Adult Obesity & Metabolic Syndrome

Question 1

How many categories is obesity divided into?

Answer 1

3 Categories:
30-34.9 = High
35-39.9 = Very high
40 + = severe

Question 2

When is BMI not the perfect measure?

Answer 2

1. Cannot distinguish between lean and fat mass
2. Elderly, ethnic groups, large muscle mass
3. Central obesity

BMI generally underestimates degree of adiposity

Question 3

Waist Circumference

Answer 3

Health risk of obesity influenced by BMI and the way that body fat is distributed

Abdominal adiposity = DM, HTN, CAD, and dyslipidemia

Men: 40 or more
Women: 35 or more

Question 4

Why is abdominal obesity bad?

Answer 4

• Release of FFA into bloodstream, which goes to liver

- Increased VAT correlates with insulin resistance only if there are increased intrahepatic TGs.

Question 5

Metabolic syndrome

Answer 5

• Almost always have abdominal obesity

- Abnormalities in glucose, blood pressure, lipids, proinflammatory/prothrombotic state.

Question 6

Criteria for metabolic syndrome

Answer 6

• Waist circumference cutoffs (men: 40, women: 35)
• TG >150 mg/dL
• HDL-C (men: 130/85)
• Fasting glucose > 110 (or 100)

Must have 3 of the 5

Question 7

Why are we gaining weight and what are the possible causes of obesity

Answer 7

• Obesity is caused by long-term positive energy balance
• Gene-environment interaction in the pathogenesis of obesity
• Costs more to be healthy

Question 8

Regulation of food intake

Answer 8

Complex appetite regulation. Pharm industry hasn’t made a safe option

Question 9

Initial office visit

Answer 9

• Eval of obesity related disease within Hx, PE, labs
• Obtain weight and weight loss history, eating, and activity behaviors
• Search for trigger factors
• Measurements (height, weight, BMI)
• categorize obesity classification and health risk
• Determine readiness
• Tx plan with other people
• Set goals (realistic)

Question 10

Drugs assoc with weight gain

Answer 10

• Steroids
• Antipsychotics
• Antidepressants
• Diabetes drugs (TZD, insulin, sulfonylureas)
• Hormonal agents

Question 11

Secondary causes of obesity

Answer 11

Uncommon

• Low metabolism
• Hypothyroidism
• Cushing’s syndrom
• Prader Willi, Down’s
• Hypothalamic disorders

Question 12

Assessing weight loss readiness

Answer 12

1. Motivation
2. Stress level
3. Psychiatric issues
4. Time availability