Obesity treatment Flashcards
(32 cards)
How do you produce weight loss
reduce food intake to create a negative energy balance. This is hard. Goal is to lose 1-2 lbs qwk
Most important strategy for decreasing dietary intaking
monitoring diet- food diary and calorie counting
What is the best diet?
The one that the patient can stick with over time
How can weight loss be maintained?
regular contact with a trained interventionist greater than one year. Exercise!!!
You should watch less tv
You will increase your energy expenditure
Changing social environment can have an impact on weight
Study showed this, so….
Sleep is also important for weight loss
don’t overeat
What is the importance of exercise
Makes improvements in body composition. Increased lean mass. Improved appetite regulation. Must exercise 60 minutes per day to prevent weight regain
Where is hunger controlled?
Lateral nucleus of the hypothalamus
Where is satiety controlled?
ventromedial nucleus of the hypothalamus
How does leptin work?
stimulate energy expenditure and block food intake. Insulin does this as well. Obese prone people have leptin resistance
What are the hunger neurons
NPY neurons- release NPY to stimulate food intake and decrease energy expenditure. Also release AgRP to inhibit catabolic pathway. NPY neurons are inhibited by leptin
What is POMC
POMC releases MSH to reduce food intake and increase energy expenditure. This is excited by insulin.
What is ghrelin?
hunger hormone. Stimulates NPY and inhibit POMC
What are PYY and GLP-1?
released by small intestine in response to meal. Satiety hormone. Stimulate POMC and inhibit NPY
What is severe childhood obesity?
120 percent of 95th percentile
What are some of the avoidable health risks associated with childhood obesity
T2DM, HTN, carotid atherosclerosis, arthritis, breast and colon cancer
What is overweight range for children
85-95% BMI
How is obesity defined in children?
> 95%
Who has the highest prevalence of obesity
older children/adolescents
Native american, black, hispanic
lower socioeconomic status
How many obese children have sleep apnea?
~1/3rd. snoring, bed wetting, morning headaches
What is obesity hypoventilation syndrome?
Weight on the chest causes restrictive lung disease, leading to hypoventilation and may lead to right heart failure. Set point for CO2 gets higher. Need to use positive pressure- using Oxygen may cause a loss of respiratory drive
How much weight do people lose with medication?
5-12%, but it only lasts as long as patient takes it. Often not covered by insurance
How does phentermine work?
Increases NE content in the brain, but it’s not addictive. Cheapest drug. Only FDA approved for 3 months of use. 5-8% weight loss. Side effects- HTN, HA, nervousness
