General Medicine - Energetic conversion of nutrients, ATP
10 important questions on General Medicine - Energetic conversion of nutrients, ATP
How is obesity assessed?
overweight: >= 25
obesity: >= 30
Not always correct because a very muscular person could be heavy, but low body fatness, which isn't unhealthy.
Distribution of body fat is a measure for health. Abdominal body fat is unhealthier than fat on the thighs and buttocks. So, a waist-to-hip ratio can be used to assess body fatness.
obesity in men: >1, obesity in women: >0.9
Definition of overweight and obesity in children below 5yrs =
- Weight-for-height grwoth standards > 2 SD above the WHO growth reference median = overweight
- weight-for-height growth standards > 3 SD above the WHO grwoth reference median = obese
Definition overweight and obesity for children aged 5-19yrs =
- BMI-for-age > 1 SD above the WHO growth reference median = overweight
- BMI-for-age > 2 SD above the WHO growth reference median = obese
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Obesity is a major risk factor for non-communicable diseases such as...
- Cardiovascular diseases (mainlu heart disease and stroke), which were the leading cause of death in 2012
- diabetes
- musculoskeletal disorders (especially osteoarthritis, a highly disabling degenerative disease of the joints)
- some cancers (including endometrial, breast, ovarian, prostate, liver, gallbladder, kidney and colon)
The risk for these diseases increase with increased BMI. Other health consequences are depression, anxiety, gallstones, varicose veins, menstrual abnormalities, hyperlipidaemia, increased morbidity and mortality.
What is bariatric surgery?
If the stomach is removed from the duodenum and reattached to the jejunum/ileum, it decreases the amount of absorption that can occur from the foods we eat.
What are the criteria which should be met to be eligible for bariatric surgery?
- Severely obese or have medical condition related to being obese + BMI > 40 without comorbidities or BMI > 35 with comorbidities
- Patient needs to have tried to lose weight in other ways (e.g., healthy eating, dieting, exercising, attempt to other lifestyle change)
- Patient will need to attent classes to understant how the body will react to the surgery, and how they need to make lifestyle changes so the surgery will be effective
What are different deficiencies that can occur before and after the surgery? And how to solve them:
After surgery, lifestyle changes are needed to avoid certain foods, eat limited quantities and regular exercise. And patients need to take: folic acid, vit B12, vit D and iron.
3 different types of bariatric surgical procedures:
- Adjustable Gastric Band
- Gastric Bypass
- Vertical Sleeve Gastrectomy
Adjustable Gastric Band =
Vertical Sleeve Gastrectomy =
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