Obesity

Question 1

What is the definition of obesity?

Answer 1

A condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired

Question 2

What is obesity related to?

Answer 2

genetics (60%-80%), also environment like healthy/toxic obesigenic environment

Question 3

What drives obesity?

Answer 3

1. Car use
2. Screen Time
3. Education level
4. Educational achievement
5. Poverty
6. Social deprivation
7. Ability to play outside

Question 4

What are the comorbidities of obesity?

Answer 4

1. Depression
2. Sleep apnoea
3. Bowel cancer
4. Osteoarthritis
5. Gout
6. Stroke
7. Myocardial infarction
8. Hypertension
9. Diabetes
10. Peripheral vascular disease

Question 5

How do you assess and manage adults in obesity?

Answer 5

1. Determine degree of overweight or obesity
2. Assess lifestyle, comorbidities and willingness to change - consider referral to specialist care, specialist assessment and management; surgery and follow up
3. Management, lifestyle changes drug treatment

Question 6

What diet and drugs can help treat obesity with orlistat?

Answer 6

1. Derivative of an endogenous lipstatin produced by Streptomyces toxytricini.
2. Gastric and pancreatic lipase inhibitor
3. Reduces dietary fat absorption by around 30%.

Question 7

What are side effects or orlistat?

Answer 7

1. Fatty and oily stool, faecal urgency, oily spotting, faecal incontinence in 7%
2. Possible deficiencies of fat-soluble vitamins
3. Not that effective

Question 8

When do you consider bariatric surgery with BMI?

Answer 8

1. BMI of 40 kg/m2 or more
2. BMI of 35-40 kg/m2 and other co-morbidities
3. BMI of 30-34.9 kg/m2 for newly diagnosed T2DM
4. Consider surgery as a first-line option for adults with a BMI >50 kg/m2

Question 9

When can bariatric surgery help?

Answer 9

– non-surgical measures have failed to achieve or maintain adequate clinically beneficial weight loss for at least 6 months
– receiving or will receive intensive specialist management
– generally fit for anaesthesia and surgery
– commit to the need for long-term follow-up.

Question 10

What is a gastric bypass?

Answer 10

the top part of your stomach is joined to the small intestine, so you feel fullersooner and do not absorb as many calories from food

Question 11

What is a gastric band?

Answer 11

a band is placed around your stomach, so you do not need to eat as much to feel full

Question 12

What is a sleeve gastrectomy?

Answer 12

some of your stomach is removed,soyou cannot eat as much as you could before and you’ll feelfull sooner