lewis ch 40 - obesity Flashcards
in what populations are obesity the highest (3)
- in the south
- black and hispanics
- lower income and less educated
classification of obesity: excess caloric intake for body’s metabolic demands
primary obesity
classification of obesity: due to other preexisting health conditions
secondary obesity
what may cause secondary obesity (4)
- chromosomal and genetic anomalies
- metabolic problems
- CNS lesions and disorders
- drugs (corticosteroids, antipsychotics)
what hormones and peptides interact with the hypothalamus (5)
- leptin (from adipocytes)
- insulin (from pancreas)
- ghrelin (from stomach)
- peptide YY (from colon)
- cholecystokinin (from small intestine)
enzyme that suppresses hunger and increases fat metabolism
leptin
enzyme that stimulates hunger and regulates it by inhibiting leptin
ghrelin
what can an increased production of adipokines lead to (3)
- insulin resistance
- dyslipidemia
- hypertension
conditions associated with obesity that can improve with weight loss
- hypertension
- high cholesterol
- sleep apnea
- diabetes type 2
- heart disease
- gallbladder disease
- osteoarthritis
what is the name for abdominal obesity
android obesity
what are android obesity patients are greater risk for developing (3)
- increased LDLs
- high triglycerides
- decreased HDLs
what disease is obesity one of the most important preventable causes of
cancer
what two types of cancer are strongly related to obesity
breast cancer
endometrial cancer
(due to excess estrogen which is stored in fat cells)
4 ways to classify Body weight and obesity
- body mass index (BMI)
- waist circumference
- waist to hip ratio (WHR)
- body shape
what BMI is considered underweight
18.5 or less
what BMI range is considered normal
18.5-24.9
what BMI range is considered overweight
25-29.9
what BMI is considered obese
30 or greater
what BMI is considered extremely obese
40 or greater
people with visceral fat with android obesity are at increased risk for (2)
cardiovascular disease
metabolic syndrome
what waist circumference is considered obese for men
40” +
what waist circumference is considered obese for women
35” +
what is the optimal waist to hip ratio
0.8
two basic techniques in behavior modification that can be used to help treat obesity
self-monitoring
stimulus control
class of drugs that can be used to suppress appetite and treat obesity
- high abuse potential
- not recommended or approved by FDA
amphetamines
class of drugs that can be used to suppress appetite and treat obesity -recommended only for short term (3 months or less)
nonamphetamines
drug for treating obesity:
- selective serotonin agonist
- suppresses appetite and creates sense of satiety
- side effects: headache, dizziness, fatigue, nausea, dry mouth, constipation
lorcaserin (belviq)
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
orlistat (Alli)
what is the criteria for eligibility for bariatric surgery
- BMI greater or equal to 40
- BMI greater or equal to 35 with other significant comorbidities
significant comorbidities (4) that combined with a BMI of 35 or greater can qualify someone for bariatric surgery
- hypertension
- type 2 diabetes
- heart failure
- sleep apnea
3 broad categories of bariatric surgeries
- restrictive
- malabsorptive
- combination of restrictive and malabsorptive
type of restrictive bariatric surgery:
-limits stomach size with inflatable band around fundus of stomach
adjustable gastric binding (AGB)
type of malabsorptive bariatric surgery:
- 75% of stomach is removed
- nonreversible
- results in elimination of ghrelin
sleeve gastrectomy
type of combination of restrictive and malabsorptive bariatric surgery:
- food bypasses 90% of stomach, duodenum, and small segment of jejunum
- possible complication: dumping sydnrome
roux-en-Y surgical procedure (RYGB)
gastric foods emptying too rapidly into small intestine
dumping syndrome
group of risk factors that increase a person’s chance of developing cardiovascular disease, stroke, diabetes (more prevalent in 60+ yo)
metabolic syndrome
what are the criteria that someone must have 3 of to be considered to have metabolic syndrome (5)
- 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
