Management of obesity

Question 1

Co-morbidities associated with obesity

Answer 1

Asthma
Cancer
Cardiovascular disease
Dementia
Depression
Type 2 diabetes
Fertility problems
Gastro-oesophageal reflux disease
Kidney disease
Liver disease
Osteoarthritis
Acute pancreatitis
Obstructive sleep apnoea syndrome

Question 2

Name 7 of the main cancers that are caused by being overweight

Answer 2

Thyroid
Breast
Liver
Bowel
Kidney
Oesophageal 
Meningioma

Question 3

Tier system for adult weight management pathway: What are the 4 tiers

Answer 3

Tier 1 - population-wide health improvement

Tier 2 - primary care - healthy weight programmes, lifestyle adviser etc

Tier 3 - Specialist weight management - access to MDT - dietetic led programme

Tier 4 - specialist surgical service

Question 4

Non-surgical options for weight management ie pharmacological (2)

Answer 4

Xenical

Orlistat

Question 5

What does Xenical do? How should it be used?

Answer 5

Combined with a healthy lifestyle, balanced diet and regular exercise, Xenical can increase your chances of losing weight or helps reduce the risk of regaining weight already lost. This medicine must be used together with a reduced-calorie diet

Question 6

How does Orlistat work

Answer 6

Inhibits pancreatic and gastric lipases. It should only be used where diet, physical activity and behavioural changes are supported.

60 mg dose can be purchased by patients with BMI >28kg/m2 and over 18 years of age.

GI adverse effects with consumption of fat

Question 7

How are specialist weight management services beneficial

Answer 7

Dietetic Input - helps patient learn about healthy balanced diet, with moderate energy deficit

Get pedometers/fitness bands; links with local providers; seated exercise class

Empowering not prescriptive