Management of Obesity

Question 1

What pharmacological intervention can be useful in weight management, and who can access it?

Answer 1

Orlistat, 60mg dose can be bought by anyone who’s over 18 with a BMI of 28 or higher

Question 2

What is the prescription dose of orlistat?

Answer 2

120mg three times a day

Question 3

What is the function of orlistat?

Answer 3

To inhibit gastric and pancreatic lipases to help with weight management

Question 4

When should orlistat be prescribed?

Answer 4

In patients with a BMI of 28 or higher that have comorbities or patients with a BMI of 30 or higher. It should only be prescribed as an adjunct to diet, physical activity and behavioural changes.

Question 5

What criteria should a patient fulfil before being considered for bariatric surgery?

Answer 5

BMI>35
Presence of at least one comorbidity that is expected to improve with weight reduction
Evidence of completion of a structured weight management programme

Question 6

What criteria would result in a patient being recommended for bariatric surgery?

Answer 6

BMI >40 or >35 plus a comorbidity
All appropriate non-surgical methods have been tried but have failed
The person has been or will receive intensive management in a specialist obesity service
The patient commits to long term follow up

Question 7

When is bariatric surgery recommended as a first line treatment?

Answer 7

In patients with a BMI >50