Obesity Flashcards
What percent of Americans are obese?
35%
what percent of Americans are overweight on top of that?
30%
Whats a classic syndrome that causes obesity and what are its symptoms?4
Prader-Willi—
almond eyes, decreased muscle tone, hypogonadism, truncal obesity
What percent of people actually have an underlying disease causing obesity?
less than 1%
Secondary causes of obesity (besides environmental)
5
- Cushing’s Syndrome—purple striae, thinning skin, easy bruising, proximal muscle weakness
- Insulinoma
- Hypothyroidism
- Hypothalamic damage resulting in hyperphagia
- Growth hormone deficiency
What increases the rate of death from all causes but especially CVD?
the higher the BMI the higher the risk
but also low BMI is associated with mortality
Describe the framingham study?
Obese at age 40?
Overweight at age 40?
Overweight and smoked at age 40?
Those who were obese at age 40 lived 6-7 years less than those who were not obese
Those who were overweight (BMI 25-29.9) lived about 3 years less
Those who were overweight & smoked lived 13-14 yrs. less
Obesity causes 80% of cases of what disease?
Type II Diabetes Mellitus
What does weight gain lead to in prediabetic patients?
impairment of glucose removal and increased insulin resistance
Hypertension is greatest in those with what kind of obesity?
upper body and abdominal obesity
What does hyperinsulinemia cause?
3
- increase sympathetic activity, 2. renal Na+ retention and
- possibly increase vascular tone
How many kg of weight lost does it take for BP to fall 1mm/Hg?
1
Obesity can cause dyslipidemia. What is affected?
2
Dyslipidemia:
- Affects all lipid values and
- can reduce HDL which is most concerning (central fat distribution is one cause)
Obesity can cause heart disease. What is affected?
- increased CHD and CV mortality (usually from DM, dyslipidemia, HTN)
- Heart failure (more cardiac work and weight)
- Atrial fib and flutter increase
What kind of strokes increase in obese men and women?
women increase risk ischemic stroke
men increase risk ischemic/ hemorrhagic stroke
What musculoskeletal diseases come about with obesity and what is the effects?
2
Ostoearthritis:
- Commonly develops in knees & ankles
- But also in non-weight-bearing joints
Obese individuals are at a greater risk and have increased death rates for what kind of cancers?
7
GI tract: Esophagus, Colon & Rectum Liver, Pancreas, and Gallbladder Kidney Non-Hodgkin’s Lympphoma Multiple Myeloma Men-Prostate Women-breast, uterus, cervix, ovary
What respiratory issues come about with obesity and what is the pathology behind it?
Sleep apnea: the obstructive type
More tissue is there and encloses on the airway
What kind of screening do we need to do for obesity?
- Measure height and weight
- Determine the BMI (females and males/ different BMI calculations for gender)
- Measure the weight circumference
How would we treat obesity?
3
Decrease food intake
Increase energy expenditure
Behavior modification
What should our goal be for decreasing food intake for weight loss?
2
- 1200-1600 cal/day
dont go less than 1000 - loss of 5% of body weight by 6 months
What do we want to work up to for exercise in treatment for obesity?
45 min 3-4 times a week
What kind of behavior modifications do we want to put into place for the treatment of diabetes?
4
- Keep food diaries, look at eating patterns
- Activity diaries
- Identify and try to deal differently w/ eating triggers,
- look at motivation
2 prominent ingrediants in OTC and herbal treatments for weight loss?
Green tea (caffeine) Chromium
What does Lorcarserin (Belvaq) do?
Agonist of serotonin C2 receptors
Decreases Appetite
What does Orlistat (Xenical, Alli) do?
lipase inhibitor, inhibits the absorption of dietary fats
causes bad side effects if you eat fay-promotes a low fat diet
What does Phentermine (Adipex-P) do?
anorectic agent, amphetamine-like.
Increases metabolism and decrease in appetite
Who do we never want to give weight loss medication to? 2
No one with addiciton or heart problems
Indications for surgical therapy for obesity?
4
- Be well-informed and motivated
2. Have a BMI > 40 or BMI
Contraindications for surgical therapy of obesity?4
- Those with untreated depression or psychosis
- Current drug or alcohol abuse
- Prohibitive surgical risks
- Inability to comply with lifelong diet and nutritional requirements
How does the lap band surgery work?
Restricts how much food the top of the stomach holds. Youll get full faster
Who would this surgery be good for specifically?
Good for a younger woman that want to have children because it can be reversible (deflate the band)
What are some of the complications that can happen with sleeve gastrectomy?
3
Can get dumping syndrome:
- eat too many carbs
- gives you feedback when you’ve eaten something you arent supposed to
- permanent and nonreversible
How does gastric bypass work on the GI tract to cause weight loss?
Restrictive and malabsorptive
How can Gastric bipass be accomplsihed surgically?
Can be laproscoptic but sometimes not
Whats the average estimated weight loss over a year?
Over two years?
62-68%
50-70%
