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
Bariatric surgery
Effects weight loss thru reducing stomachs reservoir capacity (restriction), shortening length of intestine (malabsorption), or a combo of both of these (roux en y gastric bipass)
Outcomes of bariatric surgery
-majority of patients experience complete resolution or improvement of comorbidities
__ of the US population is obese
1/3