Obesity Flashcards

1
Q

what is the healthy BMI range for an adult

A

18.5-25

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2
Q

what is an overweight BMI in an adult

A

25-30

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3
Q

what is an obese BMI in an adult

A

> 30

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4
Q

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

A

> /= 85th centile

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5
Q

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

A

> /= 95th centile

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6
Q

what is the clinical threshold centile for being overweight in children

A

> /= 91st centile

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7
Q

what is the clinical threshold centile for being obese in children

A

> /= 98th centile

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8
Q

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

A

from age 2

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9
Q

how do you calculate BMI in children under 2

A

use BMI conversion chart

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10
Q

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

A

no

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11
Q

do parents see their child as obese

A

no underestimate their childs weight

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12
Q

what are the risk factors for being overweight at 3 years

A
parental overweight 
black ethnicity 
greater birthweight 
smoking during pregnancy 
lone motherhood 
pre pregnancy overweight 
maternal employment >/- 21 hrs weeks 
solid food before 4 months
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13
Q

how does breast feeding affect childhood obesity

A

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

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14
Q

what are 2 genetic causes of obesity

A

prader-Willi syndrome, bardet-biedl syndrome

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15
Q

what are the features of prader willi syndrome

A

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

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16
Q

what are the features of bardet-biedl syndrome

A

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

17
Q

what are the negative consequences of childhood overweight/obesity

A

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

18
Q

what lifestyle changes make biggest difference to weight

A

Combined dietary, physical activity and behavioural
programmes

parental involvement very important especially for pre teens

19
Q

how do you asses childhood overweight/ obesity

A

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

20
Q

what co-morbities are common in childhood obesity

A

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

21
Q

when should you refer an obese child for paediatric review

A

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

22
Q

what is the weight loss goal for severely obese children

A

maximum weight loss of 0.5-1 kg per month

23
Q

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

A

= 5%

24
Q

why are sugary drink so bad

A

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

25
Q

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

A

for at least 180 mins throughout the day

26
Q

how should under 5s who arent walking stay physically active

A

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

27
Q

why is screen time bad

A

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

28
Q

should under 18 months have screen time

A

no apart from video chatting

29
Q

what screen time should 18-24 months have

A

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

30
Q

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

A

less than an hour, watched with parents

31
Q

what are good parenting strategies

A
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)

32
Q

what is the pharmacological option for weight loss

A

orlistat

33
Q

how does orilstat work

A

inhibits gastric and pancreatic lipase to reduce absorption of dietary fat

34
Q

what are the GI side effects of orlistat

A

oily stools, faecal urgency, nausea, abdo pain

35
Q

who should get orlistat

A

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

36
Q

what are the surgical options for obesity

A

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

37
Q

what are the complications of weight loss surgery

A

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

38
Q

who should get surgery

A

post pubertal adolescents with extreme obesity and severe co morbidities

39
Q

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

A

1 in 4