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CVDM > Eat Less Burn More > Flashcards

Eat Less Burn More Flashcards

1
Q

How can we prevent/treat obesity and diabetes?

A

Lifestyle changes
Psychological therapies
Bariatric surgery
Therapeutic agents to reduce body weight

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2
Q

Name some lifestyle changes to treat obesity and diabetes
Do these work?

A

Dieting and exercise
Generally do not produce a marked sustainable weight loss in the general population

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3
Q

What is a psychological therapy that can be used to treat obesity?
What is the issue with this?

A

CBT
Not able to deliver it on a mass scale

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4
Q

Advantages and disadvantages for using bariatric surgery to treat obesity

A

Advantages - very effective
Disadvantages - expensive, reserved for morbidly obese individuals, risks of the procedure, have to have some weight loss before surgery

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5
Q

How may therapeutic agents help treat obesity?

A

They increase energy expenditure and/or decrease consumption/absorption of food

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6
Q

Noradrenergics:
What do they do to help obesity?
Side effects
Are they approved?

A

They are appetite suppressants that inhibit noradrenaline uptake
CVD side effects
Not approved for use

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7
Q

Seratonergics:
What do they do to help obesity?
Side effects
Are they approved?

A

Appetite suppressants that act on 5-HT system
Some induce heart disease, some caused a return to original weight after weight loss
Not prescribed

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8
Q

What is the current drug for treatment of obesity?

A

Orlistat

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9
Q

How does orlistat work?

A

By inhibiting pancreatic lipase thus decreasing triglyceride absorption, reducing fat absorption in the small intestine

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10
Q

Side effects of orlistat

A

Cramping
Diarrhoea
Bloating
Flatulence
Abdominal pain

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11
Q

Why do you need to take vitamin supplements if you are prescribed orlistat?

A

Because you lose fat soluble vitamins e.g. vitamin A, vitamin D and vitamin E

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12
Q

Is orlistat effective?

A

Not particularly - only lose about 3kg in 12 months
Tendency to get rebound weight

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13
Q

Liraglutide:
Drug class
Dosage
Concerns

A

GLP-1 agonist (GLP-1 is a satiety peptide)
3mg produces 5-10% weight loss
Concerns about thyroid and pancreatic cancer

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14
Q

Semaglutide:
Drug class
Dosage
Is it easy to get?
Is it more or less effective than liraglutide?

A

GLP-1 agonist
2.4mg weekly sc injection
No - there are strict rules on the NHS
More effective than liraglutide - produces 15-20% weight loss and less side effects

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15
Q

How does weight loss surgery work?

A

It limits the amount of food that the stomach can hold, making the individual feel full after a small meal

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16
Q

Types of bariatric surgery

A

Adjustable gastric band
Route-en Y gastric bypass
Vertical sleeve gastrectomy

17
Q

What happens in adjustable gastric band surgery?

A

A band is placed at the top of the stomach to limit food entry to the stomach

18
Q

What happens in route-en Y gastric bypass?

A

The digestive tract is rerouted, by-passing most of the stomach and small intestine, accelerating the GI transit of food

19
Q

What happens in vertical sleeve gastrectomy?

A

Part of the stomach is removed leaving a sleeve, so reducing the size of the stomach, lowering food intake and increasing gastric emptying

20
Q

What is the most common type of bariatric surgery?

A

Vertical sleeve gastrectomy

21
Q

What percentage weight loss does gastric produce?

A

50-60% in one year that is sustainable

22
Q

How quickly does a dramatic improvement in glucose homeostasis and insulin sensitivity occur following bariatric surgery?

A

Within 1 week, before significant weight loss occurs

23
Q

What is energy expenditure?

A

Heat produced + work done

24
Q

What is obligatory energy expenditure?

A

Basic cell and organ physiological needs

25
Q

What is adaptive energy expenditure

A

Physical activity and adaptive thermogenesis

26
Q

Brown adipose tissue contains lots of/few mitochondria

A

Lots of mitochondria

27
Q

How is proton leak in brown adipose tissue regulated?

A

By UCP1

28
Q

How is heat generated in brown adipose tissue?

A

Proton movement

29
Q

How is UCP1 activated?

A

By long-chain fatty acids

30
Q

What is the function of brown adipose tissue?

A

To generate body heat in animals or newborns that do not shiver

31
Q

What are UCPs activated by?

A

Fatty acids and free radicals

32
Q

What is UCP expression induced by?

A

Metabolic and oxidative challenge:
Cold temperatures
Dietary restriction
Exercise

CVDM (16 decks)

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