Obesity

Question 0

Health hazards of obesity

Answer 0

htn, heart dz, hyperlipidemia, type 2 dm, stroke, heart dz, osteoarthritis, liver dz, cancer, obstructive sleep apnea, depression

obesity assoc w sig inc mortality

Question 1

Obesity overview

Answer 1

global epidemic esp in developed nations

Question 2

Body mass index

Answer 2

BMI = weight divided by height squared (kg/m^2)

normal: 18.5-24.9
overweight: 25-29.9
obese: 30+
morbidly obese: 40+

Question 3

Treatment of obesity

Answer 3

1. diet, exercise, lifestyle modifications = mainstay
2. drug therapy: pts who havent lost wt w diet and exercise
   Orlistat: 1st line agent can be continued for up to 4 yrs
3. bariatric sx
   - effective in reducing comorbidities assoc w obesity: htn, diabetes, obstructive sleep apnea, hyperlipidemia –> 29% reduction in mortality
   best evidence for pts with BMI >40

*bariatric sx based on 2 mxn:
a. restriction of intake (via small stomach reservoir)
b. malabsorption (via decreasing small bowel length)
(restrictive easier and lower complication rate but less wt loss than malabsorptive )
c. most common procedure: laparoscopic Roux-en-Y gastric bypass
Laparoscopic adjustable gastric banding (LapBand) has fewer complications, is reversible, but not as effective in acheiving wt loss compared w gastric bypass