Obesity Flashcards
what is the definition of obesity?
condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired
above what BMI is classed as obesity?
> 30
above what BMI is classed as overweight?
> 25
under what BMI is classed as underweight?
18.5
why is BMI not always accurate?
weight can be due to excess muscle mass rather than fat
what is the percentage heritability of obesity?
60 to 80%
which co-morbidities is obesity associated with?
- depression
- sleep apnoea
- bowel cancer
- osteoarthritis
- gout
- stroke
- myocardial infarction
- hypertension
- diabetes
- gallbladder disease
- infertility
- peripheral vascular disease
which part of the brain regulates appetite?
hypothalamus
what happens to the levels of diabetes and death due to diabetes if levels of obesity drop?
they decrease
what is the first thing you do when someone comes in to clinic with obesity?
determine degree of overweight or obesity, then assess lifestyle, comorbidities and willingness to change
what would you do after assessing a person with obesity’s lifestyle and co-morbidities?
Either talk them through management, lifestyle changes and possibly drug treatment, or consider referral to specialist care
what is the name of the prescription drug given for obesity in the UK? What does it do and what’s it’s mechanism of action?
Orlistat
gastric and pancreatic lipase inhibitor
reduces dietary fat absorption by 30%
what percentage does orlistat tend to reduce weight by?
2.9%
what are the side effects of orlistat?
- fatty and oily stool
- faecal urgency
- oily spotting
- faecal incontinence in 7%
- possible deficiencies of fat-soluble vitamins
which groups of patients would we consider for bariatric surgery?
They must have:
BMI >40
BMI 35-40 and comorbidities
BMI 30-34.9 for newly diagnoses T2DM
AND
- non-surgical measured failed to achieve clinically beneficial weight loss for at least 6 months
- receiving/will receive intensive specialist management
- generally fit for anaesthesia and surgery
- commit to the need for long-term follow up
Consider surgery as a first-line option for adults with BMI >50
