Management of Obesity

Question 1

List some co-morbidities associates with obesity

Answer 1

• Asthma
• Obstructive sleep apnoea
• Cardiovascular disease
• GORD
• Liver disease (i.e NAFLD)
• Acute pancreatitis
• Dementia
• Type II diabetes
• CANCER!

Question 2

Describe the adult weight management pathway

Answer 2

Tier 1: Population-wide health improvement work e.g lesiure clubs, cooking classes, walking groups etc

Tier 2: Primary care: NHS healthy weight programmes, lifestyle advisor, community diabetic, drug therapy if appropriate

Tier 3: Specialist weight management by a multi-disciplinary team (e.g diabetic led, psychological expertise, physiotherapy)

Tier 4: Bariatric SURGERY (offered by specialist surgical service)

Question 3

State the name of a (non-surgical) weight loss drug

Answer 3

• Orlistat

Question 4

How does orlistat work?

Answer 4

• Inhibits the action of pancreatic and gastric lipases (these noramlly would break down triglycerides into free fatty acids + glycerol)
• (These undigested triglycerides CANNOT be absorbed in the bloodstream.)
• (These undigested triglycerided are therefore EXCRETED, unchanged in the urine)
• (Therefore a calorie defecit and so WEIGHT LOSS!)

(everything in brackets NOT IN THE LECTURE but understanding!)

Question 5

State the normal dose and frequency of orlistat

Answer 5

120 mg, 3 times a day

Question 6

A 60 mg dose of orlistat can be purchased by patients with BMI over….

Answer 6

>28kg/m² (and over 18 years old)