Obesity Across the Lifespan Flashcards
What is the screening tool for overweight or obesity?
BMI (body mass index)
What is the BMI?
Correlates with body fatness
*IS NOT a direct measure of body fatness
What is the equation for BMI?
Weight (kg)/ Height^2 (m^2)
What is underweight?
BMI<18.5
What is normal weight?
BMI 18.5-24.9
What is overweight?
BMI 25-29.9
What is obesity I
BMI 30-34.9
What is obesity II
BMI 35-39.9
What is obesity III
BMI>40
What is the definition of appreciate component of assessement communication?
Appreciate how difficult it is for most to manage weight
What is the definition of assess component of assessment communication?
Assess, behavioral risks and factors affecting choice of goals or methods
What is the definition of advise component of assessment communication?
Advise clear, specific, and personalized behavior change advice, including personal harms and benefits
What is the definition of agree component for assessment communication
Collaboration-select appropriate treatment goals based on interest and willingness to change
What is the definition of assist component for assessment communication
Using behavior change techniques
What is a high waist circumference for men and women?
> 40in for men
35in for women
What does increasing BMI correlate with?
Increased risk of CA
What categorizes binge eating disorder?
3 or more: eating faster than normal, eating until uncomfortably full, eating to excess even though not hungry, eating alone
How does the DSM-5 define binge eating?
Recurrent episodes of binge eating at least 1x/ week for 3 months
How is BMI defined for children?
BMI is age and sex specific
*BMI for age
What are the categories of BMI for children?
Underweight: less than the 5th percentile
Normal or healthy weight: 5th percentile to less than 84th
Overweight: 85th to less than 94th
Obese: 95th or greater
How much screen time does the AAP recommend for children?
<2 =none
2-5=max 1 hour a day
What is the strongest predictor of future diabetes?
Weight gain from ages 2 to 12
What percentage of weight loss is sufficient for clinically relevant improvements?
5-10%
What is a good goal for weight loss
1-2lbs per week
What does 1lbs of fat equal to calories?
3,500 calories
What is a strong predictor of weight loss maintenance?
Increasing energy expenditure through physical activity
How many minutes of moderate-intensity PA should someone get?
150 mins
How many minutes of vigorous-intensity exercise should someone get?
75 mins
How many times is weight resistance recommended
2x per week
When should you considered pharmacotherapy
BMI> 30kg/m2 OR
BMI of 27 to 29.9 with weight related comorbidities
Who have not met weight loss goals with a comprehensive lifestyle intervention
What are weight loss medications?
Liraglutide (saxenda)
Semaglutide (Wegovy)
Orlistat (Ali OTC)
Who would be a good candidate for Semaglutide (Wegovy) and Liraglutide (Saxenda)
Type 2 DM, Cardiovascular disease, inadequate meal satiety
*Beneficial for glycemic and weight loss
What is the MOA of Orlistat (Ali OTC)
Alters fat digestion by inhibiting pancreatic lipases
What are the AE of Orlistat (Al)
Fecal urgency, oily stool, flats with discharge, fecal incontinence
Who would be a good candidate for Orlistat (Ali)
Benefits with glycemic, lipids, and blood pressure
What is the schedule for phentermine?
Schedule IV
*short term 3 months
Who should avoid taking phentermine?
Avoid in patients with heart disease, poorly controlled HTN, pulmonary hypertension, or history of addiction or drug abuse
Who would be a good candidate for phentermine/ topiramate (Qsymia)?
Men/women without HTN or coronary heart disease
What is the recommended tapering schedule for Qsymia
Taper of dose over at least one week is recommended upon discontinuation
What is the MOA of Naltrexone/Bupropion?
Bupropion-dopamine reuptake inhibitor
Who would be a good candidate for naltrexone/ burpropion?
Addictive behavior related to food
Patients desiring to quit smoking
Reduce alcohol intake
Concomitant depression
What is the BLACK BOX warning of Naltrexone/ Bupropion?
Suicidal thought and behavior and neuropsychiatric reactions
What is the most effective treatment for obesity?
Weight loss surgery
*BMI>40 or BMI>35 plus one or more obesity related complication
What is a sleeve gastrectomy?
Removing 70% of the stomach
*Pyloric sphincter and the small intestine remain intact
*Ghrelin is removed
*Not reversible
What is the Roux-en-Y gastric bypass
Attaches a small pouch created from the proximal stomach to the jejunum
*Bypassing the remainder of the stomach
What is the laparoscopic adjustable gastric band?
Inflatable device placed around the fundus of the stomach to create a small pouch
What is the recommended daily amount of food from each group?d
Vegetables: 2 1/2
Fruits: 2C
Grains: 6oz
Dairy: 3C
Protein foods: 51/2oz
Oils: 27g
What are the limits of added sugars?
<10% of calories per day
What are the limits of saturated fat?
<10% of calories per day
What are the limits of sodium?
2,300mg per day
What are the limits of alcoholic beverages?
Men: 2 drinks or less a day
Women: 1 drink or less a day
What type of formula should infants be fed?
Iron-fortified
*During the first year
*also vitamin D
How many calories should a 12-23 month eat a day?
700-1000
As we age do we need more or less calories?
Less
With each trimester do you need more or less calories?
More
When should pregnant women take folic acid?
400mcg/day
*one month before conception
What are the special nutritional considerations for pregnancy?
Seafood (8-12oz, avoid shark, swordfish, king mackerel)
Caffeine (300mg or less, 2-3 cups)
Cook deli meats and hot dogs to 165F
What are the Healthy results of BMI?
BMI<24.9
What are the Healthy results of waist circumference?
Women<35in
men<40 in
What are the Healthy results of Fasting blood sugar?
<110mg/dl
What are the Healthy results of Total Cholesterol?
<199mg/dl
What are the Healthy results of LDL?
<100mg/dl
What are the Healthy results of HDL?
> 41mg/dL
What are the Healthy results of triglycerides?
<150mg/dl
What is the definition of Physical Activity?
Any sustained body movement that increases energy expenditure
What is exercise?
subcategory of PA, that is planned, purposeful, and repeated
What is an insufficiently active person?
<150 mins of moderate-intensity or <75 mins of vigorous-intensity
What is relative intensity?
The level of effort required for a person to do an activity taking into consideration individual exercise capacity
*Talk Test
What is absolute intensity?
Amount of energy expended during the activity without considering a person cardio respiratory fitness
What is a MET?
Rate of energy expenditure while sitting a rest
What is Light-intensity activity?
Less than 3.0METS (walking slow)
What is moderate-intensity activity?
3.0 to 5.9 METS (brisk walking)
What is vigorous-intensity activity?
6.0 METS or more (jogging, running)
What is the target heart rate for moderate-intensity?
50-70% of MHR
How to solve for MHR?
220-age
What is the target heart for vigorous-intensity?
70-80% of MHR
What are the guidelines for exercise ages 6-17?
60 mins or more of moderate-to-vigorous PA daily
What are the guideline for exercise for adults?
150-300 min a week of moderate-intensity OR
75-150 min a week of vigorous-intensity
Weigh training: 2 or more days
What are the guideline of exercise for older adults?
multi component PA that include balance training as well as aerobic and muscle-strengthening activities
*Be as physically active as able
How many fall prevention programs sessions should older adults go to?
3 a week
What should pregnant women and postpartum women avoid doing?
Lying on back,
Risk of falling exercises
What are the exercise guidelines for chronic conditions and disabilities?
Same guidelines as adults (150-300 min/wk MI OR 75-150 VI)