3.15 Obesity Flashcards

(30 cards)

1
Q

What is obesity?

A

A condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired

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2
Q

What BMI is overweight?

A

25-29.9

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3
Q

What BMI is obese?

A

30+

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4
Q

What is linked to obesity?

A
genetics
access to parks and playgrounds
average car use
poor diet
screen time
education level
poverty
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5
Q

What comorbidities is obesity linked to? (12)

A
depression
stroke
obstructive sleep apnoea
myocardial infection
hypertension
diabetes
bowel cancer
osteoarthritis
peripheral vascular disease
gout
infertility 
gallbladder disease
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6
Q

How do we assess and manage obesity in adults?

A

determine degree of overweight or obesity
assess lifestyle comorbidities and willingness to change
manage lifestyle changes and drug treatments
consider referral to specialist care
specialist assessment and management; surgery and follow up

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7
Q

How do we decide the treatment for obesity?

A

intervention based on BMI, waist circumference and presence of co-morbidities

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8
Q

When do we consider drugs for treatment of obseity?

A

Obesity 2 or higher
OR
Co-morbidities present

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9
Q

When do we consider surgery for treatment of obesity?

A

Obesity level 3
OR
Obesity level 2 with comorbidities

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10
Q

What do we prescribe for obesity that isn’t drugs or surgery?

A

diet and physical activity

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11
Q

What drugs can we prescribe for treatment of obesity?

A

Orlistat

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12
Q

What is orlistat?

A

derivative of endogenous lipstatin produced by Streptomyces toxytrincini

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13
Q

What does orlistat do?

A

gastric and pancreatic lipase inhibitor

reduced dietary fat absorption by 30%

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14
Q

What are some side effects of orlistat?

A

fatty stool
faecal urgency
faecal incontinence
possible deficiencies of fat soluble vitamins (A,D,E,K)

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15
Q

When is bariatric surgery a first line treatment?

A

BMI of >50

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16
Q

What criteria must a patient meet to be eligible for bariatric surgery?

A
  • non-surgical measures have failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months
  • receiving or will receive intensive specialist management
  • generally fit for anesthesia and surgery
  • commit to the need for long term follow up
17
Q

What are the 3 types of bariatric surgery?

A

gastric bypass
gastric band
sleeve gastrectomy

18
Q

What is gastric bypass?

A

the top par of the stomach is joined to the small intestine so you feel fuller sooner and do not absorb as many calories from food

19
Q

What is gastric band?

A

a band is placed around your stomach so you do not need to eat as much to feel full
under skin pot for adjusting band tightness

20
Q

What is sleeve gastrectomy?

A

some of your stomach is removed so you cannot eat as much as before and you’ll feel fuller sooner

21
Q

What is the most effective bariatric surgery?

A

gastric bypass

22
Q

What is the problem with prescribing drugs and lifestyle changes to a patient with obesity?

A

largely ineffective

23
Q

Why does genetics play an important role in obesity with the presence of risk factors?

A

because genetics increase susceptibility to risk factors of obesity

24
Q

What is the relationship between mortality and BMI?

A

as BMI increases so does mortality

25
What is the relationship between comorbidities and obesity?
as obesity increases so does comorbidities
26
What % of your chance of being obese is based on your genes?
70%
27
How do genes affect obesity?
Can affects different aspects: - waist to hip ratio - BMI - birth weight - visceral adiposity
28
Where is leptin released from?
adipose tissue | enterocytes in the small intestine
29
What does leptin do?
Acts on hypothalamus to decrease hunger, and increase fullness
30
What is the main single gene mutation associated with extreme obesity?
Melanocortin 4 receptor mutation affecting the action of leptin