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Clin Med II > Obesity > Flashcards

Obesity Flashcards

(70 cards)

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1
Q

What is the #1 cause of preventable disease and disability?

A

Obesity

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2
Q

Is obesity a disease?

A

Yes

2013 American Medical Association

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3
Q

What classification is a BMI of 18.5-24.9?

A

Normal

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4
Q

What classification is a BMI of 25-29.9?

A

Overweight

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5
Q

What classification is a BMI ≥ 30?

A

Obese

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6
Q

What classification is a BMI of 30-34.9?

A

Obese class 1

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7
Q

What classification is a BMI of 35-39.9?

A

Obese class 2

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8
Q

What classification is a BMI of ≥ 40?

A

Obese class 3 (sever obesity)

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9
Q

At what BMI range do you measure waist circumference?

A

BMI 25-35

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10
Q

Abdominal obesity is linked to an increase in what?

A

Cardiometabolic risk

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11
Q

What waist circumference is concerning for ↑ cardiometabolic risk in men?

A

≥ 40”

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12
Q

What waist circumference is concerning for ↑ cardiometabolic risk in women?

A

≥ 35”

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13
Q

If energy in > energy out, do you gain or loose weight?

A

Gain weight

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14
Q

If energy in < energy out, do you gain or loose weight?

A

Loose weight

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15
Q

What is the goal of energy balance to promote weight loss?

A

Create negative energy balance (↑ activity, ↓ calories consumed)

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16
Q

A calorie deficit of in 500-1000/day will result in how much weight loss/wk?

A

1-2 lbs/wk

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17
Q

What recommendation can you give to a pt wanting to track their daily food intake?

A

Food diary

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18
Q

As pts loose weight, does their metabolism increase or decrease? What effect does this have on weight loss?

A

Decrease.

Makes continued weight loss more difficult

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19
Q

What is the main goal of weight loss?

A

Prevent, reverse or ameliorate complications and improve quality of life

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20
Q

What % of body weight should a pt aim to loose initially?

A

5-7% of body weight

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21
Q

A > 5% loss of body weight will result in a decrease in risk factors?

A

CVD risk factors

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22
Q

What is the #1 diet recommendation for 2020?

A

Mediterranean

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23
Q

What diets are recommended for T2DM?

A

DASH, mediterranean, carb counting, limit sugar

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24
Q

What diet is recommended for CVD?

A

DASH, low Na, mediterranean

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25
What diet is recommended for kidney disease?
DASH, renal diet
26
What diet is recommended for celiac disease?
gluten free diet
27
What diet promotes weight loss, improves lipids, reduces BP/ fasting BS/ HgA1C independent of any change in physical activity
Intermittent fasting/ time restricted eating
28
What is a modifiable risk factor of obesity?
Physical activity
29
Increased X will lead to 1. Reduced risk of mortality 2. ↓ risk of cancer/ falls 3. improved cognition/sleep 4. ↓ risk of anxiety/depression
Physical acitivty
30
How you can objectively evaluate a pt's physical activity during an office visit?
Treat physical activity as a vital sign (days/ week, minutes/ day)
31
What are the current physical activity guidelines for adults?
150-300 min/ week mod intensity OR 75-150 min/ week of vigorous intensity aerobic physical activity PLUS muscle strengthening ≥ 2 days/ week
32
What is the "talk test" for moderate and vigorous physical activity?
Moderate = cant talk but not sing Vigorous can’t say more than a few words w/p pausing to breath
33
What is the FITT exercise prescription?
Frequency (≥ 5 days/ week) Intensity (mod-vig) Time (≥ 30 min) Type
34
Who do you screen for obesity/weight management?
All adults
35
If pt w/ BMI ≥ 30 do you treat or refer them?
Refer for intensive, multi-component, behavioral intervention
36
What is the goal of comprehensive weight management interventions? (2)
1. Help make long-term changes | 2. Control trigger eating
37
Comprehensive/ high intensity interventions are most effective when you meet X/month for X months and X/time per year?
Most effective → 2x/ month for ≥ 3 months & 12-26 sessions/ year
38
What are the 5 A's of counseling?
``` Ask/address: BMI, lifestyle choices Advise: personalized tx plan Assess: willingness to change Assist: referral/resources Arrange follow up ```
39
What is the rate limiting step in weight loss?
A person's readiness to change
40
A patient centered approach asks closed or open ended questions?
Open ended
41
What is X? All pts will a BMI ≥ X are candidates for weight loss intervention
BMI ≥ 25
42
What is 1st line tx for weight loss?
Comprehensive lifestyle program
43
When should you consider drug therapy to assist w/ weight loss?
<5% weight loss in 3-6 months
44
A BMI of 25-29.9 w/ no CVD risk factors places a pt a low, moderate, or high risk?
Low risk
45
What is the tx for pt at low risk (BMI 25-29.9 w/ no CVD risk factors)?
Diet and exercise counseling to prevent weight gain
46
A BMI of 25-29.9 & ≥ 1 CVD RF OR BMI 30-34.9 places a pt a low, moderate, or high risk?
Moderate risk
47
What is the tx for moderate risk (BMI of 25-29.9 & ≥ 1 CVD RF OR BMI 30-34.9 )?
Intensive, multicomponent behavioral modifications (diet/exercise to support & maintain weight loss)
48
A BMI of 35-44 places a pt a low, moderate, or high risk?
High risk
49
What is the tx for high risk (BMI 35-44)?
Intensive multicomponent behavioral modification, consideration of drug therapy, bariatric surgery
50
At what BMI do you initiate drug therapy?
BMI ≥30 | OR > 27 w/ comorbidities
51
Will drug therapy cure obesity?
No
52
What is the goal weight loss with drug therapy?
4-8% within 6-12 mos
53
If pt does not achieve 4-5% weight loss after 3 months of using a drug what should you do?
Discontinue
54
What medication will | - Alters fat digestion by inhibiting pancreatic lipases
Orlistat
55
↑ fat in stools and GI side effects are SEs for what drug?
Orilstat
56
What drug may ↓ absorption of fat soluble vitamins so it is recommended that pts take a daily multi-vitamin?
Orlistat
57
How is Liraglutide administered?
Daily subQ injections
58
What drug is a given to T2DM pts?
Liraglutide
59
Lorcaserin (serotonin agonist) helps pts loose weight by what?
↓ appetite
60
What two drugs are | contraindicated in pts w/ HTN, CAD, hyperthyroidism?
1. Phentermine/ topiramate | 2. Phertermine
61
Is Phertermine given for short term use or long term use?
Short term. - More SEs - Potential for abuse
62
What 3 therapies are not recommended for weight lot?
dietary supplements, hCG, calcium
63
Loss of 8% excess body weight prior to surgery prior to bariatric surgery will lead to what?
Greater weight loss post op
64
Proper post-op bariatric care includes what?
lifelong surveillance
65
1. Eating disorder 2. untreated mental illness 3. drug/ETOH abuse 4. Coagulopathy 5. serve CVD 6. inability to comply w/ lifelong dietary requirement These are all contraindications for what w/ regards to weight loss?
Contraindications for bariatric surgery
66
What are the 3 mechanism for weight loss w/ bariatric surgery?
1. Restriction (reduce stomach capacity) 2. Malabsorption (shorten absorption length of bowel) 3. Decreased appetite/ improve metabolism (change release of various hormones)
67
Is the following pt considered for bariatric surgery? BMI 30-34.9 + uncontrolled T2DM or metabolic syndrome
Yes
68
Is the following pt considered for bariatric surgery? BMI ≥ 40
Yes
69
Is the following pt considered for bariatric surgery? BMI 35-39.9 + ≥ 1 serious comorbidity
Yes
70
Sleeve gastrectomy, adjustable gastric band, and roux-en-Y gastric bypass are all procedures for what?
Bariatric surgery

Clin Med II (12 decks)

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