Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5 Pathology > L2 Obesity and Overweight > Flashcards

L2 Obesity and Overweight Flashcards

1
Q

Obesity

A

chronic metabolic disease with the defining feature of excess body fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Obesity is caused by a complex interaction of…

A

excessive caloric intake
insufficient PA
behavior
genetics
family history
metabolism
social determinants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prevalence of obesity/overweight

A

> 70% of adults and 35% of children and adolescents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Obesity and overweight increase the risk for

A

type 2 diabetes
HTN
stroke/MI
gallbladder disease
OA
sleep apnea
cancer
low QOL
mental illness
mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Important statistics about obesity in america

A

-No state has a prevalence of obesity <20%
-16 states have a prevalence of obesity of 35% to 40%
-50% of non-hispanic blacks are obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes racial disparities in obesity?

A
  1. Different behaviors for PA, lifestyle
  2. Different attitudes and cultural norms concerning body weight
  3. Decreased access to healthy foods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Worldwide prevalence has ____ between 1975 to 2016

A

tripled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Energy balance idea

A

Food intake has to be balanced with PA, metabolic rate, thermogenesis

if input and output equal each other, you possibly have weight balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Outputs of energy balance

A

Physical Activity = 20%
Basal metabolic rate = 70%
Adaptive thermogenesis = 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Many of our outputs are…

A

genetically determined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes obesity?

A

Increased weight is a polygenic condition combined with energy intake exceeding energy output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Monogenic conditions

A

failing to produce leptin, causes obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Weight Set Point Hypothesis

A

-Individuals have a genetically inherited set point that governs ideal body mass
-the environment acts upon this genetic background

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thrifty Gene Theory

A

set of genes has been selected to ensure survival in an environment with a limited food supply and marked seasonality

Individuals with wasteful genes were less likely to survive vs those with thrifty genes would be more likely to survive

Obesigenic environment acts upon each person’s genetic background

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

FTO

A

Fat mass and obesity associated gene , strongest known susceptibility gene locus for obesity

increases risk of obesity by 1.2x

regulates food intake, reduced satiety, poor food choices, loss of control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Can physical activity decrease the effect of FTO on obesity risk?

A

PA reduced the risk of obesity in adults with FTO risk by 27%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Understanding of genetics and obesity

A

majority of genes are involved in CNS pathways that regulate hedonic aspects of food intake, food preference, reward processing

genetics makes weight loss or gain difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why should clinicians understand that obesity has a strong genetic component?

A
  1. SCIENTIFIC EVIDENCE SUPPORTS THIS
  2. Makes you ignorant if you ignore this component
  3. You need to be the best health advocate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Daily expenditure decreases

A

Time spent in sedentary activities has increased
Labor saving devices
decrease in number/frequency of PE classes
lack of sidewalks/safe places to be outside
long work hours and long commute times

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sleep deprivation

A

short sleep (less than 7 hours) makes it harder for individual to lose and maintain weight loss, more likely to develop diabetes

contributes to insulin resistance, inhibits beta cells from increasing insulin release, decreases leptin and increases ghrelin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Stress-induced hypercortisolemia

A

long-term increased plasma cortisol leads to abdominal obesity

teach and implement stress reduction techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Overweight BMI

A

25 to 29.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Obese BMI

A

greater or equal to 30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Why is BMI used?

A

it is inexpensive and easy to perform
it is a surrogate measure of body fatness that correlates with health risk

moderately correlated with more direct measures of body fat. Strongly correlated with adverse health outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Limitations of BMI

A

based primarily on data from white people
highly specific, but only moderately sensitive
does not account for where weight is distributed

women, older adults, non-athletes will generally have higher BMIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

BMI does not

A

predict disease risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hydrostatic weighing

A

Gold standard for determining body composition
-it is time-consuming, expensive, and difficult to perform

those with higher body fat will displace more water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

DXA

A

increasingly accepted as gold standard
-not accurate with extremely obese, expensive

uses x-rays to determine between different tissues

29
Q

BOD POD

A

Air-displacement
estimates composition from bone density
may emerge as the EASIEST gold standard
it is expensive, not a lot of machines still

30
Q

Skin-fold thickness

A

Measures subcutaneous fat at several sites, equation to determine total body fat

Advantages: portable and relatively easy
Problems: Poor reliability and poor validity. Error can be >8%. Subcutaneous fat is not equal to total body fat.

