EXAM 2- OBESITY Flashcards
How many men and women in US are obese?
32% men
35% women
How many men and women in US are overweight and obese?
72% men
64% women
What is considered overweight?
20% or more over ideal weight
What is considered obese?
30% or more over ideal weight
What is considered morbidly obese?
40% or more over ideal weight
Where are 2 major areas of fat storage?
subdermal tissue (subcutaneous)
omentum (visceral)
What are adipocytes?
metabolically active, secrete a wide variety of substances referred to as adipokines
What are the adipokines?
tumor necrosis factor alpha (TNF-alpha)
interleukin-6 (IL-6)
angiotensinogen (AGT)
plasminogen activator inhibitor (PAI)
adiponectin
leptin
resistin
What does adiponetin do?
enhances cellular sensitivity to insulin
exerts anti-inflammatory effects
protective against the formation of arteriosclerosis
GOOD adipokine
What is the relationship between adiponectin and adiposity?
inverse relationship
lower adiposity = greater amount of adiponectin
greater adiposity = less amount of adiponectin
What is leptin?
signals brain that the body has had enough to eat
obese = resistant
works with adiponectin to enhance cellular sensitivity to insulin, reduce TGs, and inhibit fat accumulation
GOOD adipokine
What does resistin do?
cause insulin resistance, enhances hepatic glucose production, raises TGs, reduce HDL, cause early arteriosclerotic lesions
BAD adipokine
What is angiotensinogen (AGT)?
adipose tissue - AGT - increased vascular tone
causes HTN and vascular changes of arteriosclerosis
BAD adipokine
What does plasminogen activator inhibitor (PAI) do?
adipose tisse - PAI - blocks action of tPA
tPA = dissolves clots
Obesity - PAI & blocks fibrinolysis and increase susceptibility to clot formation
Why does the great number of cells cause the greater risk of CVD?
adipose tissue secretion of adipokines, AGT, and PAI
What is ghrelin and what does it do?
peptide secreted by stomach that stimulates hunger, regulates food intake, and stimulus growth hormone
What are risk factors for obesity?
excess calorie intake vs output, sedentary behavior, poverty, culture, age, females, smoking, genetics, secondary disorders (Cushing’s)
What are the obesity signs as cardio risk?
apple-shaped central obesity = CVD
a waist measurement that >35 inches in women or >40 inches in men = CVD
What is the recommended % of body fat?
females = 30% or lower
males - 25% or lower
How is BMI calculated?
weight (kg)/height (m^2)
weight (lbs)/height (in^2)
ideal BMI
18.5 to 24.9
overweight BMI
25-29.9
morbid obesity BMI
30 or greater
When should someone use drug therapy for obesity?
adjunct w diet and exercise
for people with increased health risk (BMI >30)
only after 6 months trial of diet and exercise
Orlistat (Alli, Xenical)
FDA approved to promote and maintain weight loss
MOA of orlistat
reduces absorption of fat
2 year weight loss = 19 lbs
AE of orlistat
black box - liver injury
GI symptoms (minimize by decreasing fat intake)
must take w multivitamin
semaglutide (Wegovy, Rybelsus)
peptide like glucagon-like peptide-1 (GLP-1)
MOA of semaglutide
stimulates release of insulin, inhibits glucagon release, slow gastric emptying, decreases appetite
Bariatric Surgery types
liposuction, gastric bypass, gastric banding
The Metabolic Syndrome (syndrome X)
DM 2, HTN, Low HDL, insulin resistance, fatty liver, high plasma TGs, hyperglycemia
Metabolic Syndrome indicators
1) waist circumference >90/80 cm (m/f)
2) TG >150
3) HDL <40/50 (m/f)
4) BP >130/85
5) FPG >100 or w DM 2
MUST HAVE 3 of 5
What can having metabolic syndrome do to someone?
increase risk for heart disease and stroke
What is the treatment for metabolic syndrome?
weight loss, exercise, healthy diet, smoking cessation, medications for control
