Obesity and weight management — structured viva

Structured oral on obesity and weight management: defending the chronic-disease framing with Biggest Loser biology, DPP lifestyle evidence, GLP-1 pharmacotherapy (STEP 1/SURMOUNT-1), bariatric surgery criteria (STAMPEDE), and the Flegal BMI-mortality nuance.

Prompt

The examiner opens: 'Patients just need to eat less and move more — why do you make it complicated?' The viva branches through chronic-disease framing, lifestyle evidence, pharmacotherapy, bariatric surgery, weight regain biology, and the Flegal meta-analysis.

Stem

A registrar says obesity management is 'diet sheets and willpower'. You are asked to present a more sophisticated framework. ^[8]

References8Show

[1]Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 2002.PMID 11832527
[4]Flegal KM, Kit BK, Orpana H, Graubard BI Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA, 2013.PMID 23280227
[5]Look AHEAD Research Group, Wing RR, Bolin P, Brancati FL, Bray GA, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med, 2013.PMID 23796131
[6]Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med, 2014.PMID 24679060
[7]Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, et al. Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition. Obesity (Silver Spring), 2016.PMID 27136388
[8]Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med, 2017.PMID 28199805
[9]Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med, 2021.PMID 33567185
[10]Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med, 2022.PMID 35658024

Obesity and weight management — structured viva

Stem

A registrar says obesity management is 'diet sheets and willpower'. You are asked to present a more sophisticated framework. ^[8]

References8Show

[1]Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 2002.PMID 11832527
[4]Flegal KM, Kit BK, Orpana H, Graubard BI Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA, 2013.PMID 23280227
[5]Look AHEAD Research Group, Wing RR, Bolin P, Brancati FL, Bray GA, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med, 2013.PMID 23796131
[6]Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med, 2014.PMID 24679060
[7]Fothergill E, Guo J, Howard L, Kerns JC, Knuth ND, et al. Persistent metabolic adaptation 6 years after 'The Biggest Loser' competition. Obesity (Silver Spring), 2016.PMID 27136388
[8]Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes - 5-Year Outcomes. N Engl J Med, 2017.PMID 28199805
[9]Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med, 2021.PMID 33567185
[10]Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, et al. Tirzepatide Once Weekly for the Treatment of Obesity. N Engl J Med, 2022.PMID 35658024