Overweight and Obesity

how to calculate BMI?

BMI = (weight (lb) x 703) / (height² (in²))

1 kg = ? lbs

2.2

1 in = ? cm

2.54

what BMI is classified as underweight?

< 18.5

what BMI is classified as normal?

18.5 - 24.9

what BMI is classified as overweight?

25 - 29.9

what BMI is classified as obese?

30 - 39.9

what BMI is classified as morbidly obese?

> 40

asians generally have a ___ percentage of body fat than white people

higher

how to calculate the IBW for men?

IBW = 50 kg + (2.3 kg x every inch over 5 ft)

how to calculate the IBW for women?

IBW = 45.5 kg + (2.3 kg x every inch over 5 ft)

what are metabolic syndrome characteristics to look at?

waist circumference, HDL-cholesterol, serum triglyceride, serum glucose, blood pressure

a person with a BMI over __ cannot self-treat for obesity

40

to self-treat for obesity, patient must be how old?

between ages 18 and 65

what conditions are excluded for self-treatment of obesity?

pregnancy, breastfeeding, cardiovascular disease, hypertension, diabetes, dyslipidemia, eating disorders

HG is a 48 year old male, he is 5’9” and weighs 170 lbs. what is HG’s BMI and IBW?

BMI is 25.1, IBW is 156 lbs

when do you use medications for obesity?

BMI 30+, BMI 27+ with concomitant diseases/risk factors, used as adjunct to diet and physical activity, used at lowest effective dose

what concomitant diseases/risk factors are important to consider for medication treatment of obesity if they also have a BMI of 27+?

diabetes, hypertension, dyslipidemia

what is the MOA of orlistat?

blocks gastric and pancreatic lipases, which prevents breakdown and absorption of dietary fats

what does orlistat cause?

decreases in weight (5-10 lbs in 6 months), LDL, and BP

what are the criteria for Xenical (prescription)?

12+ years old, BMI 30+ or BMI 27+ with risk factos

what is the dosing for Xenical?

120 mg PO TID with meals

what is the efficacy of Xenical in comparison to Alli?

Xenical decreases fat absorption by 30% while Alli has no published studies

what are the criteria for Alli (non-prescription)?

18+ years old (for overweight adults), BMI 25+?

what is the dosing of Alli?

60 mg PO TID with meals

what are adverse effects of orlistat?

heacache, GI (flatulance, oily spotting, loose stools, fatty stools, fecal urgency), severe liver injury

who to avoid orlistat in?

thyroid disease, cholelithiasis, nephrolithiasis, pancreatitis, pregnancy

what are the contraindications for orlistat?

malabsorption syndrome, cholestasis

what are some important counseling points for orlistat?

supplement to lifestyle modification, more carbohydrates and less fat, recommend taking with multivitamin, drug interactions due to decreased absorption

what are the key to success for weightloss?

diet and exercise