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33 Cards in this Set
- Front
- Back
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% of obese americans
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25-50%
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Definition of obesity
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>20% over ideal weight
BMI >30 BMI 25-29 = overweight |
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BMI formula
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BMI = lb x ((705/70)/70)
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How is overweight defined in children?
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at or above 95th percentile (sex specific)
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explain how obesity varies among populations
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Varies by ethnic group in women, but not in men.
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Childhood obesity is highest in what 2 ethnic groups?
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Mexican American
African American Ages 12-19yo |
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What is Pickwickian Syndrome
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body weight more than 2x normal, respiratory, CV, and sleep problems
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Is obesity an eating disorder?
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No.
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2 genes implicated in obesity
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Leptin receptor (LEPR)
Melanocortin 4 receptor (MC4R) |
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Most weight lost with diet is regained in...
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5 years
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surgery in which food is rerouted past part of stomach and SI
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gastric bypass
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surgery in which size of stomach is reduced
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bariatric surgery
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Class of drugs once used for weight loss, now rare.
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Amphetamines
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Amphetamine like agent still rx'd for obesity
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phentermine (Ionamin)
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fenfluramine and denfenfluramine were taken off market because
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they caused heart valve abnormalities
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How does Orlistat (Xenical) work
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pancreatic lipase inhibitor. Limits breakdown of dietary fats, dec-ing absorption 33%
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How does sibutramine (Meridia) work
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block monoamine reuptake, increasing satiety
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Diet that may produce more weight loss of BETTER heart risk factors
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Atkins
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Purging can lead to what complications
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malnutrition
electrolyte disturbances CV problems (arrythmias) |
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what is melanosis coli
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blackened area of mucosa, sign of laxative abuse
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What is hypergymnasia
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excessive sports activity, mostly gymnastics and ballet
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Differential of eating disorders
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occult malignancy
regional enteritis chronic infection MDD Kleine Levin syndrome borderline personality |
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life threatening eating disorder
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anorexia nervosa (18%)
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Common metabolic abnormality associated with arrythmias
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hypokalemia
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Diagnostic criteria for anorexia
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body weight <85% or normal
BMI <17.5 fails to gain weight Strong fear of gaining weight Disturbed body image 3 consecutive missed periods |
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2 stages of anorexia tx
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1. restore body weight
2. prevent relapse |
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Pt should be admitted to hospital when?
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body weight is 20% or more below normal
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Rx's for anorexia
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amitriptyline (Elavil, antidep.)
fluoxetine (Prozac, SSRI) Cyproheptadine (Periactin, appetite stimulant) |
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Most effective form of psychotherapy for anorexia
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family therapy
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Criteria for bulemia nervosa
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recurrent episodes of binge eating coupled with feeling out of control over the binge eating during the episode. 2x/week for at least 3 mos.
Usually some type of compensatory mechanism (laxatives, vomiting, etc) |
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Consequences of repeat vomiting
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Parotid gland swelling/infection
tooth enamel erosion dental caries |
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What if a patient has features of anorexia, but purges
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Anorexia, binge-eating/purging type
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Bulemia tx
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cognative/behavioral therapy
Antidepressants (HCA's, MAOI's, SSRIs (fluoxetine (Prozac))). Combo drugs +therapy is more effective than alone. |
