Disclosures. Objectives. Impact of Obesity in Primary Care Practice and What To Do About It. Intuitive Surgical. Consultant
|
|
- Myron Dennis
- 5 years ago
- Views:
Transcription
1 Disclosures Intuitive Surgical Consultant Stephen Archer, MD, FACS, FASMBS Director, Bariatric Surgery, St. Charles Medical Center Bend, OR Grand Rounds June 15, Objectives Impact of Obesity in Primary Care Practice and What To Do About It Recognize the role obesity plays in the pathogenesis and epidemiology of common problems such as diabetes, cancer, etc. Describe the impact of medical treatments for treating obesity including interactions and side effects. Review bariatric surgery indications and results with respect to common ailments in primary care practice Discuss prevention strategies
2 Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2016 Obesity Trends 6 Trend In Obesity Rate in Oregon Oregon WIC Kids 2-4 y.o. Obesity Rates Diabetes Rates 8
3 Body Mass Index vs. Mortality Relative Mortality Rate Exponential Increase in Risk High risk Medium risk Low risk BMI How Did We Get Here? Source: NIH, NEJM, What is the furthest you can be from a Big Mac in the United States? How did we get here? We don t move as much 107 Miles
4 What Causes Obesity? Top 10 Family Practice Diagnoses Genetic predisposition Obesity gene Physiologic Hormones: ghrelin Decreased stretch receptors Loss of satiety mechanism (hypothalamus) Behavioral Family tradition Food to comfort child Addiction! Socioeconomic! Cultural views! Fast Food Nation! Psychosocial! Coping mechanism (i.e. stress, abuse)! Societal! Technology has decreased energy expenditure! Fast food--starting in school Hypertension ension Hyperlipidemia pidemia Diabetes es Back pain Anxiety y Obesity y Allergic rhinitis Reflux esophagitis Respiratory Problems Hypothyroidism 2018 Practice Fusion, Inc. 14 Co-morbidities of Obesity Spiritual Morbidity of Obesity Diabetes Heart disease Hypertension Hyperlipidemia Asthma Sleep apnea Gallstones Steatohepatitis Urinary incontinence Acid reflux Arthritis and gout Infertility and PCOS High risk pregnancy DVT/PE Depression Immobility Cancer Breast Colorectal Prostate Endometrial Accident prone Rashes All the medical stuff, but also Isolation We get sick when we are alone and we get better when connected. Food Addiction 16
5 Oxidative stress is increased in metabolic syndrome and type 2 diabetes mellitus (T2DM) and this appears to underlie the development of cardiovascular disease, T2DM and diabetic Pathway complications. to Increased T2DM oxidative stress appears to be a deleterious factor leading to insulin resistance, dyslipidemia, β-cell dysfunction, impaired glucose tolerance and ultimately leading to T2DM Two Hit Theory: Genes + Environment 1 2* Obesogenic Environment World J Diabetes Apr 15; 6(3): World J Diabetes Apr 15; 6(3): Closed Loop NAFLD and Metabolic Syndrome Adipocytes Not simply storage cells Metabolically active Pro-inflammatory World J Gastroenterol Sep 28; 23(36): The fields of immunology and metabolism are rapidly converging on adipose tissue. During obesity, many immune cells infiltrate or populate in adipose tissue and promote a low-grade chronic inflammation. Studies to date have suggested that perturbation of inflammation is critically linked to nutrient metabolic pathways and to obesity-associated complications such as insulin resistance and type 2 diabetes. Annu Rev Nutr Aug 21; 32:
6 Treatment of Obesity When you treat obesity you are treating the underlying problem for the morbidities Relationship to food and life is fundamental Education for patients Advocacy for the public health Medications Surgery Orlistat (Xenical) Weight Loss Medications Lipase inhibitor, reduced absorption of fat by 30% Lorcaserin (Belviq), Stimulates 5-HT (serotonin) 2C receptors on anorectic POMC neurons close to fenfluramine, but not quite, decreased appetite, induces satiety Phentermine/Topiramate (Qsymia) Centrally acting appetite suppressant (phentermine) and increased energy utilization/inhibition of appetite Bupropion/Naltrexone (Contrave) Dopamine/norepi uptake inhibitor (stimulates POMC) + opioid receptor antagonist Liraglutide (Saxenda) GLP-1 agonist similar to other meds for T2D, induces satiety 21 Drugs. 