lewis ch 40 - obesity

Question 1

in what populations are obesity the highest (3)

Answer 1

• in the south
• black and hispanics
• lower income and less educated

Question 2

classification of obesity: excess caloric intake for body’s metabolic demands

Answer 2

primary obesity

Question 3

classification of obesity: due to other preexisting health conditions

Answer 3

secondary obesity

Question 4

what may cause secondary obesity (4)

Answer 4

• chromosomal and genetic anomalies
• metabolic problems
• CNS lesions and disorders
• drugs (corticosteroids, antipsychotics)

Question 5

what hormones and peptides interact with the hypothalamus (5)

Answer 5

• leptin (from adipocytes)
• insulin (from pancreas)
• ghrelin (from stomach)
• peptide YY (from colon)
• cholecystokinin (from small intestine)

Question 6

enzyme that suppresses hunger and increases fat metabolism

Answer 6

leptin

Question 7

enzyme that stimulates hunger and regulates it by inhibiting leptin

Answer 7

ghrelin

Question 8

what can an increased production of adipokines lead to (3)

Answer 8

• insulin resistance
• dyslipidemia
• hypertension

Question 9

conditions associated with obesity that can improve with weight loss

Answer 9

• hypertension
• high cholesterol
• sleep apnea
• diabetes type 2
• heart disease
• gallbladder disease
• osteoarthritis

Question 10

what is the name for abdominal obesity

Answer 10

android obesity

Question 11

what are android obesity patients are greater risk for developing (3)

Answer 11

• increased LDLs
• high triglycerides
• decreased HDLs

Question 12

what disease is obesity one of the most important preventable causes of

Answer 12

cancer

Question 13

what two types of cancer are strongly related to obesity

Answer 13

breast cancer
endometrial cancer
(due to excess estrogen which is stored in fat cells)

Question 14

4 ways to classify Body weight and obesity

Answer 14

• body mass index (BMI)
• waist circumference
• waist to hip ratio (WHR)
• body shape

Question 15

what BMI is considered underweight

Answer 15

18.5 or less

Question 16

what BMI range is considered normal

Answer 16

18.5-24.9

Question 17

what BMI range is considered overweight

Answer 17

25-29.9

Question 18

what BMI is considered obese

Answer 18

30 or greater

Question 19

what BMI is considered extremely obese

Answer 19

40 or greater

Question 20

people with visceral fat with android obesity are at increased risk for (2)

Answer 20

cardiovascular disease

metabolic syndrome

Question 21

what waist circumference is considered obese for men

Answer 21

40” +

Question 22

what waist circumference is considered obese for women

Answer 22

35” +

Question 23

what is the optimal waist to hip ratio

Answer 23

0.8

Question 24

two basic techniques in behavior modification that can be used to help treat obesity

Answer 24

self-monitoring

stimulus control

Question 25

class of drugs that can be used to suppress appetite and treat obesity

• high abuse potential
• not recommended or approved by FDA

Answer 25

amphetamines

Question 26

class of drugs that can be used to suppress appetite and treat obesity
-recommended only for short term (3 months or less)

Answer 26

nonamphetamines

Question 27

drug for treating obesity:

• selective serotonin agonist
• suppresses appetite and creates sense of satiety
• side effects: headache, dizziness, fatigue, nausea, dry mouth, constipation

Answer 27

lorcaserin (belviq)

Question 28

drug for treating obesity:

• blocks fat breakdown and absorption in small intestine
• inhibits action of intestinal lipases resulting in undigested fat being excreted in feces
• side effects: stool leakage, severe liver injury may occur

Answer 28

orlistat (Alli)

Question 29

what is the criteria for eligibility for bariatric surgery

Answer 29

• BMI greater or equal to 40

- BMI greater or equal to 35 with other significant comorbidities

Question 30

significant comorbidities (4) that combined with a BMI of 35 or greater can qualify someone for bariatric surgery

Answer 30

• hypertension
• type 2 diabetes
• heart failure
• sleep apnea

Question 31

3 broad categories of bariatric surgeries

Answer 31

• restrictive
• malabsorptive
• combination of restrictive and malabsorptive

Question 32

type of restrictive bariatric surgery:

-limits stomach size with inflatable band around fundus of stomach

Answer 32

adjustable gastric binding (AGB)

Question 33

type of malabsorptive bariatric surgery:

• 75% of stomach is removed
• nonreversible
• results in elimination of ghrelin

Answer 33

sleeve gastrectomy

Question 34

type of combination of restrictive and malabsorptive bariatric surgery:

• food bypasses 90% of stomach, duodenum, and small segment of jejunum
• possible complication: dumping sydnrome

Answer 34

roux-en-Y surgical procedure (RYGB)

Question 35

gastric foods emptying too rapidly into small intestine

Answer 35

dumping syndrome

Question 36

group of risk factors that increase a person’s chance of developing cardiovascular disease, stroke, diabetes (more prevalent in 60+ yo)

Answer 36

metabolic syndrome

Question 37

what are the criteria that someone must have 3 of to be considered to have metabolic syndrome (5)

Answer 37

• waist circumference (40” + for men, 35” + for women)
• triglycerides greater than 150
• HDL cholesterol (less than 40 for men, less than 35 for women)
• blood pressure greater than or equal to 130/85
• fasting glucose greater than or equal to 100