12. Obesity Appendix

Question 1

TEE Total energy expenditure

Answer 1

Over 24h

Sum of

• REE resting energy expenditure, ~60%
• NREE, non-resting energy expenditure, ~30-40%
• TEF thermic effect of feeding, ~5-10%

NREE can be increased through physical activity

Question 2

Losing weight by exercise alone
How much weight
how many calories burnt
How many miles walked

Answer 2

Difficult with exercise alone. 
To lose 1 pound a week
Burn 500 extra calories a day 
Equiv walking 5 miles/day (~8km/d)
Or 35miles/week

Question 3

Caloric deficit

To lose 1 pound a week

Answer 3

To lose 1 pound a week
Eat 3500 calories less/week

Women recommended to reduce by 500cal/d,
Goal intake 1200-1500/d

Men recommended to reduce calories by 750/d,
Goal intake 1500-1800/d

Question 4

Referral to bariatric surgery

ACC/AHA 2013 obesity guidelines

Answer 4

BMI >=40 or
BMI>=35 with one or more obesity associated comorbid conditions

Must be motivated to lose weight, without sufficient response to lifestyle interventions alone

BMI 27 with comorbidities or BMI>30 is when pharmacotherapy May be combined with intensive lifestyle therapies