Obesity II Flashcards
What is the key thing to change in treating obesity?
Lifestyle
What is considered “successful” weight loss?
10% maintained over one year
When is a very low calorie diet indicated?
BMI 30+ with obesity comorbidities
How many calories is a very low weight loss diet?
800 calories or less
How long do very low calorie diets last?
12-16 weeks
What specific nutrient are VLCDs high in? Why?
Protein
Maintain lean muscle mass
Is it okay to resume a 2000 calorie diet once the VLCD is finished?
No–need to slowly build back up
What is the SMART mnemonic for goal setting?
Specific Measurable Attainable Realistic Time bound
The central concept of motivational interviewing is to do what?
Identify
Evaluate
Resolve
Ambivalence
How is motivational interviewing evocative?
Client does most of the talking
Drug treatment for obesity is indicated for whom?
BMI 30+ or 27+ with comorbidities
Drug treatment for obesity should always be accompanied by what?
Weight loss program
What is the MOA of Orlistat?
Lipase inhibitor that blocks fat absorption from the gastric/duodenal mucosa
What are the side effects of Orlistat?
Fecal discharge
Flatulence
What is the MOA of phentermine/Topiramate ER?
Phentermine = decreases appetite
Topiramate = anticonvulsant that prolongs satiety
How long is the phentermine/topiramate regime?
12 weeks
What is gastric banding?
Band around upper part of the stomach, limiting amount of food
What is the most likely side effect of gastric banding?
Emesis
What is sleeve gastrectomy?
Removal of the body of the stomach
What is a Roux-en-Y?
Tube connecting upper part of stomach with the distal small intestine
What are the problems with Roux-en-Y?
Nutritional deficiencies
Need lifelong supplements
What is dumping syndrome?
ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. Pulls blood volume out into intestines
What are the complications of bariatric surgery?
Anastomosis leaks (peritonitis/sepsis)
Stomal ulceration
What is the stomal ulceration associated with bariatric surgery?
Overabundant acid in pouch leads to excessive acid passing through stoma
Dumping syndrome can be set off how?
High sugar inntake
What causes the constipation following bariatric surgery?
Dehydration
Ca and Fe supplementation
What causes the Fe deficiency seen in ROux-en-Y surgeries?
Low gastric acid level prevent Fe cleavage from food
Little nutrient exposure to intestines
What is the cause of B12 deficiency in bariatric surgery pts?
Affects secretion of intrinsic factor
How do you prevent B12 deficiency with roux-en-y pts?
Oral supplementation
What is the cause of folate deficiency in bariatric surgery pts?
No B12 absorption = no folate absorption
Decreased consumption
What is the cause of low Vit D levels in bariatric surgery pts?
Bypasses duodenum
What is the cause of low Ca levels in bariatric surgery pts?
Bypasses duodenum
Low Vit D absoprtion
