OBESITY

Treatments

100

What two obesity treatments should always be included in an obese patient's care?

dietary restriction and increased activity close behavioral modification therapy has also been proven to be effective in weight loss

200

What are the 3 most common weight loss surgeries?

gastric bypass (RYGB), laparoscopic adjustable gastric banding, gastric sleeve Gastric bypass produces more weight loss than the lap band but has more side effects.

300

Bariatric surgery is indicated in people with obesity related complications if their BMI is AT LEAST ______?

35kg/m2 If there are no obesity related complications then BMI should be at least 40 kg/m2

400

What is the only drug approved for long term weight loss by the FDA?

Orlistat -Side Effects Include: diarrhea, fecal incontinence, loating, craps, gas, oily stools, decreased absorption of ADEK

500

What is the mechanism of action of the short term (12 weeks) drugs used in the treatment of obesity?

Increased norepinephrine release (sympathomimetic) -Side effects include- insomnia, agitation, tachycardia, hypertension

BMI

100

How do you calculate BMI?

Divide weight in kilograms by height in meters squared

200

How many pounds is 1 kilogram?

2.2 pounds

300

How many meters equal 1 foot?

~.3

400

Waist circumference of ____ inches in men or ____ inches in women is an independent risk factor for obesity related diseases in "overweight" and "obesity type 1" patients.

35 inches for men 40 inches for women

500

A patient is 220 pounds and 6 feet tall. What is his BMI?

~30.8

Obesity Criteria

100

Obesity is defined as a BMI greater than ____kg/m2?

30kg/m2

200

What BMI defines an adult as "overweight"?

25kg/m2- 29.9kg/m2

300

A patient with diabetes, congestive heart failure, and pitting edema has a BMI of 31. Is he obese?

Not necessarily. BMIs are unreliable for highly muscled people, people with wasting, pregnant women, and symptomatic congestive heart failure.

400

Define obesity type 1 and obesity type 2.

Obesity type 1- BMI 30-34.9 kg/m2 Obesity type 2- BMI 35-39.9 kg/m2

500

When is a child determined to be "overweight"?

Between 85th and 95th percentile for age. Above 95th percentile is obese.

Screening

100

Moderate or low intensity counseling together with behavioral interventions to promote sustained weight loss in obese adults is an USPSTF Grade A recommendation. True or False?

False. The USPSTF concludes that the evidence in insufficient to recommend for or against the use of moderate or low intensity counseling together with behavioral interventions to promote sustained weight loss in obese adults.

200

That clinicians screen all adult patients for obesity and offer intensive counseling and behavioral interventions to promote sustained weight loss for obese adults is a Grade A Recommendation. True or False?

False. It is a Grade B Recommendation

300

Intensive, multicomponent behavioral interventions for obese adults has been proven to reduce death and future hospitalizations. True or False?

False. There is only adequate evidence that intensive, multicomponent behavioral interventions for obese adults can lead to an average weight loss of 4 to 7 kg (8.8 to 15.4 lb). These interventions also improve glucose tolerance and other physiologic risk factors for cardiovascular disease. There is no long term evidence supporting reduction of future long term health outcomes.

400

At what age do you start screening for obesity AND what grade recommendation is it (USPSTF)?

6 years old and Grade B

500

When performing a focused physical exam on an obese patient, what are at least four obesity focused factors you will look for?

Blood pressure, BMI, waist circumference, thyroid examination, striae, centripetal fat distribution, leg edema, cellulitis, acanthosis nigricans, intertriginous rashes

Random

100

What calorie deficit equals 1 pound of weight loss?

3,500 calories

200

A higher BMI in otherwise healthy elderly patients is associated with higher mortality. True or False

False

300

Patients must minimally lose what percent of their weight in order for the loss to be clinically significant?

5-10%

400

Washing windows for 45-60 minutes, dancing (social) for 30 minutes, gardening for 30-45 minutes, walking 2 miles in ~30 minutes are all examples of mild, moderate, or intense exercise?

These are all considered moderate activities. Moderate activities burn 150 calories/day or 1000 calories/week.

500

Identify at least six conditions associated with obesity.

Coronary heart disease, hyperlipidemia, fatty liver, colon cancer, hypertension, low back pain, osteoarthritis, diabetes, reflux, sleep apnea, and polycystic ovarian syndrome