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Clin Med II > Obesity > Flashcards

Obesity Flashcards

1
Q

What is the #1 cause of preventable disease and disability?

A

Obesity

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2
Q

Is obesity a disease?

A

Yes

2013 American Medical Association

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3
Q

What classification is a BMI of 18.5-24.9?

A

Normal

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4
Q

What classification is a BMI of 25-29.9?

A

Overweight

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5
Q

What classification is a BMI ≥ 30?

A

Obese

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6
Q

What classification is a BMI of 30-34.9?

A

Obese class 1

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7
Q

What classification is a BMI of 35-39.9?

A

Obese class 2

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8
Q

What classification is a BMI of ≥ 40?

A

Obese class 3 (sever obesity)

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9
Q

At what BMI range do you measure waist circumference?

A

BMI 25-35

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10
Q

Abdominal obesity is linked to an increase in what?

A

Cardiometabolic risk

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11
Q

What waist circumference is concerning for ↑ cardiometabolic risk in men?

A

≥ 40”

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12
Q

What waist circumference is concerning for ↑ cardiometabolic risk in women?

A

≥ 35”

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13
Q

If energy in > energy out, do you gain or loose weight?

A

Gain weight

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14
Q

If energy in < energy out, do you gain or loose weight?

A

Loose weight

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15
Q

What is the goal of energy balance to promote weight loss?

A

Create negative energy balance (↑ activity, ↓ calories consumed)

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16
Q

A calorie deficit of in 500-1000/day will result in how much weight loss/wk?

A

1-2 lbs/wk

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17
Q

What recommendation can you give to a pt wanting to track their daily food intake?

A

Food diary

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18
Q

As pts loose weight, does their metabolism increase or decrease? What effect does this have on weight loss?

A

Decrease.

Makes continued weight loss more difficult

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19
Q

What is the main goal of weight loss?

A

Prevent, reverse or ameliorate complications and improve quality of life

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20
Q

What % of body weight should a pt aim to loose initially?

A

5-7% of body weight

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21
Q

A > 5% loss of body weight will result in a decrease in risk factors?

A

CVD risk factors

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22
Q

What is the #1 diet recommendation for 2020?

A

Mediterranean

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23
Q

What diets are recommended for T2DM?

A

DASH, mediterranean, carb counting, limit sugar

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24
Q

What diet is recommended for CVD?

A

DASH, low Na, mediterranean

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25
Q

What diet is recommended for kidney disease?

A

DASH, renal diet

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26
Q

What diet is recommended for celiac disease?

A

gluten free diet

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27
Q

What diet promotes weight loss, improves lipids, reduces BP/ fasting BS/ HgA1C independent of any change in physical activity

A

Intermittent fasting/ time restricted eating

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28
Q

What is a modifiable risk factor of obesity?

A

Physical activity

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29
Q

Increased X will lead to

  1. Reduced risk of mortality
  2. ↓ risk of cancer/ falls
  3. improved cognition/sleep
  4. ↓ risk of anxiety/depression
A

Physical acitivty

30
Q

How you can objectively evaluate a pt’s physical activity during an office visit?

A

Treat physical activity as a vital sign (days/ week, minutes/ day)

31
Q

What are the current physical activity guidelines for adults?

A

150-300 min/ week mod intensity

OR 75-150 min/ week of vigorous intensity aerobic physical activity

PLUS muscle strengthening ≥ 2 days/ week

32
Q

What is the “talk test” for moderate and vigorous physical activity?

A

Moderate = cant talk but not sing

Vigorous can’t say more than a few words w/p pausing to breath

33
Q

What is the FITT exercise prescription?

A

Frequency (≥ 5 days/ week)
Intensity (mod-vig)
Time (≥ 30 min)
Type

34
Q

Who do you screen for obesity/weight management?

A

All adults

35
Q

If pt w/ BMI ≥ 30 do you treat or refer them?

A

Refer for intensive, multi-component, behavioral intervention

36
Q

What is the goal of comprehensive weight management interventions? (2)

A
  1. Help make long-term changes

2. Control trigger eating

37
Q

Comprehensive/ high intensity interventions are most effective when you meet X/month for X months and X/time per year?

A

Most effective → 2x/ month for ≥ 3 months & 12-26 sessions/ year

38
Q

What are the 5 A’s of counseling?

