CSOWM QUESTIONS & CORRECT
SOLUTIONS
Management of BMI >/= 25 - ANSWERDiet, Exercise, Behavior
Management of BMI >/=30 - ANSWERDiet, exercise, behavior + pharmacotherapy
Management of BMI >/= 27 + comorbidity - ANSWERDiet, exercise, behavior +
pharmacotherapy
Management of BMI >/=35 + cormorbidity - ANSWERBariatric surgery
Management of BMI >/=40 - ANSWERBariatric surgery
Co-morbidities - ANSWERT2DM
HTN
OSA and other respiratory disorders
NAFLD
OA
lipid abnormalities
gastrointestinal disorders
heart disease
Medication assessment - ANSWEREvery month x3 months, then every 3 months
Effective weight loss % - ANSWER>/=5% in 3 months
Avoid these wt loss meds with HTN/HD - ANSWERSympathomimetics
(phentermine/diethylproprion)
Avoid these wt loss medications with CVD - ANSWERSypathomimetics
T2DM treatment + medications to support weight loss - ANSWERGLP-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 - ANSWERTricyclic antidepressants (Amitriptyline)
oral contraceptives (Ortho Tri-Cyclen, Yaz)
antipsychotics (Risperidone)
anticonvulsants
glucocorticoids (cortisol)
sulfonyureas- ( Glimepiride, Glipizide)
glitazones (Actos)
B-blockers (Propranolol, Metoprolol, Atenolol)
,Hormonal signals for appetite - ANSWERCCK- 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 - ANSWERSecreted in response to glucose and promotes insulin release from
pancreas and satiety
Ghrelin - ANSWERproduced in the stomach, orexigenic
Leptin - ANSWERproportional to fat mass, anorexigenic
Inhibits appetite
PYY - ANSWERIleum and colon, anorexigenic
CCK - ANSWERduodenum, anorexigenic
Insulin - ANSWERPancreas, anorexigenic
Phentermine - ANSWERnoradrenergic, 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) - ANSWERSeratonin agent, stimulates seratonin type 2 receptor
Brand name: Phentermine/Topiramate - ANSWERQysemia
Phentermine/Topiramate (Qysemia) - ANSWERPhentermine- stimulant
Topiramate- neurostabilizer + antiseizure
Bupropion (Wellbutrin) - ANSWERDopamine + norepinepherine reuptake inhibitor
Stimulates POMC neurons
Sibutramine (Meridia) - ANSWERDiscontinued-
, Norepinephrine, Serotonin, and Dopamine Reuptake Inhibitor Anorectic
Approved for use in adolescents >/=16
Orlistat - ANSWERblocks absorption of 25-30% of fat calories
SLGT-2 inhibitors (best for T2DM patients)- ex. Invokana - ANSWERpromote weight
loss by preventing the reabsorption of glucose as well as water
Band name: Victoza/Sandexa - ANSWERLiraglutide
Liraglutide (Victoza/Sandexa) - ANSWERInjectable, long acting GLP-1 receptor agonist
Diethylpropion - ANSWERAnorexiants, Sympathomimetic Amine Anorectic
Cautions with use of Phentermine and Diethylpropion - ANSWERmay elevate mean BP
and pulse
Do not use with pts. with hx of CVD
Monitor patient with HTN
Caution with: HTN, cardiac arrhythemia, seizures
Better choice: Lorcaserin (Seratonin receptor angonist)
cautions with Obese patients on SSRI/SNRI - ANSWERDo not use LORCASERIN
(seratonin syndrome)
Better choice- phentermine/topiramate (Qysemia) or phentermine alone or Orlistat
Appetite suppressant to avoid before/during pregnancy - ANSWERTopiramate
Medication recs for CVD - ANSWERLorcacserin or Orlistat
Behavioral treatment of Obesity - ANSWERWeekly: 4-6 months, then bi-weekly
Group: 10-15 participants
60-90 minutes
Private measurements of weight
Participants provide brief report of his/her success with goals
