Management of Obesity Flashcards
How can we define obesity?
- Increased body weight.
- Increased body fat.
- Body Mass Index (BMI)
- Metlife Tables, etc
- Waist:Height Ratio
- Body Fat%
Who are waist measurements inaccurate in?
Heavier individuals
What BMI range is underweight?
<18.5
What BMI range is healthy weight?
18.5-24.9
What BMI range is overweight?
25-29.9
What BMI range is obese?
> 30
What BMI range is severe obesity?
> 40
What is the main limitation of the BMI system?
A muscular individual can have a higher BMI without excess adipose tissue.
What is the simplest cause of obesity?
Energy intake > Energy output
What factors affect increased intake?
- Internal factors, e.g., personal factors
- External factors, e.g., social circumstances
What factors affect decreased output?
- Internal factors, e.g., physical ability
- External factors, e.g., availability
What happens to metabolic rate with age?
Decreases
What influences are there on the individual?
- Social psychology
- Food production
- Food consumption
- Individual psychology
- Individual physical activity
- Physical activity environment
- Physiology
What non-modifiable influences are there on the individual?
- Age
- Sex
- Hereditary factors
What social influences are there on the individual?
- Agriculture and food production
- Education
- Work environment
- Living and working conditions
- Unemployment
- Water and sanitation
- Health care services
- Housing
- Networks
- Lifestyle factors
What effects does obesity have on the brain?
Cerebrovascular disease
What effects does obesity have on CVS?
- Coronary artery disease
- Sudden cardiac death
- Cardiomyopathy
- Cor pulmonale
- Hypertension
- Varicose veins
- DVT and PE
What effects does obesity have on respiratory system?
- Restrictive lung disease
- OSAS
- Obesity hypoventilation syndrome
What effects does obesity have on the GIT?
- Hepatosteatosis
- Gallstones
- Hiatus hernia
- Colorectal cancer
- Diabetes mellitus
What effects does obesity have on MSK system?
Osteoarthritis of weight-bearing joint
What effects does obesity have on the reproductive system?
- Menstrual abnormalities
- Infertility
- Endometrial cancer
- Cervical cancer
How can obesity be managed in primary care?
- Prevention
- Lifestyle interventions
- Pharmacotherapy
How can obesity be managed in secondary care?
- Prevention
- lifestyle interventions
- Pharmacotherapy
- Surgery
What can be addressed in lifestyle interventions?
- Diet
- Physical activity
- Behavioural issues
What are the features of the protein sparing modified fast diet?
-Low carbohydrate diet: < 40 g of carbohydrate per day ( usually ~ 250 g )
-Ketosis & mobilisation of fat stores
-Hypothalamic satiating effect of amino acids
Slower digestion and increased thermic effect (“specific dynamic action”)
-Hypocaloric
