Obesity Lecture Powerpoint Flashcards
Obesity is inversely related to…
….education
Overweight BMI
25-29.9
Obesity BMI (class I thru III
I - 30-34.9
II - 35-39.9
III - 40+ (severe morbidly obese, will need bariatric surgery)
Screening for obesity (2)
- all adults screened with BMI measure
- waist circumference measured at the iliac crest men>40 inch women >35 inch indicative
Apple vs pear waist circumference
-apple indicates central adiposity associated with increased risk of morbidity and mortality, greater risk of hypertension, diabetes, etc,
Obesity hypoventilation syndrome (OHS) Pickwickian syndrome
A BMI greater than 30 that has limited chest mobility resulting in chronic alveolar hypoventilation worsening CO2 levels and right sided heart failure
Obesity etiology (3)
- sedentary lifestyle and increased caloric intake
- genetics
- social networks
Grehlin
Hormone released by stomach to promote hunger
Leptin
Hormone released from adipose signal to send to the brain to promote satiety
Obesity treatment (4)
-diet and exercise
-drugs
-surgery
-manage comorbidities
(based on both BMI and presence of comorbidities to determine)
Dietary advice as a provider (5)
- balanced low calorie diets/portion controlled diets (not below 1000-1200 kcal/day)
- low fat diets
- low carb diets
- mediterranean diet
- avoid fad diets
Defensive eating techniques (6)
- stop before stuffed
- be selective
- select small portions
- beware of desserts
- slow down
- be aware of why you are eating
When to use drugs for obesity (2)
- if BMI greater than 30
- BMI 27-30 if comorbid conditions exist
2 Drug options for weight loss (explanation and ADR)
- orlistat (lipase inhibitor prevents absorption of dietary fat, oily stools ADR) 1st line therapy
- Saxenda (excellent choice for those with type 2 diabetes, no ADR)
Liposuction
Removal of subQ fat by aspiration, not covered by insurance as purely cosmetic, does not improve insulin resistance or risk factors for CAD