SOLUTIONS
Management of BMI >/= 25 - ANSWERDiet, Exercise, Behavior
Management of BMI >/=30 - ANSWERDiet, exercise, behavior + pharmacotherapy
Management of BMI >/= 27 + comorbidity - ANSWERDiet, exercise, behavior +
pharmacotherapy
Management of BMI >/=35 + cormorbidity - ANSWERBariatric surgery
Management of BMI >/=40 - ANSWERBariatric surgery
Co-morbidities - ANSWERT2DM
HTN
OSA and other respiratory disorders
NAFLD
OA
lipid abnormalities
gastrointestinal disorders
heart disease
Medication assessment - ANSWEREvery month x3 months, then every 3 months
Effective weight loss % - ANSWER>/=5% in 3 months
Avoid these wt loss meds with HTN/HD - ANSWERSympathomimetics
(phentermine/diethylproprion)
Avoid these wt loss medications with CVD - ANSWERSypathomimetics
T2DM treatment + medications to support weight loss - ANSWERGLP-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 - ANSWERTricyclic antidepressants (Amitriptyline)
oral contraceptives (Ortho Tri-Cyclen, Yaz)
antipsychotics (Risperidone)
anticonvulsants
glucocorticoids (cortisol)
sulfonyureas- ( Glimepiride, Glipizide)
glitazones (Actos)
B-blockers (Propranolol, Metoprolol, Atenolol)
,Hormonal signals for appetite - ANSWERCCK- 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 - ANSWERSecreted in response to glucose and promotes insulin release from
pancreas and satiety
Ghrelin - ANSWERproduced in the stomach, orexigenic
Leptin - ANSWERproportional to fat mass, anorexigenic
Inhibits appetite
PYY - ANSWERIleum and colon, anorexigenic
CCK - ANSWERduodenum, anorexigenic
Insulin - ANSWERPancreas, anorexigenic
Phentermine - ANSWERnoradrenergic, 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) - ANSWERSeratonin agent, stimulates seratonin type 2 receptor
Brand name: Phentermine/Topiramate - ANSWERQysemia
Phentermine/Topiramate (Qysemia) - ANSWERPhentermine- stimulant
Topiramate- neurostabilizer + antiseizure
Bupropion (Wellbutrin) - ANSWERDopamine + norepinepherine reuptake inhibitor
Stimulates POMC neurons
Sibutramine (Meridia) - ANSWERDiscontinued-
, Norepinephrine, Serotonin, and Dopamine Reuptake Inhibitor Anorectic
Approved for use in adolescents >/=16
Orlistat - ANSWERblocks absorption of 25-30% of fat calories
SLGT-2 inhibitors (best for T2DM patients)- ex. Invokana - ANSWERpromote weight
loss by preventing the reabsorption of glucose as well as water
Band name: Victoza/Sandexa - ANSWERLiraglutide
Liraglutide (Victoza/Sandexa) - ANSWERInjectable, long acting GLP-1 receptor agonist
Diethylpropion - ANSWERAnorexiants, Sympathomimetic Amine Anorectic
Cautions with use of Phentermine and Diethylpropion - ANSWERmay elevate mean BP
and pulse
Do not use with pts. with hx of CVD
Monitor patient with HTN
Caution with: HTN, cardiac arrhythemia, seizures
Better choice: Lorcaserin (Seratonin receptor angonist)
cautions with Obese patients on SSRI/SNRI - ANSWERDo not use LORCASERIN
(seratonin syndrome)
Better choice- phentermine/topiramate (Qysemia) or phentermine alone or Orlistat
Appetite suppressant to avoid before/during pregnancy - ANSWERTopiramate
Medication recs for CVD - ANSWERLorcacserin or Orlistat
Behavioral treatment of Obesity - ANSWERWeekly: 4-6 months, then bi-weekly
Group: 10-15 participants
60-90 minutes
Private measurements of weight
Participants provide brief report of his/her success with goals
