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Roomies Collab Deck 2: Endocrinology and NeuroPsych > Obesity > Flashcards

Obesity Flashcards

1
Q

In adults, obesity is classified as a BMI of greater than or equal to (?)

A

30 kg/m^2

BMI should be interpreted with caution as it is not a direct measure of adiposity, particularly in patients who are very muscular or have muscle weakness or atrophy.

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2
Q

At what waist circumference are men and women at increased risk of obesity-related health problems?

A

Men >/= 94 cm (90 cm for Asian men)

Women >/= 80 cm

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3
Q

At what waist circumference are men and women at VERY HIGH risk of obesity-related health problems?

A

Men >/= 102 cm

Women >/= 88 cm

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4
Q

What are the aims of treatment for obesity? (3)

A
  1. Modest, sustainable weight loss
  2. Maintenance of a healthy weight
  3. Reduce the risk factors associated with obesity
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5
Q

What needs to be monitored in patients with obesity?

A
  1. Weight
  2. BP
  3. Blood lipids
  4. Associated conditions (e.g. diabetes)
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6
Q

What should be considered in an initial assessment of obese patients?

A
  1. Potential underlying causes (e.g. hypothyroidism)
  2. Review of appropriateness of current medications which are known to cause weight gain
    - Atypical antipsychotics
    - Beta-adrenoceptor clocking drugs
    - Insulin
    - Lithium carbonate
    - Lithium citrate
    - Sodium valproate
    - Sulphonylureas
    - Thiazolidinediones
    - Tricyclic antidepressants
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7
Q

Name 9 drugs that are known to cause weight gain

A
  1. Atypical antipsychotics
  2. Beta-adrenoceptor clocking drugs
  3. Insulin
  4. Lithium carbonate
  5. Lithium citrate
  6. Sodium valproate
  7. Sulphonylureas
  8. Thiazolidinediones
  9. Tricyclic antidepressants
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8
Q

Should drug treatment be used as the sole element of obesity treatment?

A

NEVER

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9
Q

Which patients with a BMI >/= 30 can be considered for drug treatment?

A

Only for those in whom diet, exercise and behaviour changes fail to achieve a realistic reduction in weight

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10
Q

At what BMI can anti-obesity drugs be considered in patients with other risk factors (type 2 diabetes, hypertension or hypercholesterolemia)?

A

BMI >/= 28

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11
Q

Obese patients with which condition have slower rates of weight loss?

A

Type 2 diabetes

Less strict goals should be used

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12
Q

What is the only drug currently available in the UK that is recommended specifically for the management of obesity?

A

Orlistat

It acts by reducing the absorption of dietary fat

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13
Q

What is the mode of action of the anti-obesity drug Orlistat?

A

Lipase inhibitor - reduces the absorption of dietary fat

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14
Q

Once a patient has lost weight using orlistat, should they stop using the drug?

A

Can continue orlistat to maintain weight loss

Treatment with orlistat may also be used to maintain weight loss rather than to continue to lose weight.

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15
Q

When should obese patients who are being treated with Orlistat discontinue treatment?

A

If weight loss has not exceeded 5% after 12 weeks of treatment

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16
Q

What are the contra-indications to the use of the anti-obesity drug orlistat? (2)

A

Cholestasis

Chronic malabsorption syndrome

17
Q

What vitamin supplements should you consider in patients using orlistat for weight loss?

A

Fat-soluble vitamins (especially vitamin D)

Vitamins A, D, E, and K

Particularly important in vulnerable patients including elderly and young patients

18
Q

What are the common side effects of orlistat?

A
  1. Abdominal pain (may be minimised by reduced fat intake)
  2. Anxiety
  3. Diarrhoea
  4. GI disorders
19
Q

How can the drugs methylcellulose and sterculia be used in the management of obesity?

A

They produce a feeling of satiety (used to control appetite)

Little evidence for their efficacy

20
Q

What is the mode of action of sterculia?

A

Bulk-forming laxative

It relieves constipation by increasing faecal mass which stimulates peristalsis

21
Q

Are centrally-acting appetite suppressants used in the management of obesity?

A

NO

They have been withdrawn or are no longer recommended due to serious safety concerns or their addictive potential

22
Q

In which patients can bariatric surgery be considered?

A
  1. BMI >/= 40 (Obesity III, morbid obesity)
  2. BMI 35-39.9 (obesity II) + significant disease (type 2 diabetes or high BP) which could be improved with weight loss

** if all appropriate non-surgical measures have been tried by clinically beneficial weight loss has not been achieved or maintained

Roomies Collab Deck 2: Endocrinology and NeuroPsych (49 decks)

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