31
Q

Bioelectrical impedance

A

Electrical current passes through tissue differently. a person with higher fat will have higher resistance

Advantages: easy, quick, non-invasive
Problems: hydration status impacts measurement. Poor reliability/validity. Requires lots of controls

32
Q

Distribution of body fat related to disease risk

A

Visceral fat is the most important predictor of the development of metabolic syndrome

subcutaneous fat around thighs is a negative predictor of metabolic syndrome

33
Q

Waist to Hip ratio

A

Low health risk were associated with
Males <.8
Females <.7

34
Q

Waist to hip circumference

A

body fat stored at hips is associated with some protection against CVD

body fat stored in abdomen is associated with health risks and obesity

This method is easy to perform and correlates with disease risk

35
Q

Fat in nonfat cells

A

In obesity, the ability of adipose tissue to store excess calories is impiared b/c fat cells become insulin resistance. They can no longer take up glucose. So ectopic fat accumulates in organs and muscle.

36
Q

Waist circumference

A

is an indicator of abdominal fat
increased waist circumference can be a marker for increased disease risk (even at a healthy weight)

disease risk increases with increasing waist measurement

37
Q

Waist Circumference Measurements

A

Risk increases with
Males >40 in
Females >35 in

38
Q

Bariatrics

A

Branch of medicine that deals with causes, prevention and treatment of obesity

39
Q

Goals of overweight/obesity treatment

A

Help individuals achieve a healthier weight, not an ideal one

Weight loss as small as 5-10% of initial weight is sufficient to improve obesity related complications

40
Q

Treatment methods for overweight obesity

A

Diet
Exercise
Drugs
Bariatric surgery
Behavioral modifications
Psychotherapy
Decreasing sedentary activity

41
Q

Orlistat

A

oral drug that prevents fat absorption by inhibiting pancreatic lipase

42
Q

Semaglutide

A

also known as Ozempic weekly SQ injection

MOA: activates glucagon-like-peptide (GLP-1) receptor, which increases insulin secretion, decreases glucagon

ADR: GI, injection site reactions

Newest drug that has shown superiority with improving glycemic control, reducing weight, BP, and cardioprotective effect

43
Q

Alli

A

OTC version of orlistat (reduced strength)

inhibits lipase, which decreases the ability to digest ingested fat

about 3+ lbs a year

ADRs: Gas with oily discharge, loose stools, hard to control bowl movements

44
Q

Roux-en-Y gastric bypass procedure

A

performed on individuals >100 lbs over ideal body weight, BMI >40

most effective weight loss intervention for those with class 3 obesity. Also resolves comorbidities

45
Q

Improvements after bariatric surgery

A

migraines, liver disease, diabetes, quality of life, GERD, cardio diseases, mortality

46
Q

Different treatments compared

A

Gastric bypass had the most people without using medication in comparison to medical therapy and sleeve gastrectomy

47
Q

What makes a successful loser?

