Chapter 45 Obesity Flashcards
(381 cards)
1
Q
What is obesity?
A
An excessively high amount of body fat or adipose tissue
2
Q
Why is obesity considered a global problem?
A
It is a major risk factor for leading causes of death, including type 2 diabetes, heart disease, and certain cancers
3
Q
What are some common problems associated with being overweight?
A
- Problems with mobility
- Sleeping issues
- Affected health
4
Q
What emotional issues can arise from obesity?
A
- Altered body image
- Depression
- Low self-esteem
- Withdrawal from social interaction
5
Q
How can attitudes about obesity affect individuals?
A
They can create biases and discrimination against people who are obese
6
Q
How should obesity be viewed and treated?
A
As a chronic disease, similar to diabetes and hypertension
7
Q
Where are obesity rates highest in the United States?
A
- The South
- The Midwest
8
Q
Which racial and ethnic groups have higher obesity rates?
A
- Blacks
- Hispanics
9
Q
What demographic factors contribute to higher obesity rates?
A
- Lower-income
- Less-educated Americans
10
Q
At what age can obesity begin in children?
A
As early as age 2 to 5
11
Q
What is a key part of addressing the obesity epidemic?
A
Reversing the childhood obesity crisis
12
Q
What type of disease is obesity classified as?
A
A complex, multifactorial disease
13
Q
What causes the energy imbalance leading to obesity?
A
Taking in more calories than needed for the body’s physical and metabolic functions
14
Q
What happens to fat cells in the body during obesity?
A
- Increase in the number of adipocytes
- Increase in their size (hypertrophy)
15
Q
What is adipocyte hypertrophy?
A
A process by which fat cells can increase their volume several thousand times to accommodate large increases in lipid storage
16
Q
What triggers preadipocytes to become adipocytes?
A
When the storage of existing fat cells is exceeded
17
Q
What are the two main types of obesity?
A
Primary obesity and secondary obesity
Primary obesity is due to excess calorie intake over energy expenditure. Secondary obesity is caused by medical problems.
18
Q
What causes secondary obesity?
A
Congenital conditions, endocrine disorders, CNS lesions and disorders, or drugs (e.g., corticosteroids, antipsychotics)
Secondary obesity can result from various medical issues.
19
Q
How many genes have been linked to obesity?
A
Over 400 genes
These genes affect various factors like appetite, satiety, and body-fat distribution.
20
Q
What is the role of the FTO gene in obesity?
A
Increased appetite and reduced satiety, leading to higher calorie intake
The FTO gene is associated with obesity and has a significant impact on eating behavior.
21
Q
What is the impact of family history on obesity?
A
Increases the chance of developing obesity
Genetic predisposition plays a critical role in obesity risk.
22
Q
What is the major site for regulating appetite?
A
Hypothalamus
The hypothalamus is essential for appetite control and energy balance.
23
Q
What is neuropeptide Y?
A
A powerful appetite stimulant made in the hypothalamus
Imbalances in neuropeptide Y can lead to overeating and obesity.
24
Q
Fill in the blank: The greatest increase in the number of fat cells occurs from _______.
A
infancy through adolescence
This period is crucial for fat cell development.
25
What physiological components affect appetite and energy balance?
Hypothalamus, gut, and adipose tissue
## Footnote
These components synthesize hormones and peptides that regulate appetite.
26
True or False: Having one or more obesity-related genes guarantees that a person will become obese.
False
## Footnote
Genetic predisposition increases risk but does not ensure obesity.
27
What role do hormones and peptides from the gut and adipose cells play in obesity?
They affect the hypothalamus and play a critical role in appetite and energy balance
## Footnote
These signals are vital for regulating food intake and metabolism.
28
Which group among women has the highest prevalence of being obese?
Blacks: 56.9%
## Footnote
This statistic highlights the significant obesity prevalence among Black women.
29
Which demographic has the lowest prevalence of being obese?
Asian Americans
## Footnote
This group shows a lower obesity prevalence compared to others.
30
What effect does overeating at an early age have on adults?
Alters ability to sense fullness (satiety)
## Footnote
This change can lead to continued overeating into adulthood.
31
What hormone is made in adipocytes and regulates appetite?
Leptin
## Footnote
Leptin suppresses appetite and increases fat metabolism.
32
What happens in the case of a genetic deficiency of leptin?
Causes extreme obesity
## Footnote
Most obese individuals have high leptin levels, indicating leptin resistance.
33
What role does ghrelin play in appetite regulation?
Inhibits leptin and stimulates hunger
## Footnote
Ghrelin levels rise when hungry and decrease after eating.
34
What is a notable difference in ghrelin levels for gastric bypass patients?
Do not have the premeal increase in ghrelin
## Footnote
Low ghrelin levels help suppress appetite post-surgery.
35
What are adipokines?
Substances made by adipocytes that play roles in:
* Glucose and lipid metabolism
* Insulin sensitivity
* Energy homeostasis
* Inflammation
* Immunity
* Vascular function
## Footnote
Dysfunction of adipokines is linked to obesity-related complications.
36
What is associated with excess visceral fat?
Adipokine dysfunction
## Footnote
This leads to insulin resistance and dyslipidemia.
37
What role do environmental factors play in obesity?
Key role due to access to high-calorie foods and sedentary lifestyle
## Footnote
Increased portion sizes and lack of exercise contribute to weight gain.
38
How do low-income individuals often manage their food budgets?
Buy less expensive foods with poor nutritional quality
## Footnote
These foods often have greater caloric content.
39
What psychosocial factors contribute to overeating?
Use of food for comfort or rewards, emotional eating
## Footnote
Associations with food begin in childhood during social events.
40
Fill in the blank: People often associate food with _______ during social events.
pleasure and fun
## Footnote
This association can lead to overeating during celebrations.
41
What are the health risks associated with obesity?
Increased mortality rates, reduced quality of life, cardiovascular disease, type 2 diabetes, gastrointestinal issues, respiratory problems, and musculoskeletal problems
## Footnote
Obesity leads to many health complications, with risk factors increasing as weight increases, particularly visceral fat.
42
What is a significant risk factor for cardiovascular disease?
Obesity
## Footnote
Obesity is a major risk factor for cardiovascular disease (CVD) and stroke in both men and women.
43
What type of obesity is best linked to cardiovascular risks?
Android obesity
## Footnote
Android obesity is associated with increased low-density lipoproteins (LDLs) and decreased high-density lipoproteins (HDLs).
44
Which factors can lead to hypertension in obese individuals?
* Increased circulating blood volume
* Abnormal vasoconstriction
* Increased inflammation
* Increased risk for sleep apnea
## Footnote
These factors can damage blood vessels and raise blood pressure.
45
What is the greatest risk factor for developing type 2 diabetes?
Obesity
## Footnote
Obesity leads to hyperinsulinemia and insulin resistance, which are common in type 2 diabetes.
46
How does obesity affect insulin effectiveness?
Decreases effectiveness
## Footnote
Excess weight causes too much glucose to remain in the bloodstream, leading to overproduction of insulin.
47
What condition results from lipids deposited in the liver due to obesity?
Nonalcoholic steatohepatitis (NASH)
## Footnote
NASH can progress to cirrhosis and can be fatal if not managed.
48
What respiratory problems are linked to obesity?
Sleep apnea and obesity hypoventilation syndrome
## Footnote
Increased fat around the neck can lead to snoring and hypoventilation while sleeping.
49
What does obesity do to sleep patterns?
