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Clinical Medicine 2 > Exam 3: Obesity > Flashcards

Exam 3: Obesity Flashcards

1
Q

What is the #1 cause of preventable disease and disability?

A

Obesity

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2
Q

How is BMI calculated?

A

Weight (kg)/ Height (m2)

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3
Q

What waist circumference has increased cardiometabolic risk in men?
In women?

A

Men: >40 inches
Women: >35 inches

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4
Q

In what patients should you measure waist circumference?

A

Patients with a BMI between 25 and 35

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5
Q

What are some of the health effects of obesity?

A

-Heart Disease, DM, HTN, CA, HLD, stroke, infertility, liver/gallbladder disease, etc

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6
Q

What are the factors that lead to obesity?

A
  • Behavior/lifestyle
  • Medications
  • neurohormonal
  • Environment
  • Other diseases/genetics
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7
Q

What is the initial goal of weight loss? What effect does this have on health?

A

Initial goal is loss of 5-7% of body weight, which leads to health benefits such as reduced risk of CVD

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8
Q

What two diets are commonly recommended for weight loss and protection against DM and CAD?

A

Mediterranean diet (#1) and DASH diet

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9
Q

What are the benefits of intermittent fasting?

A

Promotes weight loss, improved lipids, and reduced BP/fasting BS/HgA1C independent of any change in physical activity

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10
Q

What is the treatment for patients with a BMI >30?

A

Refer for an intensive, multi component behavior intervention to help make long term changes,
-Comprehensive and high intensity interventions most effective two times a month for >3 years, or 12-26 sessions a year

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11
Q

What are the 5 As when counseling a patient about their weight?

A
  • Ask/address
  • advise
  • Assess
  • Assist
  • Arrange
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12
Q

All patients with BMI >** are candidates for weight loss interventions.

A

25

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13
Q

What patients are at low risk for complications of obesity and what is their treatment?

A
  • BMI of 25-29.9 with no. CVD risk factors or other comorbidities
  • Diet and exercise counselling to prevent weight gain
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14
Q

What patients are at moderate risk for obesty complications and what is their treatment?

A
  • BMI of 25-29.9 and >1 CVD risk factor, OR a BMI of 30-34.9
  • intensive multi component behavioral modification (diet and exercise to support and maintain weight loss) as well as SOME drug therapy (**only indicated if BMI >27)
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15
Q

What patients are high risk for obesity complications and what is their treatment?

A

High risk: BMI of 35-40
Very high risk: >40

-Intensive multicomponent behavioral modification and consideration of drug therapy, bariatric surgery

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16
Q

When should drug therapy be considered?

A
  • BMI >30 or >27 with comorbidities

- Unsatisfactory weight loss (<5% in 3-6 months) with a comprehensive lifestyle program

17
Q

How does Orlistat work?

Side effects?

A

Alters fat digestion by inhibiting pancreatic lipase
-increased fat in stools and may decreased absorption of fat soluble vitamins

Side effect: Unpleasant GI side effects

18
Q

How does Liraglutide work ?

A

Daily SQ injection, GLP1 receptor agonist

-Common choice in Type II DM

19
Q

How does Lorcaserin work?

A

-Serotonin agonist, decreases appetite

20
Q

In what patients should you not use Phentermine/topiramate?

A

Patients with HTN, CAD, and Hyperthyroid

21
Q

What is the use of Phentermine?

A

Sympathomimetic, only FDA approved for short term use

22
Q

What is the most widely prescribed weight loss drug?

A

Phentermine

23
Q

If a patient taking weight loss medications do no have a 4-5% weight loss after 3 months, what should you do?

A

Discontinue that medication, possible try another medication

24
Q

When is bariatric surgery considered?

A
  • BMI >40
  • BMI 35-39.9 with one or more serious comorbidity
  • BMI 30-34.9 and uncontrollable type 2 DM or metabolic syndrome
25
Q

What leads to great weight loss post op in bariatric surgery?

A

Loss of 8% of excess body weight prior to surgery

26
Q

What are the contraindications for bariatric surgery?

A

Eating disorders, untreated mental illness, drug/ETOH abuse, coagulopathy, and severe cardiac disease

27
Q

What are the 3 ways that bariatric surgery increases weight loss?

A
  • Restriction
  • Malabsorption
  • Decrease appetite
28
Q

What are the 3 surgery types commonly used in for bariatric surgery?

A
  • Sleeve gastrectomy
  • Roux-en-Y
  • Adjustable gastric band
29
Q

What are the physical activity guidelines for Americans?

A

-Adults should perform at least 150-300 min/week of moderate intensity OR 75-150 min/week of vigorous intensity aerobic physical activity
AND
Muscle strengthening >2 days a week

Clinical Medicine 2 (22 decks)

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