Definitions
Name the 2 "measurements" that are used to determine health risks/obesity?
Body Mass Index
Waist Circumference
10,000steps
Name 3 oral medications that can be used for weight loss. [incl. off label use]
Phentermine (Duromine), Orlistat (Xenical), Bupropion/Naltrexone (Contrave), Topiramate (Topamax) - off label
Name 3 brand names of weight loss injectables
Ozempic, Wegovy, Mounjaro, Saxenda
Spell the drug name of Mounjaro?
Tirzepatide
What is the formula to calculate Body Mass Index (BMI)
BMI = weight (kg) / height2 (m)
Name 3 recent "fad" diets?
Atkins; Fast 800; 5:2 diet; soup diet; keto; intermittent fasting
Name 3 contraindications to phentermine?
HTN, coronary artery disease, cerebral vascular disease, epilepsy, hyperthyroidism, pregnancy, glaucoma
List 5 common side effects of injectable weight loss medications?
abdominal pain, constipation , diarrhoea, pancreatitis, nausea/vomiting, increased risk thyroid cancer, cholecystitis, choledocholithiasis, SBO, acute kidney injury
Are baseline bloods required prior to starting injectables? If yes, which bloods?
I can't find evidence that it is a requirement per se, but suggestions of:
EUC, LFT, BSL, HbA1c, cholesterol, TSH, lipase
Give 3 reasons why BMI as a value may be misleading.
doesn't distinguish between muscle mass and fat; doesn't account for fat distribution or bone density; as such is misleading in older people, muscular individuals, different ethnicities studies were based on white European male
What is time restricted eating (TRE) / intermittent fasting (IF)? Does it work?
The current popular TRE/IF diets include 16 : 8 (16 hours fasting, 8 hours eating window; eg. eating only between 10 am and 6 pm) or 5:2 diet (modified fast on 2days)
Limited short studies show some benefits, but need longer-term studies to show if any sustainable benefits.
What is the dosing schedule of Ozempic?
Ozempic®, SC, initially 0.25 mg once a week for 4 weeks, then increase to 0.5 mg once a week. If required, after at least another 4 weeks, increase to 1 mg once a week.
How much does Wegovy cost per month on a private script?
0.25mg-1.0mg - $250; 1.7mg - $370; 2.4mg - $445
How much does Mounjaro cost per month on a private script?
2.5mg - $280; 5mg - $390, 7.5-10mg - $540; 12.5-15mg - $690
Give the waist measurements for increased risk and high risk in both males and females?
Male: increased >94cm, high >102cm
Female: increased >80cm, high >88cm
What is the daily recommended calorie intake for men and women to maintain weight?
Women: 1600 - 2200
Men: 2000-2800
What is the mechanism of action of semaglutide?
glucagon-like peptide-1 analogues - increase glucose-dependent insulin secretion and suppress inappropriate glucagon secretion.
Also delays gastric emptying, which slows glucose absorption, and decrease appetite.
What is the dosing schedule for Wegovy?
0.25mg sc injection once weekly for 4weeks, then increase to 0.5mg, 1mg, 1.7mg every 4weeks to a maximum dose of 2.4mg once weekly inj.
What is the dosing schedule of Mounjaro?
2.5mg inj once weekly for 1month, then increase by 2.5mg every 4weeks to maximum dose of 10mg.
List the 6 BMI categories and their correlating BMI values?
Underweight <18.5; Normal Weight 18.5-24.9; Overweight 25-29.9; Obese I 30-34.9; Obese II 35-39.9; Obese III 40+
Name 8 foods that are staples of the Mediterranean-style Diet?
vegetables and fruits; wholegrain breads and cereals; legumes (such as beans, chickpeas, lentils); nuts and seeds; fish and seafood; extra virgin olive oil; herbs and spices; Poultry and dairy products in the Mediterranean diet include yoghurt, cheese, milk, lean proteins, including chicken or turkey, and eggs
What are the PBS indications for Ozempic?
Clinical Criteria: The treatment must be used in combination with at least one of: metformin, a sulfonylurea, insulin AND must be inadequately responsive to at least one of: metformin, a sulfonylurea, insulin AND the pt must not have achieved a clinically meaningful glycaemic response with an SGLT2 inhibitor; OR has a contraindication/intolerance requiring treatment discontinuation of an SGLT2 inhibitor.
Treatment criteria: Patient must not be undergoing concomitant PBS-subsidised treatment for type 2 diabetes mellitus with any of: an SGLT2 inhibitor, a DPP4 inhibitor, another GLP-1 receptor agonist.
What is orforglipron?
A trial oral GLP-1 manufactured by Eli Lilly
Trial results show a clinically significant reduction of glucose levels and weight among patients with early diabetes.
What is the mechanism of action of Mounjaro?
Dual receptor agonist at glucose-dependent insulinotropic polypeptide(GIP) and glucagon-like peptide-1 (GLP-1) receptors. Increases insulin sensitivity and glucose-dependent insulin secretion, reduces glucagon secretion, delays gastric emptying (which slows glucose absorption) and decreases appetite.