Obesity & Weight Loss Questions PDF

**Obesity & Weight Loss Questions** 1. **Question**: A 45-year-old male with a BMI of 32 presents to your clinic for weight loss consultation. He has no significant comorbidities. What is the most appropriate initial management?\ **Choices**:\ A. Bariatric surgery\ B. Initiate...

**Obesity & Weight Loss Questions** 1. **Question**: A 45-year-old male with a BMI of 32 presents to your clinic for weight loss consultation. He has no significant comorbidities. What is the most appropriate initial management?\ **Choices**:\ A. Bariatric surgery\ B. Initiate orlistat therapy\ C. Recommend comprehensive lifestyle interventions\ D. Start phentermine therapy\ **Correct Answer**: C\ **Explanation**: The first-line treatment for a patient with a BMI ≥30 without comorbidities is comprehensive lifestyle interventions, including dietary changes, physical activity, and behavioral therapy. 2. **Question**: Which medication is contraindicated in a patient with uncontrolled hypertension due to its sympathomimetic properties?\ **Choices**:\ A. Orlistat\ B. Liraglutide\ C. Phentermine\ D. Naltrexone/Bupropion\ **Correct Answer**: C\ **Explanation**: Phentermine is a sympathomimetic agent that can increase blood pressure and is contraindicated in patients with uncontrolled hypertension. 3. **Question**: A 50-year-old female with a BMI of 41 and type 2 diabetes has tried lifestyle modifications but struggles to lose weight. Which FDA-approved weight-loss medication is also effective for glycemic control in type 2 diabetes?\ **Choices**:\ A. Lorcaserin\ B. Liraglutide\ C. Naltrexone/Bupropion\ D. Orlistat\ **Correct Answer**: B\ **Explanation**: Liraglutide is a GLP-1 receptor agonist that promotes weight loss and improves glycemic control, making it suitable for patients with obesity and type 2 diabetes. 4. **Question**: What is the most common adverse effect associated with orlistat therapy?\ **Choices**:\ A. Hypertension\ B. Steatorrhea\ C. Tachycardia\ D. Nausea\ **Correct Answer**: B\ **Explanation**: Orlistat inhibits fat absorption, leading to gastrointestinal side effects such as steatorrhea and oily stool, particularly if dietary fat intake is high. 5. **Question**: A patient is started on naltrexone/bupropion for weight loss. What is a key contraindication to the use of this medication?\ **Choices**:\ A. Seizure disorder\ B. Type 2 diabetes\ C. Controlled hypertension\ D. History of smoking cessation\ **Correct Answer**: A\ **Explanation**: Naltrexone/bupropion is contraindicated in patients with a history of seizures because bupropion lowers the seizure threshold. 6. **Question**: What is the primary mechanism of action of phentermine in weight loss?\ **Choices**:\ A. Inhibiting fat absorption in the gastrointestinal tract\ B. Increasing norepinephrine release to suppress appetite\ C. Enhancing glucose-dependent insulin secretion\ D. Blocking dopamine reuptake\ **Correct Answer**: B\ **Explanation**: Phentermine is a sympathomimetic that increases norepinephrine release, suppressing appetite through central mechanisms. 7. **Question**: A 35-year-old female with a BMI of 39 is considering bariatric surgery. What is a key indication for bariatric surgery in this patient?\ **Choices**:\ A. Lack of interest in lifestyle changes\ B. Presence of comorbidities such as type 2 diabetes\ C. Previous history of depression\ D. BMI of 30-34 with no other conditions\ **Correct Answer**: B\ **Explanation**: Bariatric surgery is indicated for patients with a BMI ≥40 or ≥35 with comorbidities such as type 2 diabetes, hypertension, or sleep apnea. 8. **Question**: What should patients taking orlistat be counseled on regarding dietary adjustments?\ **Choices**:\ A. Increase fat intake to prevent deficiencies.\ B. Maintain a diet with less than 30% of calories from fat.\ C. Avoid all carbohydrates.\ D. Take orlistat only at bedtime.\ **Correct Answer**: B\ **Explanation**: Patients on orlistat should limit fat intake to reduce gastrointestinal side effects and ensure adequate absorption of fat-soluble vitamins. 9. **Question**: A patient with a BMI of 35 with obesity-related sleep apnea asks about weight-loss medications. Which would be the most appropriate first-line option?