Endocrine: Obesity

Question 1

Obesity in what area of the body has the following effects?

• increased risk for cardiometabolic disease
• decreased life expectancy

Answer 1

abdominal obesity

Question 2

Waist circumference is measured for pts with BMI between…

Answer 2

25-35

Question 3

A waist circumference of _____ in men and ______ in women confers increased CV risk

Answer 3

40+ men

35+ women

Question 4

This disease is defined as…

Chronic disease with ↑ body fat, adipose dysfunction resulting in adverse metabolic, biomechanical, psychosocial health consequences

Answer 4

obesity

Question 5

What labs should be considered for obesity? (4)

Answer 5

fasting glucose/Hba1c

TSH

Liver Enzymes

Fasting lipids

Question 6

What should the initial goal of weight loss be for obesity?

Answer 6

5-7% of body weight

Question 7

Weight loss of _____% or morereduces risks associated with obesity…

Answer 7

> 5%

Question 8

The following MNT diets are effective for…

DASH
Mediterranean
CHO Counting
Sugar limiting

Answer 8

T2DM

Question 9

The following MNT diets are effective for…

DASH
Mediterranean
low sodium

Answer 9

CVD

Question 10

The following MNT diets are effective for…

DASH
Renal

Answer 10

CKD

Question 11

sedentary lifestyle is a strong predictor of…

Answer 11

mortality

Question 12

The below are two immediate effects of:

↓ Anxiety & BP

↑ Sleep, cognitive fxn, insulin sensitivity

Answer 12

exercise in obese pts.

Question 13

What are 3 long-term benefits of exercise?

Answer 13

↑ CardioPulm Fitness, strength

↓ BP, depression

Question 14

how many minutes of moderate exercise are recommended weekly?

(moderate = talk, no singing)

Answer 14

150-300 min

Question 15

how many minutes of vigorous exercise is recommended in lieu of moderate…

(vigorous = few words)

Answer 15

75-150

Question 16

How many days a week should strength training occur?

Answer 16

2+

Question 17

What is the FITT protocol for exercise?

frequency, intensity, time, type

Answer 17

5+ days
modorate-vigorous
30+ minutes
major muscle groups, start w. walking

Question 18

Who should be screened for obesity?

Answer 18

all adults

Question 19

Intensive, multicomponent, behavioral intervention for obesity (BMI 30+) includes what frequency of sessions?

Answer 19

12-26/yr,

2 sessions monthly x 3+ mo

Question 20

What are the 5 As of counseling?

Answer 20

ask/address
advise
assess
assist
arrange

Question 21

What Tx?

BMI 25 to 29.9 with no CVD risk factors or comorbidities

Answer 21

diet & exercise counseling

low risk

Question 22

What tx?

BMI 25 to 29.9 AND 1+ CVD risk factors

BMI 30 to 34.9

Answer 22

Intensive, multicomponent behavioral modification

+/- drug therapy

Question 23

What tx?

BMI 35 to 40, BMI > 40

Answer 23

Intensive, multicomponent behavioral modification

+/- drug therapy

+/- bariatric surgery

Question 24

1st line tx for obesity is always…

Answer 24

lifestyle program

Question 25

if weight loss on lifestyle modification program is < 5% in 3-6 months, what can you consider?

Answer 25

drug therapy

Question 26

What is the goal of drug therapy in obesity? (3)

Answer 26

4-8% body weight loss, improve health, minimize adverse effects

Question 27

If a patient has a BMI of 30+ or > 27 with comorbidity, what can you consider adding to the tx regimen?

Answer 27

drug therapy

Question 28

Which obesity drug? Inhibits pancreatic lipase May decrease fat soluble vitamin absorption (ADEK)

Answer 28

orlistat

Question 29

Which obesity drug? GLP-1 Receptor Agonist SQ admin DOC w. T2DM

Answer 29

liraglutide

Question 30

Which obesity drug? Selective Serotonin Agonist Decrease Appetite Limited safety data

Answer 30

Lorcaserin

Question 31

This obesity drug should be avoided w. HTN, CAD, Hyperthyroid

Answer 31

phentermine/topiramate

Question 32

Which obesity drug? Sympathomimetic Most prescribed most SFx avoid w. HTN, CAD, Hyperthyroid

Answer 32

phentermine

Question 33

What four factors should be monitored during drug therapy for obesity?

Answer 33

weight, BP, HR, SFx

Question 34

Neuropsych sfx can be present with what two drugs?

Answer 34

lorcaserin, phentermine-topiramate

Question 35

If weight loss of 4-5% is not achieved after 3 mo of obesity drug therapy, what can you consider?

Answer 35

switching meds

Question 36

hCG for weight loss requires a diet of ____ and is/isn't a recommended therapy

Answer 36

500kcal not recommended

Question 37

What are three bariatric surgical procedures?

Answer 37

sleeve gastrectomy roux en Y gastric bypass Adjustable gastric band

Question 38

The below are contraindications for... ``` Eating disorder Untreated mental illness EtOH, drug abuse Coagulopathy Severe cardiac disease Inability to comply ```

Answer 38

bariatric surgery

Question 39

The below are therapeutic effects accomplished via... Restriction, malabsorption, decrease appetite via hormone modulation

Answer 39

bariatric surgery

Question 40

3 indications for bariatric surg.

Answer 40

BMI 40+ 35-29.9 + 1+ comorbidity 30-34.9 w/ uncontrolled T2DM or Metabolic Syndrome