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Sem 4, case 6 (diabetes) > overview of obesity (mini learning) > Flashcards

overview of obesity (mini learning) Flashcards

1
Q

What 2 measurements can be used to assess for obesity in adults ?

A
  • waist circumference (when BMI <35)
  • BMI
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2
Q

What are the male waist circumference ranges considered
a) low risk of obesity ?
b) high risk of obesity ?
c) very high risk of obesity ?

A

low risk <94 cm
high risk = 94-102 cm
very high risk >102 cm

When BMI is <35

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3
Q

What are the female waist circumference ranges considered
a) low risk of obesity ?
b) high risk of obesity ?
c) very high risk of obesity ?

A

low risk <80 cm
high risk = 80-88 cm
very high risk >88 cm

When BMI is <35

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4
Q

What are the BMI ranges ?

A

18.5 - 24.9 normal/healthy
25 - 29.9 overweight
30 - 34.9 obesity 1
35 - 39.9 obesity 2
40 + obesity 3

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5
Q

What method is used to assess obesity in children ?

A

centile charts

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6
Q

What is the definition of obesity ?

A

a disease process, characterised by excessive body fat accumulation with multiple organ-specific consequences

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7
Q

How do BMI measurements differ in the south asian population ?

A

they have a greater total %fat mass than white populations, so BMI ranges differ…

> 23 overweight (rather than 25)
27.5 obesity (rather than 30)

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8
Q

What are the 2 types of body weight distribution?

A
  • gynaecoid (lower fat obesity/pear shaped)
  • android (upper fat obesity/apple shaped)
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9
Q

Which hormones encourage gynaecoid weight distribution ?

A
  • progesterone
  • oestrogen
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10
Q

Which complications are associated with android obesity distribution ?

A
  • heart disease
  • type 2 diabetes
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11
Q

Which hormone encourages android weight distribution ?

A

testosterone

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12
Q

What % of UK adults are overweight or obese ?

A

63%

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13
Q

What % of men are classed as overweight or obese ?

A

67% of men

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14
Q

What % of women are classed as overweight or obese ?

A

60% of women

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15
Q

What health complications are likely to develop in obese children ?

A
  • breathing difficulties
  • insulin resistance
  • hypertension
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16
Q

What health complications are likely to develop in obese adults ?

A
  • CVD
  • hypertension
  • type 2 diabetes
  • musculoskeletal disorders
  • cancers
  • respiratory problems
  • reproductive dysfunction
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17
Q

What are the 5 As in the framework about entering into conversations about weight ?

A

Ask for permission
Assess their willingness/abilities
Advise them of a pathway
Agree on a plan
Assist help them achieve it

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18
Q

What are the 4 Ms in the framework used to assess causes and complications of obesity ?

A

Mental health
Mechanical issues
Metabolic issues
Monetary issues

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19
Q

What is the recommended amount of moderate physical activity per week for adults ?

A

150 mins/weeks

20
Q

How long per day do some patients need to be active for in order to achieve weight loss ?

A

60-90 mins a day

21
Q

What are the 4 tiers of weight management services in the UK ?

A

Tier 1. universal intervention (public health campaigns)
Tier 2. community weight management services (run by dieticians)
Tier 3. services run by MDTs (doctors, dieticians, psychologists…)
Tier 4. bariatric services

22
Q

When are patients referred to tier 3 (MDTs) in weight management ?

A
  • tried tier 2
  • BMI >40
  • BMI >35 with obesity associated comorbidities
23
Q

How long does a typical tier 3 (MDT) weight loss program last ?

A

6-12 months

aim for 5-10% weight loss

24
Q

When makes a patient eligible to be referred to tier 4 (bariatric surgery) in weight management?

A

come out of tier 3 with:
- BMI >40
- BMI >35 with obesity associated comorbidities

25
Q

What are the 2 medications used to help patients manage obesity ?

A
  • Orlistat
  • Liraglutide (Saxenda)
26
Q

What is the MOA of Orlistat?

A

gastric and pancreatic lipase inhibitor

reduces hydrolysis of triglycerides in the intestine, so decreases absorption of dietary fats

27
Q

What BMI indicates the use of Orlistat ?

A

> 30
or
28 with risk factors

28
Q

What is the MOA of Saxenda ?

A

GLP-1 Agonist

interacts with neurones that regulate appetite/decreases feeling of hunger

29
Q

In what tier of weight management should Saxenda be offered ?

A

Tier 3

30
Q

Who is indicated for use of Saxenda ?

A
  • BMI >30
  • BMI >27 with risk factors
31
Q

What habits must Saxenda be paired with to be effective ?

A
  • low calorie diet
  • increased physical activity
32
Q

When should Saxenda be stopped ?

A

if less than 5% weight reduction after 12 weeks

33
Q

What is line of weight management treatment used prior to bariatric surgery ?

A

non-surgical weight management

  • lifestyle changes
  • medications
  • psychologist help
  • physiotherapist help
  • dieticians
34
Q

What is a gastric balloon ?

A
  • temporary
  • surgeon inserts gastric balloon
  • stays in for 6-12 months
  • should see weight loss
35
Q

What is a gastric band ?

A
  • adjustable, inflatable device at top of stomach
  • forms a ring around the stomach
  • restricts how much food can pass into stomach
36
Q

What is meant by the term ‘excess weight’ ?

A

any extra weight that takes a person over a BMI of 25

37
Q

What % of ‘excess weight’ can be lost via use of a gastric band ?

A

~ 50%

38
Q

What is a gastric sleeve ?

A
  • remove greater curve of the stomach (80% of stomach)
  • left with a small, narrow tube
39
Q

What % of ‘excess weight’ can be lost via use of a gastric sleeve ?

A

70-75%

40
Q

What is a gastric bypass ?

A
  • create a pouch out of top of stomach
  • reattach the bowel to this new stomach pocket, to bypass rest of stomach

most invasive

41
Q

What % of ‘excess weight’ can be lost via use of a gastric bypass ?

A

up to 80%

42
Q

What are the 4 types of bariatric surgery ?

A
  • gastric balloon
  • gastric band
  • gastric sleeve
  • gastric bypass
43
Q

Which ethnic group are at a greater risk of developing metabolic conditions like type 3 diabetes ?

A

south asian population

44
Q

What is the criteria for bariatric surgery eligibility in the asia in population ?

A
  • BMI >30
45
Q

What are the challenges posed by gastric balloon surgery ?

A
  • inability to tolerate balloon causing vomiting and nausea
  • perforation of balloon
  • migration of balloon
46
Q

What are the challenges posed by gastric band surgery ?

A
  • slippage (stomach slips through band)
  • erosion into stomach
  • infection of band
  • acid reflux
  • swallowing difficulties
47
Q

What are the challenges posed by gastric sleeve surgery ?

A
  • non-healing of staple line
  • vitamin B12 deficiencies (part of stomach that’s removed produces intrinsic factor used for B12 absorption)

Sem 4, case 6 (diabetes) (4 decks)

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