Increases sleep deprivation
## Footnote
Sleep deprivation can impair metabolism and disrupt hormone levels, increasing appetite.
50
What musculoskeletal problem is associated with obesity?
Osteoarthritis
## Footnote
The stress on weight-bearing joints increases the incidence of osteoarthritis.
51
Fill in the blank: Obesity can lead to chronic ________ throughout the body.
inflammation
## Footnote
Chronic inflammation increases the risk for heart disease.
52
What is one of the most important preventable causes of cancer?
Obesity
## Footnote
Obesity is linked to several types of cancer including breast, colorectal, and endometrial cancer.
53
Which cancers are most strongly linked to excess body fat?
* Breast
* Colorectal
* Endometrial
* Esophagus
* Gallbladder
* Kidney
* Liver
* Ovarian
* Stomach
* Thyroid
## Footnote
These cancers show significant associations with obesity.
54
What are adipokines and how do they relate to obesity and cancer?
Adipokines are hormones from fat cells that may stimulate cell and blood vessel growth
## Footnote
Leptin, an adipokine, is increased in obesity and promotes cell proliferation.
55
How does fat tissue affect hormone levels in the body?
Fat tissue converts androgens into estrogens
## Footnote
Increased estrogen levels after menopause may lead to breast and endometrial cancer.
56
What role does insulin play in obesity-related cancer risk?
Insulin is a powerful cellular growth factor that is increased in obesity
## Footnote
It is linked to colorectal cancer.
57
What is metabolic syndrome?
A growing obesity-related health concern
## Footnote
It is characterized by a cluster of conditions that increase the risk of heart disease, stroke, and diabetes.
58
What psychosocial problems are associated with obesity?
Stigma, discrimination, low self-esteem, loneliness, and major depression
## Footnote
The emotional toll of obesity affects individuals in employment, education, and health care.
59
What is the first step in the treatment of obesity?
Determine whether any physical conditions are present that may be causing or contributing to obesity
## Footnote
This involves a thorough history and physical assessment.
60
How should healthcare providers approach assessments of patients who are overweight or obese?
Be sensitive and nonjudgmental
## Footnote
Asking specific and leading questions about weight, diet, and exercise can help gather necessary information.
61
Fill in the blank: Patients need to understand the reason for questions asked about __________.
weight or diet habits
## Footnote
This understanding helps in building trust during the assessment.
62
True or False: Personal biases related to obesity can affect how healthcare providers interact with patients.
True
## Footnote
Providers should examine their own beliefs to avoid conveying negative attitudes.
63
What should a healthcare provider assess regarding a patient's readiness for change?
Willingness to change and potential for change
## Footnote
If patients are not ready for change, providers should offer support rather than pressure.
64
What factors should be explored when obtaining a history related to obesity?
Genetic and endocrine factors such as hypothyroidism, hypothalamic tumors, Cushing syndrome, hypogonadism in men, and polycystic ovary syndrome in women.
## Footnote
These factors can significantly influence an individual's weight and metabolic health.
65
What laboratory tests are helpful in evaluating the cause and effects of obesity?
Tests include liver function tests, thyroid function tests, fasting glucose level, and a lipid panel (triglyceride level, LDL and HDL cholesterol levels).
## Footnote
These tests help identify any underlying conditions related to obesity.
66
What comorbid diseases should be assessed in relation to obesity?
Hypertension, sleep apnea, and diabetes.
## Footnote
These conditions often require special treatment and management alongside obesity.
67
What measurements should be included in a physical assessment for obesity?
Height (without shoes), weight, waist circumference, and BMI.
## Footnote
Accurate measurements are essential for proper classification and treatment planning.
68
What is the most common method for classifying body weight?
Body Mass Index (BMI).
## Footnote
BMI is widely used due to its simplicity and effectiveness.
69
How is BMI calculated?
BMI is calculated by dividing a person's weight (in kilograms) by the square of their height (in meters).
## Footnote
This formula provides a standardized measure of body weight relative to height.
70
What BMI range is considered underweight?
A BMI less than 18.5 kg/m².
## Footnote
Individuals in this category may be at risk for health issues related to low body weight.
71
What BMI range indicates normal body weight?
A BMI between 18.5 and 24.9 kg/m².
## Footnote
This range is considered optimal for health.
72
What BMI range is classified as overweight?
A BMI of 25 to 29.9 kg/m².
## Footnote
Individuals in this range may need to monitor their weight closely to avoid further health risks.
73
At what BMI is a person considered obese?
A BMI of 30 kg/m² or above.
## Footnote
Obesity significantly increases the risk for various health conditions.
74
What is the term used for individuals with a BMI greater than 40 kg/m²?
Extreme obesity (morbid or severe obesity).
## Footnote
This classification indicates a high risk for serious health problems.
75
What are some limitations of using BMI as a measurement?
BMI should be considered in relation to the patient's age, gender, and body build.
## Footnote
For example, athletes may have a high BMI due to muscle mass, while older adults may have an underestimated BMI due to loss of body mass.
76
What other measures should be combined with BMI for an accurate evaluation?
Waist circumference and waist-to-hip ratio (WHR).
## Footnote
Combining these measurements provides a more comprehensive view of an individual's health.
77
What is hyperlipidemia?
A condition characterized by elevated levels of lipids in the blood
78
What is sudden cardiac death?
An unexpected death due to heart-related issues
79
What is right-sided heart failure?
A condition where the right side of the heart cannot pump blood effectively
80
What is left ventricular hypertrophy?
The thickening of the walls of the left ventricle of the heart
81
What is coronary artery disease?
A condition caused by the narrowing of coronary arteries
82
What is deep venous thrombosis?
The formation of a blood clot in a deep vein, usually in the legs
83
What is atrial fibrillation?
An irregular and often rapid heart rate that can lead to stroke and other heart complications
84
What is hypertension?
High blood pressure that can lead to serious health issues
85
What is cardiomyopathy?
A disease of the heart muscle that affects its size, shape, and ability to pump blood
86
What is venous stasis?
The condition of slow blood flow in the veins, often leading to clot formation
87
What are varicose veins?
Enlarged veins that often appear swollen and bulging, typically in the legs
88
What is depression?
A mood disorder characterized by persistent feelings of sadness and loss of interest
89
What is low self-esteem?
A negative perception of oneself that can affect mental health
90
What is the risk of suicide?
The potential for an individual to take their own life, often linked to mental health issues
91
What is discrimination?
Unjust treatment based on different categories such as race, gender, or age
92
What is social isolation?
A state of complete or near-complete lack of contact between an individual and society
93
What is type 2 diabetes?
A chronic condition that affects the way the body processes blood sugar (glucose)
94
What is metabolic syndrome?
A cluster of conditions that increase the risk of heart disease, stroke, and diabetes
95
What is polycystic ovary syndrome?
A hormonal disorder causing enlarged ovaries with small cysts
96
What is obesity hypoventilation syndrome?
A condition in which severely overweight individuals fail to breathe deeply
97
What is sleep apnea?
A sleep disorder characterized by pauses in breathing or shallow breaths during sleep
98
What is asthma?
A condition in which your airways narrow and swell and may produce extra mucus
99
What is pulmonary hypertension?
High blood pressure in the blood vessels that supply the lungs
100
What is exercise intolerance?
The inability to perform physical activity due to fatigue or discomfort
101
What are menstrual irregularities?
Variations in the timing and flow of menstrual periods
102
What is infertility?
The inability to conceive after one year of unprotected intercourse
103
What is gestational diabetes?
