Health Questions and Answers

Archive for the 'Obesity' Category

Question: What medications are used for the treatment of obesity?

Friday, May 16th, 2008

Answer:
Phentermine, a norepinephrine agonist (15-30 mg/day)
Sibutramine, a combination norepinephrine/serotonin reuptake blocker (5, 10, and 15 mg; start with 10 mg and titrate)
Orlistat, a pancreatic lipase inhibitor (120 mg 3 times/day before meals)
Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, W.B. Saunders, 2003.

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Question: When should pharmacotherapy be considered for the treatment of obesity?

Friday, May 16th, 2008

Answer:
Typically, the first approach is diet and exercise with behavioral modifications followed by the addition of pharmacotherapy. Pharmacotherapy should be considered in patients with a BMI over 30, a BMI over 27 with comorbidities, or minimal response after 6 months of lifestyle modifications. 
Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, W.B. [...]

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Question: What are the general approach to treatment of obesity?

Thursday, May 15th, 2008

Answer:
Treatment must be individualized, and the patient’s goals must be discussed. Frequently, patients want a rapid, substantial weight loss. Unfortunately, this goal is usually not healthy or attainable in the patient’s desired time frame. Since 1 lb of fat stores approximately 3500 kcal, in order to lose 1 lb of weight per week, the person [...]

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Question: Who should be treated for obesity?

Wednesday, May 14th, 2008

Answer:
Obese people should be instructed about proper diet and exercise to prevent obesity-related complications. People with more severe obesity or those who already have obesity-related complications should be treated more aggressively.
Reference: Basa ALP, Afsharkharaghan H (Zollo A, ed): Endocrinology in Medical Secrets, 3rd ed. 2001.

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Question: What factors control energy homeostasis?

Sunday, May 11th, 2008

Answer:
Energy homeostasis is achieved by complex interactions between the brain and neural factors that control appetite and satiety, nutrient metabolism, and hormonal systems. Much research is currently being conducted in the neural mechanisms that regulate feeding and energy balance. Most evidence suggests that obese people do not have major alterations in their basal metabolic rates. [...]

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Question: What causes people to gain weight?

Sunday, May 11th, 2008

Answer:
Weight gain occurs when a person is not in energy balance. Weight maintenance occurs when people consume as many calories as they expend per day. Obesity occurs in the setting of increased caloric intake or decreased energy expenditure relative to caloric intake.
Reference: Larson PR, et al: Williams Textbook of Endocrinology, 10th ed. Philadelphia, W.B. Saunders, [...]

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Question: How common is obesity?

Saturday, May 10th, 2008

Answer:
Obesity is now thought to be one of the leading health disorders in the United States. Its prevalence has increased dramatically and it is now estimated that approximately one third of the U.S. population is obese (BMI > 30). The prevalence is higher in ethnic minorities and is rapidly increasing in children and adolescents.
Reference: Larson [...]

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