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nutrition > obesity and management pt 1 > Flashcards

obesity and management pt 1 Flashcards

1
Q

how is excess adipose tissue determined?

A

BMI
waist circumference
visual inspection of pt

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2
Q

3 risk factors for obesity

A
  1. gender - female
  2. ethnicity - black, native american, mexican american
  3. financial - lower income
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3
Q

BMI may ___ weight in pts with high muscle mass while it can ____ weight in pts with low muscle mass

A

overestimate
underestimate

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4
Q

BMI categories

A
  1. underweight = <18.5
  2. normal = 18.5-24.5
  3. overweight = 25 - 29.9
  4. obese = >30
    - Class I = 30 - 34.9
    - class II = 35 - 39.9
    - class III = >40
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5
Q

what type of fat is more concerning than subcutaneous fat

A

visceral fat

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6
Q

what type of fat is more concerning than glutofemoral fat distribution

A

truncoabdominal

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7
Q

what are the most important factors of the etiology of obesity

A
  1. lifestyle
  2. diet
    genetics also thought to pkay a role in 40-70% of obesity cases
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8
Q

7 conditions linked to onset of obesity

A
  1. Hypothalamic obesity
  2. Cushing’s Syndrome
  3. Hypothyroidism
  4. Polycystic Ovarian Syndrome
  5. Growth Hormone Deficiency
  6. Altered Gut Flora
  7. Psychiatric Disease
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9
Q

3 psychiatric meds linked to onset of obesity

A
  1. Antipsychotics - clozapine, olanzapine, risperidone
  2. Mood stabilizers - lithium, valproate, carbamazepine
  3. Antidepressants - TCAs, SSRIs
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10
Q

2 diabetic meds linked to onset of obesity

A
  1. Insulins - especially intensive insulin therapy
  2. Oral - sulfonylureas, thiazolidinediones (TZDs)
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11
Q

3 other meds linked to onset of obesity

A
  1. Glucocorticoids
  2. beta-blockers
  3. hormonal agents
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12
Q

3 females factors that influence onset of obesity

A
  1. Pregnancy - mild weight gain effect
    - Excess weight gain = increased postpartum retention
  2. Oral Contraceptives - minimal
  3. Menopause - consistent weight gain, even if taking HRT
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13
Q

2 male factors that influence onset of obesity

A
  1. Lifestyle - typically become more sedentary over time
  2. Testosterone - declines with age → more fat, less muscle
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14
Q

2 ethnicities that influence onset of obesity

A
  1. Hispanic - increased propensity to be obese
  2. Blacks - increased obesity in females, less obesity in males
    Onset - younger age of obesity onset in Hispanic and black women as compared to white women
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15
Q

3 socioeconomic status factors that influence onset of obesity

A
  1. Literacy/Education - regarding food choices and activity
  2. Financial - affordability of healthy food choices, gyms
  3. Environment - availability of fresh foods, sidewalks, parks
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16
Q

5 behavioral factors that influence onset of obesity

A
  1. Physical Activity - sedentary lifestyle promotes wt gain
  2. Sleep Deprivation - negative metabolic consequences
  3. Smoking Cessation - average 4-5 kg weight gain
  4. Diet - diet high in fats and sugars associated with obesity
  5. Eating Habits - overeating, night-eating, binge-eating
17
Q

what hormone increases hunger and appetite

A

ghrelin

18
Q

what hormone suppresses hunger

A

leptin

19
Q

3 metabolic/homeostatic factors that influence onset of obesity

A
  1. Adaptation - losing 10-20% of body weight slows BMR
  2. Gut hormones - leptin, ghrelin, orexin, GLP-1, np-Y, etc.
  3. Gut flora - abnormal microbiome is correlated with obesity
20
Q

7 factors that influence adult-onset obesity

A
  1. meds
  2. gender
  3. ethnicity
  4. socioeconomic status
  5. behavioral
  6. genetics
  7. metabolic/homeostatis
21
Q

metabolic syndrome must meet criteria of at least 3 out of 5

A
  1. Central (abdominal) obesity
  2. Low HDL
  3. Hypertension
  4. Hyperglycemia
  5. Hypertriglyceridemia
22
Q

BMI of 25-29.9 with no CVD, no obesity-related comorbidities, what is the intervention

A

counseling on avoiding wt gain, diet advice, physical activity recommendations

23
Q

BMI of 25-29.9 with 1+ CVD risk factors, or BMI of 30-34.9 get what intervention

A

Specific tools and strategies for dietary changes, increased physical activity from baseline (even if already active), behavioral intervention, pharmacotherapy

24
Q

BMI of 35+ get what intervention?

A

specific diet and exercise plans, multicomponent behavioral intervention, pharmacotherapy, bariatric surgery

nutrition (12 decks)

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