Obesity

Question 1

Complications of obesity

Answer 1

• T2DM
• HTN
• CVD
• Dyslipidaemia
• Fatty liver disease
• Gallstones
• Cancer
• Reproductive problems
• Respiratory
• Musculoskeletal conditions
• GORD
• Psychological and psychiatric morbidities

Question 2

How is weight measured?

Answer 2

Obesity = BMI
Central adiposity = Waist-to-height ratio

Question 3

Healthy BMI threshold

Answer 3

18.5 to 24.9

Question 4

Overweight BMI threshold

Answer 4

25 to 29.9

Question 5

Obesity class 1 BMI threshold

Answer 5

30 to 34.9

Question 6

Obesity class 2 BMI threshold

Answer 6

35 to 39.9

Question 7

Obesity class 3 BMI threshold

Answer 7

> 40

Question 8

Overweight BMI threshold in Black African, African-Caribbean, South Asian, Chinese, or Middle Eastern family background

Answer 8

23 to 27.4

Question 9

Obesity BMI threshold in Black African, African-Caribbean, South Asian, Chinese, or Middle Eastern family background

Answer 9

> 27.5

Question 10

Obesity classes 2 and 3 BMI threshold in Black African, African-Caribbean, South Asian, Chinese, or Middle Eastern family background

Answer 10

Just reduce the BMI measurements by 2.5

32.5 to 37.4
>37.5

Question 11

Central adiposity thresholds

Answer 11

Increased central adiposity: waist-to-height ratio 0.5 to 0.59

High central adiposity: waist-to-height ratio >0.6

Question 12

Obesity management

Answer 12

Set realistic weight loss goals
Rates of weight loss may be slower in patients with T2DM
Diet advice
Physical activity
Consider potential underlying causes
Assess for co-morbidities

Question 13

Underlying causes of obesity

Answer 13

Hypothyroidism

Medications e.g., atypical antipsychotics, beta blockers, insulin, lithium, sodium valproate, sulphonylureas, thiazolidinediones, TCAs

Question 14

Co-morbidities of obesity

Answer 14

T2DM
HTN,
CVD
Dyslipidaemia
OA
Sleep apnoea

Question 15

Drug treatment of obesity

Answer 15

Orlistat
Liraglutide
Setmelanotide

Question 16

Which drugs can control satiety?

Answer 16

Methylcellulose
Sterculia

Question 17

When can orlistat be used?

Answer 17

Patients with BMI >=30 where diet, exercise and behavioural changes fail to achieve adequate weight reduction

In those with BMI >=28 in the presence of associated risk factors

Question 18

When would bariatric surgery be offered to an obese patient?

Answer 18

Considered if BMI >=40

Between 35-39.9 with a significant disease (T2DM, HTN) which could be improved with weight loss and if all other measures fail

BMI between 30-34.9 with sudden onset T2DM