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Drug Dosing: Obese Patients01:21

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In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
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The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
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Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
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Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
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Overweight physicians during residency: a cross-sectional and longitudinal study.

Maya Leventer-Roberts, Mark R Zonfrillo, Sunkyung Yu

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    Resident physicians gain weight during training, with nearly half of overweight individuals misperceiving their body mass index (BMI) as normal. This trend worsens with postgraduate year (PGY) progression, impacting long-term health.

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    Area of Science:

    • Medical Education
    • Public Health
    • Physician Wellness

    Background:

    • Resident physicians face environmental, resource, and stress changes impacting weight status.
    • Understanding health metrics during postgraduate training is crucial for physician well-being.

    Purpose of the Study:

    • To assess body mass index (BMI), blood pressure, eating habits, and physical activity in residents.
    • To compare resident health data with nationally matched controls.

    Main Methods:

    • Combined cross-sectional and longitudinal cohort study.
    • Objective measurement of BMI and blood pressure.
    • Eating and exercise habit recall in 375 residents across 2 US academic centers.

    Main Results:

    • 43% of overweight residents self-identified as normal weight.
    • Overweight prevalence increased from 30% at PGY-1 to 49% by PGY-3.
    • Initial BMI was lower than controls, but this difference diminished over postgraduate years.

    Conclusions:

    • Overweight status is underrecognized by residents and increases with training.
    • These changes diverge from control groups, potentially impacting physicians' long-term health.
    • Interventions may be needed to address weight status during residency.