of above are independent predictors of disease risk (Table 1).
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