2015; 75(9): Weight Loss Medications Medication Mechanism of Action Side Effects Interaction/Warnings Cost/month* Note An Aside Orlistat (Xenical) Lipase inhibitor, 30% less fat absorbed Diarrhea, oily stools, etc Avoid w cyclosporin, Add MVI $ Lorcaserin (Belviq) 5-HT (serotonin) 2C agonist, POMC neurons: anorexia/ satiety Phentermine/ Centrally acting Topiramate anorectic, increased (Qsymia) metabolism, satiety Buproprion/ Dop/NE uptake Naltrexone inhibitor (POMC) + (Contrave) opioid receptor agonist constipation, cough, dizziness, dry mouth, fatigue, nausea constipation, dizziness, dry mouth, taste changes, insomnia constipation, dizziness, dry mouth, headache, increased BP, tachycardia, liver damage Serotonin syndrome possible w other antidepressants? heart valve issues Avoid w glaucoma/ hyperthyroidism. Exacerbate HTN, mania, arrhythmias BIRTH DEFECTS Can t use w opioids, increased suicidal thoughts, avoid during etoh withdrawal $ Safe long term $ Safe long term, taper off prior to surgery, Controlled so monthly Rx. $250 Safe long term use, $ w coupon taper off. (components If emergency ordered separately surgery, fentanyl much less) must be used. Hypothalamic pro-opiomelanocortin piom (POMC) neurons promote satiety. Cannabinoid noid receptor 1 (CB1R) is critical for the central regulation of food intake.... The Pomc gene encodes both the anorexigenic peptide α-melanocyte-stimulating hormone, and the opioid peptide β-endorphin. Liraglutide (Saxenda) GLP-1 agonist, satiety and anorexia Injection only, nausea, diarrhea, constipation, and pain, headache, tachycardia possible role in pancreatitis $ FDA approved for 12 weeks only *Coupons often available from drug companies Hypothalamic pro-opiomelanocortin (POMC) neurons promote satiety 24
7 Probability of Achieving 5% Weight Loss and Possibility of Adverse Events Case For/Against Bariatric Surgery For Against Decreased mortality Expensive Resolution of diabetes, HTN Weight regain up to 20% etc Unpredictable results Improved quality of life Complications Halo effect in families Higher death rate from suicide Safe Addiction transfer <1% leak rate Significant weight gain occurs continuously in patients after reaching.5% mortality ty rate the nadir weight following gastric Best treatment t currently bypass. Despite this weight gain, the long-term mortality remains low at available 3.1%. JAMA Jun 14; 315(22): How Bariatric Surgery Works 28
8 Current Most-Used Bariatric Techniques Leak Test in the OR Leak is one of several possible life threatening complications Vertical Sleeve Gastrectomy Roux-en-Y Gastric Bypass Restrictive Remove approximately threefourths of the stomach Malabsorptive & Restrictive Bypass a portion of the small intestine and create a 15-30cc stomach pouch Long Term Results Gastric Bypass Very Low Calorie Diet +/- Behavioral Modification 5 Weight change (kg) Very-low-calorie diet Modified diet plus behavior therapy Very-low-calorie diet plus behavior therapy intervention Years after intervention 4 5
9 Oncologic Model of Obesity Care Neoadjuvent medical therapy prior to surgery? Surgery Adjuvent therapy at the nadir of weight loss or before? Summit BMC has added an internist to bariatric program Firefighting vs. Prevention I do obesity treatment. You probably do too. We are standing on the edge of a fire How do we prevent the fire? Obesity Prevention Real food not processed food, prepared at home Know your farmer and rancher or be your own farmer Advocate for better school lunches Zero sugar sweetened beverages (Believe that Big Food is out there) Less screen, more activity Be a part of civic discussions about city and neighborhood planning (Obesogenic environment) Teach children how to eat and cook and sleep Weight loss surgery in parent may prevent transmission of obesity to their children (Arch Surg. 2011;146(10): ) Be aware of adverse childhood events (ACE s) Obesity Prevention Epigenetics (selective gene expression) Avoid prenatal weight gain Pediatrics 118(6):e Encourage breast feeding (data is +/-) Support the gut biome Example growing body of evidence indicating that common food additives can push our microbial communities in unhealthy directions, not only potentially aiding the emergence of new pathogens, but also encouraging diseases like obesity, diabete and inflammatory bowel disease. EAT. MOVE. CONNECT
10 Thank you St. Charles is accredited by the American College of Surgeons for Bariatric Surgery Summit Weight Loss is the only comprehensive (med + surg) on this side of the Cascades This is my cell phone number: I will see any obese patient for any reason, regardless of issue, regardless of what operation or where. Summit Weight Loss: Medical and Surgical Weight Management 37
Management of Obesity. Objectives. Background Impact and scope of Obesity. Control of Energy Homeostasis Methods of treatment Medications.
Medical Management of Obesity Ben O Donnell, MD 1 Objectives Background Impact and scope of Obesity Control of Energy Homeostasis Methods of treatment Medications 2 O'Donnell 1 Impact of Obesity According
More informationWEIGHT LOSS/MANAGEMENT IS IT JUST ANOTHER PIPE DREAM?
