Bariatrics

Question 1

Chronic condition in which an individual’s energy intake exceeds their energy expenditure activity/metabolism.

Answer 1

obesity

Question 2

What are the stigmas of Obesity?

Answer 2

low self-esteem
sloppy
eating disorders
earn less money 
depression
linked to poverty
lazy

Question 3

Strategies to avoid bias with obese patients

Answer 3

• 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?

Question 4

What are the conversions from metric to NA units?

Answer 4

• mass in lbs. x 0.455 = mass in kg

- height in inches x 0.0254 = height in meters

Question 5

What is the formula for BMI calculation?

Answer 5

Mass (Kg) / Height (M)2

Question 6

BMI Classification Index

Answer 6

Optimal: 18.5 - 24.9k/m2
Overweight: >25k/m2
Obese: >30k/m2
Very Obese: >40k/m2

Question 7

What are the other Body Fat measurements taken?

Answer 7

• waist circumference
• waist to hip ratio
• skin fold thickness
• location of fat and BF%

Question 8

Predisposing Risk Factors of Obesity

Answer 8

Sedentary lifestyle
Dietary habits 
High glycemic diet
Genetic factors
Medications
Socioeconomic factors
Smoking cessation
Psychological
Chronic Illness

Question 9

Obesity Posture Adaptations

Answer 9

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

Question 10

Obesity Gait Deviations

Answer 10

slower speed and velocity
shorter step length
longer stance phase
shorter swing phase
wider BOS
larger step width
reduced ankle PF
increased arm swing

Question 11

How would sit to stand be affected by obesity?

Answer 11

reduced trunk flexion
increased ankle DF
reduced joint torque
increased joint torque at knees

Question 12

Bed mobility considerations for an obese patient

Answer 12

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

Question 13

A test that is used if mobility status is unclear and it is the first time the person is getting up out of bed

Answer 13

Egress Test

Question 14

Abdominal adipose tissue releases fatty acids into the blood circulatory system resulting in multiple organ dysfunction and adjacent internal organs

Answer 14

Syndrome X (metabolic syndrome)

Question 15

Health Consequences of Obesity

Answer 15

Cardiovascular diseases
Hypertension (HTN)
Diabetes Mellitus
Hypercholesteremia
Neuro disorders
Gallstones
Osteoarthritis
Osteoporosis
Cancer
Heat intolerance
Respiratory dys
Skin breakdown
Dehydration

Question 16

Health Benefits of 10% weight loss

Answer 16

blood pressure
diabetes
lipids: total cholesterol, decline in LDL/increase in HDL, triglycerides

Question 17

Bariatric Medical Management

Answer 17

Diet
Exercise
Appetite suppressants  
Lipase Inhibitors 
Antidepressants
 Behavioral Therapy
Psychological Therapy and Support Groups

Question 18

Exercise Program guidelines for Obese patients

Answer 18

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.

Question 19

Bariatric Exercise Protocol

Aerobic

Answer 19

Aerobic:
modified intensity
30 to 50% MHR
Gradual increase of intensity

Question 20

Bariatric Exercise Protocol (Resistance)

Answer 20

Resistance:
established set weight
10-15 reps per set
2-3x/weekly
30 min involving 2 sets per major muscle groups 1 min rest

Question 21

Exercise Precautions for an obese patient

Answer 21

Non weight bearing exercises if joint pain and injury
Watch for hyperthermia
Hydrate before, during and after exercise
Diabetic Precautions
Monitor vital signs