This document discusses weight loss and obesity. It defines normal, overweight and obese BMI ranges. It outlines several drugs and medical conditions that can cause weight gain. The goals for weight loss include reducing calories by 500-750 kcal per day and exercising over 150 minutes per week while monitoring food intake and diet. Several natural products and prescription drugs are mentioned that may aid in weight loss, but some have safety concerns. Bariatric surgery is indicated for those with a BMI over 40 or over 35 with an obesity-related condition.
This document discusses weight loss and obesity. It defines normal, overweight and obese BMI ranges. It outlines several drugs and medical conditions that can cause weight gain. The goals for weight loss include reducing calories by 500-750 kcal per day and exercising over 150 minutes per week while monitoring food intake and diet. Several natural products and prescription drugs are mentioned that may aid in weight loss, but some have safety concerns. Bariatric surgery is indicated for those with a BMI over 40 or over 35 with an obesity-related condition.
This document discusses weight loss and obesity. It defines normal, overweight and obese BMI ranges. It outlines several drugs and medical conditions that can cause weight gain. The goals for weight loss include reducing calories by 500-750 kcal per day and exercising over 150 minutes per week while monitoring food intake and diet. Several natural products and prescription drugs are mentioned that may aid in weight loss, but some have safety concerns. Bariatric surgery is indicated for those with a BMI over 40 or over 35 with an obesity-related condition.
This document discusses weight loss and obesity. It defines normal, overweight and obese BMI ranges. It outlines several drugs and medical conditions that can cause weight gain. The goals for weight loss include reducing calories by 500-750 kcal per day and exercising over 150 minutes per week while monitoring food intake and diet. Several natural products and prescription drugs are mentioned that may aid in weight loss, but some have safety concerns. Bariatric surgery is indicated for those with a BMI over 40 or over 35 with an obesity-related condition.
—>overweight + coronary heart disease, HTN, stroke, T2DM are risk factors —>Drugs/Conditions that can cause weight gain: antipsychotics (clozapine, olanzapine, risperidone, quetiapine); diabetes (insulin, sulfonylureas, thiazolidinediones, meglitinides); valproic acid/divalproex, lithium, mirtazapine (Remeron), Steroids, Gabapentin, hormones, paroxetine, TCA, MAOI; hypothyroidism —>goal is to reduce calories by 500-750 kcal and increase exercise to >150 min/week; self-monitor food intake, exercise, diet (try low-carb, low-fat, high protein diets —>Natural Products: bitter orange, caffeine, Yerba mate, guarana, green tea (contain stimulants, can be harmful in patients with cardiovascular disease) —>RX only indicated if BMI >30 or BMI >27 + dyslipidemia, HTN, diabetes and should be used with dietary/ physical activity plans. Discontinue therapy after 12 week if 5% weight loss not achieved —>Drugs that cause weight loss: ADHD drugs, GLP-1, Pramlintides, SGLT2I, Topiramate, Bupropion, ACheI, levothyroxine, hyperthyroidism, celiacs, IBD, GERD,PUD,TB,CF —>avoid weight loss drugs in pregnancy; avoid Contrave w/uncontrolled BP, depression, seizure, opioids
Locaserin (Belviq): increased satiety stimulant to increase satiety/ decrease cravings —>Warning/SE: serotonin syndrome, decrease appetite. Use in AM —>titrate up to BID after 4 weeks increased psych disorder, priapism, —>Boxed: not for major depressive —>CI: hyperthyroidism, MAOI use disorder; bupropion increases suicidal hypoglycemia, dry mouth, —>SE: tachycardia, CNS effects, thought, avoid in pediatrics constipation, nausea constipation, dry mouth, seizure* —>CI: opioid use, uncontrolled HTN, —>has a REMS dt teratogenic risk. Orlistat (Xenical)(Alli) seizures, other bupropion products, MAOI use in 14 days. —>decreases fat absorption Liraglutide (Saxenda): increase satiety —>SE: psychiatric disorders, —>must use with a low fat meal and —>0.6 daily up to 3mg daily hepatotoxicity, dizziness, dry mouth, take ADEK +beta carotene —>has a REMS due to medullary thyroid insomnia supplementation @ bedtime or carcinoma risk. —>Naltrexone blocks opioids; D/C 2 separated by 2 hours —>Warning/SE: pancreatitis, weeks before Contrave use —>CI: cholestasis, malabsorption hypoglycemia, gastroparesis (slowed —>Warning/SE: liver damage, kidney emptying), nausea, diarrhea, abdominal stones, hypoglycemia, GI, fatty stool pain (steatosis), avoid w/cyclosporine or —>decrease diabetic dosing dt separate by 3 hours; separate with Phentermine (Adipex, Lomaira); Diethylpropion: appetite levothyroxine by 4 hours suppressant via stimulating NE release which decreases Bariatric Surgery: BMI> 40 or BMI>35 + obesity related appetite condition. Essentially restricts food intake —>CI: cardiovascular disease (uncontrolled HTN, —>must take calcium citrate, B12 & Fe. Separate out by 2 arrhythmia, HF, CAD, hyperthyroidism, glaucoma, PMH hrs prior or 4 hours post antacids. Take ADEK. Meds may drug abuse, MAOI use in 14 days need to be crushed or use of transdermal 2 months post —>SE: tachycardia, agitation, increases BP/HR surgery —>take in the AM —>Rapid weight loss can cause gall stones: use Ursodiol to dissolve them.