WEIGHT LOSS/MANAGEMENT IS IT JUST ANOTHER PIPE DREAM? THE OBESITY MEDICINE ASSOCIATION S DEFINITION OF OBESITY Obesity is defined as a chronic, relapsing, multi-factorial, neurobehavioral disease, wherein
More informationUnderstanding Obesity: The Causes, Effects, and Treatment Options
Understanding Obesity: The Causes, Effects, and Treatment Options Jeffrey Sicat, MD, FACE Virginia Association of Clinical Nurse Specialists September 29, 2017 Objectives By the end of this discussion,
More informationBariatric Surgery: Indications and Ethical Concerns
Bariatric Surgery: Indications and Ethical Concerns Ramzi Alami, M.D. F.A.C.S Assistant Professor of Surgery American University of Beirut Medical Center Beirut, Lebanon Nothing to Disclose Determined
More informationWhen Diet and Exercise Aren t Enough: Pharmacologic Management of Obesity
When Diet and Exercise Aren t Enough: Pharmacologic Management of Obesity Casey Bonaquist, DO Saturday, April 30 th, 2016 17 th Annual Primary Care & Cardiovascular Symposium Learning Objectives After
More informationWhat Are the Effects of Weight Management Pharmacotherapy on Lipid Metabolism and Lipid Levels?
What Are the Effects of Weight Management Pharmacotherapy on Lipid Metabolism and Lipid Levels? Daniel Bessesen, MD Professor of Medicine University of Colorado School of Medicine Chief of Endocrinology,
More informationAn Individualized Approach to Optimize Obesity Treatment Louis Aronne, MD
An Individualized Approach to Optimize Obesity Treatment Louis Aronne, MD Sanford I. Weill Professor of Metabolic Research Director of the Comprehensive Weight Control Program Weill Cornell Medical College
More informationBariatric surgery: Impact on Co-morbidities and Weight Loss Expectations ALIYAH KANJI, MD FRCSC MIS AND BARIATRIC SURGERY SEPTEMBER 22, 2018
Bariatric surgery: Impact on Co-morbidities and Weight Loss Expectations ALIYAH KANJI, MD FRCSC MIS AND BARIATRIC SURGERY SEPTEMBER 22, 2018 Disclosures None Objectives Review expected weight loss from
More informationObesity: Pharmacologic and Surgical Management
Obesity: Pharmacologic and Surgical Management ADRIENNE YOUDIM, MD, FACP ASSOCIATE PROFESSOR OF MEDICINE, UCLA ASSISTANT PROFESSOR OF MEDICINE, CEDARS SINAI MEDICAL CENTER JANUARY 2018 Defining Obesity
More informationOverview of Management of Obesity
Overview of Management of Obesity Srividya Kidambi, MD, MS Division of Endocrinology, Metabolism, and Clinical Nutrition Medical College of Wisconsin, Milwaukee, WI I have nothing to disclose. Objectives
More informationObesity and Bariatric Surgery
Obesity and Bariatric Surgery Disclosure Nothing to disclose Subhashini Ayloo MD, MPH, FACS Associate Professor of Surgery Director of MIS HPB/LT Rutgers, New Jersey Medical School March 24 th, 2017 Overview
More informationObesity Pharmacotherapy: Options and Applications in Clinical Practice. Scott Kahan, MD, MPH
Obesity Pharmacotherapy: Options and Applications in Clinical Practice Scott Kahan, MD, MPH Obesity Pharmacotherapy Few providers prescribe pharmacotherapy. Few patients use pharmacotherapy. Pharmacotherapy
More informationSURGICAL MANAGEMENT OF OBESITY. Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery
SURGICAL MANAGEMENT OF OBESITY Anne Lidor, MD, MPH Professor of Surgery Chief, Division of Minimally Invasive and Bariatric Surgery Multi-Factorial Causes of Morbid Obesity include: Genetic Environmental
More informationMEDICAL MANAGEMENT 101
MEDICAL MANAGEMENT 101 Christopher Still, DO, FACN, FACP Medical Director, Center for Nutrition & Weight Management Director, Geisinger Obesity Research Institute Geisinger Health Care System Your Weight
More informationOverweight and Obesity on the Menu. Marwan Akel, Pharm. D, MPH Clinical Assistant Professor School of Pharmacy Lebanese International University
Overweight and Obesity on the Menu Marwan Akel, Pharm. D, MPH Clinical Assistant Professor School of Pharmacy Lebanese International University Prevention The most efficient and cost-effective approach
More informationObesity D R. A I S H A H A L I E K H Z A I M Y
Obesity D R. A I S H A H A L I E K H Z A I M Y Objectives Definition Pathogenesis of obesity Factors predisposing to obesity Complications of obesity Assessment and screening of obesity Management of obesity
More informationWhat is obesity? OBESITY. Obesity is a health issue in which someone has so much extra fat that it negatively impacts their health.
