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29 Cards in this Set
- Front
- Back
Body Mass Index Calculation
Limitations & Advantages |
Weight in Kilograms/ Height in Meters squared
Limitations: does not distinguish between fat and lean tissue, does not indicate fat distributions Advantages: Easy, large data sets, standard for interpretation. |
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BMI Range Underweight
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< 18.5
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BMI Range Normal
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18.5 - 24.9
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BMI Range Overweight
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25.0 - 29.9
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BMI Range Obese
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30.0 - 34.9
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BMI Range Class II Obesity
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35.0 - 39.9 (Very High Risk)
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BMI Range Morbidly Obese
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> 40.0 (Extremely High Risk)
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Waist Circumference
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Positively Correlated with Abdominal Fat
Abdominal fat is an independant predictor of morbidity |
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Waist Circumference Male
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> 102cm or 40" at a greater risk of developing obesity related morbidity
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Waist Circumference Female
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< 88cm or 35" at a greater risk of developing obesity related morbidity
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Obesity Related Morbidities
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Type II Diabetes
HTN Dyslipidemia Cancers Gallbladder and Respirtory Diseases Osteoarthritis Complications in surgery and pregnancy |
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Prevelance of Obesity in Adolescence and Children
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16.5% between 6- 19 overweight
15% at risk for overweight |
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NIH Treatment Guidelines
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BMI > 25 + 2 or more risk factors
Modest Weight Loss DIet, Excercise, behavioral therapy |
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Obesity Definition
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Disruption in regulation of food intke and energy expenditure
Genetic and environmental factors interact. |
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Obesity Environmental Risk Factors
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Sedentary Lifestyle
Excess energy intake Societal "Supersize" |
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Excess Energy Intake
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Increased Portion Size
Increased frequency of eating outside the home Fat-free food perceived at low calorie or calorie free Increased food consumption Increased 300 calories per day for 1970 to 2000 |
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Goals of Treatment Weight Loss
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Modest weight loss (5-10%)
Rate: 1 pound per week Lose weight over 6 months After 6 months focus of preventing weight regain |
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Weight loss Benefits in HTN, TII DM, and dsylipidemia
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Improved glycemic control
Reduced blood pressure Improved lipid profile |
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Three Basic Weight loss Principles
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1. Diet
2. Excercise 3. Behavioral Therapy |
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Diet
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Follow dietary guidelines- increase fruits, vegetables, amd whole grains, decreased saturated fat
Reduced energy intake by about 500 kcal/day BODY FAT IS LOST WHEN ENERGY USE EXCEEDS ENERGY INTAKE |
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Atkins Diet
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Diet consists of pure protein and fat < 20g of Carbs Daily
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Atkins Biochemical Effects
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Insulin Levels Decrease
Fatty oxidation and gluconeogenesis for energy Goal: Achieve ketosis/lipolysis High Protein is needed to preserve lean body mass, Protein synthesis is low due to low IG ration |
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Atkins Metabolic Effects
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Reduction in calorie intake
Reduction in B vitamins and fiber intake Increased ketone formation. High saturated fat shown to increase LDL and risk of CVD No Long term studies |
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Excercise
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Moderate intenisty, 30 Minutes minimum most days
Imporves health and associated with maintenance of weight loss. |
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Behavioral Therapy
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Making permanent changes in eating and exercise patterns
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Pharmacotherapy
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Appetite Suppressant
- Sibutramine (Meridia) Lipase Inhibitor - Orlilstat (Xenical) |
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Meridia and Xenical
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Approved for long term use
Few studies over one year Weight loss 2-10kg with much variable Weight loss seen in first 6 months Not meant for sole treatment |
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Meridia Who?
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BMI > 30 or 27 with risk factors
5-15mg daily Not for used with SSRI's Not for patients with poorly controlled HTN, CAD, CHF, and stroke |
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Orlistat Mechanism of Action
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Occurs in the stomach and small intestine
Inhibits gastric and pancreatic lipases 30% of ingested fat not absorbed Low fat diet (<30%) to minimize side effects |