Management of Obesity Flashcards
Is the prevalence of obesity increasing or decreasing?
Increasing
What are some co-morbidities that obesity increases the risk of?
What are the 1st and 2nd top causes of cancer?
1) Smoking
2) Obesity
Explain tier 1 to 4 of adult weight management?
Tier 1:
- Healthy Helpings programme really helps with losing weight
Tier 2:
- Non-surgical weight management can be done by medicine:
- Orlistat
- Inhibits pancreatic and gastric lipases
- 60mg dose can be used by patients with BMI more than or equal to 28 and over 18 years older
- Usual prescription dose is 120mg 3 times per day
- GI adverse effects with consumption of fat
- Only used where diet, physical activity and behavioural changes are supported
- Therapy should only be continued beyond 12 weeks if patients has lost at least 5% of body weight
- Orlistat
Tier 3:
- Example of programme is Weigh Forward
- Combination of evidence based psychological model, dietetic input and physical activity for a holistic, person centred care approach
Tier 4:
- Bariatric surgery
- Variety of procedures performed on people who are obese to help with weight loss
- Gastric bypass
- Gastric band
- Vertical banded gastroplasty
- BMI >= 35 and presence of one or more severe comorbidities that would improve with weight reduction
- Also needs evidence they will comply with structured weight loss management programme involving diet, physical activity, psychological and drug interventions
- Variety of procedures performed on people who are obese to help with weight loss
What is tier 1 of adult weight management?
Population widehealth improvement work such as community interventions:
- Healthy Helpings programme helps with losing weight
- walking groups
- leisure club classes
- cooking classes
What is tier 2 of adult weight management?
Non-surgical weight management done by primary care:
- NHS healthy weight programmes
- lifestyle advice
- community dietetic
- drug therapy if appropriate
What is an example of a drug that can be used for tier 2 management of weight?
Orlistat
What is the action of orlistat?
Inhibits pancreas and gastric lipases
Who can orlistat be prescribed to?
60mg dose to patients with BMI more than or equal to 28 and over 18 years old
What is orlistat only used with?
Where diet, physical activity and behavioural changes are supported
How long should orlistat therapy be given for?
Should only be given for longer than 12 weeks if patient has lost at least 5% of body weight
What is tier 3 of adult weight management?
Specialist weight management:
- access to MDT
- psychological expertise
- physiotherapy
What is an example of a programme for losing weight?
Weigh Forward
What is tier 4 of adult weight management?
Specialist surgical service:
- bariatric surgery
- gastric bands
- specialist follow up
What are some examples of bariatric surgery procedures?
Gastric bypass
Gastric band
Vertical banded gastroplasty