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Alimentary system > 9. Obesity > Flashcards

9. Obesity Flashcards

1
Q

Describe the energy balance.

A

Balance between energy input and energy expenditure. Overweight people have net energy input.

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2
Q

What makes up the majority of energy expenditure?

A

REE: resting energy expenditure (AKA basal metabolic rate)

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3
Q

Define obesity

A

excessively high accumulation of body fat or adipose tissue in relation to lean body mass

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4
Q

How does REE change with weight loss? What is a consequence of this?

A

As you lose weight REE decreases

so it becomes increasingly difficult to lose more weight

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5
Q

How is daily EE composed?

A

Resting energy expenditure REE (AKA BMR)
Physical activity
Adaptive thermogenesis

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6
Q

What is BMI?

A

Weight (kg) / Height (m^2)

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7
Q

At what BMI is a person considered obese?

A

> ,30

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8
Q

How does classification of BMI scores change?

A

With ethnicity

E.g. Asians are obese at lower scores

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9
Q

Describe the prevalence of obesity

A

High and continues to increase

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10
Q

Describe the distribution of obesity in the UK

A

High generally, but particularly in the north

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11
Q

How does prevalence of obesity change with age?

A

Increases with age

Highest prevalence in 55-64 yr olds

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12
Q

Which ethnic groups have the highest rates of obesity?

A

Caucasian

Bangladeshi

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13
Q

How does prevalence of obesity change with social class?

A

Low social classes have higher prevalence of obesity

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14
Q

Prevalence of obesity amongst smokers

A

Lower BMI but greater central obesity

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15
Q

Describe the genetic influence on obesity

A

60% inheritable genes that influence obesity (BMI and appetite regulation)
But only explains 5% of cases

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16
Q

Government consequence of obesity

A

Obesity and its associated conditions are very expensive to treat

17
Q

List 5 major effects/ consequences of obesity

A 
Coronary heart disease
Type 2 Diabetes
Cancers
Hypertension
Depression
18
Q

What is another measure of obesity that can be used to determine risk of metabolic syndrome?

A

Waist: hip circumference

A high value indicates increased risk of metabolic syndrome

19
Q

How does distribution of fat storage dictate metabolism?

A

If fat is stored in the omentum/ associated with liver, intestine and heart
Blood flowing through fat:
Adipose tissue contains immune cells and adipocytes
Immune cells send out inflammation signals, which affect metabolism

20
Q

List 5 characteristics of an obese person, and what these leads to

A 
Deteriorated lipid profile
Impaired insulin sensitivity 
Increased susceptibility to thrombosis
Increased inflammation markers
Impaired endothelial function 
Increased risk of coronary heart disease
21
Q

What waist circumferences give a major risk of CHD in men and women?

A

Men: >102 cm
Women: >88 cm

22
Q

What aspects of the metabolic syndrome does losing weight improve? What are the consequences of this?

A

All aspects

Reduction in all mortality, diabetes related mortality and certain cancers

23
Q

What are the NICE recommended treatments for obesity?

A 
Diet
Exercise
Behavioural therapy
Drug treatment
Surgery (if BMI >40)
24
Q

Why should a multi-action approach be taken to treating diabetes?

A

Most treatments prove effective in the short term

In the long term, people regain the weight they lost

25
Q

What is PYY?

A

Fullness hormone

Released after a big meal

26
Q

What is Ghrelin?

A

Hunger hormone: Ghrelin levels increase and tell the hypothalamus that you need to eat
Energy expenditure and satiety will DECREASE

27
Q

How do levels of PYY ad Ghrelin change when obese people lose weight?

A

Release less PYY: So start to feel hungry

Increase more ghrelin: Makes you more hungry

28
Q

What is the only licenced obesity medication in the UK?

A

Orlistat

29
Q

Why are pharmaceutical drugs often removed from the market for obesity?

A

They have major side effects e.g. depression, hypertension

30
Q

How does orlistat affect diabetes risk?

A

Decreases diabetes risk

31
Q

What is the most effective and sustainable treatment option for obesity?

A

Bariatric surgery: Gastric bypass

32
Q

Is there any primary prevention action for obesity currently?

A

No

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