Obesity

Question 1

what is the healthy BMI range for an adult

Answer 1

18.5-25

Question 2

what is an overweight BMI in an adult

Answer 2

25-30

Question 3

what is an obese BMI in an adult

Answer 3

> 30

Question 4

what BMI POPULATION centile puts a child at risk of of being overweight

Answer 4

> /= 85th centile

Question 5

what BMI POPULATION centile puts a child at risk of of being obesity

Answer 5

> /= 95th centile

Question 6

what is the clinical threshold centile for being overweight in children

Answer 6

> /= 91st centile

Question 7

what is the clinical threshold centile for being obese in children

Answer 7

> /= 98th centile

Question 8

at what age can BMI be used when height can be measured accurately

Answer 8

from age 2

Question 9

how do you calculate BMI in children under 2

Answer 9

use BMI conversion chart

Question 10

should waist circumference be used to calculate a child’s BMI

Answer 10

no

Question 11

do parents see their child as obese

Answer 11

no underestimate their childs weight

Question 12

what are the risk factors for being overweight at 3 years

Answer 12

parental overweight 
black ethnicity 
greater birthweight 
smoking during pregnancy 
lone motherhood 
pre pregnancy overweight 
maternal employment >/- 21 hrs weeks 
solid food before 4 months

Question 13

how does breast feeding affect childhood obesity

Answer 13

breast feeding >/= 4 months is protective against children being overweight

Question 14

what are 2 genetic causes of obesity

Answer 14

prader-Willi syndrome, bardet-biedl syndrome

Question 15

what are the features of prader willi syndrome

Answer 15

a birth: floppy, ability to suck weak/ absent, tube feeding common

childhood: hyperphagia (food seeking and lack of satiety), reduced energy requirements due to low muscle tone

learning difficulties

hypogonadism

short stature

Question 16

what are the features of bardet-biedl syndrome

Answer 16

visual impairment, renal abnormalities, polydactyly, learning difficulties, hypogonadism, obesity
hyperphagia (excessive eating desire)

Question 17

what are the negative consequences of childhood overweight/obesity

Answer 17

poorer health in childhood (hypertension and metabolic disorders), lower self esteem, bullying, poorer school attendance/ achievements, poor adult health (obesity, CVS health…), poorer employment prospects

Question 18

what lifestyle changes make biggest difference to weight

Answer 18

Combined dietary, physical activity and behavioural
programmes

parental involvement very important especially for pre teens

Question 19

how do you asses childhood overweight/ obesity

Answer 19

BMI, eating habits, physical activity patterns, screen time, social and school history, emotional/ psychological issues, family support, stature of close family relatives, family history

Question 20

what co-morbities are common in childhood obesity

Answer 20

metabolic syndrome, resp problems, sleep apnoea, hip and knee problems, diabetes, CHD, hypertension

Question 21

when should you refer an obese child for paediatric review

Answer 21

serious obesity related morbidity that requires weight loss (benign intracranial hypertension, sleep apnoea, orthopaedic problems)
children with suspected underlying medical cause of obesity endocrine)
children under 24 months who are severely obese

Question 22

what is the weight loss goal for severely obese children

Answer 22

maximum weight loss of 0.5-1 kg per month

Question 23

hoe much of you’re daily intake should free sugars be

Answer 23

= 5%

Question 24

why are sugary drink so bad

Answer 24

low satiety, incomplete compensatory reduction in energy intake at subsequent meals, dental caries

Question 25

how long should under 5s who are walking be active for

Answer 25

for at least 180 mins throughout the day

Question 26

how should under 5s who arent walking stay physically active

Answer 26

encourage through floor based play and water based activities in safe environment

Question 27

why is screen time bad

Answer 27

associated with obesity, snacks while watching, adverts of fatty foods, disrupted sleep

Question 28

should under 18 months have screen time

Answer 28

no apart from video chatting

Question 29

what screen time should 18-24 months have

Answer 29

high quality shows watched with parents to make sure they understand what they are watching

Question 30

what screen time should 2-5 year olds get per day

Answer 30

less than an hour, watched with parents

Question 31

what are good parenting strategies

Answer 31

``` modelling positive behaviours change the environment not the child make reasonable demands effective praise reward good behaviour, ignore bad behaviour ``` goal setting, contracting, control bad stimulus (unhealthy foods)

Question 32

what is the pharmacological option for weight loss

Answer 32

orlistat

Question 33

how does orilstat work

Answer 33

inhibits gastric and pancreatic lipase to reduce absorption of dietary fat

Question 34

what are the GI side effects of orlistat

Answer 34

oily stools, faecal urgency, nausea, abdo pain

Question 35

who should get orlistat

Answer 35

adolescents with very severe to extreme obesity/ severe obesity with co morbidities only <12 when life threatening co morbidities 6-12 month trial with regular review

Question 36

what are the surgical options for obesity

Answer 36

LAGB- acts like belt around the top of stomach to create a small pouch- limits amount eaten RYGB- top section divided off by staples to form new pouch - food bypasses old stomach and part of small intestine LSG- divides stomach vertically from top to bottom - reduces size of stomach

Question 37

what are the complications of weight loss surgery

Answer 37

nutrient deificencies, hernias, wound infection, small bowel obstruction, cholelithiasis

Question 38

who should get surgery

Answer 38

post pubertal adolescents with extreme obesity and severe co morbidities

Question 39

how many children in P1 in scotland are at risk of being overwieght / obese

Answer 39

1 in 4