Overweight and Obesity Flashcards
What BMI is classified as Overweight?
25-29.9
What BMI is classified as Obese?
> 30
What BMI is classified as Clinically Obese?
> 35
What BMI is classified as Morbid Obesity?
35-40
What BMI is classified as Morbid?
> 40
When should you consider pharmacological treatment for obesity?
Adjust to diet and physical activity
Patients should have BMI >30, no other risk factors OR BMI>27 with risk factors
What is Basal Metabolic Rate?
How much energy you burn if do nothing all day
How do we induce basal weight loss?
- Increase basal metabolic rate
- Decrease eating/increase satiety
- Increase calorie shedding in urine
- Block calorie absorption from gut
What drugs are classified as stimulants?
Bezphetamine
Diethylpropion
Phendimetrazine
Phentermine
What is the MOA of stimulants?
Increase levels of NE, inhibit NE reuptake transporter NET = increase basal metabolic rate and decrease appetite
What are the A/Es of stimulants?
Increased HR and BP
Cannot be used long term
When should you use stimulants in caution?
- CV
- Renal impairment
- Anxiety issues (worsen)
- Pregnant (CI)
- Drug abuse
- Hyperthyroidism (worsen)
- Glaucoma
What are the pearls of stimulants?
Cause toxicity when used with MAOI
What is Orlistat and its MOA?
Lipase inhibitor, blocks calorie absorption
What are the A/Es of Orlistat?
GI: loose greasy stol, diarrhea, abdominal cramping/bloating
What are the pearls of Orlistat?
Taken with each fat-containing meal
Long term use
What GLP-1 Agonists can be used for Obesity and how does it work?
Decreases appetite through increase fullness/satiety
Liraglutide and Semaglutide
AE of Victoza/Saxenda? (lira)
Pancreatitis, gallbladder, irritation
Pearls of Ozempic/Ryblesus? (sema)
Labeled for weight loss, better than Liraglutide
What was Lorcaaserin and what is wrong with it?
5-HT2C Receptor Antagonist, decreases hunger/increase satiety
Withdrawn due to increased risk of cancer
What is Phentermine + Topiramate?
Qsymia
Phentermine: stimulant
Topiramate: anti-convuslant
Pearls about Qsymia?
Greater efficacy than phentermine alone
Abrupt DC = seizures
What are the AE and CI of Qsymia?
AE: mood changes, insomnia, fatigue
CI: pregnancy, glaucoma, hyperthyroidism, CV
What is Naltrexone + Bupropion?
Contrave
Naltrexone: opioid receptor antagonist
Bupropion: atypical antidepressant
AE of Contrave?
Increased risk of suicidal thoughts/behaviors, seizures, CNS depression
What is Plenity and its MOA?
Non-Pharmacologic, device that mechanically fills the stomach to encourage less eating
What is the dose for Plenity?
3 Capsules, taken 20 mins before meals with water, Cellulose and Citric Acid
What are OTC stimulant meds for obesity?
Ephedra, Caffeine, Hoodia, Bitter Orange
Caution CV and HTN
What are OTC meds for obesity with no proven significant effect?
Chitosan, Pyruvate, and Chromium