A 
Ask/address: BMI, lifestyle choices
Advise: personalized tx plan
Assess: willingness to change
Assist: referral/resources
Arrange follow up
39
Q

What is the rate limiting step in weight loss?

A

A person’s readiness to change

40
Q

A patient centered approach asks closed or open ended questions?

A

Open ended

41
Q

What is X?

All pts will a BMI ≥ X are candidates for weight loss intervention

A

BMI ≥ 25

42
Q

What is 1st line tx for weight loss?

A

Comprehensive lifestyle program

43
Q

When should you consider drug therapy to assist w/ weight loss?

A

<5% weight loss in 3-6 months

44
Q

A BMI of 25-29.9 w/ no CVD risk factors places a pt a low, moderate, or high risk?

A

Low risk

45
Q

What is the tx for pt at low risk (BMI 25-29.9 w/ no CVD risk factors)?

A

Diet and exercise counseling to prevent weight gain

46
Q

A BMI of 25-29.9 & ≥ 1 CVD RF OR BMI 30-34.9 places a pt a low, moderate, or high risk?

A

Moderate risk

47
Q

What is the tx for moderate risk (BMI of 25-29.9 & ≥ 1 CVD RF OR BMI 30-34.9 )?

A

Intensive, multicomponent behavioral modifications (diet/exercise to support & maintain weight loss)

48
Q

A BMI of 35-44 places a pt a low, moderate, or high risk?

A

High risk

49
Q

What is the tx for high risk (BMI 35-44)?

A

Intensive multicomponent behavioral modification, consideration of drug therapy, bariatric surgery

50
Q

At what BMI do you initiate drug therapy?

A

BMI ≥30

OR > 27 w/ comorbidities

51
Q

Will drug therapy cure obesity?

A

No

52
Q

What is the goal weight loss with drug therapy?

A

4-8% within 6-12 mos

53
Q

If pt does not achieve 4-5% weight loss after 3 months of using a drug what should you do?

A

Discontinue

54
Q

What medication will

- Alters fat digestion by inhibiting pancreatic lipases

A

Orlistat

55
Q

↑ fat in stools and GI side effects are SEs for what drug?

A

Orilstat

56
Q

What drug may ↓ absorption of fat soluble vitamins so it is recommended that pts take a daily multi-vitamin?

A

Orlistat

57
Q

How is Liraglutide administered?

A

Daily subQ injections

58
Q

What drug is a given to T2DM pts?

A

Liraglutide

59
Q

Lorcaserin (serotonin agonist) helps pts loose weight by what?

A

↓ appetite

60
Q

What two drugs are

contraindicated in pts w/ HTN, CAD, hyperthyroidism?

A
  1. Phentermine/ topiramate

2. Phertermine

61
Q

Is Phertermine given for short term use or long term use?

A

Short term.

  • More SEs
  • Potential for abuse
62
Q

What 3 therapies are not recommended for weight lot?

A

dietary supplements, hCG, calcium

63
Q

Loss of 8% excess body weight prior to surgery prior to bariatric surgery will lead to what?

A

Greater weight loss post op

64
Q

Proper post-op bariatric care includes what?

A

lifelong surveillance

65
Q
  1. Eating disorder
  2. untreated mental illness
  3. drug/ETOH abuse
  4. Coagulopathy
  5. serve CVD
  6. inability to comply w/ lifelong dietary requirement

These are all contraindications for what w/ regards to weight loss?

A

Contraindications for bariatric surgery

66
Q

What are the 3 mechanism for weight loss w/ bariatric surgery?

A
  1. Restriction (reduce stomach capacity)
  2. Malabsorption (shorten absorption length of bowel)
  3. Decreased appetite/ improve metabolism (change release of various hormones)
67
Q

Is the following pt considered for bariatric surgery?

BMI 30-34.9 + uncontrolled T2DM or metabolic syndrome

A

Yes

68
Q

Is the following pt considered for bariatric surgery?

BMI ≥ 40

A

Yes

69
Q

Is the following pt considered for bariatric surgery?

BMI 35-39.9 + ≥ 1 serious comorbidity

A

Yes

70
Q

Sleeve gastrectomy, adjustable gastric band, and roux-en-Y gastric bypass are all procedures for what?

A

Bariatric surgery

Clin Med II (12 decks)

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