Obesity and Metabolic Syndrome

Question 1

How do we diagnose overweight and obesity?

BMI =

Answer 1

KG/M^2

Surrogate for BF
Correlates with adverse health effects from excess BF

Question 2

BMI Classification

Answer 2

<18.5 under
18.5-24.9 normal 
25-29.9 overweight
30-34.9 obese
35-39.9 obese II
>40 Obese III

Question 3

Waist circumfrance? - 2 inches above iliac crest

Answer 3

men >40
women >35

independent risk factor

Question 4

3 groups where BMI might not reflect?

Answer 4

elderly (sarcopenic)
ethnic groups
muscular

Question 5

Major medical complication with obesity

Answer 5

T2DM
Dyslipidemia 
CAD
OSA
NASH

HTN
STROKE
CANCER

Question 6

Does physical activity mitigate the risk of obesity?

Answer 6

YES!

Question 7

5 characteristic of metabolic syndrome?

Answer 7

Abdominal obesity 
Hypertension 
Dyslipidemia (high TG low HDL)
Glucose intolerance 
Prothrombotic / Proinflammatory - not included though?

Question 8

MetSyn

Abdominal girth

Answer 8

Men >40

Women >35

Question 9

MetSyn

TG

Answer 9

> 150mg/dl

Question 10

MetSyn

HDL-C

Answer 10

Men <40

Women <50mg/dl

Question 11

MetSyn BP

Answer 11

> 130

>85

Question 12

Met Syn Fasting Glucose?

Answer 12

> 100

or some >110 mg/dl

Question 13

The Pima Indians of Arizona illustrate what contribution to the pathogenesis of obesity?

Answer 13

Environment

Because same genes but those living in Arizona (vs. MX) were like 10 BMI units higher

Question 14

Obese patient initial office eval?

Answer 14

potential obesity related disease with HP and labs

Weight history

Triggers / meds

Measure weight / height and calculate BMI

Categorize classification

Readiness?

Treatment plan

Goals and expectations

Arrange follow-up

Question 15

Note - do obese patients have realistic weight goals

Answer 15

no

Question 16

What percent of weight - loss - would have important health impacts?

Answer 16

5-10% would lead to decreased HbA1C 
BP
Total Cholesterol 
Triglycerides
and increased HDL :)

Question 17

At what point is the treatment recommended

DIET + PA?

Answer 17

27+
or
25+ with co-morbid condition

Question 18

At what point is the treatment recommended Pharmacotherapy?

Answer 18

30+
or
27+ with comorbid

Question 19

At what point is the treatment recommended surgery?

Answer 19

40+
or
35+ with comorbid