\ **Choices**:\ A. Orlistat\ B. Liraglutide\ C. Phentermine\ D. Metformin\ **Correct Answer**: B\ **Explanation**: Liraglutide is FDA-approved for weight loss in patients with a BMI ≥30 or ≥27 with comorbidities, such as sleep apnea. 10. **Question**: What is a unique mechanism of action of naltrexone in the combination medication naltrexone/bupropion for weight management?\ **Choices**:\ A. Enhances serotonin release.\ B. Acts as an opioid receptor antagonist.\ C. Inhibits fat absorption.\ D. Stimulates beta-adrenergic receptors.\ **Correct Answer**: B\ **Explanation**: Naltrexone is an opioid receptor antagonist that, when combined with bupropion, helps regulate appetite and cravings through the central nervous system. **11.**\ **Question**: A patient with a BMI of 31 has hypertension and is seeking weight loss treatment. Which medication would you avoid?\ **Choices**:\ A. Orlistat\ B. Liraglutide\ C. Phentermine\ D. Naltrexone/Bupropion\ **Correct Answer**: C\ **Explanation**: Phentermine is contraindicated in uncontrolled hypertension because it can increase blood pressure. **12.**\ **Question**: A 50-year-old patient is started on liraglutide for weight loss. What is the most common adverse effect of this medication?\ **Choices**:\ A. Pancreatitis\ B. Nausea\ C. Diarrhea\ D. Weight gain\ **Correct Answer**: B\ **Explanation**: Nausea is a common adverse effect of liraglutide, especially during dose titration. **13.**\ **Question**: Which of the following is an advantage of orlistat therapy in weight management?\ **Choices**:\ A. It improves glycemic control.\ B. It is available over-the-counter.\ C. It reduces appetite through central mechanisms.\ D. It is free of gastrointestinal side effects.\ **Correct Answer**: B\ **Explanation**: Orlistat is the only FDA-approved over-the-counter weight loss medication. **14.**\ **Question**: A 60-year-old male with type 2 diabetes is initiated on liraglutide. What other benefit, aside from weight loss, does this medication provide?\ **Choices**:\ A. Improved lipid profile\ B. Reduction in cardiovascular events\ C. Increased energy expenditure\ D. Enhanced satiety without glycemic benefits\ **Correct Answer**: B\ **Explanation**: Liraglutide has been shown to reduce cardiovascular events in patients with type 2 diabetes. **15.**\ **Question**: Which medication requires supplementation with fat-soluble vitamins due to its mechanism of action?\ **Choices**:\ A. Liraglutide\ B. Phentermine\ C. Orlistat\ D. Naltrexone/Bupropion\ **Correct Answer**: C\ **Explanation**: Orlistat inhibits fat absorption, which can lead to deficiencies in vitamins A, D, E, and K. **16.**\ **Question**: A patient with a BMI of 29 and comorbid hypertension is interested in starting weight-loss medication. What is the most appropriate recommendation?\ **Choices**:\ A. Recommend lifestyle modifications.\ B. Prescribe phentermine.\ C. Suggest bariatric surgery.\ D. Start orlistat.\ **Correct Answer**: A\ **Explanation**: Medications are typically reserved for patients with a BMI ≥30 or ≥27 with comorbidities. Lifestyle modifications are first-line for a BMI of 29. **17.**\ **Question**: What is the mechanism of action of naltrexone in combination with bupropion for weight loss?\ **Choices**:\ A. Enhances satiety through serotonin pathways.\ B. Acts as an opioid receptor antagonist to reduce cravings.\ C. Inhibits norepinephrine reuptake to increase energy.\ D. Reduces fat absorption in the gastrointestinal tract.\ **Correct Answer**: B\ **Explanation**: Naltrexone is an opioid receptor antagonist that helps regulate appetite and cravings. **18.**\ **Question**: A 35-year-old female with a history of seizure disorder is seeking weight-loss therapy. Which medication is contraindicated in this patient?\ **Choices**:\ A. Phentermine\ B. Liraglutide\ C. Orlistat\ D. Naltrexone/Bupropion\ **Correct Answer**: D\ **Explanation**: Naltrexone/bupropion is contraindicated in patients with a history of seizure disorders due to its seizure threshold-lowering effect. **19.**\ **Question**: Which medication is approved for weight management and can also be used in prediabetes or type 2 diabetes?