Weight Loss

Question 1

What’s the result of a 500 kcal decrease per day?

Answer 1

1 pound weight lost per week (3,500 kcal/ pound)

Question 2

What’s the amt of regular physical activity req to lose weight?

Answer 2

200-300 min/wk

Question 3

When’s Bariatric surgery recommended?

Answer 3

Adults with BMI >= 40

Or

BMI >= 35 + an obesity-related comorbid condition

Question 4

List OTC weight loss drugs?

Answer 4

Fastin

Caffeine- containing pdts

Alli

Question 5

In what grp of pt is rx weight loss pdts not recommended?

Answer 5

Those with small weight to lose

Those who are not obese or overweight with at least 1 weight-related co-morbidity e.g. DM, HTN

Question 6

Howz rx weight loss pdts used?

Answer 6

In addition to a dietary plan + increased physical activity, per FDA

Question 7

What’s the “7-yr rule” of new meds?

Answer 7

Don’t recommended new agents until they have been out for awhile and used in millions – not including ur pts, friends and family– in order to get a more complete understanding of ADRs

Question 8

MOA of Phentermine?

Answer 8

Sympathomimetic, with effects similar to amphetamines, causing increase in NE

Question 9

Moa of Topiramate?

Answer 9

Effects due to decreased appetite and safety, possibly by enhancing GABA, blocking glutamate receptors and/or weak inhibition of carbonic Anhydrase

Question 10

Brand name of Phentermine + Topiramate ext-release capsule?

Answer 10

Qsymia

Question 11

SEs of Qsymia?

Answer 11

Dizziness

HA

Cognitive impairment

Constipation

Dry mouth

Insomnia

Paresthesias

Reduced serum bicarbonate

Upper respiratory tract inf

Pharyngitis

Question 12

Agents under Serotonin 5-HT2c receptor agonist?

Answer 12

Lorcaserin (Belviq)

Question 13

List short-term appetite suppressants

Answer 13

Phentermine (Adipex-P, Suprenza-ODT)

Diethylpropion (Tenuate)

Question 14

Long-term lipase inhibitor agent?

Answer 14

Orlistat (Xenical) Rx

Orlistate (Alli) OTC

Question 15

How should both formulations be used?

Answer 15

Low-fat diet

Question 16

What should be taken with Orlistat?

Answer 16

MTVE A, D, E,K & Beta carotene at bedtime

Or

Separate by 2+ hrs

Question 17

What’s 1 of the most common problem of Bariatric surgery?

Answer 17

Calcium deficiency

Calcium citrate is preferred (cuz of non-acid dependent absorption)

Question 18

What causes anemia post-Bariatric surgery?

Answer 18

Vit. B12 + Iron deficiency.

Both req supplementation

Question 19

Should iron and Ca be taken together?

Answer 19

No!

They should be separated

Question 20

Why may some req lifelong supplementation of fat-soluble vits A, D, E, K?

Answer 20

Due to fat malabsorption

Question 21

How do u take meds up to 2-months post-surgery?

Answer 21

Meds should be Crushed or in liquid or transdermal form for up to 2-months post-surgery

Question 22

Why do post-Bariatric surgery req Ursodiol (Actigall, Urso 250, Urso Forte)?

Answer 22

Due to risk of gallstone formation due to rapid weight loss

These drugs dissolve gallstones

Question 23

Which drugs should be avoided post-Bariatric surgery? Why?

Answer 23

NSAIDs + Bisphosphonates

They are GI irritants

Question 24

What’s dumping syndrome?

Answer 24

Rapid gastric emptying, which occurs when in digested food moves rapidly into the small intestines

Question 25

Common sx of dumping syndrome?

Answer 25

Abdominal cramps

Nausea

Diarrhea

Question 26

Methods to avoid dumping syndrome?

Answer 26

Eat smaller meals

Use fluids btw meals only

Reduce carbs

Increase fiber

Avoid alcohol + acidic food

Don’t lie down after eating

Question 27

What rx drugs are used for dumping?

Answer 27

Acarbose (Precose)

Octreotide (Sandostatin)

Question 28

What weight loss produces clinically meaningful health benefits?

Answer 28

Wt loss of 3-5%