obesity Flashcards
people with severe obesity over 40-45 BMI are likely to develop what two things
T2DM
Obstructive sleep apnea occurs when the muscles that support the soft tissues in your throat, such as your tongue and soft palate, temporarily relax. When these muscles relax, your airway is narrowed or closed, and breathing is momentarily cut off
do cancers link with obesity if so what ones
yes 13 cancers
bowel, kidney, ovarian and liver
what cancers linked to brca1 gene
breast cancer and ovarian cancer. They also increase a man’s chance of developing male breast cancer and prostate cancer.
for sustainable weight loss what is the recommended calorie deficit
5-600kcal
what is orlistat
lipase inhibitor
Moa of orlistat
reduces absorption of calories from fat
but also fat bound vitamin D,A,E,K
other liscensend treatment is GLP-1 agonist
what tier is drug therapy commenced
tier 3
side effects of orlistat
flatulence oily discharge from the rectum oily, fatty or liquid stools passing stools more often than usual Stomach pain and discomfort sudden urge to pass stools distension of the stomach faecal incontinence Rectal pain and discomfort lower blood sugar
referral criteria for bariatric surgery
BMI over 40
BMI over 35 with co-morbities icnluding hypertension, T2DM , sleep apnoea, cardio disease, OA and dyslipidemia ( abnormal fat)
what is an adjustable gastric band
adv
dis
its reversible and less invasive as round stomach creating two portions
needs more aftercare and less weight loss, band slippage and erosion and need to be replaced after year
gastric sleeve
requires massive surgery to remove part of the stomach
gastric balloon
inflates in the stomach and least invasive and makes you feel full - only used for 6 months
gastric bypass is the gold standard what is it
RYGB vs SLGB
causes malabsorption and restriction
loads of weight loss
more effective than diabetes remission
not reversible and more vitamin deficiencies and higher operative risk with sepsis and anatomic leaks
basically cuts out the lower stomach and liver and bile addition and part of intestines
Name the 2 major types of bariatric surgery that are available in the UK, and list any other available procedures.
Gastric Sleeve
Gastric Bypass
Others: gastric band now more likely done privately, on exceptional need balloon (can only be used for 6 months
Which type of Bariatric Surgery is classed as the “Gold
Standard”?
Gastric Bypass (specifically Roux-En-Y Gastric Bypass)