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Nutritional > Obesity > Flashcards

Obesity Flashcards

1
Q

What is the fundamental cause of obesity and overweight?

A

An energy imbalance between calories consumed and calories expended

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2
Q

(T/F) - Calories taken in is greater than calories taken out

A

TRUE

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3
Q

What are multifactorial etiologies that could cause or decrease obesity or overweight?

A
  • Genetics
  • Environmental factors
  • Underlying medical condition or pharmacological agent
  • More exercise
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4
Q

How many kcal are in 1 lb?

A

3,500 kcal

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5
Q

In one gram, how many kcal are in protein?

A

4 kcal

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6
Q

About how much percent of calories should protein be consumed in one day?

A

15-20%

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7
Q

In one gram, how many kcal are in carbs?

A

4 kcal

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8
Q

About how much percent of calories should carbs be consumed in one day?

A

50-55%

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9
Q

In one gram, how many kcal are in fats?

A

9 kcal

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10
Q

About how much percent of calories should carbs be consumed in one day?

A

25-30%

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11
Q

Calculation question: If an energy balance is 50 kcal/day, what is the resulting weight gain over 1 year?

A

5 lbs

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12
Q

What two methods could be used to diagnose overweight/obesity?

A
  • BMI

- Weight circumference

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13
Q

BMI equation

A

weight (kg) / height (m^2)

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14
Q

What is considered overweight BMI?

A

25-29.9 kg/m^2

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15
Q

What is considered class I obesity BMI?

A

30-35 kg/m^2

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16
Q

What is considered class II obesity BMI?

A

35-40 kg/m^2

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17
Q

What is considered class III obesity BMI?

A

> 40 kg/m^2

18
Q

A waist circumference would be more beneficial in which patients?

A

BMI 25-34.9 kg/m^2

19
Q

What waist circumference (in inches) in females would be considered a risk of obesity?

A

Females > 35 inches

20
Q

What waist circumference (in inches) in males would be considered a risk of obesity?

A

Males > 40 inches

21
Q

What are 7 risk factors for patients who are at risk of being overweight/obese?

A 
Age (until 80 yo)
Lower socioeconomic factors
Female
Immigrants
Family History
Conditions (i.e., thyroid disorders)
Medications
22
Q

What is a realistic amount of weight loss?

A

5-10% of body weight initially

23
Q

What are 5 non-pharmacological treatments that can be done to minimize obese?

A
  • Identify and manage contributing conditions
  • Remove offending drugs (if possible)
  • Lifestyle changes
  • Fiber
  • Activity approaches
24
Q

What are 4 contributing conditions?

A
  • Cushing’s disease
  • Hyperthyroidism
  • Leptin deficiency
  • Binge-eating disorder
25
Q

FYI: What are some classes that are considered offending agents?

A 
Antidepressants
Antiepileptics
Antipsychotics
Beta-blockers
Chemotherapies
Glucocorticoids
Hormone replacement
Pioglitazones
Sulfonylureas
Insulin
26
Q

FYI: What are some drugs that should be avoided due to being weight offensive?

A
  • Carbamazepine
  • Gabapentin
  • Valproic acid
  • Atenolol
  • Metoprolol
  • Propranolol
  • Progestin injection
27
Q

FYI: What are 5 major mental health therapies that can be offensive to weight?

A 
Clozapine
Mirtazapine
Olanzapine
Paroxetine
TCAs
28
Q

(T/F) - The slower you can digest food, the less you will be in a hunger state

A

TRUE

29
Q

(T/F) - High consumers of fiber (~35g) have a best chance of decreasing comorbidities, obese, etc. compared to low consumers of fiber (1-25g)

A

TRUE - more fiber is helpful rather than low fiber

30
Q

Who is applicable in receiving pharmacological treatments for obesity? [3 types of people]

A
  • BMI >/= 30 kg/m^2
  • Waist circumference is high
  • BMI 27-30 kg/m^2 AND 2 risk factors
31
Q

What is the hierarchy of medications to choose for obesity patients?

A

Semaglutide (Wegovy) > Liraglutide (Saxenda) > Phentermine-containing medication > The others

32
Q

How does phentermine (Adipex-P) work to suppress appetite?

A

Enhances norepinephrine and dopamine neurotransmission

33
Q

(T/F) - Phentermine is considered a controlled substance

A

TRUE - scheduled IV

34
Q

Is Adipex-P the most commonly prescribed agent even though it is the 3rd in line agent?

A

Yes, it’s most commonly prescribed

35
Q

What is the duration of using Adipex-P?

A

Several weeks (short-term)

36
Q

What are some adverse effects associated with phentermine?

A

Insomnia
HTN
Palpitations
Arrhythmias

37
Q

Phentermine interacts with which drug? What measures should be taken

A

MAOIs - discontinue MAOIs 14 days before using phentermine

38
Q

What are 5 contraindications with Adipex-P?

A
  • CV disease
  • Untreated hyperthyroidism
  • Agitated states
  • Substance abusers
  • Glaucoma
39
Q

What time of the day should phentermine be avoided in?

A

At bedtime

40
Q

Which medications can be used long-term?

A

Alli (orlistat) [OTC]
Xenical (orlistat)
Qsymia (phentermine/topiramate)
Contrave (bupropion/naltrexone)

41
Q

Alli and Xenical fall in what class?

A

Protease inhibitors

42
Q

How does Alli and Xenical work to reduce obesity in patients?

A

Inhibit lipase which induces weight loss by lowering dietary fat absorption and malabsorption of cholesterol

Nutritional (5 decks)

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