Diabetes that develops during pregnancy and usually disappears after giving birth
104
What is hypogonadism?
A condition in which the body doesn't produce enough testosterone
105
What is gynecomastia?
The enlargement of breast tissue in men
106
What is sexual dysfunction?
A problem that prevents an individual from experiencing satisfaction from sexual activity
107
What is osteoarthritis?
A degenerative joint disease that results in the breakdown of cartilage
108
What is impaired mobility and flexibility?
A reduction in the ability to move and bend the body freely
109
What is gout?
A form of arthritis characterized by severe pain, redness, and tenderness in joints
110
What is lumbar disk disease?
A condition affecting the discs in the lower back, often causing pain
111
What is chronic low back pain?
Persistent pain in the lower back that lasts for an extended period
112
What is nonalcoholic steatohepatitis (NASH)?
A liver disease characterized by fat accumulation in the liver without alcohol consumption
113
What are gallstones?
Solid particles that form from bile cholesterol and bilirubin in the gallbladder
114
What is gastroesophageal reflux disease (GERD)?
A chronic digestive condition where stomach acid flows back into the esophagus
115
What is kidney cancer?
A type of cancer that starts in the kidneys
116
What is chronic kidney disease?
A long-term condition where the kidneys do not work effectively
117
What is stress incontinence?
Involuntary leakage of urine during physical activity or exertion
118
What types of cancer are associated with both genders?
* Esophagus cancer
* Pancreas cancer
* Thyroid cancer
* Colorectal cancer
* Gallbladder cancer
119
What types of cancer are associated with women?
* Endometrial cancer
* Breast cancer
* Ovarian cancer
120
What is waist circumference?
A measurement taken just above the iliac crest after exhalation to assess weight classification
## Footnote
Health risks increase if waist circumference is greater than 40 inches in men and greater than 35 inches in women.
121
What waist circumference indicates increased health risks in men?
Greater than 40 inches
## Footnote
This measurement is linked to an increased risk for cardiovascular disease (CVD) and metabolic issues.
122
What waist circumference indicates increased health risks in women?
Greater than 35 inches
## Footnote
This measurement is linked to an increased risk for cardiovascular disease (CVD) and metabolic issues.
123
How is the waist-to-hip ratio (WHR) calculated?
By dividing the waist measurement by the hip measurement
## Footnote
A higher WHR indicates abdominal obesity.
124
What is the recommended WHR for men?
1.0 or less
## Footnote
This indicates that the waist should be narrower than or the same as the hips.
125
What is the recommended WHR for women?
0.8 or less
## Footnote
This indicates that the waist should be narrower than the hips.
126
What body shape is associated with android obesity?
Apple-shaped body with fat mainly in the abdominal area
## Footnote
This body shape is linked to a higher risk for health complications.
127
What body shape is associated with gynoid obesity?
Pear-shaped body with fat distribution in the upper legs
## Footnote
Genetics plays an important role in determining body shape and weight.
128
What are some clinical problems associated with obesity?
* Bodyweight problem
* Altered blood glucose level
## Footnote
These issues can lead to further health complications.
129
What is the body mass index (BMI) threshold for obesity?
≥30 kg/m2
130
What waist circumference indicates obesity in women?
>35 in (89 cm)
131
What waist circumference indicates obesity in men?
>40 in (102 cm)
132
List some diseases related to obesity.
* Hypertension
* Cardiovascular disease (CVD)
* Stroke
* Cancer
* Chronic joint pain
* Respiratory problems
* Diabetes
* Cholelithiasis
* Metabolic syndrome
133
What are common medications taken by patients with obesity?
* Endocrine preparations
* Diet pills
* Herbal products
134
What prior surgical procedure is often associated with obesity treatment?
Bariatric surgery
135
What are some typical symptoms experienced during physical activity for obese patients?
* Drowsiness
* Somnolence
* Dyspnea on exertion
* Orthopnea
* Paroxysmal nocturnal dyspnea
136
What sleep disorder is commonly associated with obesity?
Sleep apnea
137
What device may be used to treat sleep apnea?
CPAP
138
What feelings might an obese patient experience related to their condition?
* Rejection
* Depression
* Isolation
* Guilt
* Shame
139
How might obesity affect menstrual health in women?
* Menstrual irregularity
* Heavy menstrual flow
140
What are some reproductive health issues related to obesity in men?
* Gynecomastia
* Hypogonadism
141
What cardiovascular issues are commonly seen in obese patients?
* Hypertension
* Tachycardia
* Dysrhythmias
142
What musculoskeletal problems are associated with obesity?
* Decreased joint mobility
* Decreased flexibility
* Knee pain
* Hip pain
* Low back pain
143
What are possible diagnostic findings in an obese patient?
* Increased serum glucose
* Increased cholesterol
* Increased triglycerides
* Chest x-ray showing enlarged heart
* ECG showing dysrhythmia
* Abnormal liver function tests
144
Fill in the blank: Patients with obesity often experience _______ due to their condition.
constipation
145
What factors can influence a patient's ability to adhere to a weight loss program?
* Family history of obesity
* Perception of the problem
* Methods of weight loss tried
* Personal, social, and financial resources
* Food environment
146
True or False: Obesity has no impact on sexual activity and attractiveness.
False
147
What are the overall goals for a patient with obesity?
The overall goals are that the patient will:
* modify eating patterns
* take part in regular exercise
* achieve and maintain weight loss to a specified level
* minimize or prevent health problems related to obesity
## Footnote
These goals aim for a comprehensive approach to managing obesity.
148
Why is obesity considered one of the most challenging health problems?
Obesity is challenging because most people find the weight loss process tough despite knowing its benefits.
## Footnote
Successful weight management requires a lifelong commitment.
149
What is the significance of a modest weight loss of 5%?
A modest weight loss of even 5% of starting weight can have health benefits.
## Footnote
Greater weight losses produce greater benefits.
150
What is the average weight loss from a typical weight loss program (excluding bariatric surgery)?
The average weight loss is about 10% of body weight.
## Footnote
This average is associated with significant health benefits.
151
What are some barriers to counseling patients about obesity?
Barriers include:
* time constraints
* not wanting to cause embarrassment
* lack of reimbursement for weight management services
* low patient adherence to treatment plans
* patients having a 'quick fix' mentality
## Footnote
These barriers can discourage healthcare providers from engaging in obesity treatment.
152
What role can healthcare team members play in managing obesity?
Healthcare team members can help by:
* building patient motivation
* providing information
* using motivational interviewing techniques
## Footnote
This approach helps patients understand their reasons for wanting to lose weight.
153
What should be emphasized when teaching patients about weight loss?
Stress healthy eating habits and adequate exercise as lifestyle patterns.
## Footnote
These are crucial for developing and maintaining weight loss.
154
What is a recommended method for monitoring weight loss progress?
A weekly check of body weight is recommended.
## Footnote
Daily weighing is not recommended due to fluctuations from retained water and feces.
155
Fill in the blank: Patients should record their weight at the same time of day, wearing the same type of _______.
[clothing]
## Footnote
This consistency helps in accurately tracking weight changes.
156
What is the first question to ask when assessing a patient with obesity?
What is your history with weight gain and weight loss?
## Footnote
This question helps to understand the patient's past experiences and challenges with weight management.
157
What question should be asked regarding family history in obesity assessment?
Are other family members overweight?
## Footnote
This can indicate genetic or environmental factors influencing the patient's weight.
158
How might body weight affect a patient's health?
How has your body weight affected your health?
## Footnote
Understanding this can help identify health-related concerns associated with obesity.
