Obesity

Question 1

General Health Trends

Answer 1

Physical activity is decreasing
Auto trips are increasing
Serving sizes have increased

Question 2

Metabolic Syndrome

Answer 2

This is a cluster of conditions:

Abdominal obesity
Hyperinsulinemia
High fasting plasma glucose
impaired glucose tolerance
Hypertriglyceridemia
Low HDL-cholesterol
Hypertension

Question 3

Waist/Hip Ratio

Answer 3

An index of Abdominal versus Peripheral Obesity

Question 4

Metabolic Syndrome’s impact on mortality

Answer 4

Mortality with CVD, as well as all other diseases, is greatly increased in patients with Metabolic Syndrome.

Question 5

Obese patients account for 10% of total patients, but what % of total US healthcare costs?

Answer 5

64%

Question 6

About how much does obesity add to a patient’s medical bills over a 10-year period?

Answer 6

$28,000

Question 7

Obesity Treatments

Answer 7

Lifestyle Modification
Pharmacotherapy
Surgery

Question 8

Lifestyle Modification

Answer 8

Diet: consider meal replacement
Physical activity
Behavior modification

Question 9

Pharmacotherapy

Answer 9

adjunctive

Question 10

Surgery

Answer 10

MIBS for BMI > 40;
unresponsive to intensive medical management;
onset < 25 yrs old

Question 11

Meal Replacement costs

Answer 11

reduces overall costs from baseline (study)

Question 12

Improving Long-term success

Answer 12

greater initial wight loss increases total weight loss and improves long-term maintenance

Question 13

Exercise Recommendations

Answer 13

Adults: 30 min/day; 150 min/week
1/2 if vigorous exercise (talk-test)
Children: 60 min/day

Question 14

Behaviors linked to weight-loss

Answer 14

consistency
accountability
self-monitoring
low-fat eating
physical activity

Question 15

Most important aspect in determining successful weight management

Answer 15

amount of treatment in terms of duration and quantity

Question 16

Daily Record-keeping

Answer 16

a way to keep the patient responsible to him/her self through self-monitoring

Question 17

Keeping off 30 lbs. or more for > 5 yrs averaged how many kcals per week of physical activity?

Answer 17

2621 kcals

Question 18

Strongest evidence of long-term efficacy

Answer 18

portion-controlled servings, including meal replacements

Question 19

5 A’s of Obesity Management

Answer 19

Assess
Advise
Agree
Assist
Arrange

Question 20

Assess

Answer 20

Identify behavior risks in need of intervention

gather data needed to prioritize and individualize care

Question 21

Advise

Answer 21

Clinician advice establishes behavioral issues as an important part of health care and enhances the patient’s motivation to change.

• ask about patient’s interests in weight loss
• use collected data to evaluate need for intervention

Question 22

Agree

Answer 22

Patient and clinician need to come to common ground on areas where behavior change is needed

Question 23

Assist

Answer 23

Primary care clinician offers additional treatment to address barriers to change, increase the patient’s motivation and self-help skills.

• increase total contact time
• utilize support staff
• be specific in recommendations

Question 24

Arrange

Answer 24

frequent and consistent follow-up

evaluate YOUR ability to provide necessary level of intervention

refer to more intensive or specialized treatment as necessary

Question 25

Clinicians as Role Models

Answer 25

healthcare professionals who practice healthy lifestyles are MORE LIKELY to counsel their patients to adopt healthier habits

Question 26

Effective Lifestyle/dietary interventions

Answer 26

Consistency and accountability
empathetic support, guidance
self-monitoring
physical activity
low-fat, high-quality nutrition