Obesity

Question 1

What BMI is considered overweight?

Answer 1

> 25

Question 2

What is the BMD formula?

Answer 2

= kg/m squared

Question 3

What is healthy range of BMI?

Answer 3

18.5-25

Question 4

Limitations of BMI?

Answer 4

doesn’t account for muscle mass, waist size, age, child growing, race, ill, pregnant

Question 5

What is a very high risk waist size for men and women?

Answer 5

Men= >102 cm
women= 88 cm

Question 6

What is preclinical obesity?

Answer 6

excess adipose tissue without limitations or organ dysfunction

Question 7

Complications of obesity?

Answer 7

DM, gallbladder disease, NFLD
gout

Question 8

Risk factors for obesity?

Answer 8

Low money
genetic
bad diet, stress, depression, meds

Question 9

Why doesn’t Sask consider obesity a chronic disease?

Answer 9

do not want to pay for the medications

Question 10

Is dietary restrictions for obesity a good option?

Answer 10

good to try but alone doesn’t seem to last (only 1-2 years

Question 11

Why does diet restriction sometimes not help for obese patients?

Answer 11

body has strong mechanisms to prevent weight loss

Question 12

Should diet be focused on weight loss?

Answer 12

NO- be healthier

Question 13

What is the goal for exercise?

Answer 13

> 150 min a week

Question 14

Are NHP good for weight loss?

Answer 14

FUH NO

Question 15

What are the reasons many weight loss drugs were removed from he marker?

Answer 15

heart and stroke issues
suicide, cancer
ALL are CNS stimulants= addiction

Question 16

How does orlistat work?

Answer 16

pancreatic lipase inhibitor= stop break down of fat= can’t absorb it

Question 17

True or false orlistat decreases appetite?

Answer 17

FALSE

Question 18

How does liraglutide work?

Answer 18

GLP-1 analog= low hunger, more satiety

Question 19

How does naltrexone/buproprion work?

Answer 19

increase satiety and lower cravings and hunger

Question 20

How does semaglutide work?

Answer 20

Another GLP= less appetite, less cravings and hunger and energy intake

Question 21

Is orlistat a reversible or irreversible inhibitor?

Answer 21

reversible

Question 22

Main s/e with orlistat?

Answer 22

fatty stools, farts, incontinence, ab issues

Question 23

When do you take orlistat?

Answer 23

ONLY with meal that has fat or up to 1 hr after each meal

Question 24

Who can’t use orlistat?

Answer 24

cholestasis, malabsorption syndromes

Question 25

DI with orlistat?

Answer 25

space multivitamin due to decreased absorb may make warfarin stronger due to less vitamin K

Question 26

If someone can't afford naltrexone and bupropion can they just take one of them?

Answer 26

Need both

Question 27

How does Bupropion work?

Answer 27

decreased resorb of DA and NE

Question 28

How do we evaluate efficacy of weight loss meds?

Answer 28

if >5% weight loss at 12 weeks

Question 29

Administration instructions for nal/bup?

Answer 29

no with fat meal(increases absorb, do not split tablets

Question 30

S/e of bup/nal

Answer 30

NVDC, seizures, depression

Question 31

Who can't use bup/nal?

Answer 31

opioid userws, seizures, anorexia

Question 32

What CYP does bup use and inhibit?

Answer 32

uses 2B6 and inhibits 2D6

Question 33

What are incretins?

Answer 33

GIP and GLP

Question 34

Where do you inject liraglutide?

Answer 34

ab, thigh or upper arm

Question 35

Dose for liraglutide?

Answer 35

start at 0.6 DAILY then go up to 3

Question 36

S/e of liraglutide?

Answer 36

N,V,D pancreatitis

Question 37

CI of liraglutide?

Answer 37

thyroid cancer

Question 38

How long does nausea last for semaglutide?

Answer 38

36 hours after

Question 39

Target dose of semaglutide?

Answer 39

2.4mg

Question 40

Does semaglutide have other benefits?

Answer 40

yes- decrease in MACE and CKD

Question 41

What is the black box s/e for GLP?

Answer 41

suicide risk

Question 42

What injection is daily?

Answer 42

liraglutide

Question 43

Most effective weight loss agent?

Answer 43

semaglutide

Question 44

How many times a day for bup/nal?

Answer 44

BID

Question 45

Least effective weight loss agent?

Answer 45

Bup/nal

Question 46

What happens after stopping weight loss agents?

Answer 46

weight returns

Question 47

How does tirzepatide work?

Answer 47

GIP and GLP for weight loss

Question 48

Who is tirzepatide only indicated in?

Answer 48

t2DM

Question 49

What is an issue with tirzepatide?

Answer 49

longer trial due to titration being so slow

Question 50

Differences between GIP and GLP?

Answer 50

GIP= LESS nausea GLP= increases satiety and nausea

Question 51

Is there any coverage for tirzepatide?

Answer 51

NO

Question 52

What is coming soon to semaglutide?

Answer 52

generic

Question 53

When to consider bariatric surgery?

Answer 53

BMI>35

Question 54

How much weight loss can bariatric surgery give?

Answer 54

25-45%

Question 55

Why is bariatric surgery good vs bad?

Answer 55

good= best evidence of improve QoL, loss, and resolution of obesity related dz such as T2DM Bad= lots of complications

Question 56

What are the three types of bariatric surgeries?

Answer 56

gastric bypass sleeve gastrectomy gastric banding

Question 57

How much weight loss MAY decrease CV events?

Answer 57

5-10%%

Question 58

What is the only covered thing for obesity?

Answer 58

bariatric surgery BUUUUT wait times long