159
What question addresses the patient's perception of weight?
What do you think contributes to your weight?
## Footnote
This question explores the patient's beliefs about the factors influencing their weight.
160
What is an important question about the emotional relationship with food?
What does food mean to you? How do you use food, such as stress relief, provide comfort, boredom?
## Footnote
This helps identify emotional eating patterns and their impact on weight.
161
What should be assessed regarding the patient's eating habits?
Describe your normal diet. What types of foods do you usually eat? What types of beverages and how much are you drinking?
## Footnote
This provides insight into the patient's dietary habits and potential areas for change.
162
What motivates the patient to lose weight?
Describe your motivation for losing weight.
## Footnote
Understanding motivation can guide the development of a personalized weight loss strategy.
163
What question addresses previous weight loss attempts?
What have you already tried to lose weight? Was it successful? If not, why not?
## Footnote
This helps identify effective strategies and barriers encountered in the past.
164
What should be asked about the patient's willingness to change their weight management approach?
Would you like to manage your weight differently? If so, how?
## Footnote
This assesses the patient's openness to new strategies and methods.
165
What question identifies potential obstacles to weight loss?
What sort of barriers do you think impede your weight loss efforts?
## Footnote
Identifying barriers can help in creating practical solutions.
166
What should be considered regarding external stressors?
Are there any major stresses that will make it hard to focus on weight control?
## Footnote
This question acknowledges the impact of stress on weight management.
167
What question addresses the patient's commitment to exercise?
How much time can you devote to exercise on a daily or weekly basis?
## Footnote
Understanding available time for exercise helps in planning an effective routine.
168
What should be assessed regarding social support for weight loss?
Describe the support you have from family and/or friends for losing weight.
## Footnote
Support systems can significantly influence weight loss success.
169
What is the most effective approach to weight loss?
A holistic approach that includes nutrition therapy, exercise, behavior therapy, and possibly drugs or surgical intervention.
## Footnote
Combining multiple aspects supports more effective weight loss and weight control efforts.
170
What are the two different processes a supervised plan of care must focus on?
* Successful weight loss, requiring a short-term energy deficit
* Successful weight control, requiring long-term behavior changes
## Footnote
Both processes are essential for effective weight management.
171
What is a realistic and healthy goal for weight loss?
Losing 1 to 2 lb per week.
## Footnote
Setting mutual goals at the beginning of a weight loss program is important.
172
True or False: Trying to lose too much weight too quickly can lead to frustration and failure.
True
## Footnote
This can negatively impact the patient's motivation and adherence to the weight loss program.
173
Fill in the blank: A holistic approach to weight loss combines nutrition therapy, exercise, behavior therapy, and _______.
[drugs or surgical intervention]
## Footnote
This combination is essential for effective weight loss strategies.
174
What happens to skin and underlying tissue when large amounts of weight are lost quickly?
They lose elasticity and tone
## Footnote
Slower weight loss offers better cosmetic results.
175
What should patients be reminded of regarding weight loss plateaus?
Plateaus are normal occurrences during weight loss
## Footnote
They may last from several days to several weeks.
176
What is recommended for patients to help track their eating habits?
Keep an electronic or paper journal
## Footnote
They should record daily food and drink consumption and exercise.
177
What factors can influence a patient's eating habits?
Food preferences, cultural traditions, food availability, and motivation
## Footnote
Reviewing the journal can help find relationships among food intake, exercise, and weight loss.
178
What is a cornerstone for any weight loss or maintenance program?
Restricting diet intake below energy requirements
## Footnote
There is no best diet for weight loss.
179
What should a weight loss diet emphasize?
* Fruits
* Vegetables
* Whole grains
* Fat-free or low-fat dairy products
## Footnote
Lean meat, fish, poultry, beans, and eggs provide sufficient protein and B-complex vitamins.
180
What types of foods should be limited in a weight loss diet?
* Saturated fats
* Cholesterol
* Salt
* Added sugars
## Footnote
Encourage appropriate fluid intake in the form of water.
181
What is a common issue with restrictive diets?
They are hard to maintain on a long-term basis
## Footnote
The more restrictive the diet, the greater the demand for discipline.
182
What is the debate regarding the number of meals a person on a diet should eat?
Some advocate several small meals per day
## Footnote
This is because the body's metabolic rate temporarily increases right after eating.
183
What is a very low-calorie diet plan?
Limits calories to a total of 800 or less per day
## Footnote
These diets are not sustainable long-term and should be monitored by trained HCPs.
184
What is a fad diet?
A diet that promises fast weight loss with minimal effort
## Footnote
They often advocate eliminating one category of foods and are promoted widely.
185
What is a common outcome for people who follow fad diets?
They often regain the weight lost, if not more
## Footnote
Therefore, discourage using a fad diet.
186
What does the degree of success of any diet depend on?
The amount of weight to lose
## Footnote
A moderately obese person will have different success metrics compared to someone with less weight to lose.
187
What is the impact of body composition on weight loss?
Men generally lose weight more quickly than women due to a higher percentage of lean body mass
## Footnote
Women have a higher percentage of body fat, which is metabolically less active than muscle tissue.
188
What portion size is equivalent to a serving of vegetables or fruit?
The size of a woman's fist or a baseball
## Footnote
This helps in visualizing appropriate serving sizes.
189
What is the recommended portion size of meat?
3 oz, about the size of a person's palm or a deck of cards
## Footnote
This helps maintain portion control in diet.
190
What is the standard size for chopped vegetables?
½ cup
## Footnote
This measurement aids in managing vegetable intake.
191
How much moderate exercise is recommended per week for weight loss?
At least 150 minutes
## Footnote
Alternatively, 75 minutes of vigorous exercise is also effective.
192
What is a suggested way to incorporate exercise into daily routines?
Parking farther from entry doors or taking the stairs
## Footnote
Small changes in daily habits can enhance physical activity.
193
What are the key assumptions behind behavior therapy for obesity?
1. Persons who are obese have maladaptive eating and exercise patterns. 2. These habits can be modified with specific interventions
## Footnote
This therapy aims to change behavior patterns related to eating and physical activity.
194
What behavior techniques are included in behavior therapy?
1. Self-monitoring 2. Stimulus control 3. Rewards
## Footnote
These techniques help individuals track and modify their behaviors.
195
What does self-monitoring involve?
Keeping a record of food and calorie intake, physical activity, and body weight
## Footnote
This helps in recognizing behavior patterns.
196
What is the purpose of stimulus control in behavior therapy?
Eliminating cues that trigger eating
## Footnote
This can help break the chain of overeating linked to specific activities.
197
True or False: Rewards for weight loss should be food-related.
False
## Footnote
Rewards should not involve food to avoid reinforcing unhealthy eating habits.
198
What is the benefit of joining support groups for weight management?
They offer support, tips, and information on dieting
## Footnote
Examples include TOPS and WW.
199
What is the role of behavior modification training in weight loss programs?
To help individuals adjust their diet after stopping commercial products
## Footnote
This is crucial for maintaining weight loss.
200
What BMI is considered obese?
30 kg/m² or greater
## Footnote
Individuals with a BMI of 27 kg/m² or greater with weight-related conditions may also qualify for drug therapy.
201
What are the potential benefits of workplace weight loss programs?
Improved work performance, decreased absenteeism, lower hospitalization, and lower insurance costs
## Footnote
Both employees and employers can benefit from such programs.
202
What is the primary role related to drug therapy in obesity management?
To teach the patient about proper administration, side effects, and how the drugs fit into the overall weight loss plan.
