2: Aspects of obesity

Question 1

At a fundamental level, what causes obesity?

Answer 1

More energy in than energy out

Question 2

Which three food groups contribute the most to obesity?

Answer 2

Carbohydrates

Fat

Protein

Question 3

Excess of what drinks can cause obesity?

Answer 3

Alcohol

Question 4

What three processes contribute to energy expenditure in the body?

Answer 4

Basal metabolism - e.g digesting food, heartbeat, breathing…

Thermogenesis - temperature regulation of the body

Physical activity

Question 5

Which gene is thought to be associated with obesity?

Answer 5

FTO

Question 6

Obesity is associated with a lot of _-__.

Answer 6

co-morbidities

Question 7

What are some cardiovascular complications of obesity?

Answer 7

Hypertension

PE / Stroke

Heart failure

Question 8

What are some respiratory complications of obesity?

Answer 8

Sleep apnoea

Asthma

Question 9

What are some musculoskeletal complications of obesity?

Answer 9

Osteoarthritis

Chronic pain syndromes (e.g fibromyalgia)

Question 10

If you have obesity, you are more likely to develop ___.

Answer 10

cancer

Question 11

Obesity causes ___ ___ which leads to overproduction of insulin by the pancreas, causing ___.

Answer 11

insulin resistance

hyperinsulinaemia

Question 12

What are some incretins, found in the GI tract, which influence glucose absorption and appetite?

Answer 12

GIP and GLP-1

acted on by GLP-1 agonists (exenatide) and DPP-IV inhibitors (gliptins)

Question 13

What is a hormone which informs the hypothalamus of the body’s fat content, has an effect on appetite and reduces resting metabolic rate?

Answer 13

Leptin

Question 14

If no leptin is being produced, or your leptin receptors function incorrectly, the hypothalamus thinks you’re in a state of ___ and will increase your appetite.

Answer 14

starvation

Question 15

What cell structure, when stressed, triggers inflammation?

Answer 15

Endoplasmic reticulum

Question 16

What situations stress the ER?

Answer 16

Obesity

Infection

Question 17

Inflammation brings about insulin resistance and hyperlipidaemia, which both bring on one another.

What are the long term consequences of

a) insulin resistance
b) hyperlipidaemia?

Answer 17

a) Diabetes

b) Atherosclerosis

Question 18

Through which three means can obesity be treated?

Answer 18

Lifestyle - diet, exercise, stop smoking and drinking

Drugs

Bariatric surgery

Question 19

What is a hypocaloric diet?

Answer 19

More calories OUT than IN

Question 20

Hypocaloric diet are low in ___ and ___.

Answer 20

carbohydrates

fat

Question 21

What is the only licensed drug for obesity in the UK?

Answer 21

Orlistat (i.e Alli)

Question 22

Orlistat blocks fat absorption by inhibiting the action of enzymes called ___.

What symptom does this produce?

Answer 22

lipases

steattorhea

Question 23

What are the two general types of bariatric surgery?

Answer 23

Restrictive (gastric band - reduces stomach capacity)

Malabsorptive (gastric bypass - absorptive part of stomach skipped)

Question 24

Gastric bypass is an example of ___ bariatric surgery.

Gastric banding is an example of ___ bariatric surgery.

(malabsorptive , restrictive)

Answer 24

Gastric bypass - malabsorptive

Gastric band - restrictive

Question 25

Evidence shows that, out of lifestyle changes, drugs and surgery, the intervention which causes the best outcome in patients with obesity is ___.

Answer 25

surgery

sadly

Question 26

People who have had bariatric surgery are more likely to have ___ deficiencies.

Give an example?

Answer 26

micronutrient

Vit B12, which causes anaemia

Question 27

Patients who have had gastric bypass surgery are prescribed ___ supplements.

Answer 27

vitamin supplements

Question 28

In terms of metabolism, what falls as weight does?

What is this process called?

Answer 28

Resting metabolic rate

Adaptive thermogenesis

This is why it’s harder to lose weight as you go on

Question 29

The (higher / lower) your resting metabolic rate, the more difficult it is to lose weight.

Answer 29

lower metabolic rate = harder to lose weight

as energy expenditure is less

Question 30

The body sees weight loss as a threat to ___.

Answer 30

survival