Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nutrition > Lecture 4: Obesity Part 2 > Flashcards

Lecture 4: Obesity Part 2 Flashcards

1
Q

What are some of the common behavioral interventions for obesity?

A

Setting realistic goals using body weight %.
Self-monitoring
Stimulus control
Slowing eating style
Nutritional education
Meal planning
Stress reduction and problem solving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the standard minimum for physical activity?

A

30 minutes a day, 5 days a week.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the ultimate goal of a diet as obesity intervention?

A

Reducing caloric intake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should we remember to keep in mind while dieting?

A

Ensuring adequate nutrition still.
Consider food volume relative to its density.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What kind of foods in general are calorie dense?

A

Processed foods.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the usual kcal/day goal for a diet?

A

1000-1500.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is considered a low-cal diet?

A

200-800 kcal/day.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the most important consideration when doing obesity interventions?

A

Patient compliance!

No point in doing all this if the patient is not willing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Is there any advantage to a specific diet?

A

No.

Low-carb may have a fast initial weight loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the general guidelines for prescribing an anti-obesity medication?

A

Adult use only EXCEPT FOR orlistats/xenical (12+).

BMI >= 30, >=27 if 1+ comorbidity present.

Most are 12 weeks or less. Efficacy is measured at 12 weeks.

Cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MOA of phentermine/Adipex?

A

Sympathomimetic that stimulates NE release.
Schedule 4 medication, short-term use only. (12 wk)

Historically, it was the MOST prescribed rx for weight loss in the US.

Suppresses appetite/causing early satiety.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What SE come from phentermine/adipex?

A

HTN
Tachycardia
Insomnia
Agitation
Palpitations
Constipation
Dry mouth

AKA NE release SE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the main CIs to phentermine/adipex?

A

Allergy
CVD
Hypothyroidism
Agitated State
Substance use hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the DDI for phentermine/adipex?

A

Psych meds
AntiHTNs
Antihistamines
Insomnia meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the efficacy in terms of weight loss for phentermine/adipex?

A

7-8kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the MOA of orlistat/xenical?

A

Inhibition of intestinal lipase, blocking FAT absorption.

Causes dose-dependent increases in fecal fat excretion.

Blocks 25-30% of the calories absorbed from fat.
Also helps BP and lipid profile as a result.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the SE of orlistat/xenical?

A

Borborygmi
Cramps
Flatus
Oily spotting
Fecal incontinence.

Decreased absorption of the fat-soluble vitamins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the rare SE of orlistat/xenical?

A

Liver injury
Calcium oxalate stones
AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the CI of orlistat/xenical?

A

Allergy
Pregnancy
Cholelithiasis
Hx of kidney stones
Chronic malabsorption syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the DDI of orlistat/xenical?

A

Multivitamins
Fat-soluble vitamins
Warfarin
Levothyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the efficacy in terms of weight loss for Orlistat/xenical?

A

5-10kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the removed drug for obesity from the US market?

A

Lorcaserin/Belviq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the efficacy in terms of weight loss for Orlistat/xenical?

A

5-10kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the MOA of liraglutide/saxenda and semaglutide/wegovy?

A

GLP-1 agonists.
Originally made for DM pts.

Increased insulin release.
Decreased glucagon release.
Slows gastric emptying.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How are liraglutide and semaglutide administered?

A

Injection.

Lira is daily.
Sema is weekly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the primary SE of liraglutide and semaglutide?

A

N/V

Diarrhea
Hypoglycemia
Anorexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the rare SE of liraglutide and semaglutide?

A

Pancreatitis
Gallbladder disease
Kidney injury

28
Q

What are the CIs of liraglutide and semaglutide?

A

Allergy
Pregnancy
Personal or FMHx of medullary thyroid cancer or MEN 2A or 2B.

29
Q

What are the DDIs of liraglutide and semaglutide?

A

Other hypoglycemic agents.
Serotonergic drugs
Thiazides

30
Q

What is the efficacy in terms of weight loss for liraglutide and semaglutide?

A

7-8kg for lira.

10-15kg for sema.

31
Q

What is the MOA of tirzapetide/mounjaro?

A

GLP-1 and GIP receptor agonist
Originally made for DM pts.

Increased insulin release
Decreased glucagon release
Slowed gastric emptying.
Better effect than GLP-1 agonist alone.

32
Q

How is tirzapetide/mounjaro administered?

A

SC injection into the abdomen, thigh, or upper arm.

33
Q

What are the main SE of tirzapetide/mounjaro?

A

N/V

Diarrhea
Hypoglycemia
Anorexia

Essentially its the same as tiraglutide and semaglutide.

34
Q

What are the CIs and DDis of tirzapetide/mounjaro?

A

Identical to tiraglutide and semaglutide.

35
Q

What are the main differences between the two glutides and tirzapetide?

A

Tirzapetide is also a GIP agonist.

Tirzapetide has a wider efficacy range of 7-20kg.

36
Q

What is the MOA of cellulose and hydrogel (plenity)?

A

Expands in the GI tract to create a sensation of satiety.
It is classified as a medical device.
No duration restriction.

