Obesity for final year mbbs

2.  Obesity is an abnormal increase in the
proportion of fat cells
 Primarily occurs in the visceral and
subcutaneous tissues of the body
 Second leading cause of preventable
death
 Third leading reason for liver
transplantation

3.  Body mass index (BMI) – see chart, p. 945
 Waist circumference
› People with excessive visceral fat in waist are more
prone to cardiovascular disease and metabolic
syndrome
 Waist-to-hip ratio (WHR)
› Waist measurement is divided by hip measurement
› AWHR measurement >.08 is at risk for
complications

4.  What is considered to be normal BMI?
 What is classified as overweight?
 What is considered obese?

6. Health risks increase if the
waist circumference is
>____ in a female and
>____ in a male?

7.  Apple shape have more visceral,
abdominal fat and are prone to:
 Elevated triglycerides
 Metabolic syndrome
 Decreasing insulin sensitivity
 High levels of HDL cholesterol
 Increasing blood pressure
 Release of more fatty acids into the
bloodstream

8.  Genetic/Biologic basis
 Environmental factors
 Psychological factors

9.  Problems occur at higher rates for obese patients
 Mortality rate rises as obesity increases
› Especially with increased visceral fat
 Obese patients have a decreased quality of life
 Most conditions improve with weight loss

11.  Also know as Insulin Resistance
 Diagnostic Criteria:
› IncreasedWaist circumference
› ElevatedTriglycerides
› Elevated HDL
› Elevated Blood Pressure
› Fasting Blood Glucose > 110mg/dl
 These people are at risk for heart disease, stroke,
Diabetes, renal disease

12.  Modify eating patterns
 Participate in a regular physical activity
program
 Achieve weight loss to a specified level
 Minimize or prevent health problems related
to obesity

15.  NutritionalTherapy
› Low calorie with adequate amounts of fruits and
vegetables, bulk, and meets daily vitamin
requirements
› Avoid fad diets
› Small Portions
 Exercise
› 30 minutes to 1 hour per day

16. Patients desire to change lifestyle
+
Exercise
+
Diet control
Weight Loss

18.  Used to treat morbid obesity
 Currently the only treatment found to have a
successful and lasting impact for sustained weight
loss

19.  Must meet all of the following criteria to be
considered an ideal candidate
› BMI ≥40 kg/m2 with one or more
obesity-related complication
› 18 years or older
› Understands the risks and benefits
› Has been obese for >5 years
› Has tried and failed to lose weight

20.  Three broad categories
› Restrictive
› Malabsorptive
› Combination of restrictive and
malabsorptive

21.  1. ORLISTAT
 2. LIRAGLUTIDE
 3.PHENTERMINE
 4.TOPIRAMATE
 5. LORCASERIN
 NALTREXONE/BUPROPION