OBESITY What is obesity? Obesity is a health issue in which someone has so much extra fat that it negatively impacts their health. Obesity is most often measured by body mass index (BMI), which looks at
More informationTreatment of Obesity SAJIDA AHAD MERCY GENERAL SURGERY
Treatment of Obesity SAJIDA AHAD MERCY GENERAL SURGERY Objectives 1. Learn classification and evaluation of overweight and obese patient 2. Discuss impact of voluntary weight loss on morbidity and mortality
More informationThe New Trend of Anti-Obesity Drug
2016 년대한당뇨병학회춘계학술대회 The New Trend of Anti-Obesity Drug MIN-SEON KIM ASAN MEDICAL CENTER Conflict of Interest Nothing to declare Index Introduction: Obesity Epidemiology, Pathophysiology and Comorbidity
More informationDiabesity. Metabolic dysfunction that ranges from mild blood glucose imbalance to full fledged Type 2 DM Signs
Diabesity Metabolic dysfunction that ranges from mild blood glucose imbalance to full fledged Type 2 DM Signs Abdominal obesity Low HDL, high LDL, and high triglycerides HTN High blood glucose (F>100l,
More informationViriato Fiallo, MD Ursula McMillian, MD
Viriato Fiallo, MD Ursula McMillian, MD Objectives Define obesity and effects on society and healthcare Define bariatric surgery Discuss recent medical management versus surgery research Evaluate different
More informationWHAT S THE SKINNY ON WEIGHT LOSS MEDICATION SAFETY? January 25, 2019 Pennsylvania Pharmacists Association
WHAT S THE SKINNY ON WEIGHT LOSS MEDICATION SAFETY? January 25, 2019 Pennsylvania Pharmacists Association MEGAN N DUNLOP, PHARMD, CTTS CLINICAL PHARMACIST, UPMC COMMUNITY PROVIDER SERVICES LEARNING OBJECTIVES
More informationWithout Background for printing as Pocket Reference
Without Background for printing as Pocket Reference Diabetes Prevention Program 1 LOOK AHEAD 3 Multi-center trial in patients with impaired glucose tolerance Weight loss of 7% reduced the rate of progression
More informationFaculty/Presenter Disclosure
Weight loss & Obesity WHAT S NEW & EXCITING? Tina Korownyk Dept of Family Medicine, UofA Faculty/Presenter Disclosure Faculty/Presenter: Tina Korownyk Relationships with commercial interests: None 1 Drowning
More informationLearning Objectives. Currently Available Options. Update on Weight Loss Pharmacotherapy. Dan Bessesen, MD
Update on Weight Loss Pharmacotherapy Dan Bessesen, MD Daniel.bessesen@ucdenver.edu Learning Objectives List the medications that are currently available for the treatment of obesity, describe their mechanisms
More informationNon-surgical Treatment for Adult Obesity
Non-surgical Treatment for Adult Obesity Kathy Foreman, CNP Comprehensive Weight Management and Bariatric Surgery Program The Ohio State University Wexner Medical Center Objectives Definition, prevalence
More informationUpdate on the Recent Advances in Obesity Management. Benjamin O Donnell, MD Oct 5 th, 2018
Update on the Recent Advances in Obesity Management Benjamin O Donnell, MD Oct 5 th, 2018 Objectives Background Control of Energy Homeostasis Approach to Diet and Exercise Medications Recently Approved
More informationObesity Management in Type 2 Diabetes
Obesity Management in Type 2 Diabetes Clare J. Lee, MD, MHS Assistant Professor of Medicine, Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University Disclosures None Objectives Describe
More informationDisclosures. Obesity and Its Challenges: Outline. Outline 5/2/2013. Lan Vu, MD Division of Pediatric Surgery Department of Surgery
Obesity and Its Challenges: Bariatric Surgery: Why or Why Not I have nothing to disclose Disclosures Lan Vu, MD Division of Pediatric Surgery Department of Surgery Outline Growing obesity epidemic Not
More informationRealistic Expectations: Drugs in the Treatment of Obesity. Lora Cotton, D.O. January 20, 2013
Realistic Expectations: Drugs in the Treatment of Obesity Lora Cotton, D.O. January 20, 2013 Overview Approach FDA approved agents will be covered FDA approval guidelines Candidates Expectations Mechanisms,
More informationFrustrating Plateaus & Post Operative Weight Gain
Frustrating Plateaus & Post Operative Weight Gain Christopher Still, DO, FACN, FACP Director, Center for Nutrition & Weight Management & Geisinger Obesity Research Institute Geisinger Health Care System
More informationManaging Obesity as a Disease. Disclosure. Objectives
Managing Obesity as a Disease Ji Hyun Chun (CJ), PA-C, BC-ADM OptumCare Medical Group: Endocrinology, Irvine, CA President, American Society of Endocrine PAs none Disclosure Objectives Recognize obesity
More informationTreating Obesity- NOT Just with Surgery
Treating Obesity- NOT Just with Surgery Identify obesity as a major health problem Define and describe causes of obesity with contributing factors. Discuss pertinent details to seeing an obese patient
More informationMedical Management of Obesity: Multidisciplinary Team and Pharmacologic Therapy. Shelby Sullivan University of Colorado School Of Medicine
Medical Management of Obesity: Multidisciplinary Team and Pharmacologic Therapy Shelby Sullivan University of Colorado School Of Medicine Disclosures Research Support / Grants R01DK094483-02 Klein/Mittendorfer
More informationThe ABCDs of Obesity
The ABCDs of Obesity Adipose Based Chronic Disease Michael A. Bush, M.D. Clinical Chief, Division of Endocrinology Cedars-Sinai Medical Center Clinical Associate Professor, Geffen School of Medicine, UCLA
More informationBariatric Surgery: A Cost-effective Treatment of Obesity?
