Jan 15 Weight Loss, Diet, Exercise, Med, surgery and fads Flashcards
How many weight loss medications are approved in Canada? What are their names an WL%?
Xenical® (orlistat): 3% WL
Contrave® (naltrexone and bupropion): 8.1% WL
Saxenda® (liraglutide): 8% WL
Wegovy® (semaglutide): 15% WL
Xenical®:
What is it?
What does it do?
Expected WL%
Side effects:
Cost per month?
Xenical® (orlistat):
Gastrointestinal lipase inhibitor
Inhibits lipase and decreases the absorption of fat in the intestines
3% WL
Loose bowel movements and liver failure (rare)
180$
Contrave®:
Expected WL%
Cost per month?
Bupropion/naltrexone combo (CONTRAVE)
Bupropion: depression/smoking cessation
Naltrexone: opioid/alcohol dependence
8.1% WL
250$
Saxenda®:
What is it? (2 facts)
What does it do?
Expected WL%
Side effects:
Cost per month?
Saxenda (liraglutide)
- GPL1(hormone), released from the intestine to create the feeling of fullness.
- People with obesity have low levels of GPL1, and these levels decrease further with weight loss.
GPL1 helps restore normal eating pattern, and can improve you
* Blood sugars, and pressure
* Cholesterol.
8% WL
- Nausea
- Gallstone
- Acute pancreatitistis (rare)
400$
Wegovy®:
What is it?
Expected WL%
Cost per month?
Semaglutide (Wegovy)
injectable GLP-1
15% WL
1627$
Name 3 Diabetes Medications Brands
Ozempic (Semaglutide)
Rybelsus (Semaglutide),
Tirzepatide (Mounjaro)
Failed weight loss drugs caused what?
(3 facts)
Failed weight loss drugs
- CV Problems
- Cancer
- Suicide
Gastric Banding
(3 facts)
(2 cons)
Gastric Banding
- Keyhole surgery, a band is tied around the stomach resulting in a unbalanced hour-glass shape with a small upper portion.
- Feeling of fullness after ingesting a small portion of food.
- Band is balloon-like and filled with saline solution which allows changes in the tightness of the band via a needle through an access port placed just below the skin
Cons
- Not great long term weight loss
- Not covered by OHIP
Gastric Sleeve:
Process: (2 steps)
Food intake is restricted.
Process:
1. 60 - 80% of the rounded, larger part of the stomach is removed and the stomach takes the shape of a tube or sleeve.
2. The tube-shaped stomach is sealed closed with staples or sutures. The remaining portion of the stomach holds about 15% as much food as the original stomach.
Gastric Bypass:
Process: (3 steps)
Gastric Bypass: Food is delayed from mixing with bile pancreatic juices that aid in absorption of nutrients.
Process:
1. Stapling creates small stomach pouch
2. Remaining stomach completely stapled and divided from stomach pouch
3. Outlet of small stomach pouch empties into jejunum section of sm. intestine
Who Got Bariatric Surgery in Canada
Surgical candidates: (2 facts)
Who Got Bariatric Surgery in Canada?
2007 – 2009 - Survey
Surgical candidates - 1.5 million
0.1% of surgery-eligible patients are mainly younger and healthier candidates
Bariatric Surgery Effect on cardiovasular risk
(Name 4 and their percentages)
Bariatric Surgery effect on Cardiovascular Risk
Lower hypertension (62%)
Lower Dyslipidemia (70%)
Lower Diabetes (77%)
Lower Sleep Apnea (86%)
Surgical Weight Loss and Mortality Risk
Rel. Risk?
what percentage reduction in risk of death over 5 year Mortality?
how many Weight Management Patients are not interested in Bariatric Surger?
Surgical Weight Loss and Mortality Risk
Rel. Risk = 0.11 (.04-.27)
89% reduction in risk of death over 5 year Mortality
77% of Weight Management Patients are not interested in Bariatric Surgery
Wait Times in Canada
Do you need to wait for self-pay?
Short waiting time?
Where does it have the longest waiting time? (Name 2 provinces)
Where does it have the shortest waiting time?
(Name 2 provinces)
No wait for self pay
longest of any surgically treatable condition
Longest
Alberta 7-10 yrs
Quebec 3-15 yrs
Shortest
Ontario, Appointment 6montsh to a year, surgery 2-3 yrs
Saskatchewan 2-3 yrs
Negatives of Life After Bariatric Surgery
(3 facts)
Negatives of Life After Bariatric Surgery
- Changes in diet (risk for malnutrition, dehydration, constipation)
- The self-harm/suicide attempt risk
- Increased risk for anxiety and sleep disorders, opioid use
Interest in Bariatric Surgery at WMC
Top 2
- Fear of other complications from surgery 53%
- Don’t need surgery to lose weight 42%
Weight bias delays diagnosis and reduces survival from what?
Weight bias delays diagnosis and reduces survival from breast cancer
Weight loss products were what in 2017?
Average loss per victim of $_____
- Weight loss products were the #1 type of fraudulent scam in 2017
- average loss per victim of $186.