\ **Choices**:\ A. Phentermine\ B. Orlistat\ C. Liraglutide\ D. Naltrexone/Bupropion\ **Correct Answer**: C\ **Explanation**: Liraglutide is effective for weight loss and improves glycemic control in patients with prediabetes or type 2 diabetes. **20.**\ **Question**: A patient has lost 5% of their baseline weight after 12 weeks on phentermine. What is the next best step?\ **Choices**:\ A. Increase the dose.\ B. Discontinue therapy.\ C. Continue therapy as is.\ D. Switch to liraglutide.\ **Correct Answer**: C\ **Explanation**: A weight loss of 5% or more at 12 weeks indicates effective therapy, and treatment can be continued. **21.**\ **Question**: A patient with a BMI of 36 and severe obstructive sleep apnea has failed to lose weight despite lifestyle modifications and pharmacotherapy. What is the most appropriate next step?\ **Choices**:\ A. Repeat pharmacotherapy with orlistat.\ B. Consider bariatric surgery.\ C. Initiate a very low-calorie diet.\ D. Refer to a pulmonologist for CPAP therapy only.\ **Correct Answer**: B\ **Explanation**: Bariatric surgery is indicated for patients with a BMI ≥40 or ≥35 with comorbidities who have failed conservative treatments. **22.**\ **Question**: What is the primary mechanism by which phentermine promotes weight loss?\ **Choices**:\ A. Suppressing appetite via norepinephrine release.\ B. Enhancing insulin sensitivity.\ C. Inhibiting fat absorption in the gastrointestinal tract.\ D. Reducing gastric emptying.\ **Correct Answer**: A\ **Explanation**: Phentermine increases norepinephrine release in the hypothalamus, leading to appetite suppression. **23.**\ **Question**: A patient on naltrexone/bupropion reports persistent nausea. What should you recommend?\ **Choices**:\ A. Discontinue the medication.\ B. Adjust the dose or titrate more slowly.\ C. Switch to phentermine.\ D. Add an antiemetic.\ **Correct Answer**: B\ **Explanation**: Nausea is a common side effect during titration of naltrexone/bupropion and can often be managed with dose adjustments. **24.**\ **Question**: Which of the following is a contraindication for liraglutide therapy in weight management?\ **Choices**:\ A. Personal or family history of medullary thyroid carcinoma.\ B. Type 2 diabetes.\ C. Controlled hypertension.\ D. Obstructive sleep apnea.\ **Correct Answer**: A\ **Explanation**: Liraglutide is contraindicated in patients with a history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2. **25.**\ **Question**: Which weight-loss medication is most associated with flatulence and oily stools?\ **Choices**:\ A. Liraglutide\ B. Naltrexone/Bupropion\ C. Orlistat\ D. Phentermine\ **Correct Answer**: C\ **Explanation**: Orlistat inhibits fat absorption, leading to gastrointestinal side effects such as steatorrhea and oily stools. **26.**\ **Question**: A patient with obesity and well-controlled depression is interested in weight-loss therapy. Which medication should be avoided?\ **Choices**:\ A. Liraglutide\ B. Orlistat\ C. Phentermine\ D. Naltrexone/Bupropion\ **Correct Answer**: D\ **Explanation**: Naltrexone/bupropion can exacerbate mood disorders and is relatively contraindicated in patients with depression. **27.**\ **Question**: A 40-year-old patient on phentermine presents with insomnia. What is the best recommendation?\ **Choices**:\ A. Switch to orlistat.\ B. Advise the patient to take the medication earlier in the day.\ C. Reduce the dose of phentermine.\ D. Discontinue phentermine immediately.\ **Correct Answer**: B\ **Explanation**: Taking phentermine earlier in the day may mitigate insomnia caused by its stimulant effects. **28.**\ **Question**: Which of the following weight-loss medications is approved for long-term use?\ **Choices**:\ A. Phentermine\ B. Orlistat\ C. Lorcaserin\ D. Methamphetamine\ **Correct Answer**: B\ **Explanation**: Orlistat is one of the few weight-loss medications approved for long-term use. Phentermine is approved for short-term use only. **29.**\ **Question**: A patient with a BMI of 42 asks about dietary options to improve weight loss. Which of the following is recommended?