obesity

Question 1

what are the classes of obesity

Answer 1

Healthy weight— BMI of 18.5–24.9 kg/m2
Overweight — BMI of 25–29.9kg/m2
Obesity l — BMI of 30–34.9kg/m2
Obesity ll — BMI of 35–39.9kg/m2
Obesity lll — BMI of 40kg/m2or more

Question 2

genetic conditions connected to obesity

Answer 2

Genetic syndromes associated with hypogonadism (for example Prader-Willi syndrome andLaurence-Moon-Biedl syndrome).

Hypothalamic damage (for example due to a tumour, trauma, or surgery).

Polycystic ovary syndrome.

Growth hormone deficiency.
Cushing’s syndrome.
Hypothyroidism.

Question 3

medications which cause or a linked to obesity

Answer 3

Pizotifen.
Beta-blockers.
Corticosteroids.
Lithium.
Antipsychotics — especially atypical antipsychotics e.g. aripiprazole
Anticonvulsants — sodium valproate, gabapentin, vigabatrin.
Antidepressants — tricyclics, mirtazapine, monoamine oxidase inhibitors (MAOIs).
Insulin — when used in the treatment of type 2 diabetes.
Oral hypoglycaemic drugs — sulphonylureas, thiazolidinediones (glitazones).

Question 4

how to determine if a patient is obese or overweight

Answer 4

• use clinical judgement to decide when to measure a persons height and weight
• approach the subject carefully
• calculate the persons bmi
• interpret the bmi
• consider waist circumference in addition to to bmi in people with a bmi of less than 35

Question 5

orlistat 60mg p medicine

Answer 5

• whilst taking orlistat the patient should be on a nutritional balanced, mildly hypocaloric diet that contains 30% of calories from fat

caution with orlistat
- reduces the availability of oral contraceptive- advise additional contraceptive method if they experience severe diarrhoea

• may impair the absorption of fat soluble vitamins - advise patients to use at bedtime to help ensure adequate vitamin intake
• patients taking thses medications should be referred to their GP-amiodarone, oral anticoagulants (including warfarin), acarbose, antiepileptics, ciclosporin, levothyroxine.

Question 6

when would you not supply orlistat

Answer 6

• chronic malabsorption syndrome
• cholestasis
• pregnant or breastfeeding
• children
• concurrent treatment with ciclosporin

Question 7

side effects of orlistat

Answer 7

• experience gastrointestinal symptoms
  such as oily leakage from rectum
  flatulence
  faecal urgency
  fatty oily stools

if patients experience these symptoms then advise a lower fat diet and that such effects usually occur in the first few weeks and tend to settle with time

Question 8

when will you refer to the gp

Answer 8

• patient taking medicine for diabetes
• patients taking hypertension or hyper cholesterolaemia
• patient taking amiodarone
• patient taking levothyroxine
  patient taking antiepileptic med
• patient been on orlistat for 6 months and longer
• unable to to lose weight after 12 weeks of treatment
• rectal bleeding while taking orlistat
• patient with kidney disease

Question 9

what are the cations with orlistat

Answer 9

oral contraceptive - reduces the availability of oral contraceptive

• fat soluble vitamins a,d,e and k - it if you talk orlistat it impairs the absorption of these vitamins

if the patient is taking , ORAL ANTICOAGULANTS LIKE WARFARIN , ANDYIEPILEPTICS

Question 10

what are prescription only medications for weight loss

Answer 10

• SAXENDA - to help u feel fuller and reduce cravings , it helps to regulate sugar levels