Exam 4 - Obesity 🍕🍔🥓🍩

Question 1

What BMI ranges classify normal, overweight, and obesity?

Answer 1

Normal: 18.5 to 24.9
Overweight: 25 to 29.9
Obesity: > or equal to 30

Question 2

When should you measure waist circumference to determine cardiometabolic risk?

Answer 2

BMI between 25 and 35

Question 3

What waist measurements correlate to increased cardiometabolic risk?

Answer 3

Men: > or equal to 40 inches

Women: > or equal to 35 inches

Question 4

What percentage of weight loss can reduce risk factors for CVD?

Answer 4

Loss of 5% or greater reduces risk factors

Question 5

What are the commonly recommended diets for Type 2 DM?

Answer 5

DASH, Mediterranean, Carb Counting, Limit Sugar

Question 6

What are the commonly recommended diets for Cardiovascular disease?

Answer 6

DASH, Low Na, Mediterranean

Question 7

What are the commonly recommended diets for Kidney Disease?

Answer 7

DASH, Renal diet

Question 8

What are the commonly recommended diets for Celiac Disease?

Answer 8

Gluten free diet

Question 9

Who should be screened for obesity?

What warrants a referral for an intensive, multicomponent behavioral intervention?

Answer 9

All adults should be screened for obesity.

BMI of 30 or greater should be referred.

Question 10

What defines low risk obesity and what is the recommended treatment plan?

Answer 10

Low risk: BMI of 25-29.9 with no CVD risk factors or other comorbidites

Treatment: Diet and exercise

Question 11

What defines moderate risk obesity and what is the recommended treatment plan?

Answer 11

Moderate risk: BMI of 25-29.9 AND 1 or more CVD risk factors; OR BMI of 30-34.9

Treatment: Diet/Exercise, Intensive multicomponent behavioral modification, and some will have drug therapy

Question 12

What defines high risk obesity and what is the recommended treatment plan?

Answer 12

BMI of 35-40

Treatment: Intensive multicomponent behavioral modification, consideration of drug therapy, bariatric surgery

Question 13

When should drug therapy be considered for obesity?

Answer 13

BMI of 30 or greater, OR >27 with comorbidies

Question 14

What is the 1st line treatment for obesity?

Answer 14

Comprehensive lifestyle program

Question 15

What is the mechanism of Orlistat?

What should be advised while taking this drug?

What are some side effect?

Answer 15

Alters fat digestion by inhibiting pancreatic lipases, increasing fats in the stool.

Take multi-vitamin daily as may decrease absorption of fat soluble vitamins

“Unpleasant” GI side effects

Question 16

What drug is a common choice in Type 2 Diabetics and can help with weight loss?

Answer 16

Liraglutide

Question 17

What is the mechanism of Lorcaserin?

Answer 17

Serotonin agonist which decreases appetite

Question 18

What is the mechanism of Phentermine?

Answer 18

Sympathomimetic

Question 19

What is the most widely prescribed weight loss drug?

Answer 19

Phentermine

Question 20

Which drugs should NOT be used in patients with HTN, CAD, or hyperthyroidism?

Answer 20

Phentermine and Phentermine/topiramate

Question 21

When is bariatric surgery considered?

Answer 21

• BMI of 40 or greater
• BMI 35 to 39.9 + at least 1 serious comorbidity
• BMI 30-34.9 + uncontrollable type 2 DM or metabolic syndrome

Question 22

What are the 2018 physical activity guidelines for Americans?

Answer 22

150-300 min/week of moderate intensity
OR
75-150 min/week of vigorous intensity aerobic physical activity

PLUS muscle strengthening 2 or more days/week

Question 23

What is a great initial activity to recommend to those starting an exercise prescription?

Answer 23

Walking

Question 24

What is the initial goal for weight loss in obese patients?

Answer 24

Lose 5-7% of body weight

Question 25

When should drugs for obesity be discontinued?

Answer 25

If 4-5% weight loss is not obtained after 3 months