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CDM 2 Exam 3 > Lecture 4.1 - Obesity & Metabolic Syndrome > Flashcards

Lecture 4.1 - Obesity & Metabolic Syndrome Flashcards

1
Q

Weight bias ranks….

A

just below race, gender and age as the 4th most common form of discrimination in the US

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2
Q

Explicit vs implicit bias

A

Explicit: bias within conscious awareness intentionally influences outward behavior

Implicit: unconscious attitudes & stereotypes affecting actions and decision, activated w/o awareness or control

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3
Q

HCP weight bias impacts care

A
  1. perceived med adherence is lower

2. HCP spend less time w/ pts in clinic

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4
Q

Reasons obese pts avoid care

A
  1. 36% uncomfortable with HCP
  2. 46% unsolicited advice
  3. 36% negative provider attitude
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5
Q

Weight bias impacting coverage

A
  1. Only few states include coverage of any anti-obesity medications
  2. Many think its for cosmetic reasons
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6
Q

Patients who experience stigma have….

A

2.4X more likely to have MDD, stress over body image

Consume more calories

More likely to avoid exercise and increased BP

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7
Q

Weight stigma impacts quality of care…..

A

Worse pt outcomes when HCPs provide less Patient centered care

20% of pts achieved > 10% weight loss if they did not perceive judgement by their HCP vs if they did

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8
Q

Strategies to mitigate weight bias in HC environment

A

Avoid stigmatizing words…fat, obese, unhealthy, etc

Implement sensitivity training & check materials for language/imagery

Increase obesity education in med schools

Include topics such as AOM, obesity care guidance on exams

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9
Q

Biomarkers used to estimate obesity?

A

BMI
Waist:circumference
Waist:hip ratio

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10
Q

Obesity is….

A

excessive fat accumulation impair health

Presence and severity measured directly by imaging

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11
Q

Underweight BMI

A

< 18.5

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12
Q

Normal Range BMI

A

18.5-25

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13
Q

Overweight BMI

A

25-30

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14
Q

Obese BMI

A

30+

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15
Q

Obese I BMI

A

30-35

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16
Q

Obese II BMI

A

35-40

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17
Q

Obese III BMI

A

> 40

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18
Q

Waist Circumference

A

Measure central obesity and predicts risk incidence of BMI, so measure both BMI + Waist circumference is recommended

It varies with ethnicity & BMI doesn’t always reflect obesity-related risk to health

19
Q

Waist Circumference cut-offs

A

Men: > 94cm, 37in
Women: > 80cm, 31.5in

20
Q

Obesity Staging Systems

A

Edmonton Obesity Staging System (EOSS)

better predictor of mortality than BMI alone

Domains: Medical, Mental, Functional

21
Q

Key risk factor for cardiometbolic disease?

A

Obesity

22
Q

Metabolic Syndrome is…

A

complex of interrelated risk factors for CVD and T2D, including dysglycemia, raised blood pressure, elevated TGs, low HDL and obesity

23
Q

Clinical Diagnosis of Metabolic Syndrome

A

3 of the 5 following….

  1. Elevated Waist circumference
  2. Elevated TH
  3. Reduced HDL-C
  4. Elevated BP
  5. Elevated fasting glucose
24
Q

Obesity-related complications can be improved with….

A

5-10% weight loss

25
Q

0-5% weight loss can improve….

A

Hypertension

Hyperglycemia

26
Q

5-10% weight loss can improve….

A

T2D prevention
NAFLD = fatty liver
PCOS = ovary disorder
Dyslipidemia

27
Q

10-15% weight loss can improve…

A 
CVD
USI
NASH
OSA
GERD
Knee OA
28
Q

> 15% weight loss can improve….

A

TD2 remission
CV mortality
HFpEF

29
Q

Historic Perception of Body weight reduction….

A

Energy intake > Energy expenditure = gain weight

Energy intake < Energy expenditure = weight loss

30
Q

Appetite enhancing hormone

A

Ghrelin (orexigenic)

31
Q

Appetite suppressing hormones

A

CCK (Anorexigenic)
Peptide YY
GLP-1

32
Q

Stomach produces which hormone?

A

Ghrelin

33
Q

Intestine produce which hormone?

A

CCK
GLP-1
PYY
OXM

34
Q

Pancreas produces which hormone?

A

Amylin
Insulin
PP
Glucagon

35
Q

Adipose tissues produce which hormone?

A

Leptin

Adiponectin

36
Q

Gherlin (Orexigenic) What it does

A

Activates NPY, AgRP = feel hungy

Block POMC, CART = inhibit feeling full

37
Q

Anorexigenic Hormones, what they do

A

Activate POMC,CART = feel full

Block NPY, AgRP = not hungry

38
Q

Homeostatic eating…..

A

depends on your Anorexigenic and Orexigenic Hormones

39
Q

Hedonic eating…..

A

Eating for pleasure

40
Q

Executive function…..

A

Deciding to eat

41
Q

Body weight is primarily regulated by….

A

hormonal and neuronal signaling along the gut-brain axis

42
Q

How does sleep play into obesity?

A

can effect appetite control

43
Q

Adaptations to weight loss promote weight regain by….

A
  1. Subjective perceptions of appetite increase hunger and desire to eat
  2. Hormone lvls, increase orexigenic signaling and decrease certain anorexigenic signals
  3. Metabolism, decrease energy expenditure rates

CDM 2 Exam 3 (13 decks)

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