203
True or False: Drugs can cure obesity.
False
204
What must patients understand about drug therapy and weight management?
Without substantial changes in food intake and increased exercise, they will gain weight when they stop drug therapy.
205
What factors can help determine the best drug for a patient?
Careful evaluation for other medical conditions.
206
What should patients review with their healthcare provider regarding weight loss treatments?
Their insurance coverage for weight loss treatments.
207
What should patients be advised against regarding drug dosages?
Not to change drug dosages without consulting with the HCP.
208
Fill in the blank: Patients should be discouraged from buying over-the-counter diet aids unless recommended by a _______.
[HCP]
209
What does bariatric surgery involve?
Surgery on the stomach and/or intestines to help a person with extreme obesity lose weight.
210
What is the only treatment currently with a successful and lasting impact for sustained weight loss in extreme obesity?
Bariatric surgery.
211
What are the criteria for bariatric surgery?
Having a BMI of 40 kg/m² or more, or a BMI of 35 kg/m² or more with at least 1 weight-related comorbidity.
212
List at least three weight-related comorbidities that qualify for bariatric surgery.
* Type 2 diabetes
* Hypertension
* Sleep apnea
213
What improvements can result from bariatric surgery?
* Better glucose control
* Improvement or reversal of diabetes
* Normalization of BP
* Decreased total cholesterol and triglycerides
* Decreased GERD
* Decreased sleep apnea
214
How does insurance coverage for bariatric surgery vary?
It varies, and those who cover surgery often require extensive documentation.
215
What is often required as part of the documentation for bariatric surgery insurance coverage?
Participation in a supervised weight loss program for at least 6 months and a psychologic evaluation.
216
What type of candidates are screened for bariatric surgery?
Candidates with psychologic, physical, and behavioral problems that are associated with poor surgical outcomes.
217
What are some contraindications for bariatric surgery?
* Mood disorders
* Binge eating disorders
* Substance use
* Illnesses that reduce life expectancy
218
What are the three broad categories of bariatric surgery?
* Restrictive
* Malabsorptive
* Combination of malabsorptive and restrictive
219
What is the main goal of restrictive procedures in bariatric surgery?
To reduce the size of the stomach, causing the patient to feel full more quickly.
220
What happens in malabsorptive procedures?
The small intestine is shortened or bypassed, so less food is absorbed.
221
What are the benefits of laparoscopic bariatric procedures?
* Fewer wound infections
* Shorter hospital stays
* Faster recovery period
222
What is the mechanism of action for bupropion in Contrave?
Antidepressant
## Footnote
Bupropion is primarily used as an antidepressant and is part of the combination therapy in Contrave.
223
What is the mechanism of action for naltrexone in Contrave?
Opioid antagonist
## Footnote
Naltrexone blocks the effects of opioids and is combined with bupropion in Contrave for obesity treatment.
224
What are some nursing considerations for bupropion/naltrexone?
* Monitor for suicidal thoughts and behaviors
* Neuropsychiatric reactions
* Can increase BP and heart rate
* Not for patients with uncontrolled hypertension
## Footnote
These considerations are critical due to potential side effects and contraindications.
225
What is the mechanism of action for liraglutide (Saxenda)?
Glucagon-like peptide 1 (GLP-1) agonist
## Footnote
Liraglutide mimics the effects of GLP-1, which promotes satiety and is also used in type 2 diabetes treatment.
226
What are the side effects of liraglutide (Saxenda)?
* Nausea
* Diarrhea
* Headache
* Fatigue
* Dizziness
## Footnote
These side effects can impact patient adherence to treatment.
227
What is the primary function of orlistat (Xenical, Alli)?
Inhibits gastrointestinal (GI) lipase
## Footnote
Orlistat blocks fat breakdown and absorption in the intestine, aiding in weight management.
228
What should be monitored when using orlistat?
* Suicidal ideation
* Pancreatitis
## Footnote
Monitoring these conditions is important due to the potential severe side effects associated with orlistat.
229
What are the side effects of orlistat?
* Stool leakage
* Flatulence
* Diarrhea
* Abdominal bloating
* Liver injury
* Kidney stones
## Footnote
These side effects are particularly pronounced if a high-fat diet is consumed.
230
What is the recommended administration for orlistat?
Taken with each main meal containing fat
## Footnote
This ensures maximum efficacy in fat absorption reduction.
231
What are the components of phentermine/topiramate ER (Qsmyia)?
* Phentermine: Sympathomimetic
* Topiramate: Decreases appetite
## Footnote
This combination works synergistically to promote weight loss.
232
What are the side effects of phentermine/topiramate ER?
* Dizziness
* Insomnia
* Dry mouth
* Headache
* High blood pressure
## Footnote
These side effects necessitate careful patient monitoring.
233
Who should avoid using phentermine/topiramate ER?
* Patients with glaucoma
* Patients with hyperthyroidism
* Pregnant patients
* Patients with uncontrolled hypertension or heart disease
## Footnote
These contraindications are important to prevent serious health risks.
234
What does Plenity do?
Increases the volume of stomach and small intestine contents
## Footnote
This mechanism helps induce satiety and aids in weight loss.
235
What are the side effects of Plenity?
* Abdominal pain
* Constipation
## Footnote
These side effects can affect patient comfort and adherence.
236
What is semaglutide (Wegovy) used for?
Weight management and type 2 diabetes treatment
## Footnote
Semaglutide is a GLP-1 analog that promotes satiety and is administered via subcutaneous injection.
237
How often is semaglutide administered?
Once weekly
## Footnote
This dosing schedule improves patient compliance compared to daily medications.
238
What potential risk is associated with semaglutide for patients with type 2 diabetes?
Hypoglycemia
## Footnote
Careful monitoring of blood sugar levels is essential for safety.
239
What is the mechanism of action for bupropion in Contrave?
Antidepressant
## Footnote
Bupropion is primarily used as an antidepressant and is part of the combination therapy in Contrave.
240
What is the mechanism of action for naltrexone in Contrave?
Opioid antagonist
## Footnote
Naltrexone blocks the effects of opioids and is combined with bupropion in Contrave for obesity treatment.
241
What are some nursing considerations for bupropion/naltrexone?
* Monitor for suicidal thoughts and behaviors
* Neuropsychiatric reactions
* Can increase BP and heart rate
* Not for patients with uncontrolled hypertension
## Footnote
These considerations are critical due to potential side effects and contraindications.
242
What is the mechanism of action for liraglutide (Saxenda)?
Glucagon-like peptide 1 (GLP-1) agonist
## Footnote
Liraglutide mimics the effects of GLP-1, which promotes satiety and is also used in type 2 diabetes treatment.
243
What are the side effects of liraglutide (Saxenda)?
* Nausea
* Diarrhea
* Headache
* Fatigue
* Dizziness
## Footnote
These side effects can impact patient adherence to treatment.
244
What is the primary function of orlistat (Xenical, Alli)?
Inhibits gastrointestinal (GI) lipase
## Footnote
Orlistat blocks fat breakdown and absorption in the intestine, aiding in weight management.
245
What should be monitored when using orlistat?
* Suicidal ideation
* Pancreatitis
## Footnote
Monitoring these conditions is important due to the potential severe side effects associated with orlistat.
246
What are the side effects of orlistat?
* Stool leakage
* Flatulence
* Diarrhea
* Abdominal bloating
* Liver injury
* Kidney stones
## Footnote
These side effects are particularly pronounced if a high-fat diet is consumed.
