CMS200 - Wk 2

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Questions and Answers

What is a primary method used to classify obesity?

Air displacement plethysmography (ADP)

Body mass index (BMI) (correct)

Waist-to-hip circumference measurement

Skinfold thickness measurement

Which of the following factors does NOT contribute to the increase in obesity prevalence?

Cultural influences

Genetic influences

Environmental influences

Rapid weight loss diets (correct)

What condition is NOT typically associated with obesity?

Sleep apnea

Hypertension

Heart disease

Anemia (correct)

Which of the following measurement tools can also be used for assessing body fat besides BMI?

Dual-energy x-ray absorptiometry (DXA) Signup and view all the answers

What is the effect of obesity on health-related quality of life?

It can deteriorate health-related quality of life. Signup and view all the answers

What is the BMI classification for Class I obesity?

30 - 34.9 Signup and view all the answers

Which of the following is a limitation of using BMI as an assessment tool?

It does not differentiate between fat mass and fat-free mass. Signup and view all the answers

What is the sensitivity for detecting obesity in women using BMI?

51.4 Signup and view all the answers

What measurement indicates central adiposity in adults?

Waist circumference Signup and view all the answers

Which group is noted as having a different obesity cut-off for BMI, specifically using 25 kg/m2?

Asian populations Signup and view all the answers

What waist circumference measurement is associated with increased cardiometabolic risk in women?

88 cm Signup and view all the answers

What is the waist-to-hip ratio (WHR) cutoff for obesity in men?

<blockquote> 1.0 </blockquote> Signup and view all the answers

Which anthropometric measure provides a gold standard for body fat assessment?

Dual Energy X-ray Absorptiometry (DXA) Signup and view all the answers

According to sensitivity data, which measure shows the highest sensitivity for diagnosing obesity in women?

Bioelectric Impedance Analysis (BIA) Signup and view all the answers

What is a significant limitation of Dual Energy X-ray Absorptiometry (DXA)?

Limited use for BMI ≥ 35 Signup and view all the answers

Which of the following is a limitation of using skinfold thickness as a measure?

Requires significant calibration Signup and view all the answers

What waist circumference measurement indicates obesity in men?

102 cm Signup and view all the answers

Which factor can reduce the accuracy of Bioelectric Impedance Analysis (BIA)?

Poor hydration status Signup and view all the answers

What WHR indicates obesity in women?

<blockquote> 0.85 </blockquote> Signup and view all the answers

What is the sensitivity range for diagnosing obesity in women using WHR?

34 - 92 Signup and view all the answers

Study Notes

Overview

Obesity is a chronic, multifactorial condition characterized by an excess and abnormal accumulation of body fat.
It's a significant health risk factor.
Body Mass Index (BMI) is a common tool for measuring obesity.
Other anthropometric tools include waist circumference, waist-to-hip ratio, skin fold thickness, dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and air displacement plethysmography (ADP).

BMI

BMI is calculated by dividing weight in kilograms by height in meters squared.
Online calculators are available.
Obesity is defined as a BMI of 30 kg/m2 or higher, categorized into:
- Class I: 30-34.9 kg/m2
- Class II: 35-39.9 kg/m2
- Class III: 40 or higher

Waist Circumference

Measures central adiposity, often referred to as abdominal obesity.
Cutoff values:
- Men: > 40 inches (> 102 cm)
- Women: > 35 inches (> 88 cm)

Waist-to-Hip Ratio (WHR)

Calculated by dividing waist circumference by hip circumference.
Provides information about body fat distribution.
Cutoff values:
- Men: > 1.0
- Women: > 0.85

Other Anthropometric Measures

Dual-energy X-ray absorptiometry (DXA): Considered the gold standard for body fat assessment, but expensive and uses radiation.
Bioelectrical impedance analysis (BIA): Relatively inexpensive and portable, but accuracy can be affected by hydration status.
Skinfold thickness: Convenient and inexpensive, but less accurate than other methods.

Physical Examination

Assess BMI, degree, and distribution of body fat.

Birth Outcomes for Mothers with Obesity

Increased risk of pregnancy loss (25-37% higher)
Increased risk of stillbirth (1.7X for class I obesity, 2X for class II, 2.5X for class III)
Increased risk of congenital abnormalities (e.g., 7% increased risk of neural tube defects)
Increased risk of macrosomia (large for gestational age baby)

Offspring Outcomes

Children of obese mothers are at an increased risk of developing obesity and metabolic disorders in childhood and adulthood.
Increased risk of neurodevelopmental concerns (e.g., Autism Spectrum Disorder) and asthma.

Breastfeeding

Obese mothers are 13% less likely to initiate breastfeeding and have shorter durations.

Recommended Weight Gain In Pregnancy

Based on pre-pregnancy BMI.
Recommended total weight gain and average weekly weight gain:
- BMI < 18.5: 12.5-18 kg (28-40 lbs), 0.5 kg (1.0 lb) per week
- BMI 18.5-24.9: 11.5-16 kg (25-35 lbs), 0.4 kg (1.0 lb) per week
- BMI 25.0-29.9: 7-11.5 kg (15-25 lbs), 0.3 kg (0.6 lb) per week
- BMi ≥ 30: 5-9 kg (11-20 lbs), 0.2 kg (0.5 lb) per week

Menopause and Weight Gain

Characterized by permanent cessation of menses for at least 12 months.
Alters body composition, leading to modest weight gain and increased body fat (visceral and central abdominal fat most significantly increased).
Reduced energy expenditure due to decreased spontaneous activity and lean body mass.
Increased risk of depression, which can lead to increased food intake and decreased physical activity.
Menopausal women are 3 times more likely to develop obesity and metabolic syndrome abnormalities than premenopausal women (20% gain ≥ 9.9 lbs during a 3-year period).

Medications Associated with Weight Gain

Anti-diabetics: Insulin, meglitinides, sulfonylureas, thiazolidinediones.
Anti-hypertensives: Alpha-adrenergic blockers, Beta-adrenergic blockers (atenolol, metoprolol, nadolol, propranolol).
Anti-depressants: Lithium, MAO inhibitors, mirtazapine, SNRIs (duloxetine, venlafaxine), SSRIs (citalopram, paroxetine), TCAs (amitriptyline, desipramine, dosepin, imipramine, nortiptyline).
Anti-psychotics: Clozapine, haloperidol, olanzapine, quetiapine, risperidone.
Anti-epileptics: Carbamazepine, gabapentin, pregabalin, valproic acid.
Contraceptives: Medroxyprogesterone acetate.
Anti-histamines: First-generation antihistamines (e.g., chlorpheniramine, diphenhydramine, promethazine).

Edmonton Obesity Staging System (EOSS)

Classifies obesity severity based on BMI and health-related factors.
Increasing stages are associated with increased risk of complications, mortality, and C-section rates.

Other Care Considerations

Leading cause of chronic conditions.
1 in 10 premature deaths are estimated to be attributable to obesity.
Associated with physical and mental health conditions (sleep disorders, anxiety, depression, eating disorders, and serious psychiatric disorders).
Social stigma and inequities in access to employment and education contribute to healthcare challenges.

Patient Education:

Obesity is associated with increased mortality due to comorbidities like type 2 diabetes, heart disease, depression, liver disease, sleep apnea, osteoarthritis, certain cancers, etc.

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Description

Test your knowledge on the various methods for measuring obesity, including Body Mass Index (BMI), waist circumference, and waist-to-hip ratio. This quiz covers the definitions, cutoffs, and classifications related to obesity and its health risks. Enhance your understanding of these key anthropometric tools in managing weight healthily.