Lecture 30 - Obesity II Flashcards
What is the number 1 therapeutic (highest efficiency) in obesity?
Bariatric Surgery
Positive on Weight loss
Ambivalent effects on blood pressure
What are the lifestyle therapeutic approaches to obesity?
Reduce consumption of energy-dense food
Exercise
What are the pharmalogical therapeutic approaches to obesity?
Orlistat aka Xenical or Alli (Intestinal lipase inhibitor)
Phentermine or Duromine (an amphetamine)
Saxenda or liraglutide (GLP1 stimulator, incretin mimetics)
Contrave (naltrexone+bupropion)(opioid antagonist+ antidepressant)
What is Orlistat aka Xenical or Alli?
An Intestinal lipase inhibitor
(MAP and heart rate drop/ gastrointestinal disturbances/kidney stones)
What is Phentermine or Duromine?
An amphetamine
(supresses central appetite, abuse substance, rise in MAP and heart rate, unwanted side effects)
What is Saxenda or liraglutide?
A GLP1 stimulator, incretin mimetics
(anti-diabetic drug-lowers BG)
What is Contrave (naltrexone+bupropion)?
An opioid antagonist+ antidepressant
(mood effects, contraindication when taking opioids and alcohol)
How can we measure obesity?
- Body mass index (BMI)
- Waist circumference (WC)
- Waist to hip ratio (WHR)
- Bioelectrical impedance (BIA)
- Densitometry (underwater weighing)
- Dual Energy X-ray Absorptiometry (DEXA)
- Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI)
Why is waist circumference used to measure obesity?
Easy to measure, inexpensive, strongly correlate with body fat, predicts risk for CVD.
Why is waist to hip ratio used to measure obesity?
Waist to hip ratio (abdominal adiposity)
Relative easy to measure, inexpensive, strongly correlate with body fat, predicts risk for CVD – hip measurement and interpretation difficult.
Why is Bioelectrical impedance (BIA) used to measure obesity?
Relative easy to measure and inexpensive, correlate with body fat, predicts risk for CVD - difficult to calibrate, hydration-dependent.
What is BIA?
Bioelectrical impedance (BIA)
Small imperceptible safe electric current through your body and measures your resistance to the current, which is different for water and fat - %fat is calculated.
Why is Densitometry (underwater weighing) used to measure obesity?
Subjects weight in air and underwater – body volume/density and %fat; very accurate, cumbersome, expensive
Why is Dual energy X-ray absorptiometry (DEXA) used to measure obesity?
X-rays pass differently to different body tissues – fat free mass, fat mass, bone density. Accurate, simple, expensive, low level radiation.
Why is Computerised Tomography (CT) and
Magnetic Resonance Imaging (MRI) used to measure obesity?
Tissue, organ and whole body fat; lean muscle mass, bone mass. Most accurate, very expensive, also radiation.
