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16 Cards in this Set
- Front
- Back
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What is the gold standard for obesity?
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>25% in men >33% by DEXA.
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Do retroperitoneal fat and increased waist circumference confer significant additional risk?
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yes.
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There is an increase in relative mortality for men and women with a BMI below __ and a BMI above ___.
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20, 25
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If 40 years old and BMI >40: Only ____ chance of living to age 65 as that of a person who is of normal weight.
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1/3
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What comes first, insulin resistance or hyperG?
- obesity confers a ___ RR of developing diabetes. |
insulin resistance.
- 6 fold RR |
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Are pts with both HTN and dyslipidemia at markedly higher risks of developing CVD?
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yes, the effect is synergistic.
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Above what BMI should we consider medications? Surgery?
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30-34 start considering meds
(>27 if there are complications) >35 consider meds and/or surgery (of course all of this is + diet/exercise) |
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Does metabolic rate vary with weight loss?
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yes it does! It varies directly.
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Normal person needs ___ kcal/kg to maintain weight? (per day)
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22
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When is drug tx considered to be working?
What usually happens when the drug is stopped? |
2 kg weight loss during the first month
5% fall by 3-6 months 10-15% is good response, >15% is excellent Weight is usually regained. |
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What do the following have to do with feeding and satiety?
- 5HT - DA - NE How do most weight loss drugs work? What is orlistat? - does it also improve lipids and BG? |
- facilitates satiety
- inhibits feeding - inhibits feeding either as releasing agents of these nt's (dexamphetamine, phentermine [NE/DA]; fenfluramine, dexfenfluramine [5HT]) or as reuptake inhibitors (sibutramine). Selective Lipase inhibitor - makes consuming too many fats highly unpleasant. - yes |
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How does phentermine work?
- SE? - is continuous tx more effective than alternate phentermine and placebo? |
NE/DA releasing agent --> causes early satiety
- may ^BP - not really, both are much better than placebo alone tho'. |
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Sibutramine
- how long is it approved for use? - what does it do? - SE? |
- up to two years
- 5HT and NE reuptake inhibitor - increases thermogenesis in animals, may ^BP |
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Orlistat
- intestinal SE? - what should be given concurrently, though not a the exact same time? |
- cramps, flatus, fecal incontinence, oily spotting --> tends to improve after first several weeks.
- multivitamin, to help with malabsorption of fat soluble vitamins. |
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Is serious psychological dz a contraindication to weight loss surgery?
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yes.
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What are the two successful weight loss surgeries in current use?
- complications of the more serious procedure? |
Roux-en-Y Gastric Bypass
- 1/200 mortality, anastomotic leak (0.1%), marginal ulcer (5%), N&V @ 3 months (10-15%), nutritional deficiencies Lap Band |
