Obesity Flashcards
Define Obesity
Abnormal/excessive fat accumulation that presents a risk to health
What BMI measurements are indicative of obesity?
30-34.9kg/m2 (Grade I)
35-39.9kg/m2 (Grade II)
>40kg/m2 (Grade III)
How is BMI calculated?
Weight (kg)/height (m) squared
What are the contraindications to the use of BMI?
Very muscular people
Elderly people lower morbidity 25-30
Asian people risk factors appear at a lower BMI
What is the approximate prevalence of obesity?
20%
What are the risk factors for obesity?
Excessive calorie consumption Minimal physical activity Genetics Medications (steroids, oral hypoglycaemic agents, antidepressants) Medical conditions (PCOS, Cushing's)
What conditions are associated with causing obesity?
Hypothyroidism Cushing's syndrome GH deficiency PCOS Hypothalamic damage Genetic syndromes associated with hypogonadism
What are the clinical complications of obesity?
Metabolic syndrome (DM, HTN, Hyperlipidaemia)
Non-alcoholic fatty liver disease/liver cirrhosis
Restricted ventilation (sleep apnoea)
Mechanical affects (incontinence, varicose vv, arthritis)
Increased peripheral steroid conversion in adipose
What are the social complications of obesity?
Withdrawal
Stigma
Loneliness/loss of social structure
Huge economic cost
What are the main interventions used to manage obesity?
Structured advice on healthy weight/lifestyle
Advice regarding diet/exercise (600kcal deficit)
Drug treatment for comorbidities
Poss. surgical referral
What is the only anti-obesity drug used in the UK?
Orlistat
How does Orlistat work?
Lipase inhibitor, reduces absorption of dietary fat (30%)
How are supplements used to manage obesity?
Vitamin/mineral supplements used in obesity to avoid development of deficiencies
What are the surgical management options for obesity?
Restrictive (gastric banding)
Malabsorptive (biliopancreatic diversion)
Combination (Roux-en-Y bypass)
What are the indications for surgical management of obesity?
BMI >40
>35 w/ obesity related complications
