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Obesity Flashcards

(51 cards)

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1
Q

What is the definition of obesity according to WHO?

A

Obesity is characterized by an abnormal or excessive accumulation of body fat that impairs health.

WHO, 2018

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2
Q

What are the behavioral causes of obesity?

A

Eating habits, limited physical activity, psychosocial disorders.

Behavioral causes include lifestyle choices and mental health factors.

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3
Q

List the environmental/socioeconomic causes of obesity.

A
  • Limited access to healthy foods
  • Socioeconomic status
  • Environmental factors influencing physical activity

These factors can contribute to obesity prevalence.

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4
Q

What physiological factors can contribute to obesity?

A

Hormone imbalances/hypothyroidism

These conditions can disrupt metabolic processes.

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5
Q

Identify genetic predispositions that can lead to obesity.

A

Genetic factors that influence body weight regulation.

Genetic predispositions can affect metabolism and appetite.

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6
Q

What are some risks associated with obesity?

A
  • Anxiety and depression
  • Heart disease & stroke
  • Type II diabetes
  • Cancer
  • Osteoarthritis
  • Sleep apnea & respiratory disorders
  • Hypertension
  • Pregnancy complications
  • Fatty liver disease
  • Urinary incontinence

These risks highlight the severe health implications of obesity.

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7
Q

What is metabolic syndrome?

A

A cluster of conditions that increase the risk of heart disease, stroke, and diabetes.

Often associated with obesity.

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8
Q

What is the pathophysiology of obesity?

A

results from excessive intake of obesogenic foods and low energy expenditure, leading to increased adipocyte accumulation. Dysfunctional adipose tissue releases biochemical mediators that cause inflammation, promoting the development of various diseases.

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9
Q

What does the health history assessment for obesity include?

A
  • Recent weight fluctuations
  • Family history
  • Dietary/Exercise patterns
  • Sleep habits
  • Prescribed medications
  • Smoking status
  • Diagnostic labs

Comprehensive assessments are crucial for effective management.

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10
Q

What does the physical assessment for obesity include?

A

Body Mass Index (BMI)
Waist circumference (> 40 in for men and > 35 in for women)
Waist-to-hip ratios (0.9 for men and 0.8 for women)

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11
Q

What is the Body Mass Index (BMI) range for pre-obese?

A

25-25.9

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12
Q

What is the Body Mass Index (BMI) range for Class I obesity?

A

30–34.9.

BMI is a common measure used to classify obesity.

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13
Q

What is the Body Mass Index (BMI) range for Class II obesity?

A

35–39.9

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14
Q

What is the Body Mass Index (BMI) range for Class III (severe) obesity?

A

≥40

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15
Q

What are the different management strategies for obesity?

A
  • Lifestyle modifications
  • Pharmacologic therapy
  • Nonsurgical interventions
  • Surgical interventions

These strategies aim to promote weight loss and maintenance.

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16
Q

What are some lifestyle modification strategies for obesity management?

A
  • Adopting behavioral interventions
  • Setting weight loss goals
  • Managing stress
  • Prioritizing sleep
  • Adjusting dietary habits
  • Increasing physical activity

Lifestyle changes are foundational in obesity management.

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17
Q

What are the indications for pharmacologic therapy for obesity?

A
  • BMI > 30
  • BMI > 27 with related comorbidities (e.g., DM II, HTN)

Pharmacologic therapy is considered when lifestyle changes are insufficient.

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18
Q

What action does pharmacologic therapy for obesity take?

A

Reducing caloric absorption or intake
Reduces appetite and hunger
Enhance satiety

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19
Q

What are safety considerations for pharmacologic therapy for obesity?

A

Antiobesity meds are teratogenic

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20
Q

What is vagal blocking (gastric stimulation) in the context of obesity treatment?

A

An implanted device intermittently blocks the vagus nerve to aid weight loss.

This is an example of a nonsurgical intervention.

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21
Q

What is Intragastric balloon therapy in the context of obesity treatment?

Study These Flashcards
A

Endoscopic placement of an inflatable balloon in the stomach
Remains in place for 3 to 6 months
Adverse effects: balloon rupture causing obstruction

22
Q

What is Bariatric embolization in the context of obesity treatment?

Study These Flashcards
A

Embolized arteries supplying the gastric fundus to decrease ghrelin (hunger hormone) production/secretion

23
Q

What percentage of weight loss is expected from bariatric surgery?

Study These Flashcards
A

10% to 35% of total body weight within 2 years

24
Q

What is the BMI criteria for bariatric surgery?

