Obesity

Question 1

What BMI indicates a probable diagnosis of obesity?

Answer 1

Overweight 25 - 30
Obese class 1 30 - 35
Obese class 2 35 - 40
Obese class 3 > 40

Question 2

Describe the step-wise approach to treating obesity

Answer 2

conservative: diet, exercise
medical: orlistat, liraglutide
surgical

Question 3

Mechanism of action of Orlistat

Answer 3

Pancreatic lipase inhibitor

Question 4

Adverse effects of orlistat

Answer 4

• faecal urgency/incontinence
• flatulence

Question 5

Describe who should be managed with orlistat according to NICE guidelines

Answer 5

adults who have:
- BMI of >28 with associated risk factors
- BMI of >30 or more
- Continued weight loss e.g. 5% at 3 months

Question 6

For how long is orlistat commonly used?

Answer 6

<1 year

Question 7

Mechanism of action of liraglutide

Answer 7

glucagon-like peptide-1 (GLP-1) mimetic

Question 8

NICE criteria for starting liraglutide

Answer 8

BMI of at least 35 kg/m²
Prediabetic hyperglycaemia (e.g. HbA1c 42 - 47)