A

-changes in eating and exercise
-walking regularly
-ate breakfast
-weighed themselves once a week
-watched less TV

48
Q

Role of Diet in weight loss

A

deficit of 500 kcal/day should result in initial weight loss of 1 pound a week

dietary adherence is the most important predictor of weight loss, irrespective of type of diet

Eliminate caloric beverages and processed foods, portion control, self-monitoring

49
Q

Sugar and belly fat

A

excess calories from foods high in sugars or saturated fats may be more likely to settle in deep belly fat

50
Q

Cutting calories vs Exercise More

A

those that are told to cut calories lose more weight than those that are told to exercise more

51
Q

Why exercise won’t make you thin

A

do not over-compensate because you are exercising

it is more important to incorporate activity throughout the day rather than relying on exercise bouts

52
Q

Role of Exercise in body weight

A

exercise only modestly improves weight loss

it is difficult to maintain to exercise programs, weight loss is not seen on the scale

It is important in preventing obesity and maintaining long term weight loss and preserving lean body mass while dieting

Requires >1 hour per day of mod intensity to maintain weight loss

53
Q

Benefits of Exercise (Not weight loss)

A

glycemic control
lipid profiles
blood pressure
body composition
aerobic fitness
hemostatic factors

54
Q

Why do individuals who lose weight often regain it?

A

huge decrease in basal metabolic rate

Major changes in hormones that drive appetite

55
Q

10,000 steps a day

A

reasonable estimate of daily activity for healthy adults

not reasonable for children or certain groups

helpful for those that are pedometer dependent

individuals who achieve 10,000 are seen as “active)

56
Q

Walking intensity

A

need about 100 steps/min for 30 min/day to acheive moderate exercise intensity by walking

Health benefits can be acheived with exercise bouts lasting at least 10 min. Try to get 1000 steps in 10 min

57
Q

Decreasing Sedentary Activity

A

activity that occurs in the remaining time OUTSIDE of the 150 min of exercise is critical to health

prolonged sitting was a risk factor for all-cause mortality, independent of PA

Try to sit less than 8 hours a day and meet PA requirements to decrease mortality rates

58
Q

Sedentary Behavior

A

sitting and lying down while being awake, and incur no more than 1.5 mets

most individuals are sedentary and inactive

59
Q

Why is prolonged sitting bad for health?

A

increased plasma triglyceride levels
decreases plasma HDL level
affects carb metabolism
decreases insulin sensitivity

60
Q

Strategies to decrease sedentary time

A
  1. Get past the concept of scheduled exercise sessions
  2. Change commuting habits
  3. Stand up every 30 min and walk for 5 min
  4. Stand up for tasks
  5. Walk up stairs
  6. Educate that threshold for benefits is low!
61
Q

5 things obesity researchers agree on

A

Avoid processed carbs
fill up on fiber
exercise for your health
cut yourself some slack
ask for help

62
Q

How long does a conversation has to be in order for a patient to make changes to their weight?

A

3 to 5 minutes

63
Q

Patients who were obese and were advised by their HCPs to lose weight were ________ more likely to try to lose weight

A

3x

64
Q

What do patients want from HCPs regarding weight?

A

Talk
Non-offensive terms
Advice they can use

65
Q

Tips for talking about weight with patients

A
  1. Address your pts’ chief health concerns or complaints first, independent of weight
  2. Open the discussion
  3. Decide if the pt is ready to control weight
  4. Set a weight goal
  5. Prescribe healthy eating and PA behaviors
  6. Follow up
66
Q

Sensible weight goals

A

5 to 10% reduction in body weight over 6 months
1.5 to 2 lbs per week

67
Q

Weight Myths

A
  1. I can lose it later
  2. Once its off, it will stay off
  3. Fat is fat, no matter where it is
  4. You have to go out of your way to overeat
  5. All extra calories are equal
  6. You can boost your metabolism
  7. There’s a magic bullet diet
  8. I can work off the extra calories
68
Q

Bottom Lines of Weight myths

A
  1. Slower metabolism and less lean mass make it hard to lose extra pounds
  2. Many dieters gain back weight because they begin to eat more
  3. Extra calories can lead to fat, like deep-belly which is dangerous
  4. What is typically served in restaurants is high calories
  5. Excess calories from food high in sugar or unhealthy fats may be more likely to settle in the belly
  6. Don’t depend on “metabolism boosters”
  7. Don’t depend on a miracle diet
  8. Don’t count on exercise alone to lose weight

5 Pathology (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions