Obesity Flashcards
What is the definition of obesity?
Excess accumulation of body fat that has an adverse effect on health
Describe BMI in terms of sensitivity and specificity ini detecting obesity?
High specificity but not as good sensitivity
What is a healthy BMI?
18.5 - 24.9
What is an overweight BMI?
25 - 29.9
What BMI is considered obese?
BMI> 30
What are some conditions that causes of obesity?
Cushing’s
Hypothyroidism
PCOS
Hypogonadism
What are some medications that can cause obseisty?
Steroids
Antiretrovirals
What are some consequences of obesity?
Depression
Low self esteem
Osteoarthritis
GORD
Thrombosis
Chronic pain
T2DM
Dyslipidaemia
HTN
Ischamic heart disease
Gout
NASH/NAFLD
Cancer
Low income.
What is metabolic syndrome?
When a patient has 3/5 of the following:
-diabetes
-inc BP
-central adiposity
-high cholesterol
-high triglycerides.
How do you manage a patient with obesity?
Need to know weigh history from birth
Any previous attempts at weight loss
Current habits
Family history
Patients expectations
What are you looking for on examination for a patient with obesity?
BMI
Weight
Insulin resistance signs
CVS (HTN, HF)
Resp (Obstructive sleep apnoea, pulmonary HTN)
Heaptomegaly, herniate)
Decreased mobility, osteoarthritis
What investigations would you do on an obese patient?
FBC
U+E
LFT
HbA1c
Lipid profile
Thyroid function tests
Vitamin D (associated with insulin resistance)
ECG
What advice would you give to an obese patient?
Diet (600Kcal deficit per day)
Around. 300min/weke moderate intensity exercise
Set goals
What are some anti obesity medications that can be trialed if lifestyle changes dont work?
Orlistat
Liraglutide saxenda
What is the next step if patients fail to lose weight after 1 yr of trying lifestyle changes and medications?
Bariatric surgery
When is bariatric surgery contraindicated?
If have physiological disorders like addiction or binge eating
