Obesity Flashcards
(46 cards)
1 cause of preventable disease and disability
Obesity
BMI classifications
Overweight: 25-29.9 Obesity>30 Class I: 30-34.9 Class II: 35-39.9 Class III: >40 (severe obesity)
When might BMI not be accurate?
Body builder
When do you measure waist circumference?
When a pt has a BMI b/w 25-35 kg/m2
Based on waist circumference, who is at increased risk of obesity?
> 40 inches in men
>35 inched in women
Ethnic variability of waist circumference
35.4 inches for males and 31.5 inches for female in the Asian population
How do you create a negative energy balance?
Increase activity and decrease calories consumed
Create 500-1000 calories per day deficit=weight loss of 1-2 lbs per week
Labs important for obesity
History and PE Fasting glucose and/or HbA1C TSH Liver enzymes Fasting lipids
Ideas for nutrition counseling
Balance calories Enjoy food but eat less Avoid oversize portions Know foods to eat more and less often Make 1/2 plate fruits and veggies Switch to skin or 1% milk 1/2 of grains are whole grain Reduce sodium Drink water instead of sugary drinks
DASH diet
Emphasize vegetables, fruits, low-dat dairy with moderate whole grains, fish, poultry and nuts
Mediterranean diet
Plant-based: fruits, veggies, whole grain braids and cereals, beans, nuts and seeds
Principal source of dietary fat is olive oil
Fish and poultry but limit red meat
Recommended diets for type 2 DM
DASH, mediterranean, carb counting, limit sugar
Recommended diets for CVD
DASH, low Na, mediterranean diet
Recommended diets for CKD
DASH, renal diet (less animal protein)
Recommended diets for celiac disease
Gluten free
Very important modifiable risk factor
Sedentary lifestyle
Who do you screen for obesity?
ALL adults
Most effective high intensity obesity interventions
Two x mo for >3 mos (12-26 sessions a year) or intensive, multicomponent behavioral intervention
Strategies for counseling
Ask/address Advise Assess (readiness to change) Assist Arrange f/u
Goals of obesity intervention
Prevent, treat or reverse complications of obesity
When do you see significant health benefits with weight loss?
5% body weight loss
Obesity tx based on low risk
(BMI of 25-29.9 with no CVD RF or other comorbidities)
Diet and counseling to prevent weight gain
Obesity tx based on moderate risk
(BMI 25-29.9 AND >1 CVD RF or BMI 30-34.9)
Intensive multicomponent behavioral modification and SOME drug therapy (>27)
Obesity tx based on high risk and very high risk
(BMI of 35-40 is high and >40 is very high)
Intensive multicomponent modification and consider drug therapy, bariatric surgery