Lecture 36 - Coordinating Metabolism: Obesity Flashcards

1
Q

What is obesity?

A

A chronic complex disease defined by excessive
fat deposits that can impair health.

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2
Q

What does obesity influence?

A

Quality of living, such as sleeping, moving and
can have a negative impact on mental health.

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3
Q

What does obesity increase the risk of?

A

Type 2 diabetes, heart disease, stroke, impaired reproduction, liver and gall bladder disease, respiratory disorders and certain cancers.

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4
Q

New Zealand has the …. highest rate of adult obesity

A

Third

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5
Q

What are some potential ways of achieving weight loss?

A
  1. Reducing energy intake
  2. Increasing activities
  3. Increasing basal metabolism
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6
Q

What are some ways of reducing energy intake?

A

Calorie restriction, low fat diet, low carb diet, blocking
fat absorption (Xenical).

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7
Q

Why may diet weight loss be difficult to maintain?

A

The body resets to a lower basal metabolic rate

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8
Q

What are ketogenic diets?

A

Diets restricted in carbs

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9
Q

What do ketogenic diets promote?

A

The use of body fat and ketosis

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10
Q

What do ketogenic diets do to insulin secretion?

A

Reduce it

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11
Q

What do ketogenic diets do to your appetite?

A

Reduce appetite because proteins make you feel more full

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12
Q

What do keto diets based on saturated fats do?

A

Increase LDL levels

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13
Q

What is Xenical?

A

a pancreatic lipase inhibitor that reduces fat absorption , was heavily marketed for weight loss.

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14
Q

Why was Xenical not a favourable drug?

A

Due to moderate weight loss in trials and many side-effects
i.e. leakage, gas and fatty stools.

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15
Q

What are ways that basal metabolic rate can be increased?

A
  • Increasing muscle mass because muscle is more metabolically active than fat and burns more ATP at rest.
  • Uncouplers i.e. substances that uncouple OxPhos in the mitochondria, causing energy to be released as heat rather than generating ATP
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16
Q

What are examples of things that increase basal metabolism?

A
  • Dinitrophenol (DNP) and FCCP (cause hyperthermia and organ failurei.e. very toxic).
  • BAM 15 (safer and showing promising results in preclinical studies).
  • Uncoupling protein activators i.e. Mirabegron which targets UCP1 in brown adipose (associated with some heart problems).
  • Thyroid hormones (also associated with some heart problems).
17
Q

What is Leptin and what does it do?

A

A hormone from adipose that signals to reduce appetite

18
Q

What does GLP-1 from the gut do?

A

Signals to reduce appetite

19
Q

What does Ghrelin from the stomach do?

A

Signals that the gut is empty and stimulates appetite

20
Q

What are GLP-1 agonists good for?

A

Off-label weight loss

21
Q

What is semaglutide?

A

A peptide similar to the endogenous hormone GLP-1

22
Q

What effects does GLP-1 have in terms of weight loss?

A

Decreases gastric emptying

23
Q

What does GLP-1 do in terms of diabetes?

A
  • Less glucagon secretion
  • more insulin secretion + biosynthesis
  • More somatostatin secretion
  • Less apoptosis
24
Q

What may leptin deficiency cause?

A

Overeating

25
Q

Does leptin resolve obesity?

A

Leptin doesn’t resolve obesity as it is leptin resistance that’s the problem

26
Q

Can leptin deficiency occur in humans?

A

Yes but it is very rare

27
Q

What are the competing paradigms of obesity pathogenesis?

A

Energy Balance model vs Carbohydrate-Insulin Model

28
Q

What is the primary dietary driver in the energy balance model?

A

Energy dense, ultra-processed foods high in portion size, fat, sugar but low in protein and fibre

29
Q
A