Obesity

Question 1

What is obesity

Answer 1

The condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired

Question 2

How is obesity defined through BMI?

Answer 2

Healthy = 18.5-24.9
Overweight = 25-29.9
Obesity I = 30-34.9
Obesity II = 35-39.9
Obesity III = 40+

Question 3

Is obesity genetics?

Answer 3

There are both genetic and environmental factors:

identical twins do tend to show similar genetic profiles

• someone may be prone or resistent to obesity but this is driven and decided by environment

Question 4

Describe the physiology of how genetics can affect obesity?

Answer 4

…

Question 5

What can drive obesity ( stats shown in slides )

Answer 5

• Car use
• playgrounds + park
• Screen time
• education level
• educational achievement
• social deprivation

Question 6

What comorbidities are linked with obesity?

Answer 6

• Depression
• sleep apnoea
• bowel cancer
• osteoarthritis
• stroke
• diabetes
• Hypertention
• peripheral vascular disease
• gout
• Myocardial infarction
• Cancer risk increases

Question 7

Does BMI have association with mortatlity?

Answer 7

Yes

As obesity is a risk factor for many diseases

Question 8

What is leptin deficiency?

Answer 8

Young obesity, will be born a normal weight but then overeat and feel hungry

Question 9

How to assass and manage adult obesity?

Answer 9

Determine degree of overweight

Assess lifestyle, comorbidites and willingness to change

Lifestyle changes / drug treatment

Specialist assessment …

Question 10

What drugs can we give for obesity?

Answer 10

• orlistat

it is derivative of an endogenous lipstatin produced by streptomyces toxytricini

It is a gastric and pancreatic lipase inhibitor

Question 11

What are the side effects of orlistat?

Answer 11

Fatty/oily stool

Faecal urgency, oily spotting, faecal incontinence in some

Question 12

What is bariatric surgery?

Answer 12

consider for BMI 40+ or 35-40 with other comobitidies or BMI of 30-35 for newly diagnsed T2

Need to have tried other methods, need long term follow up and be fit for surgery

Question 13

What is a gastric bypass?

Answer 13

top part of stomach joined to intestine

Question 14

What is a gastric band?

Answer 14

Bad around stomach to reduce capacity

Question 15

What is a sleeve gastrectomy?

Answer 15

Some of the stomach is removed so you cannot eat as much and feel full sooner