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Exam (elaborations)

CSOWM QUESTIONS AND ANSWERS 2024/2025

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Management of BMI >/= 25  Diet, Exercise, Behavior Management of BMI >/=30  Diet, exercise, behavior + pharmacotherapy Management of BMI >/= 27 + comorbidity  Diet, exercise, behavior + pharmacotherapy Management of BMI >/=35 + cormorbidity  Bariatric surgery Managem...

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  • October 8, 2024
  • 39
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CSOWM
  • CSOWM
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CSOWM QUESTIONS AND ANSWERS
2024/2025
Management of BMI >/= 25

 Diet, Exercise, Behavior


Management of BMI >/=30

 Diet, exercise, behavior + pharmacotherapy


Management of BMI >/= 27 + comorbidity

 Diet, exercise, behavior + pharmacotherapy


Management of BMI >/=35 + cormorbidity

 Bariatric surgery


Management of BMI >/=40


 Bariatric surgery


Co-morbidities

 T2DM
HTN

OSA and other respiratory disorders

NAFLD

OA

lipid abnormalities


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gastrointestinal disorders

heart disease




Medication assessment


 Every month x3 months, then every 3 months


Effective weight loss %

 >/=5% in 3 months


Avoid these wt loss meds with HTN/HD

 Sympathomimetics (phentermine/diethylproprion)


Avoid these wt loss medications with CVD


 Sypathomimetics


T2DM treatment + medications to support weight loss

 GLP-1 analog (mitigates associated weight gain due to insulin) or SGLT-2 inhibitors +
metformin. If using insulin, recommend basal instead of combo


Drugs that induce weight gain

 Tricyclic antidepressants (Amitriptyline)
oral contraceptives (Ortho Tri-Cyclen, Yaz)

antipsychotics (Risperidone)

anticonvulsants

glucocorticoids (cortisol)

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sulfonyureas- ( Glimepiride, Glipizide)

glitazones (Actos)

B-blockers (Propranolol, Metoprolol, Atenolol)




Hormonal signals for appetite

 CCK- duodenum
K cells- duodenum and jejunum: gatric inhibitory polypeptide

PYY- ileum and colon

GLP-1 -ileum




Pancreas- Insulin




Adipose tissue: Leptin




Liver- glucagon




GLP-1


 Secreted in response to glucose and promotes insulin release from pancreas and
satiety


Ghrelin

 produced in the stomach, orexigenic



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Leptin

 proportional to fat mass, anorexigenic


Inhibits appetite




PYY

 Ileum and colon, anorexigenic


CCK


 duodenum, anorexigenic


Insulin

 Pancreas, anorexigenic


Phentermine

 noradrenergic, dopaminergic sympathomimetic amine


Start with 7.5-15mg/d, increase only with no results




Do not prescribe for someone with hx of psych dz or substance abuse




Lorcaserin (Belviq)

 Seratonin agent, stimulates seratonin type 2 receptor



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