Obesity Flashcards
What is obesity?
condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired.”
Classifying overweight and obesity
What drives obesity?
Poverty
Social deprivation
Educational level
Educational achievement
Car use
Screen time
Ability to play outside
Genetics
Comorbidities associated with obesity
Depression
Stroke
Obstructive sleep apnoea
Myocardial infarction
Hypertension
Diabetes
Bowel cancer
Osteoarthritis
Peripheral vascular disease
Gout
What diseases is obesity a risk factor in?
Type II diabetes
Cardiovascular disease
Cancer
Gallbladder disease
Gout
Aggravated arthritis
Obstructive sleep apnoea
Infertility
Assessment and management of obesity
How do we treat different levels of obesity?
Symptoms of leptin deficiency
Infertility.
Stunted linear growth.
Decreased body temperature.
Decreased energy expenditure.
Decreased immune function.
What does leptin administration restore in leptin deficient children?
LH pulsatility
Is leptin an anti-starvation hormone?
leptin is an anti-starvation hormone rather than anti-obesity hormone.
Presence of leptin is a signal to the CNS that system has sufficient fat reserves for normal functioning- but high leptin has little effect
What is orlistat derived from?
What does it do?
Derivative of an endogenous lipstatin produced by Streptomyces toxytricini.
Gastric and pancreatic lipase inhibitor
Reduces dietary fat absorption by around 30%.
Side effects of orlistat
Fatty and oily stool, faecal urgency, oily spotting, faecal incontinence
Possible deficiencies of fat-soluble vitamins
What is liraglutide/ saxenda?
Long-acting glucagon-like peptide-1 receptor agonist
Daily injection.
Double the dose used for T2DM.
4-5% weight loss.
For what patients would you consider bariatric surgery to treat obesity?
BMI of 40 kg/m2 or more
BMI of 35-40 kg/m2 and other co-morbidities
BMI of 30-34.9 kg/m2 for newly diagnosed T2DM.
– non-surgical measures have failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months
– receiving or will receive intensive specialist management
– generally fit for anaesthesia and surgery
– commit to the need for long-term follow-up
Consider surgery as a first-line option for adults with a BMI >50 kg/m2.
Common types of bariatric surgery
Gastric bypass– the top part of your stomach is joined to the small intestine, so you feel fullersooner and do not absorb as many calories from food
Gastric band– a band is placed around your stomach, so you do not need to eat as much to feel full
Sleeve gastrectomy–some of your stomach is removed,soyou cannot eat as much as you could before and you’ll feelfull sooner.
