OBESITY Flashcards
What is obesity?
A condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired
How do you classify obesity?
BMI: Healthy weight = 18.5-24.9 Overweight = 25-29.9 Obesity I = 30-34.9 Obesity II = 35-39.9 Obesity III = 40+
What is the genetics of obesity?
60-70% of chance of being obese is down to genetics
Seen in identical twin study
Most common gene mutation seen in obesity is MC4R (melanocortin receptor)
Most of the gene mutations affect the apatite circuit
List some factors which have driven rising obesity rates
Ability to play outside Car use Screen time Education level/achievement Poverty Social deprivation
What co-morbidities is obesity associated with?
Depression Stroke Sleep apnoea Myocardial infarction Hypertension Diabetes Bowel cancer/other cancers Osteoarthritis Peripheral vascular disease Gout Infertiltiy
What is the relationship between mortality ratio and BMI?
Exponential curve as BMI increases so does mortality ratio
What is the assessment and management of obesity in adults?
Determine degree of overweight/obesity
Assess lifestyle, comorbidities and willingness to change
Consider referral to specialist
If specialist referred, surgery and follow up
If no specialist referred, lifestyle changes and drug treatment
When is drug treatment considered in patients with obesity?
If co-morbidities present for all categories and obesity II and III
When is surgery considered in patients with obesity?
If co-morbidities present in obesity II and all of obesity III
What drug can be prescribed to overweight individuals and what is it?
Orlistat
- Derivative of endogenous lipstatin produced by
Streptomyces toxytricini
- Gastric and pancreatic lipase inhibitor
- Reduces dietary fat absorption by around 30%
What are some negatives of orlistat?
Steatorrhea
Possible deficiencies of fat-soluble vitamins
No long-term data on orlistat on obesity-related morbidity/mortality
When is bariatric surgery considered?
BMI of 40+
BMI of 35-40 with co-morbidities
BMI of 30-34.9 for newly diagnosed T2DM
Patient must be generally fit enough for anaesthesia and surgery
Must be ready to commit to need for long-term follow-up
What are 3 common types of bariatric surgery?
Gastric bypass
Gastric band
Sleeve gastrectomy
Describe the procedure of a gastric bypass
Top part of stomach joined to small intestine so feel fuller sooner and don’t absorb as many calories
Describe the procedure of a gastric band
A band placed around stomach so you don’t need to eat as much to feel full
