Complications and Management of Obesity

Abdominal obesity

Fat deposited around abdominal organs, more metabolically active fat - pro inflammatory adipokines, released free fatty acids into hepatic portal vein = increased lipids and insulin resistance

Complications of obesity

Cardiovascular disease, type ii diabetes, sleep apnoea, psychological issues, musculoskeletal condition, cancers

Management of condition

Discuss lifestyle, surgical and pharmacological options, review of current medications, exercise and mental health

Practical suggestions for lifestyle modifications

Online exercise program including meal plan, including family, reducing stress and sharing of load, financial cost of unhealthy habits

Management - lifestyle

Minimal complications associated with this, dietary therapy aiming to reduce calorie intake, physical activity, behaviour modification, treating underlying conditions and reviewing meds, must be sustainable and practical for patient 

Management - surgical approach

Bariatric surgery = substantial permanent weight loss, has complications, appropriate for patients with bmi of 40 or greater, or bmi of 35 with another obesity related condition

Surgical approach - restrictive

Reducing physical capacity of person to take food - reduce stomach size

Surgical approach - malabsorptive

Decreasing functional length of small intestine to reduce nutrients being absorbed, complications with ensuring patient is still receiving enough nutrients

Management - pharmacological approach

Indicated for treating overweight or obese with at least one obesity related condition, involves drugs inhibiting nutrient absorption - glucagon like peptide one analogue and noradrenergic drug (associated with addictive properties)