Obesity II

Question 1

What is the key thing to change in treating obesity?

Answer 1

Lifestyle

Question 2

What is considered “successful” weight loss?

Answer 2

10% maintained over one year

Question 3

When is a very low calorie diet indicated?

Answer 3

BMI 30+ with obesity comorbidities

Question 4

How many calories is a very low weight loss diet?

Answer 4

800 calories or less

Question 5

How long do very low calorie diets last?

Answer 5

12-16 weeks

Question 6

What specific nutrient are VLCDs high in? Why?

Answer 6

Protein

Maintain lean muscle mass

Question 7

Is it okay to resume a 2000 calorie diet once the VLCD is finished?

Answer 7

No–need to slowly build back up

Question 8

What is the SMART mnemonic for goal setting?

Answer 8

Specific
Measurable
Attainable
Realistic
Time bound

Question 9

The central concept of motivational interviewing is to do what?

Answer 9

Identify
Evaluate
Resolve
Ambivalence

Question 10

How is motivational interviewing evocative?

Answer 10

Client does most of the talking

Question 11

Drug treatment for obesity is indicated for whom?

Answer 11

BMI 30+ or 27+ with comorbidities

Question 12

Drug treatment for obesity should always be accompanied by what?

Answer 12

Weight loss program

Question 13

What is the MOA of Orlistat?

Answer 13

Lipase inhibitor that blocks fat absorption from the gastric/duodenal mucosa

Question 14

What are the side effects of Orlistat?

Answer 14

Fecal discharge

Flatulence

Question 15

What is the MOA of phentermine/Topiramate ER?

Answer 15

Phentermine = decreases appetite

Topiramate = anticonvulsant that prolongs satiety

Question 16

How long is the phentermine/topiramate regime?

Answer 16

12 weeks

Question 17

What is gastric banding?

Answer 17

Band around upper part of the stomach, limiting amount of food

Question 18

What is the most likely side effect of gastric banding?

Answer 18

Emesis

Question 19

What is sleeve gastrectomy?

Answer 19

Removal of the body of the stomach

Question 20

What is a Roux-en-Y?

Answer 20

Tube connecting upper part of stomach with the distal small intestine

Question 21

What are the problems with Roux-en-Y?

Answer 21

Nutritional deficiencies

Need lifelong supplements

Question 22

What is dumping syndrome?

Answer 22

ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. Pulls blood volume out into intestines

Question 23

What are the complications of bariatric surgery?

Answer 23

Anastomosis leaks (peritonitis/sepsis)

Stomal ulceration

Question 24

What is the stomal ulceration associated with bariatric surgery?

Answer 24

Overabundant acid in pouch leads to excessive acid passing through stoma

Question 25

Dumping syndrome can be set off how?

Answer 25

High sugar inntake

Question 26

What causes the constipation following bariatric surgery?

Answer 26

Dehydration

Ca and Fe supplementation

Question 27

What causes the Fe deficiency seen in ROux-en-Y surgeries?

Answer 27

Low gastric acid level prevent Fe cleavage from food

Little nutrient exposure to intestines

Question 28

What is the cause of B12 deficiency in bariatric surgery pts?

Answer 28

Affects secretion of intrinsic factor

Question 29

How do you prevent B12 deficiency with roux-en-y pts?

Answer 29

Oral supplementation

Question 30

What is the cause of folate deficiency in bariatric surgery pts?

Answer 30

No B12 absorption = no folate absorption

Decreased consumption

Question 31

What is the cause of low Vit D levels in bariatric surgery pts?

Answer 31

Bypasses duodenum

Question 32

What is the cause of low Ca levels in bariatric surgery pts?

Answer 32

Bypasses duodenum

Low Vit D absoprtion