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Related Concept Videos

Obesity01:24

Obesity

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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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Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

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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 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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Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

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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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Hormonal Regulation of the Menstrual Cycle01:22

Hormonal Regulation of the Menstrual Cycle

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The ovarian cycle regulates endometrial changes throughout a single menstrual cycle via the coordinated action of gonadotrophin-releasing hormone (GnRH) and gonadotrophins.
At puberty, GnRH begins a pulsatile release pattern, which triggers the anterior pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The frequency and amplitude of GnRH pulses vary across the menstrual cycle, with faster pulses favoring LH release and slower pulses favoring FSH...
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Hormonal Control of the Ovarian Cycle01:30

Hormonal Control of the Ovarian Cycle

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The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle.  At puberty, GnRH secretion increases in both frequency and...
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Multidisciplinary Approach to Obesity Management: A Case Report
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Hormonal contraception and obesity.

Katharine B Simmons1, Alison B Edelman2

  • 1Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

Fertility and Sterility
|August 28, 2016
PubMed
Summary

Obesity does not significantly impact most hormonal contraceptive effectiveness, but data are limited for severe obesity. Combined hormonal patch and emergency contraception may be less effective in obese women.

Keywords:
Contraceptioneffectivenessobesitypharmacokineticssafety

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Area of Science:

  • Reproductive Health
  • Endocrinology
  • Public Health

Background:

  • Overweight and obesity rates are increasing globally, posing a public health challenge.
  • Historically, contraceptive studies excluded women above 130% ideal body weight, creating knowledge gaps.
  • Altered drug metabolism in obesity suggests potential impacts on hormonal contraceptive efficacy.

Purpose of the Study:

  • To review contraceptive use in women with obesity.
  • To compare steroid hormone metabolism, effectiveness, and safety in obese versus normal-weight women.
  • To identify contraceptive methods potentially affected by obesity.

Main Methods:

  • Literature review of studies on contraceptive use in women with varying body weights.
  • Analysis of pharmacokinetic and pharmacodynamic data related to obesity and hormonal contraception.
  • Synthesis of evidence on the effectiveness and safety of different contraceptive methods.

Main Results:

  • Most studies show oral contraceptive pill effectiveness is not compromised by obesity.
  • Data are limited for women in the highest obesity categories, and progestin type effects are unclear.
  • Effectiveness of most non-oral contraceptives appears unaffected, except for the combined hormonal patch and oral levonorgestrel emergency contraception.

Conclusions:

  • While most hormonal contraceptives are effective in obese women, caution is advised for the combined hormonal patch and oral levonorgestrel emergency contraception.
  • Further research is needed on contraceptive effectiveness in severe obesity and by specific progestin type.
  • Understanding contraceptive efficacy in obesity is crucial for patient care and public health.