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Nutritional Disorders
 
 

Obesity

 
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Overview

    • Classification

      Based on body mass index (BMI)
    • Underweight - <18.5
    • Normal - 18.5 - 24.9
    • Overweight - 25 - 29.9
    • Obese - 30 - 34.9
    • Severely obese - 35 - 39.9
    • Morbidly obese - 40+
  •  
    BMI Calculator

Manifestations

    • Conditions Associated with Obesity

    • Metabolic syndrome - type 2 diabetes mellitus, hypertension, hyperlipidaemia
    • Ischaemic heart disease (IHD)
    • Stroke
    • Respiratory - obstructive sleep apnoea, asthma
    • Gastrointestinal - reflux, cholelithiasis, non-alcoholic fatty liver disease (NAFLD)
    • Polycystic ovarian syndrome (PCOS)
    • Osteoarthritis
    • Varicose veins
    • Gout

Management of Obesity

    • Management Options

    • Non-Pharmacologic

    • Diet - very low calorie; in conjunction with a dietician
    • Exercise - increase incidental exercise and reduce sedentary time; consider exercise classes involving a physiotherapist
    • Pharmacologic

    • Orlistat - an intestinal lipase inhibitor (essentially cases steatorrhoea)
    • Phentermine (Duramine) - an appetite suppressant
    • Naltrexone + buproprion (Contrave)
    • Surgical

    • Restrictive - gastric banding, sleeve gastrectomy
    • Malabsorptive - Roux-en-Y gastric bypass
    • Pearls

    • Set realistic weight loss goals (e.g. 5-10%)
    • Aim to improve comorbid conditions, such as diabetes
    • Use non-pharmacologic and pharmacologic strategies
 
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