Bariatric Surgery: A Cost-effective Treatment of Obesity? Shaneeta M. Johnson MD FACS FASMBS 2018 NMA Professional Development Seminar Congressional Black Caucus Foundation Annual Legislative Conference
More informationFaculty Disclosures. Vera Tarman, MD, Author:
Faculty Disclosures Vera Tarman, MD, Author: Food Junkies: The Truth About Food Addiction (book) Dangerous Liaisons: Comfort and Food (DVD) Biology of Addiction, Biology of Recovery (DVDs) Standard Treatments
More informationObesity Management in Women
Defining Obesity Obesity Management in Women Alka M. Kanaya, M.D. Assistant Professor of Medicine October 19, 2007 An increase in fat accumulation, to the extent that health may be adversely affected BMI
More informationObesity Management in Patients with Diabetes Jamy D. Ard, MD Sunday, February 11, :15 a.m. 11:00 a.m.
Obesity Management in Patients with Diabetes Jamy D. Ard, MD Sunday, February 11, 2018 10:15 a.m. 11:00 a.m. Type 2 diabetes mellitus (T2DM) is closely associated with obesity, primarily through the link
More informationDonna H Ryan, MD, FACP Pennington Biomedical Research Center Baton Rouge, LA.
Donna H Ryan, MD, FACP Pennington Biomedical Research Center Baton Rouge, LA Donna.Ryan@pbrc.edu National Summit on Health Disparities April 22, 2013 Disclosure Dr. Ryan has served as an advisor to Nutrisystem
More informationLosing weight (and keeping it off) calls for changes to how you live your life, as well as to your connection to food and exercise.
OBESITY Treatment Losing weight (and keeping it off) calls for changes to how you live your life, as well as to your connection to food and exercise. If you ve tried on your own and still find that you
More informationPast, Present and Future of Pharmacotherapy for Obesity
Past, Present and Future of Pharmacotherapy for Obesity Dan Bessesen, MD Chief of Endocrinology; Denver Health Medical Center Professor of Medicine, University of Colorado School of Medicine Daniel.Bessesen@ucdenver.edu
More informationWeight Loss Surgery. Outline 3/30/12. What Every GI Nurse Needs to Know. Define Morbid Obesity & its Medical Consequences. Treatments for Obesity
3/30/12 Weight Loss Surgery What Every GI Nurse Needs to Know Kenneth A Cooper, D.O. March 31, 2012 Outline Define Morbid Obesity & its Medical Consequences Treatments for Obesity Bariatric (Weight-loss)
More informationUpdate on Treating Obesity: A Multidisciplinary Approach. Marie Harkins, FNP BC, CDE Cayuga Center for Healthy Living
Update on Treating Obesity: A Multidisciplinary Approach Marie Harkins, FNP BC, CDE Cayuga Center for Healthy Living Objectives 1. Define obesity as a disease 2. List the stepwise approach to obesity treatment
More informationObesity: The Role of Pharmacotherapy The Annual Women s & Children s Health Update Saturday 17th February 2018 Benefits of modest weight loss 3-10%
Obesity: The Role of Pharmacotherapy Professor John B Dixon, MBBS PhD Professorial Research Fellow Head, Clinical Obesity Research Baker IDI Heart & Diabetes Institute Melbourne, Australia The Annual Women
More informationOBESITY AND WEIGHT LOSS SURGERY FOR THE PRIMARY CARE PHYSICIAN
OBESITY AND WEIGHT LOSS SURGERY FOR THE PRIMARY CARE PHYSICIAN Nicole Basa, M.D., F.A.C.S., F.A.S.M.B.S Assistant Professor of Surgery Texas A&M Medical School Bariatric Medical Director- Cedar Park Regional
More informationCopyright 2017 by Sea Courses Inc.
Appetite Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored, or transmitted in any form or by any means graphic, electronic, or mechanical,
More informationObesity and Weight Loss Surgery for the Primary Care Physician
Saturday General Session Obesity and Weight Loss Surgery for the Primary Care Physician Nicole Basa, MD Bariatric and General Surgeon Cedar Park Surgeons, PA Cedar Park, Texas Educational Objectives By
More informationLearning Objectives 11/8/2014. Obesity: Strategies to Tackle the Epidemic MA ACP Annual Scientific Meeting 1. Body Mass Index Calculation
Fatima Cody Stanford, MD, MPH Obesity Medicine & Nutrition Massachusetts General Hospital Harvard Medical School Learning Objectives Review the prevalence of obesity in the USA Outline pathogenesis and
More informationJordan Garrison Jr. MD, FACS, FASMBS
Jordan Garrison Jr. MD, FACS, FASMBS A life-long progressive, lifethreatening, geneticallyrelated, costly, multifactorial disease of excess fat storage with multiple comorbidities ~ 25% industrialized
More informationADVANCE AT YOUR OWN PACE
ADVANCE AT YOUR OWN PACE Welcome and Introductions Obesity and Its Impact on Health Surgeon Introduction Surgical Weight Loss Options AGENDA OSVALDO ANEZ, MD 28 years of experience Performed approximately
More informationPutting It in Perspective Using Medications for Chronic Weight Management. Donna H. Ryan, MD Pennington Biomedical Research Center
Putting It in Perspective Using Medications for Chronic Weight Management Donna H. Ryan, MD Pennington Biomedical Research Center ryandh@pbrc.edu Why Use Medications? Medications help patients lose more
More information10/28/11. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle
Bariatric Surgery: What the Primary Care Provider Should Know 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive
More informationLorcaserin (Belviq ) Rimonabant 2008 Sibutramine (Reductil, ) (World Health organization, WHO) 1996 WHO Orlistat (Xenical, )
(World Health organization, WHO) 1996 WHO (Body mass index, BMI)2427 kg/m 2 27 kg/m 2 25% 30%2013-2014 43.5%(48.9%38.3%) (AACE/ACE)2016 1 BMI 27 kg/m 2 BMI 35 kg/m 2 (The Food and Drug Administration,
More information3 Things To Know About Obesity Surgery
3 Things To Know About Obesity Surgery Dr Jon Armstrong 1st Edition Introduction... 3 1. Am I A Candidate?... 4 2. What Are The Options?... 5 3. How Does It Work?... 6 Conclusion... 9 Follow me here...
