8-25 Obesity

Question 1

1) Definition of Obesity?

2) How do you find the BMI

Answer 1

1) Obesity= BMI of 30 or more! [GRTR than 95 percentile for age and gender :-((( ]
2) BMI= Weight(kg) / height (m^2)

Question 2

List the BMI ranges for the 4 Stages of Obesity [4]

Answer 2

*Stage 1 Obesity= 30-34.9

• *Stage 2Obesity = 35-39.9
• **Obese FLAt OuT= BMI is GReater than 40

****SUPER OBESE=BMI GREATER THAN 50!

Question 3

Statistically, What are the Prevalence percentages for OBESITY in our country :-/ [4]

Answer 3

1) 70% Adults are overweight or obese
2) 35% Adults are OBesE

3) 17% of children are OBesE
4) 6% ADULTS ARE MORBIDLY OBESE!

Question 4

What are the 6 theories of etiology for Obesity??

Answer 4

1- Energy intake exceeds energy expenditure (eating a lot more than what you’re actually burning up)
2-Dietary intake INC
3-PHysical activity DEC
4-Genetics (FTO gene/mutated MC4R)
5-Environment (epigenetics[physical vs. maternal/womb]
6-Medications(anti-psychotics, beta blockers, steroids)

Question 5

What’s the newest theory of etiology for Obesity? [3]

Answer 5

New theory of Gut bacteria, social networking and viruses being the cause of Obesity

Question 6

How many calories are in 1 lb. ?

Answer 6

3500 calories = 1 lb. !

Question 7

What is the energy expenditure breakdown for normal people [3]

Answer 7

60-70% Resting expenditure/BMR
20-25% Physical activity
5-10% thermogenesis

Question 8

Children with 1-Obese parent have ___% chance of developing Obesity themselves

Answer 8

Children with 1 Obese parent have 50% chance of developing Obesity themselves!

Question 9

Children with BOTH PARENTS OBESE have ____% chance of developing it themselves

Answer 9

Children with TWO OBESE PARENTS have 85% chance of developing Obesity themselves!

Question 10

BMI ranges for underweight vs. Normal Weight :-) vs. Overweight(almost obese)

Answer 10

A: underweight: less than 18.5 BMI
B: Normal Weight :-)) = [18.5 - 24.9] BMI

C: Overweight(almost obese): 25-29.9 BMI[85-95 percentile for age and gender]

Question 11

List metabolic complications of having more “Fat” than normal..

Answer 11

Fat cells are active endocrine organs that secrete cytokines–>inflammation, dyslipidemia, HTN, Type2DM

Question 12

1) What are some mechanical complications of “fat”

2) What type of appetite regulatory problems occur in overwt pt? [2]

Answer 12

extra Fat–>sleep apnea and osteoarthritis

2)
+INC Ghrelin=INC Obesity ///
+INC Leptin, CCK, PYY (decreases hunger) Resistance=INC Obesity

Question 13

True or False: Infertility, Cancer and Thrombosis are actually all related to Obesity?

Answer 13

TRUE! Cancer, Thrombosis, Infertility and Pancreatitis (in addition to many more) are linked to obesity

Question 14

What are some Psychosocial Consequences of Obesity? [5]

Answer 14

1. Depression
2. DEC education
3. DEC Quality of life
4. DEC household income
5. INC disability/loss of productivity

Question 15

Wht are the 3 treatment options for Obesity?

Answer 15

1- Behavior Modification
2-Pharmacotherapy
3-Bariatric Surgery

Question 16

Obesity is a ____relapsing dz that needs to be _____ NOT ______!

Answer 16

Obesity is a CHRONIC relapsing dz that needs to be MANAGED NOT CURED!

Question 17

Overweight pt (BMI range:_______) will lose ____years of Life by the age of 40

Answer 17

OverWEIGHT pts (BMI: 25-29.9) will lose 3 years of Life by age of 40

Question 18

OBESE pt (BMI range:_______) will lose ____years of Life by the age of 40

Answer 18

OBESE pts (BMI: 30 and Up) will lose 6-7 years of Life by the age of 40

Question 19

OBESE SMOKER pt (BMI range:_______) will lose ____years of Life by the age of 40

Answer 19

OBESE SMOKER pts (BMI still 30 and Up but smoke too) will lose 13-14 years of life by age of 40!!

Question 20

1 lb. of weight = ___lbs excess force on your knees

Answer 20

1 lb of weight = 4 lbs excess force on Knees!

Question 21

A-Weight loss in __year is the BEST indicator for how much wt can be loss in ____ years

B-What is the theory behind this Wt lost maintenance?

Answer 21

A-Wt loss in 1 year is the BEST indicator of how much wt can be lost in 4 years!

B-Theory: 10% of body weight lost and kept off for 1 year=SUCCESS –>20% adults have achieved this goal!

Question 22

What is the US Dietary Recommendation of Physical Activity for people who want to MAINTAIN GOOD WEIGHT? [2]

Answer 22

USD recommends to spend 150 minutes of moderate Physical Activity per week
OR
75 min. of Vigorous activity + 2 strength training days =MAINTAIN WEIGHT

Question 23

1) What are the recommended doses of Meal Replacement for Obese pt?
2) How effective is Meal Replacements?

Answer 23

1) Recommends using a MR(slim fast/lean cuisine/special K) for 1-2 meals every day
2) Pt lose 10 lb more or 3-5 kg with MR!

Question 24

40% of Adults sit for __ hours/day

Answer 24

40% of Adults sit for 6 hours per day–>LAZY lol

Question 25

1) What are the 2 indications for usage of Pharmacotherapy in Obese pt?
2) How effective is this?
3) What is Qsymia?

Answer 25

A)BMI>27 w/comorbidities OR BMI>30 period

B)Failed Wt loss with Lifestyle Modifications for 3 months

2) 5-10% effective/not very effective
3) Qsymia=Phentermine + Topiramate

Question 26

What are the 3 indications for usage of Bariatric Surgery in Obese pts?

Answer 26

1. BMI>35 with comorbidities OR BMI>40 period
2. Failed medical wt loss for 6 months
3. Absence of uncontrolled psychiatric disorder or substance abuse

Question 27

A-What’s the Gold Standard operation for Bariatric Surgery and describe it??

B-What’s next in line and more new age?

Answer 27

A. Gastric Bypass Surgery is the Gold Standard!=bypasses intestine/DEC digestive hormones/ulcer formations/dumping-diarrhea problems from not breaking down High carbs/MOST EFFECTIVE

B-Stomach pouch removal-leaves only a stomach sleeve (small volume)

Question 28

What are the 5 barriers to treating Obesity

Answer 28

Treating Obesity is TURCC man!!

1) Time=MD don’t have time
2) Utility=MD don’t think it’s worth their time
3) Reimbursement=medical tx has no $/Srgery does
4) Cultural barriers
5) Comfort Level=MD not comfortable assessing Obese pt therapy