Obesity 1

Question 1

obesity: prevention

Answer 1

optimal nutrition for maintaining a healthy body weight

Question 2

obesity: pathogenesis

Answer 2

excess adiposity
aberrant fat distribution
inflammation

Question 3

obesity: prognosis

Answer 3

dietary changes to reduce body weight/alter pathogenesis

Question 4

obesity causes __ accumulation in adipose tissue which leads to __

Answer 4

obesity causes macrophage accumulation in adipose tissue which leads to low-grade systemic inflammation

Question 5

macrophages in adipose release __

Answer 5

macrophages in adipose release cytokines (TNF-alpha, IL-1)

Question 6

cytokines in adipose cause

Answer 6

endocrine dysfunction

Question 7

cytokines in muscle cause

Answer 7

impaired glucose disposal

Question 8

cytokines in fat cause

Answer 8

impaired beta-cell function and cell regeneration

Question 9

cytokines in liver cause

Answer 9

reduced suppression of glucose production

Question 10

obesity can cause (4)

Answer 10

1. inflammation
2. oxidative stress
3. insulin resistance
4. dysfunctional angiogenesis

Question 11

treatments of obesity (4)

Answer 11

1. lifestyle changes: diet and physical activity
2. behavioral weight loss programs
3. pharmacotherapy
4. weight loss surgery

Question 12

obesity is a chronic condition characterized by __, which increases risk for adverse metabolic, biomechanical, and pschosocial health consequences

Answer 12

obesity is a chronic condition characterized by excess body fat, which increases risk for adverse metabolic, biomechanical, and pschosocial health consequences

Question 13

causes of obesity (6)

Answer 13

1. genetic/epigenetic factors
2. metabolic
3. medical coniditons
4. environmental
5. medications
6. behavioral factors

Question 14

BMI =

Answer 14

weight (kg)/height (in^2)

Question 15

underweight BMI category

Answer 15

<18.5

Question 16

normal weight BMI category

Answer 16

18.5-24.9

Question 17

overweight BMI category

Answer 17

25.0-29.9

Question 18

obese BMI category

Answer 18

30+

Question 19

3 classes of obesity

Answer 19

Class 1: 30.0-34.9
Class 2: 35.0-39.9
Class 3: 40+

Question 20

advantages of BMI (4)

Answer 20

high correlation to % total body fat
minimal time
inexpensive
non-invasive

Question 21

limitations of BMI (2)

Answer 21

1. surrogate measure
2. ignores ethnic variability

Question 22

when is BMI an overestimation

Answer 22

high levels of muscle

Question 23

when is BMI an underestimate

Answer 23

low levels of muscle

Question 24

other screening methods for obesity (3)

Answer 24

1. skinfold thickness
2. waist-hip ratio (WHR) –> asian population has decreased waist circumference, so bound is lower
3. DXA

Question 25

obesity and breast cancer: more adipocytes = more __ = more __

Answer 25

obesity and breast cancer: more adipocytes = more **estrogen** = more **tumor growth**

Question 26

breast cancer: increased number and size of adipocytes results in increased number of

Answer 26

pro-inflammatory immune cells

Question 27

breast cancer: increased number and size of adipocytes results in increased secretion of __, __, and __

Answer 27

breast cancer: increased number and size of adipocytes results in increased secretion of **pro-inflammatory factors**, **pro-angiogenic factors (growth of blood vessels)**, and **estrogen**

Question 28

3 categories of obesity impacting fertility in men

Answer 28

1. physical 2. seminal 3. hormonal

Question 29

physical impacts of obesity on male fertility (3)

Answer 29

1. increased erectile dysfunction 2. increased scrotal temperature 3. increased sleep apnea (disrupts nocturnal rise in testosterone)

Question 30

seminal impacts of obesity on male fertility (4)

Answer 30

1. oligozoospermia 2. azoospermia 3. increased DFI 4. decreased semen volume

Question 31

hormonal impacts of obesity on male fertility (4)

Answer 31

1. increased estrogen 2. decreased testosterone 3. increased insulin 4. increased leptin

Question 32

what is obstructive sleep apnea (OSA)?

