Obesity Treatment in Special Populations

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Slide 1 : Obesity Treatment in Special Populations Smokers All smokers, regardless of weight, should quit smoking. Implement weight gain prevention, treatment efforts as necessary. Older adults Evaluate risk-to-benefit ratio. Diverse patient populations Tailor treatments to patient needs.
Slide 2 : Obesity and Sleep Apnea The major correlates of sleep apnea: Prevalence is higher in males than in females. Obese men and women have higher prevalence. May be more prevalence among special populations with higher prevalence of obesity. The major consequences of untreated sleep apnea: Severe arterial hypoxemia. Increased risk of cardiac arrhythmia. Increased risk of high blood pressure. Possible increased risk of stroke.
Slide 3 : Obesity and Sleep Apnea Treatment of obesity ameliorates obstructive sleep apnea Medical treatment. Surgical treatment. Benefits of treatment A 10% weight reduction is associated with a 50% reduction in severity of sleep apnea. Reduction of specific cardiovascular risk factors.
Slide 4 : CASE STUDIES
Slide 5 : A 45-year-old man comes in for his annual physical. Height 5’10”, weight 210 lb, nonsmoker, no history of CAD, DM, or dyslipidemia. On questioning, he is unconcerned about his weight, which he attributes to “too much food and too little exercise.” His wife, however, has been nagging him to lose weight. On physical exam, he is moderately obese, BP 140/99, pulse 78 and regular, waist circumference 42 inches; no other abnormalities detected. Clinical assessment: What further evaluation would you perform? How would you address his obesity?
Slide 6 : A 32-year-old woman comes to your office requesting “diet pills” because “I’m too fat.” Height 5’5”, weight 149 lb. Difficulty losing weight after her second pregnancy 18 months ago; about 8 pounds heavier than her prepregnancy weight. Always overweight—lost and regained 10 to 15 lb numerous times. Used to go to a gym to exercise 2 or 3 days a week—now no time because of her young children. On physical exam, no abnormalities detected; waist circumference 30 inches, BP 118/72, pulse 84 and regular, lipids and glucose within normal limits. Clinical assessment: What is her BMI? Would you prescribe weight loss medications? What would you advise her regarding weight management?

 


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