Obesity Flashcards Preview

X Clin Med II Exam 4 > Obesity > Flashcards

Flashcards in Obesity Deck (46)
Loading flashcards...
1

#1 cause of preventable disease and disability

Obesity

2

BMI classifications

Overweight: 25-29.9
Obesity>30
Class I: 30-34.9
Class II: 35-39.9
Class III: >40 (severe obesity)

3

When might BMI not be accurate?

Body builder

4

When do you measure waist circumference?

When a pt has a BMI b/w 25-35 kg/m2

5

Based on waist circumference, who is at increased risk of obesity?

>40 inches in men
>35 inched in women

6

Ethnic variability of waist circumference

35.4 inches for males and 31.5 inches for female in the Asian population

7

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

8

Labs important for obesity

History and PE
Fasting glucose and/or HbA1C
TSH
Liver enzymes
Fasting lipids

9

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

10

DASH diet

Emphasize vegetables, fruits, low-dat dairy with moderate whole grains, fish, poultry and nuts

11

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

12

Recommended diets for type 2 DM

DASH, mediterranean, carb counting, limit sugar

13

Recommended diets for CVD

DASH, low Na, mediterranean diet

14

Recommended diets for CKD

DASH, renal diet (less animal protein)

15

Recommended diets for celiac disease

Gluten free

16

Very important modifiable risk factor

Sedentary lifestyle

17

Who do you screen for obesity?

ALL adults

18

Most effective high intensity obesity interventions

Two x mo for >3 mos (12-26 sessions a year) or intensive, multicomponent behavioral intervention

19

Strategies for counseling

Ask/address
Advise
Assess (readiness to change)
Assist
Arrange f/u

20

Goals of obesity intervention

Prevent, treat or reverse complications of obesity

21

When do you see significant health benefits with weight loss?

5% body weight loss

22

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

23

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)

24

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

25

When do you consider drug therapy?

BMI>30 or >27 with comorbidities
(<5% weight loss in 3-6 mos is when to start discussing-with a goof lifestyle program)

26

Goals of drug therapy

Reduce weight (4-8% in 6-12 mos)
Improve health
Minimize adverse effects

27

What does Orlistat (Alli/ Xenical) do?

Alter fat digestion by inhibiting pancreatic lipases
Increases fat in stools

28

Side effects of Orlistat

May decrease absorption of fat soluble vits (ADEK) so much take a multi vitamin daily
Unpleasant GI side effects

29

What does liraglutide do?

GLP-1 receptor agonist (daily SQ injection)
Pts with type 2 DM

30

Side effects of liraglutide

N/v