TEST YOUR KNOWLEDGE: SECONDARY CAUSES OF OBESITY
Year : 2017 | Volume
: 5 | Issue : 1 | Page : 40--41
Test your knowledge: Secondary causes of obesity
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. Test your knowledge: Secondary causes of obesity.Saudi J Obesity 2017;5:40-41
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. Test your knowledge: Secondary causes of obesity. Saudi J Obesity [serial online] 2017 [cited 2022 Oct 5 ];5:40-41
Available from: https://www.saudijobesity.com/text.asp?2017/5/1/40/210583
CHOOSE ONE BEST ANSWER FOR EACH OF THE FOLLOWING QUESTIONS
1. The prevalence of secondary obesity among children and adolescents is estimated to be about:
2. A 25 year old female whose her BMI is 31kg/m2, she attended for consultation. Which one of the following findings suggest secondary cause of her obesity?
A. Dry skin
B. Increased waist circumference (92 cm)
C. High fasting blood glucose
D. High cholesterol
3. A 7 year old male child was brought to clinic by his parents for weight assessment. His BMI was above 95th centile. Which one of the following tests are recommended to be done for him at this visit?
A. Serum calcium
B. Serum cortisol
C. Serum growth hormone
D. Serum glucose
4. A 18 year old female whose BMI is above 30 kg/m2 should be evaluated for secondary causes of obesity if she complains of:
A. Severe fatigue
B. Chronic headache
C. Hair fall
D. Menstrual disturbance
E. All above
5. A 35 year old female who attended clinic for weight management. She stated that she worries that she may have thyroid abnormalities . Her BMI was 31kg/m2. The next step to manage this lady would be:
A. Ask for thyroid function test and give appointment within two weeks
B. Reassure her that most of individuals with obesity have normal thyroid
C. Take comprehensive history and conduct physical examination
D. Counsel her about diet therapy and physical activity.
ANSWERS AND EXPLOITATIONS
Secondary causes of obesity among children and adolescents are rare (less than 1%), However, they should be considered if there is any finding suggesting underlying cause such as sudden weight gain, short stature, dysmorhic features, chronic headache, dry skin, skin hyperpigmentation and developmental delay.
In this lady, skin dryness, fall of hair, constipation, sad mood, fatigue could indicate secondary cause such hypothyroidism. High blood pressure and high glucose and high lipid could be a part of metabolic syndrome in this lady rather than manifestations of secondary cause.
This child most likely to have obesity as a result of intake of imbalanced diet and physical inactivity, however, physician should look for the clinical manifestations of secondary cause of obesity. It is not recommended to ask for further investigations such as (TSH, Growth hormone, calcium or cortisol) unless there is suggesting or secondary cause of obesity (dsymorphic features, dry skin, developmental delay, short stature, skin striae). In this child blood glucose should checked to rule out associated diabetes.
This lady with obesity should be assessed thoroughly by taking comprehensive history and complete physical examination and to ask for further tests in the case of having manifestations of secondary causes (severe and chronic headache, visual disturbance, severe fatigue, dry skin, hair fall, voice tone changes, neck swelling, skin striae, skin hyperpigmentation, menstrual cycle disturbance.
This patient should be assessed using step by step approach including : detail history with exploring the idea, concern and expectation of this lady, reasons for visit and then conducting complete physical examination to look for secondary cause of obesity and co-morbidities . As obesity in adults may associated with diabetes and dyslipidemia, blood glucose and lipid profile should be requested. Regarding asking for thyroid function test, we can ask for it if there is any symptom or sign suggesting such condition, however, it is not routinely recommended.
Allen G. Secondary Causes of Obesity. American Family Physician 2011;83(8):972-973
Karam GJ, McFarlane SI. Secondary causes of obesity Review. Therapy 2007;4(5):641-650