Weight Management

Question 1

Weight loss has been shown to improve glycemic control by doing three things

Answer 1

increasing insulin sensitivity increasing glucose uptake diminishing hepatic glucose output

Question 2

BMI FOR Overweight

BMI for obesity

Answer 2

OW. 25-29.9

OB. >= 30

Question 3

Should we use BMI or waist circumference to assess?

Answer 3

Both

Question 4

Do people with obesity and diabetes have greater difficulty with achieving weight loss compared to people with obesity but without diabetes

Answer 4

Yes

Question 5

What percentage of weight loss can improve insulin sensitivity, glycemic control and blood pressure.

Answer 5

5-10%

Question 6

The 2006 Canadian Obesity Guidelines have suggested how much weight loss per month is safe?
How much kcal daily reduction do you need to achieve helathy weight reduction?

Answer 6

2 to 4 kg/month

500 kcal/day

Metabolic and physiologic adaptations following weight loss can promote weight regain and make sustained weight loss challenging (26). Adjustment of the caloric deficit may be required as weight loss progresses.

Question 7

Waist circumference (WC) and risk of developing health problems

Answer 7

Men ≥102 cm

Women ≥88 cm

Question 8

WC cut-offs may be lower in some populations (e.g. older individuals especially in the presence of the metabolic syndrome (such as hypertriglyceridemia).

Answer 8

Europid
Sub-Saharan African
Eastern Mediterranean and Middle Eastern (Arab)

∗ ≥94 cm ≥80 cm

South Asian, Chinese, Japanese
South and Central American

≥90 cm	≥80 cm

†Increased WC can also be a marker for increased risk, even in persons with healthy weight

Question 9

What two types if programs have demonstrated better results than solo health-care professional-based interventions

Answer 9

Structured interprofessional programs and group programs have demonstrated better results (34) compared to solo health-care professional-based interventions

Question 10

How does liraglutide work for weight loss?

Answer 10

Liraglutide is a GLP-1 receptor agonist, which acts to
1- increase satiety
2- decrease hunger in the brain

Question 11

What two drugs approved for weight loss in canada

are also both proven to reduce risk of progressing from pre to D

Answer 11

Orlistat (xenical)

Lira

Question 12

Bariatric surgery is highly effective and inidcated at what BMI?

Answer 12

BMI ≥40.0 
OR
BMI 35.0 to 39.9 kg/m2 + presence of comorbidities, such as type 2 diabetes, who have demonstrated an inability to achieve weight loss maintenance following an adequate trial of healthy behaviour interventions and/or pharmacotherapy.

Question 13

Which type of bariatric surgery has been mostly abandoned in north america?

Answer 13

The gastric band has largely been abandoned in North America due to less sustained weight loss and metabolic benefits, and high surgical complication rates necessitating band removal

Question 14

Checklist for weight management programs

Answer 14

Assess and treats Comorbid conditions

Recommends healthy behaviour modifications and pharmacotherapy or surgery for those who qualify.

Provides individualized nutritional physical activity and behavioural programs and counselling

Reasonable weights loss goals set at 1-2kg per MONTH

Cost not prohibitive

No requirement to buy products

No unsubstantiated claims

Provides access to weight maintenance program