Obesity

Question 1

adverse effects of orlistat

Answer 1

pts who have diet >30% of total calories can develop symptoms similar to fat malabsorption disorders: flatus, fecal incontinence and abdominal distension

can also decrease absorption of fat soluble vitamins so need to take daily multivitamin

Question 2

indications for orlistat

Answer 2

BMI>30 or <27 and comorbidities (DM2, HLD, HTN)

Question 3

what does orlistat do?

Answer 3

drug inhibits pancreatic lipase to alter fat digestion and decrease fat absorption and increase fecal fat excretion.

Question 4

if someone is on orlistat and develops calcium oxalate stones

Answer 4

they need to stop it

Question 5

who should NOT get orlistat?

Answer 5

people with history of calcium oxalate stones.

It can decrease intestinal calcium binding and leads ot decreased available Ca for oxalate to bind to and result in stones

Question 6

symptoms of fat malabsorption:

Answer 6

flatus, fecal incontinence and abdominal distension

Question 7

symptoms of lactose intolerance

Answer 7

bloating, flatulence crampy abdominal pain and water diarrhea after consumption of diary products.

Question 8

causes of lactose intolerance

Answer 8

from ethnic groups (whites)
bacterial overgrowth, GI disease that results in villus flattening
inflammatory bowel disease

Question 9

is orlistat associated with lactose intolerance?

Answer 9

no.

Question 10

how to treat orlistat induced fat malabsorption?

Answer 10

lower fat intake can reduce symptoms.

Question 11

Metabolic syndrome consists of:

Answer 11

abdominal obesity
impaired glucose metabolism
HLD
HTN

Question 12

what must be checked every 3 years with metabolic syndrome:

Answer 12

fasting plasma glucose
fasting lipid panel
blood pressure
waist circumference.  
Need ASCVD risk for 10 yr risk