Obesity

Question 1

Define

Answer 1

DEFINITION: a BMI > 30 kg/m2

Can also be defined using waist circumference:

Men

Low Risk = < 94 cm

Very High Risk = > 102 cm

Women

Low Risk = < 80 cm

Very High Risk = > 88 cm

A higher waist to hip ratio, indicating central fat distribution, is

commoner in MALES and is associated with greater health risks

↘ T2DM, IHD, dyslipidaemia, HTN ,osteoarthritis, cancer (breast and bowel)

Question 2

Causes

Answer 2

There are genetic factors that affect the risk of become obese

There are a few monogenic forms of obesity (e.g. leptin deficiency, Prader-Willi syndrome)

Common obesity is caused by energy intake > energy usage

Conditions associated with obesity include:

• Genetic (Prader–Willi syndrome, Lawrence–Moon

syndrome)

• Hypothyroidism
• Cushing’s syndrome
• Hypothalamic damage (e.g. tumour or trauma →

damage to satiety regions)

Question 3

Epidemiology

Answer 3

24% of men and 25% of women are obese

Question 4

Signs

Answer 4

Noticing that you’re fat (lol)

Routine health check

Symptoms of complications (e.g. T2DM, coronary heart disease, obstructive sleep apnoea)

High body weight, BMI and waist circumference

Question 5

Investigations

Answer 5

Measure serum lipids

Measure HbA1c

Hormone profile (check for hormonal cause of obesity)

TFTs - hypothyroidism can cause obesity

Other investigations depending on comorbidities

Question 6

Medication which may aggravate weight gain

Answer 6

Medication which may aggravate weight gain

 Oral hypoglycaemic agents, especially sulfonylureas and thiazolidinediones (also insulin)

 Antidepressants including TCAs, mirtazapine, MOA-I

 Anticonvulsants, particularly sodium valproate,

gabapentin, vigabatrin

 Antipsychotics, especially the atypical antipsychotics

amisulpride, aripiprazole, clozapine, olanzapine,

quetiapine and risperidone

 Lithium

 Corticosteroids

 Beta-blockers

 Pizotifen

 Progestogen-only contraceptive injections