Obesity

Question 1

adult obesity according to BMI

Answer 1

class I is 30.0-34.9

Question 2

Classes of obesity and division of each

Answer 2

Class I - 30.0-34.9
Class II - greater than or equal to 35 BMI
Class III - greater than 40 BMI

Question 3

classes of obesity and division of each in CHILDREN

what do they also consider?

Answer 3

look at their growth percentile as well
obesity starts at greater or equal to the 95th percentile

then goes to severe obesity

Question 4

BMI - how to measure (units)

Answer 4

weight (kg)/ height (m squared)

Question 5

overweight BMI

Answer 5

25.0-29.0

Question 6

normal adult BMI

Answer 6

18.5-24.9

Question 7

underweight childhood

Answer 7

less than the 5th percentile

Question 8

normal weight child

Answer 8

5th percentile to the 85th percentile

Question 9

severe obesity child

Answer 9

greater or equal to 120% of the 95th percentile or a BMI of greater than or equal to 35

also greater or equal to 140% of the 95th percentile or BMI of greater than or equal to 40

Question 10

overweight child

Answer 10

greater than or equal to 85th to the 95th percentile (less than the 95th tho) - as obesity starts at greater than or equal to being in the 95th percentile

Question 11

what is the statistic for children who are overweight by the age of 5?

Answer 11

4 TIMES more likely to become obese

Question 12

what has happened to the US childhood obesity rates since 1970?

Answer 12

they have tripled

Question 13

does obesity cause disease? is it a disease?

Answer 13

YES to both

multifactorial

Question 14

result of increase in fat stores?

Answer 14

MULTIFACTORIAL COMPLICATOINS

- major increase in free fatty acids will lead to major insulin resistance problem

Question 15

result of increase in fat stores?

Answer 15

MULTIFACTORIAL COMPLICATOINS

- major increase in free fatty acids will lead to major insulin resistance problem

Question 16

based on current data, can direct causation be established with obesity and oral disease?

Answer 16

NO direct causation BUT yes you can see the association

Question 17

adipokines implication?

Answer 17

adipokines –> inflammation –> changes associated with periodontal inflammation

Question 18

association in increase in BMI results in?

Answer 18

increase in periodontal disease (1-3)

maybe association

Question 19

association in increase in BMI results in?

Answer 19

increase in periodontal disease (1-3)

maybe association

Question 20

how can we improve dental appointments for the obesity?

Answer 20

improvements in the physical environment

• do you have narrow doorways?
• blood pressure cuffs to fit..
• chair safety
• alteration of pharmokinetics of the drugs

Question 21

recommended rate of weight loss

Answer 21

1-2 pounds per week
based on a deficit of 500-1000 k/cal ay

also significant level for improvements in other diseases they have – llike sleep apnea (as an example)

Question 22

weight loss will help how? - general

Answer 22

improvements in cardiometabolic complications

Question 23

modest percent of weight loss change?

Answer 23

5-10% (1-2 pounds per week)

Question 24

modest percent of weight loss change?

Answer 24

5-10% (1-2 pounds per week)

Question 25

obesity treatment paradigm

Answer 25

bottom - behavior / lifestyle modification

middle - pharmocotherapy

surgery

Question 26

pharmocotherapy benefits

Answer 26

can increase weight loss in 3-8% above that seen from just behavior and lifestyle modification

Question 27

pharmocotherapy benefits

Answer 27

can increase weight loss in 3-8% above that seen from just behavior and lifestyle modification

Question 28

when do you go to option of surgery

Answer 28

morbid obesity - BMI over 40
for the individuals who have failed lifestyle modification, have weight related complications and may be the best option for the morbid obese

Question 29

what population is surgery effective for?

Answer 29

more effective for those with BMI over 40 kg/msquared for long term weight loss

Question 30

three bariatric surgery options

Answer 30

Roux

Question 31

improvements in weight loss after roux-en-Y gastric bypass surgery?

Answer 31

70% of excess weight loss by two years post -op

Question 32

sleeve gastrectomy

Answer 32

purely restrictive

Question 33

improvements in weight loss after sleeve gastrectomy surgery?

Answer 33

60% excess weight loss after 2 years

Question 34

improvements in weight loss after lap band surgery?

Answer 34

50-60% weight loss after 2 years

Question 35

improvements in weight loss after lap band surgery?

Answer 35

50-60% weight loss after 2 years

Question 36

dental complications after bariatric surgery?

Answer 36

xerostomeia

increased dental erosion/demineralization

Question 37

what are the 7 key points - general

Answer 37

1. obesity is a multifactorial relapsing disease
2. overweight /obesity is defined by body mass index (BMI)
3. obesity is a disease throughout the lifespan
4. all HCP including those in dentistry must be adequately prepared to care for this population
5. obesity is associated with
   - increased cardiometabolic risk
   - as well as increased poor dental health care and outcomes
6. treatment options always include diet exercise, behavior change , but may lso include pharmocology and surgery
7. after 6-12 months of weight loss - depending on the treatment some weight gain is expected but about 5% or more can be maintained long term