Obestiy And Weight Loss

Question 1

What are the BMI limits for each class of weight in adults?

Answer 1

Underweight <18.5

Normal = 18.5-24.9

Overweight = 25.0-29.9

Obesity type 1 = 30-34.9

Obesity type 2 = 35.0-39.9

Obesity type 3 = > or equal to 40

• *also waist sizes greater than the following can signify obesity**
• men = 40inches
• women = 35 inches

Question 2

What are the weight class ranges for children?

Answer 2

Underweight = <5% percentile

Healthy weight = 5-84 percentile

Overweight = 85-94 percentile

Obesity 1 = greater than 95 percentile

Obesity 2 = greater than 120% of 95th percentile

Obesity 3 = greater than 140% of 95th percentile

Question 3

Does maternal obesity affect child obesity?

Answer 3

Yes there is data that suggests there is a correlation

Question 4

What is the general weight loss goal for overweight patients?

Answer 4

Goal is 5-10% of body weight or 0.5kg (1.1lbs)/week for 6 months

Lifestyle modifications to get this are:

• reduce energy intake by 500-1000 kcal/day
• initiate 30 min of moderate intensity exercise 3-5 times per week
• CBT

Question 5

What are the main categories of weight loss treatment?

Answer 5

1) low-moderate intensity lifestyle
- 5% weight loss reported
- improves DM2/HTN/hyperlipidemia, nonalcoholic steatohepatitis (NASH)

2) intensive lifestyle interventions
- 5-10% weight loss reported
- improves DM2/HTN/hyperlipidemia, nonalcoholic steatohepatitis (NASH)

3) medications for weight loss
- 5-15% weight loss reported
- improves DM2/HTN/hyperlipidemia, nonalcoholic steatohepatitis (NASH)

4) endoscopic procedures
- 15-20%
- remission/DM2/HTN/OSA

5) bariatric surgeries
- 25-35%
- remission/DM2/HTN/OSA

Question 6

What are the indications for bariatric surgery

Answer 6

1) BMI > 40kg/m or >35 with an associated medical comorbidity
2) failed dietary therapy
3) psychiatrically stable without alcohol dependence or illegal drug use
4) knowledgeable about the operation and its sequelae
5) motivated individual
6) there are no known medical problems precluding probable survival
* NEEDS all of these*

Question 7

What is roux-en-Y gastric bypass?

Answer 7

Take a part of the patients jejunum and anastomosis it to the cardia of the stomach
(essential bypass most of the stomach)

also anastomosis jejunum to jejunum to allow for gastric contents to still flow into circulation