247
What is the recommended administration for orlistat?
Taken with each main meal containing fat
## Footnote
This ensures maximum efficacy in fat absorption reduction.
248
What are the components of phentermine/topiramate ER (Qsmyia)?
* Phentermine: Sympathomimetic
* Topiramate: Decreases appetite
## Footnote
This combination works synergistically to promote weight loss.
249
What are the side effects of phentermine/topiramate ER?
* Dizziness
* Insomnia
* Dry mouth
* Headache
* High blood pressure
## Footnote
These side effects necessitate careful patient monitoring.
250
Who should avoid using phentermine/topiramate ER?
* Patients with glaucoma
* Patients with hyperthyroidism
* Pregnant patients
* Patients with uncontrolled hypertension or heart disease
## Footnote
These contraindications are important to prevent serious health risks.
251
What does Plenity do?
Increases the volume of stomach and small intestine contents
## Footnote
This mechanism helps induce satiety and aids in weight loss.
252
What are the side effects of Plenity?
* Abdominal pain
* Constipation
## Footnote
These side effects can affect patient comfort and adherence.
253
What is semaglutide (Wegovy) used for?
Weight management and type 2 diabetes treatment
## Footnote
Semaglutide is a GLP-1 analog that promotes satiety and is administered via subcutaneous injection.
254
How often is semaglutide administered?
Once weekly
## Footnote
This dosing schedule improves patient compliance compared to daily medications.
255
What potential risk is associated with semaglutide for patients with type 2 diabetes?
Hypoglycemia
## Footnote
Careful monitoring of blood sugar levels is essential for safety.
256
What is Adjustable Gastric Banding (AGB)?
Inflatable band encircles stomach, creating a gastric pouch with about 30 mL (1 oz) capacity
## Footnote
Band can be adjusted to restrict capacity and is reversible.
257
List three advantages of Adjustable Gastric Banding (AGB).
* Food digestion occurs normally
* No dumping syndrome
* Low complication rate
258
What are some disadvantages of Adjustable Gastric Banding (AGB)?
* Nausea and vomiting initially
* Problems with adjusting device
* Weight loss may be more limited than with other types of surgery
259
What is Sleeve Gastrectomy?
About 75% of stomach removed, creating a sleeve-shaped stomach with 60-150 mL (2-5 oz) capacity
## Footnote
Preserves stomach function and does not bypass intestines.
260
What is Gastric Plication?
Adapted version of sleeve gastrectomy where sleeve is created by suturing rather than removing stomach
## Footnote
Minimal surgery compared to sleeve gastrectomy.
261
What is the purpose of the Intragastric Balloon?
Involves placing a deflated balloon into stomach, which is then filled with saline to occupy space
## Footnote
Left in place up to 6 months.
262
What are potential complications of the Intragastric Balloon?
* Nausea
* Vomiting
* Abdominal pain
* Indigestion
* Gastric ulcers
263
What is Biliopancreatic Diversion (BPD)?
70% of stomach removed horizontally, with anastomosis between stomach and intestine
## Footnote
Can lead to abdominal bloating and foul-smelling gas (steatorrhea).
264
List two nutrition problems associated with Biliopancreatic Diversion.
* Malabsorption of fat-soluble vitamins
* Iron deficiency anemia
265
What is Roux-en-Y Gastric Bypass (RYGB)?
Surgery creates a small gastric pouch connected to jejunum, bypassing remaining stomach and first segment of small intestine
## Footnote
Combines restrictive and malabsorptive surgery.
266
What are the benefits of Roux-en-Y Gastric Bypass (RYGB)?
* Better weight loss results
* Lower incidence of malnutrition
* Rapid improvement of weight-related co-morbidities
267
What is a Gastric Pacemaker?
Device implanted into abdomen to deliver electrical impulses to vagus nerve, indicating when stomach is full
## Footnote
Least invasive of weight loss surgeries.
268
List two side effects of the Gastric Pacemaker.
* Nausea
* Vomiting
269
True or False: The Adjustable Gastric Banding procedure can be reversed.
True
270
Fill in the blank: The Biliopancreatic Diversion often leads to _____ bowel movements a day.
3 or 4 loose
271
What is the main purpose of restrictive surgeries in obesity treatment?
To limit the amount allowed to enter the stomach
## Footnote
This helps patients feel full more quickly and reduces the risk of anemia or cobalamin deficiency.
272
Name two common types of restrictive surgeries.
* Adjustable gastric banding
* Sleeve gastrectomy
273
What does adjustable gastric banding (AGB) involve?
Limiting stomach size with an inflatable band placed around the fundus
## Footnote
The band is connected to a port for inflation or deflation.
274
How does the adjustable gastric band affect the stomach?
Divides the stomach into 2 unequal parts, creating a new smaller stomach
## Footnote
The upper part holds less, causing quicker fullness.
275
What are some risks associated with adjustable gastric banding?
* Band slipping
* Food intolerance
276
What percentage of the stomach is removed in sleeve gastrectomy?
About 75%
277
What hormonal change occurs due to sleeve gastrectomy?
Elimination of hormones that stimulate hunger, such as ghrelin
278
What is endoscopic sleeve gastroplasty?
A minimally invasive procedure that makes the stomach smaller without resection or bypass
## Footnote
This is done by placing sutures endoscopically.
279
How does gastric plication reduce stomach size?
By folding the stomach wall inward and placing sutures to secure it
## Footnote
This method is reversible since there is no gastric resection.
280
What is the function of intragastric balloon systems?
Use an inflated balloon to occupy space in the stomach
281
What is the main purpose of restrictive surgeries in obesity treatment?
To limit the amount allowed to enter the stomach
## Footnote
This helps patients feel full more quickly and reduces the risk of anemia or cobalamin deficiency.
282
Name two common types of restrictive surgeries.
* Adjustable gastric banding
* Sleeve gastrectomy
283
What does adjustable gastric banding (AGB) involve?
Limiting stomach size with an inflatable band placed around the fundus
## Footnote
The band is connected to a port for inflation or deflation.
284
How does the adjustable gastric band affect the stomach?
Divides the stomach into 2 unequal parts, creating a new smaller stomach
## Footnote
The upper part holds less, causing quicker fullness.
285
What are some risks associated with adjustable gastric banding?
* Band slipping
* Food intolerance
286
What percentage of the stomach is removed in sleeve gastrectomy?
About 75%
287
What hormonal change occurs due to sleeve gastrectomy?
Elimination of hormones that stimulate hunger, such as ghrelin
288
What is endoscopic sleeve gastroplasty?
A minimally invasive procedure that makes the stomach smaller without resection or bypass
## Footnote
This is done by placing sutures endoscopically.
289
How does gastric plication reduce stomach size?
By folding the stomach wall inward and placing sutures to secure it
## Footnote
This method is reversible since there is no gastric resection.
290
What is the function of intragastric balloon systems?
Use an inflated balloon to occupy space in the stomach
291
What is the purpose of gastric balloons?
To help patients feel more full and reduce the amount of food they can eat
## Footnote
Gastric balloons are less invasive than gastric bypass surgery.
292
How do fluid-filled balloons differ from air balloons?
Fluid-filled balloons are placed endoscopically and filled with saline, while air balloons are swallowed in a capsule and inflated with nitrogen gas
## Footnote
Fluid-filled balloons can hold between 400 to 700 mL of saline.
293
What are some risks associated with gastric balloons?
Vomiting, nausea, abdominal pain, indigestion, gastric ulcers, changes in balloon size
## Footnote
Balloons should not be used in patients with certain gastrointestinal conditions.