More informationAnti-Obesity Agents Drug Class Prior Authorization Protocol
Anti-Obesity Agents Drug Class Prior Authorization Protocol Line of Business: Medicaid P & T Approval Date: February 21, 2018 Effective Date: March 1, 2018 This policy has been developed through review
More informationFDA approves Belviq to treat some overweight or obese adults
FDA approves Belviq to treat some overweight or obese adults Silver Spring, MD, USA (June 27, 2012) - The U.S. Food and Drug Administration today approved Belviq (lorcaserin hydrochloride), as an addition
More informationTechnique. Matthew Bettendorf, MD Essentia Health Duluth Clinic. Laparoscopic approach One 12mm port, Four 5mm ports
Matthew Bettendorf, MD Essentia Health Duluth Clinic Technique Laparoscopic approach One 12mm port, Four 5mm ports Single staple line with no anastamosis 85% gastrectomy Goal to remove
More informationNavigating the new weight loss medications Jacqueline Jordan Spiegel, MS, PA-C, DFAAPA Associate Professor Midwestern University
Navigating the new weight loss medications Jacqueline Jordan Spiegel, MS, PA-C, DFAAPA Associate Professor Midwestern University Objectives Discuss the evolution of obesity as a diagnosis and disease.
More informationAn Introduction to Bariatric Surgery
An Introduction to Bariatric Surgery What is bariatric surgery? Bariatric surgery is a treatment used to help people with obesity manage their health and weight. Why use surgery to manage obesity? Obesity
More informationA Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications
A Bariatric Patient in my Waiting Room: Choosing the Right Patient for the Right Operation: Bariatric Surgery Indications Shahzeer Karmali MD FRCSC FACS Associate Professor Surgery University of Alberta
More informationCURRENT STRATEGIES IN MANAGEMENT OF OBESITY. Prevalence of Obesity (Adults)
CURRENT STRATEGIES IN MANAGEMENT OF OBESITY Robert B. Baron MD MS Professor of Medicine Associate Dean for GME and CME Director, UCSF Weight Management Program Declaration of full disclosure: No conflict
More information6/23/2011. Bariatric Surgery: What the Primary Care Provider Should Know. Case Presentation: Rachelle
Bariatric Surgery: What the Primary Care Provider Should Know 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression obstructive
More informationOBESITY:Pharmacotherapy Vs Surgery
OBESITY:Pharmacotherapy Vs Surgery Dr. Ranajit Sen Chowdhury Associate Professor Department of Medicine Sir Salimullah Medical College & Mitford Hospital. 1 Historical Perspective Paleolithic Era > 25,000
More informationThe US FDA, EMA and our TGA use these cutpoints in assessing drug efficacy. Disclosures: Professor John B Dixon
Obesity: The Role of Pharmacotherapy Professor John B Dixon, MBBS PhD Professorial Research Fellow Head, Clinical Obesity Research Baker IDI Heart & Diabetes Institute Melbourne, Australia The Annual Women
More informationBariatric Intake Form
Name Today s Date Age Date of Birth Phone Address How did you find us? Emergency Contact Name Relationship Phone Home ( ) Work ( ) Cell ( ) Address Physicians Primary Care Cardiologist Psychologist Sleep
More informationChapter 9 Weight Control: Overweight and Underweight
Chapter 9 Weight Control: Overweight and Underweight Please do not use your cell phone during class!! Obesity Statistics According to the Center for Disease Control: Approximately 69-70% of adult Americans
More informationDr. Shahebina Walji MD. Clinical Lecturer, University of Calgary Medical Director, Calgary Weight Management Centre
Dr. Shahebina Walji MD Clinical Lecturer, University of Calgary Medical Director, Calgary Weight Management Centre info@cwmc.ca 403.272.2962 Impact of obesity on Canadians Obesity as a chronic medical
More informationEmpower Preventive Medicine. Timothy J. McCormick, DO, MPH 4221 Baymeadows Suite 6 Jacksonville, FL
Empower Preventive Medicine Timothy J. McCormick, DO, MPH 4221 Baymeadows Suite 6 Jacksonville, FL 32217 904-367-4005 Drtim@emprevmed.com Obesity Medicine Old paradigm: Obesity was a matter of willpower,
More informationCertified Bariatric Nurse Review Course. Session 1
Certified Bariatric Nurse Review Course Session 1 Session 1 Review of CBN certification Introduction to Morbid Obesity History of weight loss surgery Objectives The purpose of this program is to inform
More informationWhere are We Now? Editor s Note: Who Qualifi es for Obesity Medications?
