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Preventative Med. & Nutrition > Exam #1: Obesity II > Flashcards

Exam #1: Obesity II Flashcards

1
Q

What should the assessment of an obese patient focus on in addition to anthropometric data?

A
  • Social hx
  • Familial hx
  • Food/ nutrition behavior
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2
Q

What are the four major categories of barriers to obesity intervention?

A

1) Mental
2) Economics
3) Mechanical (physical activity)
4) Metabolic

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3
Q

What are the five stages of change?

A

1) Pre-contemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance

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4
Q

What is the pre-contemplation stage of change?

A

No intention to change over next 6 months

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5
Q

What is the contemplation stage of change?

A

Aware of problem; thinking about changing in 6 months

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6
Q

What is the preparation stage of change?

A

Intends to change in 30 days and may have made small changes

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7
Q

What is the action stage of change?

A

Actively engaged in change for less than 6 months

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8
Q

What is the maintenance stage of change?

A

Engaged in behavior for at least 6 months

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9
Q

What are the major methods of obesity treatment?

A
  • Altering diet
  • Increasing physical activity
  • Behavior therapy
  • Pharmacology
  • Surgery

**A combination of these is key

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10
Q

What is key to successful treatment of obesity?

A
  • Lifestyle change (weight loss only is unsuccessful 40% of the time)
  • Multidisciplinary approach
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11
Q

What is the definition of successful weight loss?

A
  • Losing 10% of initial eight

- Maintaining that for at least one year

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12
Q

What can a 10% weight loss improve?

A
  • Lipid levels
  • Blood glucose
  • Risk of heart disease
  • Lifestyle
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13
Q

Who is approved for a very low calorie diet (VLCD)?

A
  • BMI is 30+

- 27 w/ comorbidities

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14
Q

What is the definition of VCLD?

A

> 800 calories

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15
Q

What is important to remember when a patient has finished a VLCD program?

A

Must gradually refeed over 4-6 weeks

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16
Q

What is the limitation of VLCD?

A

Modest long-term outcome with common weight regain

17
Q

What is one of the most successful weight loss program types?

A

Behavior modification

*****Success especially seen when paired with other treatment types

18
Q

What does behavior modification include?

A
  • Goal-setting
  • Self-monitoring
  • Stimulus control
  • Cognitive reconstruction
  • Stress management
  • Social support
  • Relapse prevention
19
Q

What are the three essentials of motivational interviewing?

A

MI is:

1) A conversation
2) Collaborative
3) Evocative

20
Q

What patients are good candidates for drug therapy?

A
  • BMI >30

- 27 w/ comorbidities

21
Q

What is Orlistat? What is the mechanism of action?

A
  • Weight loss drug
  • Approved for peds

*****Lipase inhibitor that blocks fat absorption

22
Q

What is Phentermine/Topiramate ER? What is the mechanism of action?

A

Phentermine= appetite suppressant

Topiramate= anticonvulsant that decreases hunger and increases satiety

23
Q

What is gastric banding?

A

Placing a band around the upper stomach to create a 15 mL pouch

24
Q

What are the advantages of gastric banding?

A
  • Easily removed/ reversed
  • Faster recovery
  • Can be adjusted in office
25
Q

What are the disadvantages to gastric banding?

A
  • Weight loss if less dramatic
  • More likely to regain weight
  • Vomiting
  • Can slip out of place
26
Q

What is a sleeve gastrectomy?

A

75% of stomach is removed in line with the greater curvature

27
Q

What are the advantages to sleeve gastrectomy?

A
  • Simpler than bypass
  • Lower risk than bypass
  • Doesn’t effect absorption
  • Rare nutritional deficiencies
28
Q

What are the disadvantages to sleeve gastrectomy?

A
  • Irreversible
  • New
  • No long term data
29
Q

What is Roux-en-Y Gastric Bypass?

A
  • 15-25 mL pouch made w/ outlet

- Bypass distal stomach, duodenum, and jejunum

30
Q

What are the pros of Roux-en-Y Gastric Bypass?

A
  • Dramatic weight loss
  • C-morbid conditions improve
  • Good long term results
31
Q

What are the cons of Roux-en-Y Gastric Bypass?

A
  • Irreversible
  • Nutritional deficiency common
  • Need life long supplements
  • Dumping Syndrome
32
Q

What are the common complications of bariatric surgery?

A
  • Leaks
  • Stomal ulceration
  • Dumping syndrome
  • Constipation*

*Most common

33
Q

What is dumping syndrome?

A

Weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation, occurring after meals in some patients who have undergone gastric surgery.

34
Q

What foods will worsen Dumping Sydrome?

A

High sugar foods and beverages

35
Q

What are the major deficiencies seen following bariatric surgery?

A
  • Iron deficiency anemia
  • B12
  • Folate
  • Ca++ and Vitamin D

Preventative Med. & Nutrition (30 decks)

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