obesity

Question 1

What is obesity defined as? What BMI?

Answer 1

Excessive fat accumulation in adipose tissue to extent that it affects their health. BMI> 30 obese.

Question 2

Risks of obesity for asians & afrocarribeans?

Answer 2

• Asians develop diabetes at lower BMI.

- Afrocarribeans have less favourable CV profiles at lower BMI.

Question 3

What is an example of genetic cause of obesity?

Answer 3

Leptin - dysfunction. Can cause obesity

Question 4

What are factors driving obesity?

Answer 4

Genetic predisposition + environmental factors. Unhealthy diet, sedentary lifestyle

Question 5

What are comorbidities associated with obesity?

Answer 5

Stroke, MI, bowel cancer, infertility, depression, osteoarthritis

Question 6

Why is it hard to lose weight when genetically obese?

Answer 6

Constantly feel that they are starving (appetite regulation impaired)

Question 7

What is included in obesity assessment for adults?

Answer 7

Determine degree of obesity, comorbidities, willingness to change. Lifestyle + medications –> surgery and follow up

Question 8

What does orlistat do? Side effect? Overall effect?

Answer 8

• Inhibits lipase so get less fat absorption and less overall calories absorption.
• Steatorrhea.
• Not very effective and has side effects.

Question 9

When do you consider bariatric surgery? When is it first line option?

Answer 9

• BMI > 40. BMI 35-40 if comorbidities. BMI 30 if newly diagnosed T2D. If other treatments haven’t worked for 6 months. Fit for surgery and anaesthesia. Long term commitments after surgery.
• First line for BMI>50.

Question 10

What is gastric bypass? how does it work?

Answer 10

top of stomach connected to small intestine. feel full faster and absorb less calories

Question 11

what is gastric band? how does it work?

Answer 11

band placed on stomach, so feel full faster

Question 12

what is sleeve gastrectomy? how does it work?

Answer 12

part of stomach removed so feel full faster

Question 13

What is the order of effectiveness of these surgeries?

Answer 13

Gastric bypass > sleeve gastrectomy > gastric band