Obesity

Question 1

What is obesity?

Answer 1

a condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired

Question 2

Method of classifying weight

Answer 2

BMI

Question 3

How to calculate BMI?

Answer 3

weight (kg) / height (m^2)

Question 4

Is BMI always accurate?

Answer 4

doesn’t account for fat/muscle ratio can always be used as a good measure for depicting healthy weight/overweight

Question 5

Is obesity genetic?

Answer 5

genetic predisposition, combination of environment too

Question 6

Influence of leptin of early life programming of obesity

Answer 6

leptin resistance

Question 7

How has obesity incidence been changing over the years?

Answer 7

increased rapidly

Question 8

What factors can drive obesity/are associated with obesity?

Answer 8

ability to play outside (parks), car use, screen time, education level, achievement poverty, social deprivation

Question 9

Obesity is associated with what comorbidities?

Answer 9

depression, stroke, sleep apnoea, MI, hypertension, diabetes, bowel cancer, osteoarthritis, gout, peripheral vascular disease

Question 10

Obesity is a risk factor in what disease areas?

Answer 10

T2DM, CVD, cancer, gallbladder disease, obstructive sleep apnoea, aggravated arthritis, gout, infertility

Question 11

What happens to disease incidence and mortality if you reduce obesity levels?

Answer 11

decreases

Question 12

Outline the assessment and management of adults with obesity.

Answer 12

determine degree of overweight or obesity > assess lifestyle, comorbidities and willingness to change > consider referral to specialist care, lifestyle changes, drug treatment, surgery

Question 13

How to decide level of intervention for obesity?

Answer 13

Based on BMI, waist circumference and any present co morbidities: general lifestyle advice > drugs > surgery

Question 14

Diet advice includes?

Answer 14

varied balanced diet, increasing fruits and vegetables

Question 15

What drugs can be used to treat obesity?

Answer 15

Orlistat (endogenous lipstatin derivative), gastric/pancreatic lipase inhibitor

Question 16

Orlistat reduce weight by roughly?

Answer 16

2-9%

Question 17

Why are attrition rates for Orlistat high (33%)?

Answer 17

side effects include fatty/oily stool, faecal urgency, oily spotting, faecal incontinence, possible deficiencies of fat soluble vitamins

Question 18

For what BMI populations should you consider surgery?

Answer 18

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.

Question 19

For what other populations should you consider surgery?

Answer 19

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

Question 20

What is a gastric bypass?

Answer 20

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

Question 21

What is a gastric band?

Answer 21

a band is placed around your stomach, so you do not need to eat as much to feel full

Question 22

What is a sleeve gastrectomy?

Answer 22

some of your stomach is removed,soyou cannot eat as much as you could before and you’ll feelfull sooner

Question 23

How effective are types of bariatric surgery?

Answer 23

GBP most effective then VBG then banding