General and Medical Considerations of Obesity Flashcards
What is apart of weight history assessment?
Family history
Key life stages
Current and/or past medications
Sleep or circadian rhythm patterns
Significant stressors
Major changes in physical activity
What are key life stages for weight history?
Infancy
Childhood
Puberty/Teen years
Obstetric history
Menopause
What medications cause weight gain?
Psychiatric and Neurologic Medications
▫ Antipsychotics
▫ Antidepressants
▫ Antiepileptic
▫ Mood stabilizers
Steroid Hormones
▫ Progestational steroids
▫ Corticosteroids
▫ Hormonal contraceptives
Anti-diabetic Agents
▫ Insulin
▫ Sulfonylureas
▫ Thiazolidinediones
Antihistamines
Antihypertensive Agents
▫ a receptor blockers
▫ B-adrenergic receptor blockers
▫ Calcium channel blockers
Highly Active Antiretroviral Therapy
What antipsychotic medications cause weight gain?
Olanzapine
Clozapine
Risperidone
Quetiapine
Aripiprazole
What antidepressant medications cause weight gain?
- Tricyclics - Imipramine, Amitriptyline
- Triazolopyridines - Trazodone
- Serotonin reuptake inhibitors - Paroxetine, Fluoxetine, Citalopram
- Tetracylcics - Mirtazapine
- Monoamine oxidase inhibitors
What antiepileptic drugs cause weight gain?
Gabapentin (higher doses)
Valproic acid
Carbamazepine
Divalproex
What mood stabilizers cause weight gain?
- Lithium
- Carbamazepine
- Lamotrigine
- Gabapentin (higher doses)
What sleep or circadian rhythm patterns impact weight?
Insufficient Sleep
Circadian Misalignment
▫ Shift work
▫ Jet-lag
Insomnia
Obstructive Sleep Apnea
Narcolepsy
Periodic Limb Movement Disorder
Night Eating Syndrome and Sleep-Related Eating Disorder
When discussing weight history with patients, what questions do you ask?
What has worked
What has not worked
Previous dietary approaches
Medication use
Weight loss surgery
Exercise
Barriers
What are environmental factors that can impact weight?
- Food deserts
- Transportation
- Physical safety for activity
- Lack of access to places for physical activity
- Climate conditions
- Living conditions related to storing/preparing foods
- Work schedule and work physical environment
- Access to screen-based activities
Health related quality of life survey helps determine?
An individual’s or perceived physical and mental health over time.
What are treatment options for behavior therapy?
- Motivational interviewing
- Interpersonal therapy
- Behavioral therapy
- Cognitive therapy
- Cognitive behavioral therapy
- Maintenance-tailored therapy
- Acceptance-based therapy
What are possible contraindications in weight management treatment?
Pregnancy
Eating disorders
▫ Anorexia nervosa
▫ Bulimia
Substance/alcohol use disorders
Treatment specific – i.e. pharmacologic, endoscopic, surgical
contraindications
A comprehensive physical exam should include all of the following?
Inspection
Auscultation
Palpation
Percussion
Polysomnography is a diagnostic test that screens for?
Obstructive sleep apnea
What are possible etiologies of obesity?
- Metabolic factors
- Genetic factors
- Level of activity
- Medications
- Endocrine factors
- Race, sex, and age factors
- Ethnic and cultural factors
- Socioeconomic status
- Dietary habits
- Smoking cessation
- Pregnancy and menopause
- Psychological factors
- History of gestational diabetes
- Lactation history (in mothers)
