S1W1 Obesity and Energy Balance part 6

Question 1

For what BMI would diet and exercise be the main weight loss method?

Answer 1

BMI 18.5 - 29.9
(normal weight and overweight)

Question 2

For what BMI would medication be the main weight loss method in conjuction with exercise and diet?

Answer 2

BMI 30 - 39.9
(obese 1 and obese 2)
or a BMI > 27 with co-morbidities

Question 3

For what BMI would surgery be used for weight loss?

Answer 3

BMI > 40
or > 35 with co-morbidities

Question 4

Why is is difficult to prescribe exercise as a weight loss method for someone with a very high BMI?

Answer 4

• so much body fat makes manoeuvrability difficult
• exercising is psychologically difficult for people with high BMI

Question 5

How much weight loss does bariatric surgery lead to?

Answer 5

• Most severe form of weight loss surgery, makes the stomach the size of a tennis ball, reroutes the intestines, leads to around 25% weight loss
• Less severe forms of weight loss surgery, lead to 10/15% weight loss in the long term

Question 6

How much weight loss do recent obesity medications lead to?

Answer 6

up to about 15% weight loss

Question 7

What is semaglutide?

Answer 7

• A weight loss drug that is a synthetic form of a hormone called GLP-1, which is a satiety hormone
• it also has impacts on insulin secretion so has been used as a drug for type 2 diabetes in the past
• in a high dose it supresses appetite

Question 8

Explain the research around semaglutide for weight loss

Answer 8

• study by Wilding et al (2021)
• Individuals with obesity randomised to either take the drug or placebo
• Injection once a week
• The group with the semaglutide lost around 15/16%
• Accounting for placebo effect, direct effect of the drug of around 14%
• Game changing drug
• National Institute of Health and Care Excellence have recommended semaglutide to be used by the NHS
• If you have a BMI > 30, you are eligible for this for 2 years