Obesity Flashcards
what is obesity
Obesity: condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired
What are the BMIs for different classes of weight
BMI = weight in kg / (height in m)^2 Underweight: <18.5 Normal: 18.5 - 24.9 Overweight: 25-29.9 Obese: 30-34.9 Extremely obese: 35>
Why can BMI be inaccurate
BMI is good for large data sets but can be inaccurate due to muscle mass
What are comorbidities associated with obesity
Comorbidities: depression, sleep apnoea, bowel cancer, osteoarthritis, gout, stroke, mi, hypertension, diabetes, gallbladder disease, infertility, peripheral vascular disease
What mortality risks increases with BMI
Obesity is risk factor for type ii diabetes, cardiovascular disease, cancer, gallbladder disease, obstructive sleep apnoea, aggravated arthritis, gout, infertility
what drives obesity 1
1) genetic predisposition
2) Obesogenic environment
3
what are factors effecting genetic predisposition of obesity
Genetic predisposition
hypothalamus regulates appetite, emotion and reward associated with food
gut hormones affecting appetite might be affected by genes
What are factors effecting obesogenic environment of obesity
Obesogenic environment
ability to go outside, care use, screen time, education level, educational achievement, poverty, social deprivation, food marketing, junk food
what are treatment for obesity
Lifestyle - not very effective
Drugs - not very effective
E.g. orlistat
derivative of endogenous lipostatin
gastric and pancreatic lipase inhibitor
reduces dietary fat absorption by around 30% - not most effective
fatty oily stool, faecal urgency, oily spotting, possible fat soluble vitamin deficiency, high attrition rates
Surgery - effective but impractical for large numbers
Bariatric surgery is considered for patients with bmi >40 / bmi 35-40 + comorbidities / bmi 30-34.9 and newly diagnosed t2dm
Non surgical methods have failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months
Intensive specialist care management
Need to be fit for anaesthesia and surgery and commit to need for long term follow up
Surgery is option 1 when bmi > 50
what are the 3 types of stomach surgery for obesity
Gastric bypass - top part of stomach joined to SI so feel fuller sooner and don’t absorb as many calories from food
Gastric band - band around stomach so don’t need to eat as much to be full
Sleeve gastrectomy - part of stomach is removed so can’t each as much and feel full sooner
extra
extr
extr
extr
extr
extr
extr
extr
extr
extr
