Obesity surgery

Question 1

What is a healthy BMI

Answer 1

18.5-25

Question 2

Treatment pathway for obesity

Answer 2

lifestyle changes
Drug changes,
bariatric surgery

Question 3

What is orlistat

Answer 3

A lipase inhibitor

reduces absorption of calories from fat and fat bound A, D, E and K

Question 4

Side effects of orlistat

Answer 4

flatulence, oily discharge, oily stools, more frequent stools, stomach pain, faecal incontinence, lower blood sugar

Question 5

NICE criteria for bariatric surgery

Answer 5

• BMI > 40
• BMI > 35 with comorbidities - hypertension, T2D, sleep apnoea, cardiovascular disease, osteoarthritis and dyslipidaemia
• In patients with recent diabetes, surgery if BMI > 30

Question 6

Gastric band

Answer 6

Restriction of stomach via an inflatable band

Question 7

Gastric balloon

Answer 7

Inflate balloon in stomach - you can’t fill with as much food

Question 8

Gastric sleeve

Answer 8

Cuts off greater curvature of the stomach

Cuts out cells that make hunger hormones

Question 9

Gastric bypass

Answer 9

Gold standard for bariatric surgery

Question 10

Enters-encephalic endocrine axis

Answer 10

Ghrelin is hunger stimulating hormone
As you lose weight, ghrelin increases
RYGB cuts out ghrelin-producing cells

Question 11

entero-insular asís

Answer 11

GLP-1 increases insulin secretion and insulin sensitivity of cells

Question 12

Which cancers are linked to obesity more than smoking?

Answer 12

Bowel, kidney, ovarian and liver

Question 13

site of leptin secretion

Answer 13

Adipose tissue and stomach

Question 14

Function of leptin

Answer 14

Acts on brain and vagus nerve to decrease food intake

Question 15

Where is ghrelin secreted?

Answer 15

Stomach

Question 16

Function of ghrelin

Answer 16

Acts on brain and hypothalamus to increase food intake

Question 17

Where is CCK secreted?

Answer 17

Intestine

Question 18

Function of CCK

Answer 18

Acts on vagus and GIT to decrease food intake and slow gastric emptying

Question 19

Where is GLP-1 produced?

Answer 19

Intestine

Question 20

Function of GLP-1

Answer 20

Acts on vagus nerve and GIT to decrease food intake and slow gastric emptying

Question 21

Where is PYY made?

Answer 21

Intestine