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Dr Nicki Mazey

Introduction. Predisposing factorsCo-morbiditiesManaging Obesity in primary careSleep apnoea/Binge eatingTools availableAnti-obesity medication Bariatric Surgery (NICE)Health and Safety

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Dr Nicki Mazey

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    1. Dr Nicki Mazey

    2. Introduction Predisposing factors Co-morbidities Managing Obesity in primary care Sleep apnoea/Binge eating Tools available Anti-obesity medication Bariatric Surgery (NICE) Health and Safety…yawn….

    3. Causes of Obesity

    4. Co-morbidities

    5. Managing Obesity in primary care Engage Screen Referral Monitoring Education Patients don’t lie Smoking

    6. History Onset. Factors causing and maintaining Eating Patterns Weight loss attempts Activity. Limiting factors FH Co-morbidities (sleep and intertrigo) Meds Alcohol Smoking Occupation

    7. Examination General Height Weight BMI Fat mass BP Pulse Cushingoid Thyroid Hair/secondary sexual characteristics CVS Resp Skin infections

    8. Investigations Bloods Dexamethasone suppression Depression screening HAD scores Sleep apnoea

    9. Sleep Apnoea Epworth Scores

    10. Binge Eating History top tips! Initial management distraction, regular meals, fluoxetine Therapy referral

    11. Tools available

    12. Orlistat, Sibutramine, Rimonabant, Amphetamines and dodgy stuff off the internet! Pros and cons Best time to try Contraindications Orlistat policeman/dietician support. In conjunction with diet and exercise or don’t have significant benefit. Anti-obesity medication

    13. Orlistat Policeman 120mg tds Gallstones, medication (warfarin) Pros Cons

    14. Sibutramine 10mg and 15mg Contraindications Monitoring Requirements Pros Cons

    15. Rimonabant 20mg morning Central mode (canaboid receptors) Depression Monthly monitoring HAD Diabetics Triglycerides

    17. Bariatric Surgery Lap Band, Gastric bypass, Duodenal switch. Who? When? What? How? Pros Cons Follow up NICE guidelines/PCT. Bingo/Hoops Cosmetic problems

    18. Equipping your practice

    19. Case Studies and Questions

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