\ **Choices**:\ A. Low-fat diet\ B. Low-carbohydrate diet\ C. High-protein, calorie-restricted diet\ D. All of the above\ **Correct Answer**: D\ **Explanation**: Multiple dietary approaches (low-fat, low-carbohydrate, high-protein) can be effective as long as they create a caloric deficit. **30.**\ **Question**: What is the most common adverse effect of naltrexone/bupropion therapy?\ **Choices**:\ A. Seizures\ B. Insomnia\ C. Nausea\ D. Weight gain\ **Correct Answer**: C\ **Explanation**: Nausea is the most common adverse effect of naltrexone/bupropion, especially during dose titration. **31.**\ **Question**: A patient asks if phentermine can be used long-term for weight loss. What is the correct response?\ **Choices**:\ A. Yes, phentermine is approved for long-term use.\ B. No, phentermine is approved only for short-term use.\ C. It depends on the dose prescribed.\ D. Phentermine use is contraindicated in all patients.\ **Correct Answer**: B\ **Explanation**: Phentermine is approved for short-term use only, typically for up to 12 weeks. **32.**\ **Question**: Which medication has dual indications for weight loss and glycemic control in type 2 diabetes?\ **Choices**:\ A. Naltrexone/Bupropion\ B. Orlistat\ C. Liraglutide\ D. Phentermine\ **Correct Answer**: C\ **Explanation**: Liraglutide, a GLP-1 receptor agonist, is indicated for both weight loss and glycemic control in type 2 diabetes. **33.**\ **Question**: Which medication combination works by targeting the brain\'s reward system and appetite regulation?\ **Choices**:\ A. Phentermine/Topiramate\ B. Liraglutide/Metformin\ C. Naltrexone/Bupropion\ D. Orlistat/Calcium\ **Correct Answer**: C\ **Explanation**: Naltrexone/bupropion acts on the brain\'s reward system and appetite centers to reduce cravings and control hunger. **34.**\ **Question**: What is the primary contraindication to orlistat therapy?\ **Choices**:\ A. Renal disease\ B. Malabsorption syndromes\ C. Hypertension\ D. Depression\ **Correct Answer**: B\ **Explanation**: Orlistat is contraindicated in patients with chronic malabsorption syndromes due to its mechanism of action. **35.**\ **Question**: A patient on liraglutide for weight loss reports severe abdominal pain and nausea. What is the next step?\ **Choices**:\ A. Decrease the dose of liraglutide.\ B. Discontinue liraglutide immediately and evaluate for pancreatitis.\ C. Switch to orlistat.\ D. Add a proton pump inhibitor.\ **Correct Answer**: B\ **Explanation**: Severe abdominal pain with liraglutide may indicate pancreatitis, which requires discontinuation and further evaluation. **36.**\ **Question**: Which medication may cause oily spotting or steatorrhea, especially if dietary fat intake is not restricted?\ **Choices**:\ A. Orlistat\ B. Phentermine\ C. Liraglutide\ D. Naltrexone/Bupropion\ **Correct Answer**: A\ **Explanation**: Orlistat inhibits fat absorption, leading to oily spotting and steatorrhea if dietary fat is high. **37.**\ **Question**: Which weight-loss medication acts as a GLP-1 receptor agonist?\ **Choices**:\ A. Liraglutide\ B. Phentermine\ C. Naltrexone/Bupropion\ D. Orlistat\ **Correct Answer**: A\ **Explanation**: Liraglutide is a GLP-1 receptor agonist that promotes weight loss by delaying gastric emptying and reducing appetite. **38.**\ **Question**: What is a key monitoring parameter for patients taking phentermine?\ **Choices**:\ A. Serum creatinine\ B. Blood pressure\ C. Serum electrolytes\ D. Liver function tests\ **Correct Answer**: B\ **Explanation**: Blood pressure should be monitored regularly in patients taking phentermine due to its potential hypertensive effects. **39.**\ **Question**: What is a unique property of orlistat compared to other weight-loss medications?\ **Choices**:\ A. It suppresses appetite.\ B. It inhibits fat absorption.\ C. It acts on dopamine receptors.\ D. It improves glycemic control directly.\ **Correct Answer**: B\ **Explanation**: Orlistat works by inhibiting fat absorption in the gastrointestinal tract, leading to reduced calorie intake. **40.**\ **Question**: Which of the following is a contraindication to phentermine therapy?\ **Choices**:\ A. Obstructive sleep apnea\ B. Pregnancy\ C. Controlled hypertension\ D. Type 2 diabetes\ **Correct Answer**: B\ **Explanation**: Phentermine is contraindicated during pregnancy due to potential risks to the fetus.