37
Q

What are the main SE of plenity?

A

Diarrhea
Adominal distension
Pain

Caution in pts with GI motility issues.

38
Q

What are the CIs of plenity?

A

Allergy
Pregnancy

39
Q

What is the MOA of naltrexone SR/Bupriopion SR (Contrave)?

A

Opioid antagonist/NE and dopamine reuptake inhibitor.
Decreased appetite.

40
Q

What are the main SE of contrave?

A

Nausea
Constipation
HA

Vomiting
Dry mouth
Stimulant-like effects

NOT RECOMMENDED FIRST-LINE.

41
Q

What are the CIs of Contrave?

A

Allergy
Pregnancy
Uncontrolled HTN
Epilepsy
Anorexia/bulimia
MAOI use in past 2 weeks
Current use of opioid of bupriopion

42
Q

What are the DDIs of contrave?

A

ETOH
psych meds
opiates
metoprolol

43
Q

What is the efficacy in terms of weight loss for contrave?

A

5-10%

44
Q

What is the MOA of phentermine/topiramate (Qsymia)?

A

Stimulates NE release/anticonvulsant
SCHEDULE 4 medication. (12 wk use only)
Suppresses appetite/causes early satiety.

45
Q

What are the main SE of Qsymia?

A

Dry mouth
Constipation
Paresthesia

46
Q

What are the CIs of Qsymia?

A

Allergy
Hyperthyroidism
Glaucoma
Substance USE HX
MAOI use in past 2 weeks
Pregnancy

47
Q

What are the DDIs of Qsymia?

A

ETOH
Psych meds
AntiHTNs
Insomnia meds
Loop diuretics
metformin

48
Q

What is the efficacy in terms of weight loss for Qsymia?

A

8-10kg

49
Q

What is the MOA of HCG?

A

Increased metabolic rate and appetite suppression.
Given along with a low-cal diet to maintain muscle tone.

50
Q

Is HCG recommended?

A

No.
No proof of increased weight loss over a placebo.
Efficacy is therefore unknown.

51
Q

Who is a candidate for bariatric surgery?

A

BMI >=40

BMI>=35 + an obesity-related comorbidity.

BMI >= 30 if metabolic syndrome or severe, uncontrollable T2DM.

52
Q

What are the obesity related comorbidities?

A

T2DM
HTN
HLD
OSA
NAFLD/NASH
OHS
GERD
Asthma
Pseudotumor cerebri
Severe OA
Severe UI
Impaired quality of life
Cannot get other surgeries

53
Q

What do you usually need to do prior to bariatric surgery?

A

Medically guided weight loss program.

Pre-op assessment.

54
Q

What are the CIs to bariatric surgery?

A

Not obese
Age <18 or >65
Psychiatric history (bulimia)
Alcoholic
Pts who can’t withstand anesthesia or are non-compliant.

55
Q

What are the two things bariatric surgery affects in the body?

A

Restriction: limitation of food intake.

Malabsorption: Decreases nutrient absorption.

56
Q

What is a Roux-en-Y Bypass (RYGB)?

A

Most common bariatric surgery, anastomosing a small pouch to the small bowel.

Restrictive and malabsorptive.

Usually causes 70% of excess weight loss.

High complication rate of 40%:
Healing
Nutritional deficiences (anemias)
Gallstones.

57
Q

Image of RYGB

A
58
Q

What is a sleeve gastrectomy? (SG)

A

Removal of greater curvature of the stomach.
MC procedure in the world in 2016.
Easier and safer to perform than RYGB.

Mostly restrictive.

Excess weight loss of 60%

Complications still present:
Healing (more surgical site leak than RYGB)
Long-term GERD (more than RYGB)
Nutritional (less than RYGB)

59
Q

Image of SG

A
60
Q

What is a laparoscopic adjustable gastric banding (LAGB)?

A

Compartmentalization of upper portion of stomach via an adjustable, prosthetic band.

Declining popularity.
Modest amt of weight loss.
High rate of revision and weight regain.

Works solely as a restrictive procedure.
Excess weight loss of 50%.

Less complications than SG or RYGB:
Device failures
Long-term esophageal erosion and weight regain.

61
Q

Image of LAGB

A
62
Q

What is liposuction?

A

Removal of fat tissue via aspiration.
No influence on comorbidity development/progression.

Purely cosmetic.

63
Q

What is aspiration therapy?

A

Percutaneous gastronomy tube placed endoscopically.

You can drain some of the food you eat.
Not endorsed by ASBMS.

64
Q

What is a biliopancreatic diversion with duodenal switch (BPD/DS)?

A

Done for BMI 50+.

Technically difficult procedure with high rates of complications.

SADI-S is a variant done using SG to lower complications.

65
Q

What is an intragastric balloon?

A

SAline filled balloon placed endoscopically for 6 months.
Increased feeling of satiety by reducing gastric volume.

Newer procedure, 30% weight loss.

66
Q

Image of BPD/DS

A
67
Q

Image of Intragastric balloon

A

Nutrition (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions