Obesity Flashcards
What is obesity?
a condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired
Method of classifying weight
BMI
How to calculate BMI?
weight (kg) / height (m^2)
Is BMI always accurate?
doesn’t account for fat/muscle ratio can always be used as a good measure for depicting healthy weight/overweight
Is obesity genetic?
genetic predisposition, combination of environment too
Influence of leptin of early life programming of obesity
leptin resistance
How has obesity incidence been changing over the years?
increased rapidly
What factors can drive obesity/are associated with obesity?
ability to play outside (parks), car use, screen time, education level, achievement poverty, social deprivation
Obesity is associated with what comorbidities?
depression, stroke, sleep apnoea, MI, hypertension, diabetes, bowel cancer, osteoarthritis, gout, peripheral vascular disease
Obesity is a risk factor in what disease areas?
T2DM, CVD, cancer, gallbladder disease, obstructive sleep apnoea, aggravated arthritis, gout, infertility
What happens to disease incidence and mortality if you reduce obesity levels?
decreases
Outline the assessment and management of adults with obesity.
determine degree of overweight or obesity > assess lifestyle, comorbidities and willingness to change > consider referral to specialist care, lifestyle changes, drug treatment, surgery
How to decide level of intervention for obesity?
Based on BMI, waist circumference and any present co morbidities: general lifestyle advice > drugs > surgery
Diet advice includes?
varied balanced diet, increasing fruits and vegetables
What drugs can be used to treat obesity?
Orlistat (endogenous lipstatin derivative), gastric/pancreatic lipase inhibitor
Orlistat reduce weight by roughly?
2-9%
Why are attrition rates for Orlistat high (33%)?
side effects include fatty/oily stool, faecal urgency, oily spotting, faecal incontinence, possible deficiencies of fat soluble vitamins
For what BMI populations should you consider surgery?
BMI of 40 kg/m2 or more, BMI of 35-40 kg/m2 and other co-morbidities, BMI of 30-34.9 kg/m2 for newly diagnosed T2DM.
For what other populations should you consider surgery?
non-surgical measures have failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months, receiving or will receive intensive specialist management, generally fit for anaesthesia and surgery, commit to the need for long-term follow-up
What is a gastric bypass?
the top part of your stomach is joined to the small intestine, so you feel fullersooner and do not absorb as many calories from food
What is a gastric band?
a band is placed around your stomach, so you do not need to eat as much to feel full
What is a sleeve gastrectomy?
some of your stomach is removed,soyou cannot eat as much as you could before and you’ll feelfull sooner
How effective are types of bariatric surgery?
GBP most effective then VBG then banding
