Flashcards in Obesity II Deck (32)
What is the key thing to change in treating obesity?
What is considered "successful" weight loss?
10% maintained over one year
When is a very low calorie diet indicated?
BMI 30+ with obesity comorbidities
How many calories is a very low weight loss diet?
800 calories or less
How long do very low calorie diets last?
What specific nutrient are VLCDs high in? Why?
Maintain lean muscle mass
Is it okay to resume a 2000 calorie diet once the VLCD is finished?
No--need to slowly build back up
What is the SMART mnemonic for goal setting?
The central concept of motivational interviewing is to do what?
How is motivational interviewing evocative?
Client does most of the talking
Drug treatment for obesity is indicated for whom?
BMI 30+ or 27+ with comorbidities
Drug treatment for obesity should always be accompanied by what?
Weight loss program
What is the MOA of Orlistat?
Lipase inhibitor that blocks fat absorption from the gastric/duodenal mucosa
What are the side effects of Orlistat?
What is the MOA of phentermine/Topiramate ER?
Phentermine = decreases appetite
Topiramate = anticonvulsant that prolongs satiety
How long is the phentermine/topiramate regime?
What is gastric banding?
Band around upper part of the stomach, limiting amount of food
What is the most likely side effect of gastric banding?
What is sleeve gastrectomy?
Removal of the body of the stomach
What is a Roux-en-Y?
Tube connecting upper part of stomach with the distal small intestine
What are the problems with Roux-en-Y?
Need lifelong supplements
What is dumping syndrome?
ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. Pulls blood volume out into intestines
What are the complications of bariatric surgery?
Anastomosis leaks (peritonitis/sepsis)
What is the stomal ulceration associated with bariatric surgery?
Overabundant acid in pouch leads to excessive acid passing through stoma
Dumping syndrome can be set off how?
High sugar inntake
What causes the constipation following bariatric surgery?
Ca and Fe supplementation
What causes the Fe deficiency seen in ROux-en-Y surgeries?
Low gastric acid level prevent Fe cleavage from food
Little nutrient exposure to intestines
What is the cause of B12 deficiency in bariatric surgery pts?
Affects secretion of intrinsic factor
How do you prevent B12 deficiency with roux-en-y pts?