weight control

Question 1

obesity treatment pyramid

Answer 1

sugery 20- 40

endoscopic procedures 10-20

pharmacotherapy 5-20

presciptive nutritinal

intervention

beahviour 2-5

Question 2

Multicomponent/Behavioral
Intervention

Answer 2

Healthy meal plan

• Physical activity

change behaviour* Behavioral intervention:
– self-monitoring, goal-setting, stimulus control (e.g.,
reducing the availably of tempting foods), stress
reduction, improved sleep quantity and quality,
and/or psychological therapy

Question 3

Maintain or Regain

Answer 3

Those who regain weight:
* Exercise little
* Use popular/fad diets
* Make drastic and unpleasant changes in their diets and
physical activity levels
* Take diet supplements
* Cope with problems and stress by eating

Those who maintain their weight loss (versus regain):
* Exercise regularly.
* Make small and comfortable changes in diet and physical
activity.
* Eat breakfast.
* Choose low-fat foods.
* Keep track of their weight, dietary intake, and physical activity
level.

Question 4

Can Organized Weight-loss
Programs Help

Answer 4

totally fine they help people to understand portion control and what food are high in fat

Question 5

Prescription Nutrition
Intervention

stepping it up

Answer 5

Meal replacements
1-2 meals per day (portion and stimulus control)
maybe have to use this to bring down before surgury

Intermittent fasting
16:8 and 5:2 common formats
16 hours fast 8 hours can consuome 5 days normal 2 days fast

Specific diet
DASH diet, Portfolio dietary pattern, etc

Question 6

Why Are Diets So Unsuccessful?

Answer 6

• They are often hard to follow
• They are often very different from what we
  are accustomed to
• It’s easy to slip off the diet and “cheat”
• People want a quick fix that works
• Persistent obesity changes the biology of the
  body

the longer somone has obesity the body makes it harder and harder to lose weghigght

3500 kcal ≈ 1 pound —- a myth? yes because wevreyone is diffrent

Question 7

Obesity Creates a ‘New Biology’ that
Hinders Weight Loss/Maintenance

Answer 7

Full year after significant
weight loss
Ghrelin - 20% higher
PYY - 20% lower
Body acted as if starving
“Post-dieting syndrome”
Post weight loss
Muscle biopsy – burns 20-
25% less energy during low-
intensity exercise & activities
of daily living
Skeletal muscle’s work
efficiency increased
Goldsmith R, et al. AJP 2010; 298:R79-88
Following calorie restriction
Functional MRI – activation in the
attention and reward regions in
response to food
Caloric deprivation increases thereward value of high-calorie foods
more than low-calorie foods

Question 8

Naltrexone and bupropion (Contrave®) a question on both

Answer 8

– low dose naltrexone (medication used to manage alcohol
and opioid dependency) plus bupropion (antidepressant
that’s also prescribed for smoking cessation)
– work on two separate areas of the brain that control hunger
and cravings
– oral tablet

Question 9

Orlistat (Xenical®

Answer 9

blocks fat absorption in the intestine,
therefore you absorb fewer calories
– capsule taken during or just following each
main meal
– lose about 2-3 kg more than those not
taking drug over a year

Question 10

Liraglutide (Saxenda® - daily)

Answer 10

– is a fullness signal GLP-1 (glucagon-like peptide-1) receptor
agonist. Acts by decreasing appetite.
– prefilled pen that you self-inject daily
– nausea common

Question 11

4. Semaglutide (Wegovy® - weekly) ozympic

Answer 11

GLP-1 (glucagon-like peptide-1) receptor agonist
– acts on neurons in the brain to help you feel more satisfied,
reduces hunger, controls cravings
– prefilled pen that you self-inject weekly
– nausea commo

Question 12

Ozempic and Wegovy

Answer 12

both GLP-1 receptor agonists
(semaglutide)
 Ozempic approved for treatment of type 2 diabetes but used off-
label for weight loss; Wegovy is approved for weight loss
 Side effects: nausea, vomiting, diarrhea, abdominal pain and, more
rarely, pancreatitis, and a potential link to a risk of thyroid tumors

Question 13

5. Tirzepatide (Zepbound®)

Answer 13

– Approved May 2025
– Zepbound – obesity
– Mounjaro – type 2 diabetes
– Dual GIP/GLP1 receptor agonist
– Lose up to 25% of total body weight when combined with
intensive diet and exercise

most effective

Question 14

Endoscopic Procedures

Answer 14

Gastric Balloon
Inflatable silicone balloon to reduce stomach
volume
Endoscopic sleeve gastroplasty
Stitches placed inside stomach to reduce volume up
to 70% (dissolve in about 1 year)
Gastric injections
Freeze stomach muscles to slow digestion; series of
injections; can be repeated in 6 months; painless

Question 15

Surgery

Answer 15

Only available to a certain clinical population
* over 18 years old
* BMI > 40 kg/m²
* BMI > 35kg/m² plus 1 or more of high cholesterol, high blood pressure,
sleep apnea, diabetes, or joint problems
* have tried different ways to manage weight but it remains high
* Can reduce weight by up to 50% and most can
maintain the weight loss
* Risks of complications during and after surgery
* Very expensive

Question 16

Bariatric Surgery

what is most effective

Answer 16

Gastric band – safest type of bariatric surgery but requires routine follow up for
band adjustments.

Gastric bypass – reduce stomach from size of small football to an egg; bypass
first section of small intestine.
mopst efectivvvcvvvvvvve

Sleeve gastrectomy – about 2/3 of stomach removed, leaving a sleeve/tube
behind. Hunger cells are removed giving a metabolic response.
*Greatest
weight loss

Question 17

Liposuction

Answer 17

Maximum amount of fat removed is 5
litres (about 4.5 kg)
* Cosmetic surgery; not intended for
weight loss
* Risks including that your skin may
appear bumpy, wavy or withered due to
uneven fat removal, poor skin elasticity
and unusual healing. These changes
may be permanent.
* Liposuction permanently removes fat
cells from the targeted areas of the
body. So, if you gain weight, the fat will
still be stored in different parts of the
body.