Obesity Treatment: Drugs, Surgical Options, and Popular Diets Flashcards
Not related to this lecture: at 6”2, what should your weight maximally be to avoid weight-related complications?
178 lbs (a BMI of 22.9); a BMI of 23 is where weight-related complications are known to start increasing
When counseling a patient on medications to assist in weight loss, you should be sure the patient understands that the drugs must be taken _____________.
chronically; typically, when patients stop taking these medications, their weight returns
One common reason people don’t take weight-loss medications is _______________.
that insurance companies won’t pay for them and they’re extremely expensive
Which weight-loss drug is chemically related to amphetamine?
phentermine
Side effects of phentermine include headache, hypertension, and nervousness. This makes sense, because phentermine is _____________.
a sympathomimetic
How does orlistat work?
It inhibits pancreatic lipase, thereby decreasing fat absorption.
Side effects of orlistat include ______________.
increasing urgency of stooling and steatorrhea
Which weight-loss drug is the safest?
Orlistat (it’s actually available OTC)
Why was phen/fen removed from the market?
It (mostly the fen) caused valvular heart disease.
____________ works by binding to and activating serotonin 2C receptors.
Lorcaserin
The most effective weight-loss medication is ___________.
topiramate/phentermine (can go up to 12%); this combination also raises HDL, lowers BP, and decreases glucose levels
Weight-loss drugs also reduce _____________.
A1c (Dr. Bessesen showed the trial for naltrexone/bupropion)
The most popular kind of stomach surgery is ____________.
sleeve gastrectomy
The most effective stomach surgery is _____________.
gastric bypass
Why is gastric surgery effective?
Because they aren’t secreting ghrelin!
Long-term studies on gastric-bypass surgery show that ______________.
compared to controls, those who had gastric bypass have fewer cases of diabetes, MI, and cancer
What is the mortality of gastric bypass surgery?
0.7%
One of the downsides of phentermine is that ____________.
there is no data on long-term safety
Women need to have a negative pregnancy test before taking ________.
phentermine/topiramate
Which weight-loss drug is the cheapest? Most effective? Safest? Has the fewest side effects?
Cheapest: phentermine
Safest: orlistat
Has the fewest side effects: lorcaserin
Most effective: phentermine/topiramate
Avoid phentermine in patients with _________ problems.
psychiatric
Paresthesias are a side effect of which weight-loss medication?
Topiramate/phentermine
Which drug is considerate to have intermediate effectiveness and safety and is thus a second-line option?
Naltrexone/bupropion
________ percent of those who had gastric bypass were able to maintain an A1c less than 6% without medications.
42%