Obesity Medications Where are We Now? by Christopher D. Still, DO, FACP, FACN, Nadia Boulghassoul-Pietrzykowska, MD, and Jennifer E. Franceschelli, DO Editor s Note: Please note that some of the medications
More informationDeveloping nations vs. developed nations Availability of food contributes to overweight and obesity
KNH 406 1 Developing nations vs. developed nations Availability of food contributes to overweight and obesity Intake Measured in kilojoules (kj) or kilocalories (kcal) - food energy Determined by bomb
More informationACHIEVING HEALTH: AGENDA: Achieving Health: A Look at Your Weight Management Options
ACHIEVING HEALTH: A Look at Your Weight Management Options Achieving Health: A Look at Your Weight Management Options AGENDA: Achieving Health: A Look at Your Weight Management Options Topic 1 Behavior
More informationHealthy weight 18.5 to <25. Diabetes Dispatch. Overweight 25 to <30. Obese class I 30 to <35. Obese class II 35 to <40
A L A S K A N A T I V E D I A B E T E S T E A M Diabetes Dispatch Volume 10, Issue 4 Winter 2015 T he American Medical Association, the World Health Organization, and the US Food and Drug Administration
More informationBariatric Surgery and Post Operative Patient Care Alisha M. Fuller DNP, CBN, FNP BC Tristate Bariatrics Clinical Director, NP Manager
Bariatric Surgery and Post Operative Patient Care Alisha M. Fuller DNP, CBN, FNP BC Tristate Bariatrics Clinical Director, NP Manager Presentation Objectives Causes of Obesity Measuring Obesity Medical/Psychological/Social
More informationCurrent Management of Obesity
Current Management of Obesity Alka M. Kanaya, MD Professor of Medicine, Epidemiology & Biostatistics UCSF, Controversies in Women s Health December 11, 2015 I have nothing to disclose 1 Prevalence of Obesity
More informationUpdate on Bariatric Surgery. Learning Objectives: At the end of this lecture you should be able to: Currently Available Options
Update on Bariatric Surgery Dan Bessesen, MD Chief of Endocrinology; Denver Health Medical Center Professor of Medicine, University of Colorado School of Medicine Daniel.Bessesen@ucdenver.edu Learning
More informationBariatric Surgery. The Oregon Bariatric Center Surgical Team
Bariatric Surgery The Oregon Bariatric Center Surgical Team Colin MacColl, MD, Medical Director, Bariatric Surgeon Jessica Folek, MD, Bariatric Surgeon I have no disclosures Disclosures Objectives What
More informationDisclosures OBESITY. Overview. Obesity: Definition. Prevalence of Obesity is Rising. Obesity as a Risk Factor. None
Disclosures None OBESITY Florencia Halperin, M.D. Medical Director, Program for Management Brigham and Women s Hospital Instructor in Medicine, Harvard Medical School Overview Obesity: Definition Definition
More informationThe Implications of Obesity as a Disease
AGA Technology Workshop The Implications of Obesity as a Disease Lee M. Kaplan, MD, PhD Obesity, Metabolism & Nutrition Institute Massachusetts General Hospital Harvard Medical School LMKaplan@partners.org
More informationBASELINE TRAITS AS PREDICTORS OF SUCCESS IN MEDICAL WEIGHT MANAGEMENT
BASELINE TRAITS AS PREDICTORS OF SUCCESS IN MEDICAL WEIGHT MANAGEMENT MASTER S THESIS SUBMITTED TO THE FACULTY OF UNIVERSITY OF MINNESOTA COLLEGE OF FOOD, AGRICULTURE, AND NATURAL RESOURCE SCIENCES BY
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A Abdominal obesity, pathophysiology of, 272 273 Absorption-blocking supplements, 401 Acupuncture, 401 402 Adipocytes, pathologic, 272 Adipokines,
More informationAPhA March 2016 Annual Meeting Obesity Cases
APhA March 2016 Annual Meeting Obesity Cases Case #1 Pam is a 47 yo obese Caucasian woman; grade school teacher with a history of HTN, HoTR, and depression who presents for her annual physical. CC: I m
More informationDisclosures. Start the Conversation. Agenda. Behavioral and Medical Approaches for Obesity Treatment 10/18/2014
Disclosures Behavioral and Medical Approaches for Obesity Treatment Scott Kahan, MD, MPH Director, National Center for Weight and Wellness Clinical Director, Strategies To Overcome and Prevent (STOP) Obesity
More informationWhen Lifestyle Modification Therapy is Not Enough: Pharmacotherapy for Severe/Complicated Pediatric Obesity