294
What is the Roux-en-Y gastric bypass (RYGB)?
A combination of restrictive and malabsorptive surgery creating a small gastric pouch and attaching it to the small intestine
## Footnote
After the procedure, food bypasses 90% of the stomach and parts of the small intestine.
295
List some complications of the Roux-en-Y gastric bypass.
* GI tract leaks
* Gastric remnant distention
* Ulcers
* Gallstones
* Hernias
* Iron deficiency anemia
* Dumping syndrome
296
What is dumping syndrome?
A condition where gastric contents empty too rapidly into the small intestine, causing symptoms like vomiting and diarrhea
## Footnote
Patients are discouraged from eating sugary foods to avoid this syndrome.
297
What is a gastric pacemaker?
An implantable device that controls nerve impulses from the brain to the stomach, decreasing hunger and increasing satiety
## Footnote
It is surgically placed under the skin in the abdomen.
298
What is aspiration therapy?
A procedure that involves removing a portion of gastric contents 20 to 30 minutes after each meal
## Footnote
It requires significant patient engagement.
299
What are some preoperative care considerations for patients with obesity?
* Obtain health information
* Identify comorbidities
* Coordinate care with specialists
* Provide appropriately sized equipment
300
True or False: A larger BP cuff size is necessary for patients with obesity.
True
## Footnote
This helps avoid measurement errors.
301
How should patients with obesity be transported in a hospital?
Using a wheelchair with removable arms that accommodates the patient's size
## Footnote
The wheelchair should also be able to pass through doorways easily.
302
What assessment techniques are needed for heart, lung, and bowel sounds?
Different assessment techniques are required due to the large chest wall, which makes sounds often distant.
## Footnote
An electronic stethoscope can amplify these sounds for better assessment.
303
Why might obtaining venous access be difficult in certain patients?
Excess adipose tissue may complicate venous access.
## Footnote
A longer IV catheter (longer than 1 inch) is recommended to reach the vein through overlying tissue.
304
What techniques should be taught to patients to prevent pulmonary complications after surgery?
Teach coughing, deep breathing techniques, and methods of turning and positioning.
## Footnote
Using a spirometer before surgery can help prevent and treat postoperative lung congestion.
305
What should be arranged for patients who use CPAP at home for sleep apnea?
Arrange for CPAP use while the patient is hospitalized.
306
What is crucial for patients scheduled for bariatric surgery to understand?
Patients should understand the surgical procedure, the type of procedure, and the surgical approach.
## Footnote
Frequent assessment of vital signs and general assessment is essential to monitor for complications.
307
What is the focus of initial postoperative care?
Careful assessment and immediate intervention for cardiopulmonary complications.
308
What risk is associated with anesthetics in patients with excess adipose tissue?
Patients are at risk for resedation as anesthetics are stored in adipose tissue and released back into the bloodstream post-surgery.
309
What maneuver should be prepared for if a patient becomes sedated after surgery?
Be prepared to perform a head-tilt or jaw-thrust maneuver.
310
How does obesity affect a patient's breathing postoperatively?
Obesity can cause shallow and rapid breathing due to compression of the diaphragm and thoracic structures.
## Footnote
This results in hypoxemia due to retained CO2 and less O2 delivery to the lungs.
311
What position should the head of the bed be in to assist with lung expansion?
The head of the bed should be elevated to reduce abdominal pressure and increase lung expansion.
312
What precautions should be implemented to prevent venous thromboembolism (VTE)?
Diligence in turning and ambulation postoperatively.
313
When should the patient typically begin walking after surgery?
The patient will typically begin walking the evening after surgery and at least 3 or 4 times each day.
314
What potential problems should be monitored for after bariatric surgery?
Wound infection, dehiscence, and delayed healing.
## Footnote
Frequent assessment of the patient's skin is essential.
315
What diet is usually started within 24 hours after bariatric surgery?
A low-sugar, clear-liquid diet.
## Footnote
Begin with 15-mL increments every 10 to 15 minutes.
316
What should patients avoid to reduce the incidence of air swallowing after surgery?
Avoid gulping fluids or drinking with a straw.
317
What should be assessed for in the preoperative care of a patient undergoing bariatric surgery?
Use of assistive devices, physical limitations, mobility
## Footnote
Assessing mobility is crucial for planning postoperative care.
318
What baseline assessments should be performed preoperatively for a patient undergoing bariatric surgery?
Vital signs, pulse oximetry, height, weight, BMI, skin condition, nutrition status, heart, lung, and bowel sounds
## Footnote
These assessments help establish a baseline for postoperative comparison.
319
What laboratory values and diagnostic tests should be assessed preoperatively?
Baseline laboratory values and diagnostic test results, including pulmonary function tests
## Footnote
These tests provide important information about the patient's health status.
320
What should be taught to the patient and caregiver preoperatively?
Procedure details, postoperative care, coughing and deep breathing techniques, incentive spirometer use, turning and positioning methods
## Footnote
Education is key to preventing complications after surgery.
321
Why is frequent assessment and intervention necessary after bariatric surgery?
To prevent VTE (venous thromboembolism)
## Footnote
VTE is a significant risk factor in postoperative patients.
322
What immediate postoperative assessments should be performed?
Vital signs, pulse oximetry, heart and lung sounds
## Footnote
These assessments help monitor the patient's recovery status.
323
What should be assessed regarding the abdominal wound immediately postoperative?
Amount and type of drainage, condition of the incision, signs of infection
## Footnote
Monitoring the wound is vital to detect any complications early.
324
What signs may indicate an anastomosis leak?
Tachycardia, fever, tachypnea, chest and abdominal pain
## Footnote
Early detection of leaks can prevent severe complications.
325
What should the patient be encouraged to do every 2 hours postoperative?
Turn, cough and deep breath, and use incentive spirometer
## Footnote
These activities help prevent pulmonary complications.
326
What position should the patient be maintained in immediately postoperative?
Upright at a minimum of a 45-degree angle
## Footnote
This position aids in respiratory function and comfort.
327
What dietary progression should be initiated immediately postoperative?
Start with room temperature water and low-sugar clear liquids
## Footnote
Gradual introduction of liquids is essential for recovery.
328
How should fluid intake be structured for the patient after surgery?
Begin with 15 mL every 10-15 min, gradually increase to 90 mL every 30 min
## Footnote
This gradual increase helps the patient tolerate fluids without complications.
329
What should be observed for to assess dehydration after bariatric surgery?
Thirst, decreased urine output, headache, dizziness
## Footnote
Monitoring for dehydration is critical in the postoperative phase.
330
True or False: Patients should be encouraged to drink with a straw after bariatric surgery.
False
## Footnote
Drinking with a straw can lead to increased air intake and discomfort.
331
What diet is a patient typically discharged on after bariatric surgery?
Full liquid diet
## Footnote
Patients may progress to a pureed or soft foods diet within 10 to 14 days depending on tolerance.
332
What is the usual diet composition recommended for patients after bariatric surgery?
High in protein with some carbohydrates and fiber
## Footnote
It should consist of 6 small feedings daily.
333
How long after bariatric surgery do most patients transition to their usual diet?
4 to 6 weeks
## Footnote
This transition may include protein supplementation once or twice a day.
334
What should patients avoid consuming with meals after bariatric surgery?
Fluids
## Footnote
Consuming fluids with meals can promote diarrhea and dumping syndrome.
335
What is dumping syndrome?
