Obesity Worksheet

Obesity Worksheet
1. Define Obesity and discuss its prevalence in the Pakistani adult and child population according to
the latest National Nutrition Survey. Compare the obesity rates from the last two NNS results to
identify the trend in our local population.
2. Define the main characteristics of Obesity
Aetiology
Related Co-
morbidities
Definition criteria
Metabolic
abnormalities
Risk Factors
Dietary intervention
strategies
Medical intervention
Surgical intervention
HAMEED LATIF HOSPITAL Department of Clinical Nutrition

CARE, CONCERN, COMPASSION Internship Program
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Syeda Zainab Abbas
3. Define and discuss the 10 hormones that are involved in appetite regulation in terms of function,
site of production and action
Hormone Site of Production Action

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4. When talking about weight loss for obese individuals, the transtheoretical model is frequently used
as a model for motivation and weight loss expectation. Describe the siz steps highlighted by the
model.
5. Eating breakfast is considered a healthy food habit and some are proponents of the use of breakfast
as a step towards weight loss. Discuss current evidence that supports or disproved that statement.

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6. The term briatric is derived from baros (weight) and iateria (medical treatment). Define the criteria
for an individual to be eligible for bariatric surgery.
7. There are several types of bariatric surgery. Identify the five most common ones and explain them
in terms of average loss after surgery, technique, length of hospital stay and impact on comorbidities
like Type 2 Diabetes, Hypertension, Sleep Apnea and high Cholesterol levels

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8. Diet related complications are commonly seen in patients who have recently undergone bariatric
surgery. What are the possible common complications? Explain your reasoning
9. Our gut has several sites of absorption for different macro and micro nutrients. Identify the nutrients
absorbed from each of the following sites;
a. Duodenum
b. Ileum
c. Jejunum

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10. Weight management is defined as the adoption of healthful and sustainable eating along with
physical activity behaviours indicated for a reduced disease risk and improved feelings of well-being
and energy. Explain how the following can be modified for weight loss and why it is important to keep
a check on them;
a. Energy
b. Protein
c. Fat
d. Carbohydrates
e. Physical Activity
11. What are the biggest mental barriers to weight management for obese individuals?

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12. Other approaches to weight loss and management can include Behaviour modification, VLCDs,
Meal replacements, and pharmacotherapy. Describe each of these approaches and how they can help
achieve weight goals.

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Syeda Zainab Abbas
Case Study
The patient is a 37-year old Pakistani male who is admitted for roux-en-Y gastric bypass surgery
tomorrow morning. He has been obese his entire adult life with highest weight 6 months ago at 197
kg. He has lost around 11 kg since then, and has been seeing a dietitian for a preoperative nutrition
program.
He has a history of Type 2 Diabetes, Hypertension, Hyperlipidaemia and osteoarthritis and has a total
right knee replacemet surgery 3 years ago. He takes metformin 1000mg twice daily, Insulin glargine
35u pm, Furosemide 25mg/day and Lovastatin 60mg/day.
The patient’s current weight is 186 kg with a height of 5’10” and blood pressure of 135/90. He also
suffers from 2+ pitting oedema with a rash present between skinfolds. He is NPO until his surgery.
Impaired Laboratory Results
Potassium 5.8 mEq/L

Glucose 145 mg/dL
Cholesterol 320 mg/dL
HDL-C 32 mg/dL
VLDL 45 mg/dL
LDL 232 mg/dL
TG 245 mg/dL
HbA1c 7.2%
1. Discuss the primary health risks involved with morbid obesity. What health risks does the patient
present with?
2. By performing an Internet search or literature review, find one example of a bariatric surgery
program. Describe the information that is provided for the patient regarding qualification for surgery.
Outline the personnel involved in the evaluation and care of the patient in this particular program.

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3. The patient has had type 2 diabetes for several years. His physician shared with him that after
surgery he will not be on any medications for his diabetes and that he may be able to stop his
medications for diabetes altogether. Describe the proposed effect of bariatric surgery on the
pathophysiology of type 2 diabetes. What, if any, other medical conditions might be affected by weight
loss?
4. On post-op day one, the patient was advanced to the Stage 1 Bariatric Surgery Diet. This consists of
sugar-free clear liquids, broth, and sugar-free Jell-O. Why are sugar-free foods used?
5. Over the next two months, the patient will be progressed to a pureed-consistency diet with 6–8 small
meals. Describe the major goals of this diet for the Roux-en-Y patient. How might the nutrition
guidelines differ if the patient had undergone a Lap-Band procedure?

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6. The patient’s Dietitian has discussed the importance of hydration, protein intake, and intakes of
vitamins and minerals, especially calcium, iron, and B12. For each of these nutrients, describe why
intake may be inadequate and explain the potential complications that could result from deficiency.
7. Assess the patient’s height and weight, calculate his BMI< IBW and what a reasonable weight goal
would be for him. Give your rationale for the method used to determine this.

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8. Determine the appropriate progression of the patient’s post-bariatric-surgery diet. Include
recommendations for any supplementation that you would advise. Also describe any pertinent lifestyle
changes that you would view as a priority fro him.
9. Long term weight maintenance is important when aiming for a healthy life. Develop a diet plan for
the patient for when his post surgery diet ends. Calculate all his macronutrient needs and Energy
requirements.

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Diet Plan
Meal Food Serving kcal

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Obesity Worksheet

2. Define the main characteristics of Obesity

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

Hormone Site of Production Action

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

Impaired Laboratory Results

Potassium 5.8 mEq/L

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

Meal Food Serving kcal

HAMEED LATIF HOSPITAL Department of Clinical Nutrition

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