Endocrine: Obesity Flashcards
Obesity in what area of the body has the following effects?
- increased risk for cardiometabolic disease
- decreased life expectancy
abdominal obesity
Waist circumference is measured for pts with BMI between…
25-35
A waist circumference of _____ in men and ______ in women confers increased CV risk
40+ men
35+ women
This disease is defined as…
Chronic disease with ↑ body fat, adipose dysfunction resulting in adverse metabolic, biomechanical, psychosocial health consequences
obesity
What labs should be considered for obesity? (4)
fasting glucose/Hba1c
TSH
Liver Enzymes
Fasting lipids
What should the initial goal of weight loss be for obesity?
5-7% of body weight
Weight loss of _____% or morereduces risks associated with obesity…
> 5%
The following MNT diets are effective for…
DASH
Mediterranean
CHO Counting
Sugar limiting
T2DM
The following MNT diets are effective for…
DASH
Mediterranean
low sodium
CVD
The following MNT diets are effective for…
DASH
Renal
CKD
sedentary lifestyle is a strong predictor of…
mortality
The below are two immediate effects of:
↓ Anxiety & BP
↑ Sleep, cognitive fxn, insulin sensitivity
exercise in obese pts.
What are 3 long-term benefits of exercise?
↑ CardioPulm Fitness, strength
↓ BP, depression
how many minutes of moderate exercise are recommended weekly?
(moderate = talk, no singing)
150-300 min
how many minutes of vigorous exercise is recommended in lieu of moderate…
(vigorous = few words)
75-150
How many days a week should strength training occur?
2+
What is the FITT protocol for exercise?
frequency, intensity, time, type
5+ days
modorate-vigorous
30+ minutes
major muscle groups, start w. walking
Who should be screened for obesity?
all adults
Intensive, multicomponent, behavioral intervention for obesity (BMI 30+) includes what frequency of sessions?
12-26/yr,
2 sessions monthly x 3+ mo
What are the 5 As of counseling?
ask/address advise assess assist arrange
What Tx?
BMI 25 to 29.9 with no CVD risk factors or comorbidities
diet & exercise counseling
low risk
What tx?
BMI 25 to 29.9 AND 1+ CVD risk factors
BMI 30 to 34.9
Intensive, multicomponent behavioral modification
+/- drug therapy
What tx?
BMI 35 to 40, BMI > 40
Intensive, multicomponent behavioral modification
+/- drug therapy
+/- bariatric surgery
1st line tx for obesity is always…
lifestyle program
if weight loss on lifestyle modification program is < 5% in 3-6 months, what can you consider?
drug therapy
What is the goal of drug therapy in obesity? (3)
4-8% body weight loss, improve health, minimize adverse effects
If a patient has a BMI of 30+ or > 27 with comorbidity, what can you consider adding to the tx regimen?
drug therapy
Which obesity drug?
Inhibits pancreatic lipase
May decrease fat soluble vitamin absorption (ADEK)
orlistat
Which obesity drug?
GLP-1 Receptor Agonist
SQ admin
DOC w. T2DM
liraglutide
Which obesity drug?
Selective Serotonin Agonist
Decrease Appetite
Limited safety data
Lorcaserin
This obesity drug should be avoided w. HTN, CAD, Hyperthyroid
phentermine/topiramate
Which obesity drug?
Sympathomimetic
Most prescribed
most SFx
avoid w. HTN, CAD, Hyperthyroid
phentermine
What four factors should be monitored during drug therapy for obesity?
weight, BP, HR, SFx
Neuropsych sfx can be present with what two drugs?
lorcaserin, phentermine-topiramate
If weight loss of 4-5% is not achieved after 3 mo of obesity drug therapy, what can you consider?
switching meds
hCG for weight loss requires a diet of ____ and is/isn’t a recommended therapy
500kcal
not recommended
What are three bariatric surgical procedures?
sleeve gastrectomy
roux en Y gastric bypass
Adjustable gastric band
The below are contraindications for…
Eating disorder Untreated mental illness EtOH, drug abuse Coagulopathy Severe cardiac disease Inability to comply
bariatric surgery
The below are therapeutic effects accomplished via…
Restriction, malabsorption, decrease appetite via hormone modulation
bariatric surgery
3 indications for bariatric surg.
BMI 40+
35-29.9 + 1+ comorbidity
30-34.9 w/ uncontrolled T2DM or Metabolic Syndrome
