Management of obesity Flashcards
What are the 4 tiers of management of obesity
1 - reducing risk of obesity
2 - primary care
3 - specialist weight management
4 - specialist surgical service
What is the only licensed pharmaceutical weight management drug
Orlistat
What is the function of orlistat
Inhibits pancreatic and gastric lipases - inhibits fat absorption
What are the side effects of orlistat
steatorrhoea when consuming large amount of fatty food
What does a patient need to be prescribed orlistat
BMI over 30
BMI over28 with comorbidities
What is key in specialist weight management
Psychologists
What are the surgical weight reduction surgeries
Bariatric surgery:
Gastric band procedure
Gastric bypass - malabsorption and patient feels full quicker
Sleeve gastrectomy - majority of stomach except for a sleeve of stomach is removed which makes stomach full quicker so sends hormones to reduce hunger faster
What happens in bariatric gastric band surgery
Bands put around top of stomach to restrict food consumption
How does the bariatric bands cause weight loss
Cause stomach to get full and expand sooner which causes hormones to reduce hunger to be released
When should bariatric surgery (weight loss surgery) be considered for a patient
BMI of at least 35
Presence of comorbidities which will improve with the surgery
What is a complication of gastric banding
The bands can slip and erode into the stomach
The bands can have incorrect tightness which will cause complications
What hormone does bariatric surgery cause less release of
Ghrelin which causes the feeling of hunger - when inhibited decreases hunger
What happens in laparascopic sleeve gastrectomy
Small intestine anastamosed with the top of the stomach so most of the stomach is bypasses - causes malabsorption because the duodenum and first part of jejunum are also bypassed
