(Peri-Op & Anaesthesia) (GP)

Overview

• Chronic adverse condition due to an excess amount of body fat
• Defined as BMI ≥30kg/m², can be grouped into classes 1-3
• Prevalence → ∼40% of Adults and ∼20% of Adolescents (12-19 yrs old)
• Aetiology → genetics, behavioural (larger portion sizes, sedentary lifestyles, poor dietary habits), environmental (low socioeconomic level), hormonal (hypothyroidism, hypercortisolism, insulinoma)

Making Diagnosis

Clinical Features:

• Large Waist Circumfrence
• Comorbid Conditions → T2DM, CVD, hypertension, hyperlipidaemia, GORD, OSA, gout, cancer, gallbladder disease, cancer

Investigations:

• BMI → (weight in kg) / (height in m)². Not accurate in pregnancy or people with a large amount of muscle mass (eg. professional athletes)
  • BMI Interpretation

Management Plan

• Class 1 (BMI ≥30kg/m²) → dietary changes + increase in physical activity are first line. Consider medication - Orlistat (pancreatic lipase inhibitor).
• Class 2 with comorbities OR Class 3 OR Other measures innefective → surgical therapy (bariatric surgery - sleeve gastrectomy)