Obesity Flashcards
Define metabolic syndrome
Different key criteria for different groups but all agree on the 4 core components:
–Obesity
–Insulin resistance/glucose intolerance
–Hypertension
–Dyslipidaemia
discuss the aetiology of obesity for individuals (nature vs nuture) including the social determinants of health
Nature:
•Genetic and epigenetic mechanisms
•Biological bases for food preferences and regulate motivation for physical activity
Nuture: •Diet & exercise •Work environment •Infrastructure in which one lives; walking distance/car required •Cultural norms •The built environment •National wealth •Government policy
discuss the aetiology and evolution of the obesity epidemic in Australia over the last three decades
the obesity rates in Australian adults risen from 10% in 1980 -> 28% in 2011
Causes:
•Major change in global food systems – processing (energy densification) of food
•Ensuring food is more appealing – market and laboratory research by food and drink companies to “addict” consumers through added fats, sugar and flavour enhancers
•Food becoming much cheaper with quicker, more convenient supply – the rise of the fast food industry
•Movement from individual to mass preparation of food
•Greater availability and ubiquity of food (e.g. vending machines)
•Massive ongoing advertising, promotion to children and adults; sponsorship of sport – normalising of their products in the culture of Australia
•Decreased incidental (the exercise we get in carrying out in our daily activities) physical exercise – rise in car ownership and use, (more so in Australia and USA compared to European countries and Japan)
•Children not walking but being driven to school, decreased emphasis on physical education in schools
•Rapid rise in sedentary entertainments eg TV, videos, video games, internet, social media
•Mechanisation of the workplace and in the home - decreased manual labour
discuss the future projections of obesity and outline the health service demands and cost implications
Between 2000 and 2025, the adult prevalence of obesity is estimated to increase from 20.5 to 33.9%, while the prevalence of normal [sic] weight is estimated to decrease from 40.6 to 28.1%
list the common complications of obesity
- CVD
- DM
- Stroke
- HTN
- arthritis
- cancer
- depression, anxiety, low QOL & self esteem
- reduced life expectancy by >9 years
describe the social implications of obesity
- fewer friends
- lower educational attainment
- lower employment
- more bullying
- lower salary
- less likely to marry
- more likely to divorce
- more likely to committ suicide
describe treatment options available for patients with obesity (including individual and family approaches)
- Diet & exercise
- Behaviour therapy
- Weight loss agents
- Bariatric surgery
discuss the ways of managing the obesity epidemic at community, national and international levels
Community: exercise groups
National: campaigns for more exercise & healthier diet. public health intervention programs. Implementing a healthier infrastructure
International: setting recommended daily intake & dietary goals. Raising awareness to companies to limit the use of excessive fats & sugars
Name some of weight loss agents
- SSRI’s – Fluoxetine
- Phentermine (Duromine)
- Topiramate (Topamax): off label use
- Duromine + Topamax (Qsymia)
- Lorcaserin (Belviq)
- Bupropion + Naltraxone (Contrave)
- Leptin + Amylin
- Orlistat
- Exenatide (Byetta): off label use
- Liraglutide (Victoza): off label use
- Amylin (long acting)
- Leptin (long acting)
What are the (3) types of bariatric surgery available?
- Adjustable gastric banding: a band around the top of stomach
- Sleeve gastrectomy: part of stomach is removed (longitudinally)
- Roux-en Y bypass: small bowel is connected to the top of stomach to bypass directly into colon. (straight from esophagus to small bowel). Most successful
Define overweight & obesity
In an adult:
Overweight: 25-30kg/m2 BMI
Obese: >30kg/m2 BMI
In a child:
Overweight: 18-19 kg/m2 BMI
Obesity: >20 kg/m2 BMI