Answer 32

during sleep, airway structures like the tongue, soft palate and uvula either become too relaxed or are compressed due to external pressure, blocking the airway. The airway can be narrow with a partial obstruction and snoring or it may actually close and cut off breathing.

Question 33

In obesity, there may be an increase in soft tissue inside the airway or excess tissue externally, which cause increased __ and __ of the airway

Answer 33

In obesity, there may be an increase in soft tissue inside the airway or excess tissue externally, which cause increased **pressure** and **compression** of the airway

Question 34

clinical symptoms of OSA

Answer 34

Excessive daytime somnolence Loud snoring Observed episodes of stopped breathing (apnea) during sleep Abrupt awakenings accompanied by gasping or choking Morning headaches Difficulty concentrating during the day Mood changes, such as depression or irritability High blood pressure

Question 35

gastrointestinal reflux disease (GERD)

Answer 35

the sphincter muscle at bottom of your esophagus relaxes at the wrong time, allowing stomach acid to back up into the esophagus

Question 36

with obesity, increased body fat (especially in abdomen), increased __ on lower esophageal sphincter causes __ and allows acid to reflux into esophagus

Answer 36

with obesity, increased body fat (especially in abdomen), increased **pressure** on lower esophageal sphincter causes **relaxation** and allows acid to reflux into esophagus

Question 37

clinical symptoms of GERD

Answer 37

burning (heartburn) in chest chest or abdominal pain regurgitation of liquids/solids belching chronic cough, esp at night laryngitis asthma flare

Question 38

progression of GERD

Answer 38

endoscopy → esophagitis → Barrett’s esophagus → dysplasia → esophageal cancer

Question 39

venous insufficiency is when:

Answer 39

valves in the leg veins do not function properly, and the return of blood to the heart is impaired.

Question 40

venous insufficiency: abdominal obesity leads to increased __

Answer 40

venous insufficiency: abdominal obesity leads to increased **intraabdominal pressure (IAP)**

Question 41

increased IAP is transmitted to veins of __, greater tension on venous __, and increased __

Answer 41

increased IAP is transmitted to veins of **lower limbs**, greater tension on venous **walls**, and increased **diameter**

Question 42

venous insufficiency progression

Answer 42

Chronic increased pressure on vessel walls → decreased venous elasticity → venous valve dysfunction over time with venous stasis/pooling of blood (also incr risk for deep venous thrombosis)

Question 43

clinical symptoms of venous insufficiency

Answer 43

Varicose veins → pressure changes shape of blood vessels) Swelling of the legs and ankles Itching (pruritus) Hyperpigmentation (dark discoloration of the skin) Skin abnormalities like thickening Increased risk of infection and ulcers

Question 44

osteoarthritis (OA) is

Answer 44

Degenerative disorder due to increased stress on joints → breakdown of cartilage in the joints. Without cartilage, the joint space becomes more narrow and can cause pain due to friction (bone on bone) → lead to bone damage & inflammation in joint space as well.

Question 45

OA: higher bodyweight = increased

Answer 45

OA: higher bodyweight = increased stress on joints in lower extremities

Question 46

clinical symptoms of OA

Answer 46

Pain; exacerbated by extensive use Reduced range of motion and crepitus Stiffness Swelling

Question 47

why is it so hard to lose and maintain weight loss (3)

Answer 47

1. Obesogenic environment 2. Neuronal mechanisms that reward us when we eat fatty, starchy or sugary food 3. Counterregulatory adaptations to weight loss to protect us from starvation

Question 48

obesogenic environment promotes __ and discourages __

Answer 48

obesogenic environment promotes **overconsumption** and discourages **volitional physical activity**