When Lifestyle Modification Therapy is Not Enough: Pharmacotherapy for Severe/Complicated Pediatric Obesity Claudia Fox, MD MPH Diplomate, American Board of Obesity Medicine Medical Director, Pediatric
More informationCommonly Performed Bariatric Procedures in Singapore. Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital
Commonly Performed Bariatric Procedures in Singapore Lin Jinlin Associate Consultant General, Upper GI and Bariatric Surgery Changi General Hospital Scope 1. Introduction 2. Principles of bariatric surgery
More informationObesity in Children. JC Opperman
Obesity in Children JC Opperman Definition The child too heavy for height or length Obvious on inspection 10 to 20% over desirable weight = overweight More than 20% = obese Use percentile charts for the
More informationMANAGEMENT OF OBESITY: A
MANAGEMENT OF OBESITY: A Systematic Approach In the United States (over the last decade) the overall prevalence of obesity is: Robert B. Baron MD MS Professor of Medicine Associate Dean for GME and CME
More informationUnderstanding. Obesity. An educational resource provided by the Obesity Action Coalition
Understanding Obesity An educational resource provided by the Obesity Action Coalition What is obesity? Obesity is a disease characterized by excessive body fat. People who are affected by obesity usually
More informationSurgical Therapy for Morbid Obesity. Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 2008
Surgical Therapy for Morbid Obesity Janeen Jordan, PGY 5 Surgical Grand Rounds April 7, 28 Obesity BMI > 3 kg/m 2 Moderate 35-4 kg/m 2 Morbid >4 kg/m 2 1.7 BILLION Overweight Adults in the world 63 MILLION
More informationBenefits of Bariatric Surgery
Benefits of Bariatric Surgery Dr Tan Bo Chuan Registrar, Department of Surgery GP Forum 27 May 2017 Improvements of Co-morbidities Type 2 diabetes mellitus Hypertension Hyperlipidemia Degenerative joint
More informationA SYSTEMATIC APPROACH TO
A SYSTEMATIC APPROACH TO OBESITY Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest Prevalence of Obesity (Adults): 2008
More informationNEW DEVELOPMENTS IN ASSESSMENT AND TREATMENT OF OBESITY
Prevalence of Obesity (Adults)! Obesity: 33.8% Men: 32.2% Women: 35.5% Overweight + obesity: 68% Men: 72.3% Women: 64.1% Severe Obesity: 6% Flegal JAMA 2010 Men and Women Aged 40 to 59 Years in 1999-2000
More informationCURRENT STATE. of the Treatment of Obesity
CURRENT STATE of the Treatment of Obesity by Stephen Boyce, MD Obesity continues to be a serious health concern claiming hundreds of thousands of lives worldwide annually. So much of our thinking around
More informationI. ALL CLAIMS: HEALTH CARE PROFESSIONALS
HCP Prescribing Information Date/Version January 2015 Version 2 Page: 1 of 5 I. ALL CLAIMS: HEALTH CARE PROFESSIONALS Indications and Usage Saxenda (liraglutide [rdna origin] injection) is indicated as
More information10/29/2011. Metabolic, Obstetric, and Gynecological Consequences of Bariatric Surgery. Case Presentation: Rachelle. Jonathan Carter, MD
Metabolic, Obstetric, and Gynecological Consequences of Bariatric Surgery 2,000 B.C. 2,000 A.D. Case Presentation: Rachelle 35 year-old woman with morbid obesity. 5 1 236 lbs BMI 44.5 PMHx: mild depression
More informationOBESITY IN TYPE 2 DIABETES
OBESITY IN TYPE 2 DIABETES Ashley Crowl, PharmD, BCACP Assistant Professor University of Kansas Objectives Review how to manage obesity in patients with type-2 diabetes mellitus Compare antiobesity agents
More informationBariatric Surgery: The Primary Care Approach
The 8 th Annual Conference of the Lebanese Society of Family Medicine October 25 th 2009 Bariatric Surgery: The Primary Care Approach Bassem Y. Safadi, MD, FACS Associate Professor of Clinical Surgery
More informationCURRENT STRATEGIES IN OBESITY
Prevalence of Obesity (Adults)! Obesity: 33.8% Men: 32.2% Women: 35.5% Overweight + obesity: 68% Men: 72.3% Women: 64.1% Severe Obesity: 6% Flegal JAMA 2010 Men and Women Aged 40 to 59 Years in 1999-2000
More informationDisclosure Medtronic - Speaker/ Research Grant/ Robotics Advisory Board Gore - Education Grant/ Speaker Teleflex - Consultant Da Vinci - Proctor
Sleeve Plus Options Disclosure Medtronic - Speaker/ Research Grant/ Robotics Advisory Board Gore - Education Grant/ Speaker Teleflex - Consultant Da Vinci - Proctor Mederi - Speaker Novadaq - Advisory
More information