Bariatrics Flashcards
Chronic condition in which an individual’s energy intake exceeds their energy expenditure activity/metabolism.
obesity
What are the stigmas of Obesity?
low self-esteem sloppy eating disorders earn less money depression linked to poverty lazy
Strategies to avoid bias with obese patients
- consider patients exp in your setting
- recognize the complex etiology: not just willpower
- acknowledge difficulty of lifestyle change
- identify one’s own bias
- do I treat the individual or only the condition?
What are the conversions from metric to NA units?
- mass in lbs. x 0.455 = mass in kg
- height in inches x 0.0254 = height in meters
What is the formula for BMI calculation?
Mass (Kg) / Height (M)2
BMI Classification Index
Optimal: 18.5 - 24.9k/m2
Overweight: >25k/m2
Obese: >30k/m2
Very Obese: >40k/m2
What are the other Body Fat measurements taken?
- waist circumference
- waist to hip ratio
- skin fold thickness
- location of fat and BF%
Predisposing Risk Factors of Obesity
Sedentary lifestyle Dietary habits High glycemic diet Genetic factors Medications Socioeconomic factors Smoking cessation Psychological Chronic Illness
Obesity Posture Adaptations
anterior displacement of COG increased head protrusion exaggerated thoracic kyphosis increased lumbar lordosis pelvic anteversion hips in IR knees hyperextension feet: pedis planus wider BOS compensatory scoliosis
Obesity Gait Deviations
slower speed and velocity shorter step length longer stance phase shorter swing phase wider BOS larger step width reduced ankle PF increased arm swing
How would sit to stand be affected by obesity?
reduced trunk flexion
increased ankle DF
reduced joint torque
increased joint torque at knees
Bed mobility considerations for an obese patient
use appropriately sized beds
patients likely have preferred bed mobility techniques based on size
elevated risk of friction injuries
friction reduction sheets, Trendelenburg position, airflow mattress, bed rails, additional assistance
A test that is used if mobility status is unclear and it is the first time the person is getting up out of bed
Egress Test
Abdominal adipose tissue releases fatty acids into the blood circulatory system resulting in multiple organ dysfunction and adjacent internal organs
Syndrome X (metabolic syndrome)
Health Consequences of Obesity
Cardiovascular diseases Hypertension (HTN) Diabetes Mellitus Hypercholesteremia Neuro disorders Gallstones Osteoarthritis Osteoporosis Cancer Heat intolerance Respiratory dys Skin breakdown Dehydration
Health Benefits of 10% weight loss
blood pressure
diabetes
lipids: total cholesterol, decline in LDL/increase in HDL, triglycerides
Bariatric Medical Management
Diet Exercise Appetite suppressants Lipase Inhibitors Antidepressants Behavioral Therapy Psychological Therapy and Support Groups
Exercise Program guidelines for Obese patients
2000-2800 kcal per week expenditure at 60 min/daily (250-300 min/weekly)
Gradual duration progression
5 - 20 min progression of time
Short bouts of exercise repeated during the day.
Bariatric Exercise Protocol
Aerobic
Aerobic:
modified intensity
30 to 50% MHR
Gradual increase of intensity
Bariatric Exercise Protocol (Resistance)
Resistance: established set weight 10-15 reps per set 2-3x/weekly 30 min involving 2 sets per major muscle groups 1 min rest
Exercise Precautions for an obese patient
Non weight bearing exercises if joint pain and injury
Watch for hyperthermia
Hydrate before, during and after exercise
Diabetic Precautions
Monitor vital signs