Study These Flashcards
A
  • BMI ≥ 40 without excessive surgical risk
  • BMI ≥ 35 with one or more comorbidities
  • BMI ≥ 30 with type 2 diabetes with poor glycemic control
25
What is inclusion criteria for bariatric surgery?
* Ability to perform ADLs and self-care * Support system * Failure of previous nonsurgical attempts at weight loss * Expectation that patient will adhere to postoperative care, follow-up visits, and recommended medical management, including the use of dietary supplements
26
What is the exclusion criteria for bariatric surgery?
* Reversible endocrine or other disorders that can cause obesity * Current substance use disorder * Uncontrolled, severe psychiatric illness * Lack of comprehension of risks, benefits, expected outcomes, alternatives, and lifestyle changes required with bariatric surgery
27
What are the types of bariatric procedures?
* Roux-en-Y gastric bypass (RYGB) * Sleeve gastrectomy * Gastric banding * Biliopancreatic diversion with duodenal switch ## Footnote Each procedure has unique mechanisms and outcomes.
28
How does gastric bypass surgery alter the digestive tract?
It creates a small stomach pouch connected directly to the small intestine, bypassing most of the stomach and the first section of the small intestine.
29
What is a sleeve gastrectomy?
It is a restrictive weight-loss surgery that reduces the size of the stomach by about 80–85%, forming a tube-shaped "sleeve."
30
What is gastric banding and how does it work?
A band is placed around the upper part of the stomach to restrict food intake; a port is inserted through the skin for band adjustments.
31
Why has the use of gastric banding declined in recent years?
Due to concerns about long-term complications, the need for frequent follow-up and adjustments, and a higher rate of reoperation
32
What is Biliopancreatic Diversion with Duodenal Switch (BPD/DS)?
BPD/DS is a restrictive and malabsorptive bariatric surgery that combines sleeve gastrectomy with rerouting of the small intestine to reduce calorie and nutrient absorption.
33
What is the typical weight loss outcome after Biliopancreatic Diversion with Duodenal Switch (BPD/DS) surgery?
70–80% of excess weight is usually lost within 2 years, with higher long-term weight loss than other bariatric surgeries
34
What are potential risks of Biliopancreatic Diversion with Duodenal Switch (BPD/DS) surgery?
Malnutrition, vitamin deficiencies, and the need for lifelong nutritional monitoring
35
Who is Biliopancreatic Diversion with Duodenal Switch (BPD/DS) surgery recommended for?
Patients with a BMI greater than 50
36
What are the preoperative considerations for bariatric surgery?
* Education and counseling * Risks and benefits of surgery * Post-surgical outcomes * Lifelong Vitamin B12 injections and Iron * Dietary changes pre-op (clear liquids 24-48 hours prior) ## Footnote Preoperative preparation is crucial for successful outcomes.
37
What dietary changes are recommended post-bariatric surgery?
* Clear liquids for the first 48 hours * Advance to full liquids, pureed diets, soft foods, solid foods by week 8. ## Footnote Proper nutrition is vital for recovery and long-term success.
38
What potential complications should be assessed postoperatively of bariatric surgery?
* Anastomotic leakage * Fever * Abdominal pain * Tachycardia * Leukocytosis ## Footnote Monitoring for these complications is essential for patient safety.
39
What is dumping syndrome?
A condition occurring within 2 hours of eating, characterized by symptoms such as tachycardia, dizziness, and abdominal cramping. ## Footnote It can be a significant post-surgical complication.
40
What are some medications that can affect weight?
Antihistamines Beta blockers Statins Steroids PPIs Hormonal contraceptives SSRIs Mood stabilizing medications ## Footnote These medications can aid in weight management but come with potential side effects.
41
What are some of the side effects of antiobesity medications?
* Oily discharge * Flatulence * Increased defecation * Abnormal sensations * Dizziness * Altered taste * Insomnia * Constipation ## Footnote Awareness of side effects is important for patient education.
42
What dietary guidelines should patients follow post-surgery?
* Eat smaller, more frequent meals * Focus on protein and fiber * Avoid drinking fluids with meals * Consume prescribed dietary supplements ## Footnote Following these guidelines can enhance recovery and weight loss.
43
What are some causes of weight regain post-bariatric surgery?
* Hormonal imbalances * Dietary non-adherence * Physical inactivity * Mental health conditions * Surgical failure ## Footnote Understanding these factors is important for managing outcomes.
44
What strategies can help prevent and manage weight regain after surgery?
* Cognitive behavioral therapy * Lifestyle counseling * Counseling with a dietitian * Pharmacological therapy * Surgical conversion ## Footnote These strategies can support long-term success.
45
Effects of obesity on Mechanics of Ventilation and Circulation
* Anatomic Remodeling including compression of the oropharynx and increased neck circumference and chest diameter * Central & Peripheral Circulation Compromise
46
What does anatomic remodeling caused by obesity predispose patients to?
* Obstructive sleep apnea * Respiratory Failure * Obesity Hypoventilation Syndrome ( characterized hypercapnia, hypoxemia and sleep-disordered breathing)
47
What is Central & Peripheral Circulation Compromise?
* Increased risk of Heart Failure and HTN, * Blood flow stasis increasing risk for VTE/DVT/PE * Increased difficulty finding peripheral access (needs USIV)
48
Why avoid high-Fowlers for obesity?
Increases intra-abdominal pressure, which can restrict lung expansion and worsen breathing
49
Why is low-semi-Fowlers better for obesity?
Reduces pressure on the diaphragm and improve lung capacity creating better oxygenation
50
Effects of obesity on Pharmacokinetics and Pharmacodynamics
* Some drugs have enhanced effects while others have diminished effects * Opioid agents frequently require higher dosages to achieve pain relief, but are more likely to have serious adverse effects of sedation and respiratory depression.
51
Effects of obesity on Skin Integrity and Mobility
* Vulnerable for developing pressure injuries secondary to: diminished supply of blood, oxygen, and nutrients to peripheral tissue * Increased skin moisture and increased skin friction * Decreased mobility

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