FOCUS: Preventive Cardiology and Obesity
Obesity is a risk factor for nearly all forms of cardiovascular and cardiometabolic disease. In fact, the epidemic status of obesity in the United States has been identified as responsible for the rise in deaths from heart disease after 4 decades of steady decline.
Prevention and management of overweight and obesity is central to primary prevention of CVD. Test yourself on the most recent guidance from the American Heart Association/American College of Cardiology (AHA/ACC) on comprehensive interventions to treat patients with this chronic, relapsing disease.
1. What proportion of initial weight is considered to be clinically meaningful weight loss?
Answer: A. ≥5% of initial weight. According to a review of the evidence by the ACC/AHA, a loss of ≥5% of initial weight is considered clinically meaningful weight loss.
2. A diet for initial weight loss by individuals with obesity should reduced caloric intake by at least how much per day?
Answer: B. 500 calories. As part of an integrated lifestyle intervention for initial weight loss, a diet for individuals with obesity typically is designed to decrease calorie intake by at least 500 calories per day from baseline.
3. Which of the above is recommended by the ACC/AHA as the initial primary screening measurement for identifying individuals in need of weight loss?
Answser: D. BMI. The ACC/AHA recommends annual BMI screening as the primary screening measurement for identifying individuals in need of weight loss.So far, BMI is the most standardized approach to defining overweight/obesity,
4. Using waist circumference to assess cardiometabolic risk is recommended in which of the scenarios above?
Answer: A. patients with BMI <35 kg/m2. Increased waist circumference is an indication of central adiposity, which is associated with increased cardiometabolic risk and increased risk for ASCVD. Because BMI alone may miss central adiposity, the ACC/AHA recommends measuring waist circumference in all individuals with a BMI <35 kg/m2.
5. Which of the above has not been FDA-approved for treatment of obesity?
Answer: E. Exenatide. While the GLP-1 agonist class, which includes exenatide, is associated with weight loss, liraglutide is the only drug in this class to date that has received FDA approval for weight loss.