Met 2: Adult obesity & metabolic syndrome

Question 1

What is the formula for BMI?

Answer 1

Weight (kg) / Height (m^2)

*weight for your square height

Question 2

Is BMI calculation the same for men and women?

Answer 2

YES

Question 3

What are the classifications of BMI?

Answer 3

• Underweight: less than 18.5
• Normal: 18.5-25
• Overweight: 25-30
• Class I obesity: 30-35
• Class 2 obesity: 35-40
• Class 3 obesity: over 40

Question 4

BMI is less useful in patients who are… (3)

Answer 4

• elderly
• certain ethnic groups
• high muscle mass

Question 5

What is sarcopenic obesity?

Answer 5

A patient whose BMI is normal but they have low muscle mass and a relative excess of fat.

So, they can experience the negative consequences of obesity.

Question 6

What measurement independently increases risk for diabetes, HTN, CVD, sleep apnea?

Answer 6

WAIST CIRCUMFERENCE (abdominal adiposity)

Question 7

What qualifies as increased abdominal circumference for men and women?

Answer 7

35+ inches in women

40+ inches in men

Question 8

In what patients should you measure waist circumference?

Answer 8

If BMI is 25-35 (intermediate obesity risks)

Question 9

At the same level of obesity, rank which races have highest/lowest risk of obesity-related complications.

Answer 9

Highest risk: Asians

Whites

Latinos

Lowest risk: African Americans

Question 10

Explain obesity risk among African Americans compared to whites.

Answer 10

An African American person will have decreased risk of diabetes, hyperlipidemia, CVD, etc compared to a white person of the same BMI.

Essentially, AA bodies tolerate obesity better than white bodies.

Question 11

Compare the prevalence of obesity among white, hispanic, and african american

Answer 11

• Whites: lowest prevalence of obesity
• Hispanic: intermediate prevlance of obesity
• AA: highest prevalance of obesity

Question 12

Is the obesity prevalence increasing, stable or decreasing?

Answer 12

Prevalence of obesity is increasing

Question 13

At what BMI does mortality risk really increase?

Answer 13

BMI of 30+

Question 14

How can obese individuals reduce mortality risk?

(aside from losing weight)

Answer 14

Physical activity level reduces mortality independent of any weight changes

Question 15

What are the criteria for metabolic syndrome

Answer 15

Increased waist circumference (over 102 cm for men, over 88 cm for women) and two of

1. Fasting TG over 150
2. HDL less than 50 for women, less than 40 for men
3. SBP over 130 or DBP over 185
4. Fasting BG over 100

(Being treated for any of these conditions counts)

Question 16

How does metabolic syndrome cause atherosclerosis and cardiovascular disease?

Answer 16

It induces a pro-inflammatory state

Question 17

How does sleep affect weight?

Answer 17

Sleep deprivation prevents weight loss by breaking down lean body mass

Question 18

What are 4 criteria for Binge Eating Disorder

Answer 18

1. Eating a large amount of food in 2 hrs
2. Feeling a lack of control while eating
3. Feeling distressed by this behavior
4. No compensatory behavior (ie not bulimic)

Question 19

Describe the requirements in each category for initiating weight-loss therapy

• Motivation
• Stress level
• Psychiatric
• Time availability

Answer 19

Describe the requirements in each category for initiating weight-loss therapy

• Motivation: pt seeks weight loss
• Stress level: no major life crises
• Psychiatric: no untreated psychiatric disorder
• Time availability: can devote 15-30 mins/day