A condition that occurs when food moves too quickly from the stomach to the small intestine
## Footnote
It can cause symptoms like diarrhea and abdominal pain.
336
What are some potential nutrition deficiencies expected after malabsorptive bariatric surgery?
Anemia, vitamin deficiencies, and diarrhea
## Footnote
Common vitamin deficiencies include folate, calcium, vitamin D, iron, and vitamin B12.
337
What is a common psychologic issue patients may face after bariatric surgery?
Feelings of guilt for needing surgery to lose weight
## Footnote
Patients may struggle with self-esteem and body image issues.
338
What are the expected outcomes for patients after bariatric surgery?
* Achieve and maintain optimal weight
* Improvement in obesity-related comorbidities
* Integrate healthy practices into daily routines
* Be free from adverse side effects of surgery
* Improved self-image
## Footnote
These outcomes are assessed during follow-up care.
339
True or False: Women should consider postponing pregnancy for 12 to 18 months after bariatric surgery.
True
## Footnote
This is important to avoid complications related to anemia and nutrition deficiencies.
340
What happens to women's fertility after bariatric surgery?
It often returns
## Footnote
Women must consider the risks of pregnancy after surgery.
341
What impact does obesity have on older adults?
* Worsens physical function
* Leads to frailty and disability
* Associated with decreased survival
## Footnote
Obese individuals may live up to 7 years less than those of normal weight.
342
What is a significant contributor to increased body fat in older adults?
Decrease in energy expenditure
## Footnote
This contributes to the prevalence of obesity among older people.
343
What can massive weight loss after bariatric surgery lead to?
Large quantities of flabby skin
## Footnote
This can result in altered body image and may require cosmetic surgery.
344
What dietary habits should patients adopt after bariatric surgery?
Eat slowly and stop when feeling full
## Footnote
Overeating can lead to vomiting and abdominal pain.
345
What is premature immobility associated with?
Excess intraabdominal weight can cause problems with urinary incontinence, hypoventilation, and sleep apnea.
346
How does obesity affect older adults?
Obesity affects the quality of life for older adults and weight loss can improve physical functioning and obesity-related health complications.
347
What is a lipectomy?
A lipectomy (adipectomy) is the surgical removal of excess skin and adipose tissue.
348
What areas can a lipectomy target?
* Abdomen
* Waist
* Hips
* Back
* Buttocks
* Breasts
* Arms
349
What are common outcomes after a lipectomy?
Body image and self-esteem usually improve after surgery.
350
What complications should be monitored after a lipectomy?
* Effects of anesthesia
* Poor wound healing
* Infection
351
What is the main limitation of a lipectomy regarding obesity?
Tissue removal does not prevent obesity from recurring, especially if eating habits stay the same.
352
What is liposuction?
Liposuction is a suction-assisted lipectomy that helps improve facial appearance or body contours.
353
Who is a good candidate for liposuction?
A person with excess fat under the chin, along the jawline, in the nasolabial folds, over the abdomen, or around the waist and upper thighs.
354
Why is liposuction not usually recommended for older individuals?
Because the skin is less elastic and will not accommodate the new underlying shape.
355
What is metabolic syndrome?
A group of metabolic risk factors that increase the chance of developing cardiovascular disease, stroke, and diabetes.
356
What percentage of adults have metabolic syndrome?
Just over 1 in 3 adults.
357
What is the prevalence of metabolic syndrome in those aged 60 and older?
50%.
358
What are the conditions that diagnose metabolic syndrome?
* Obesity
* Hypertension
* Abnormal lipid levels
* High glucose
359
What is the main underlying risk factor for metabolic syndrome?
Insulin resistance related to excess visceral fat.
360
What is insulin resistance?
The decreased ability of the body's cells to respond to the action of insulin.
361
What can hyperinsulinemia result from?
The pancreas compensating by secreting more insulin due to insulin resistance.
362
What are additional characteristics of metabolic syndrome?
* Hypertension
* Increased risk for clotting
* Abnormal cholesterol levels
363
What is the net effect of the states associated with metabolic syndrome?
An increased prevalence of coronary artery disease.
364
What is the cornerstone of treatment for metabolic syndrome?
The adoption of a healthy lifestyle.
365
What are the clinical manifestations of metabolic syndrome?
* Impaired fasting glucose
* Hypertension
* Abnormal cholesterol levels
* Obesity
366
What should be the focus of interventions for metabolic syndrome?
Weight loss and controlling risk factors for cardiovascular disease and type 2 diabetes.
367
What are the diagnostic criteria for metabolic syndrome?
Any 3 of the 5 measures are needed to diagnose metabolic syndrome.
## Footnote
The five measures include waist circumference, triglycerides, HDL cholesterol, blood pressure, and fasting glucose.
368
What is the waist circumference criterion for men to diagnose metabolic syndrome?
≥40 in (102 cm)
## Footnote
This measurement indicates abdominal obesity, which is a risk factor for metabolic syndrome.
369
What is the waist circumference criterion for women to diagnose metabolic syndrome?
≥35 in (89 cm)
## Footnote
This measurement is significant for assessing obesity-related health risks in women.
370
What triglyceride level is considered a criterion for metabolic syndrome?
>150 mg/dL (1.7 mmol/L) OR drug treatment for high triglycerides
## Footnote
Elevated triglycerides are associated with increased cardiovascular risk.
371
What is the HDL cholesterol criterion for men in diagnosing metabolic syndrome?
<40 mg/dL (0.9 mmol/L) OR drug treatment for high cholesterol
## Footnote
Low HDL cholesterol levels are linked to higher cardiovascular disease risk.
372
What is the HDL cholesterol criterion for women in diagnosing metabolic syndrome?
<50 mg/dL (1.1 mmol/L) OR drug treatment for high cholesterol
## Footnote
Similar to men, lower HDL levels in women also indicate increased risk.
373
What is the blood pressure criterion for diagnosing metabolic syndrome?
≥130 mm Hg systolic BP OR ≥85 mm Hg diastolic BP OR drug treatment for hypertension
## Footnote
High blood pressure is a significant risk factor for cardiovascular disease.
374
What fasting glucose level is a criterion for diagnosing metabolic syndrome?
≥100 mg/dL OR drug treatment for elevated glucose
## Footnote
Elevated fasting glucose levels can indicate insulin resistance and diabetes risk.
375
What are two primary benefits of regular exercise?
Weight loss and maintaining a healthy weight
## Footnote
Regular exercise is essential for overall health and can counteract sedentary behaviors.
376
What type of diet should be promoted for weight loss?
A diet low in saturated fats
## Footnote
This type of diet helps in managing weight, particularly in individuals with abdominal obesity.
377
What is a priority for individuals with abdominal obesity and metabolic syndrome?
Weight loss and maintaining a lower weight
## Footnote
Addressing these factors can significantly improve health outcomes.
378
How does increasing regular exercise affect metabolic syndrome?
Lowers risk of metabolic syndrome
## Footnote
Sedentary lifestyles are a contributing factor to metabolic syndrome.
379
What are the effects of exercise on triglyceride and HDL cholesterol levels?
Decreases triglyceride levels and increases HDL cholesterol levels
## Footnote
These changes are beneficial for individuals with metabolic syndrome.
380
What medication can lower glucose levels and enhance insulin sensitivity?
Metformin (Glucophage)
## Footnote
This medication is often prescribed for patients with type 2 diabetes.
381
Fill in the blank: Patients with obesity may be candidates for _______.
bariatric surgery
## Footnote
Bariatric surgery is considered for individuals who have not achieved weight loss through other means.
