Obesity Flashcards

1
Q

What is obesity?

A

A condition of abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired

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2
Q

What BMI is considered clinically obese?

A

> 30

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3
Q

Is obesity genetic?

A
  • around 60-70%
  • Identical twins tend to have similar BMIs, irrelevant of environment
  • polygenomic
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4
Q

Mechanism of appetite?

A
  • leptin (body fat)
  • insulin (pancreas)
  • hypothalamus
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5
Q

What is the most common gene associated with obesity?

A

MC4R

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6
Q

What factors that effect the risk of obesity?

A
  • ability to play outside
  • car use
  • screen time
  • education level / achievement
  • poverty
  • social deprivation
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7
Q

What drives obesity?

A

The environment either heightens or reduces the impact of genetics on the risk of obesity

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8
Q

What co-morbidities are associated with obesity?

A
  • depression
  • sleep apnoea
  • stroke
  • myocardial infarction
  • hypertension
  • diabetes
  • peripheral vascular disease
  • gout
  • osteoarthritis
  • bowel cancer
  • infertility
  • gallbladder disease
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9
Q

Impact of obesity of cancer?

A

Incidence of cancers increases in those with obesity

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10
Q

What does an BMI above 35 mean for your life expectancy?

A

2 x the risk of death of those of a healthy BMI

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11
Q

Only effective example of reduction in obesity at a national level?

A
  • economy collapse, fuel and food shortages
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12
Q

How do we treat obesity?

A
  • determine degree of obesity
  • assess lifestyle, co-morbidities and willingness to change
  • management, lifestyle changes, drug treatment
  • consider referral to specialist
  • possibly: bariatric surgery
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13
Q

Why do weight rebounds happen?

A

Hypothalamus thinks: starvation, therefore encourages you to regain +more (increases appetite)

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14
Q

What does leptin deficient mean?

A
  • inhibit immune + reproductive system
  • insatiable hunger
  • body is in survival mode, irrelevant of what is seen in the mirror
  • almost impossible to lose weight
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15
Q

How to address health issues caused by diabetes?

A
  • identify how difficult losing weight is
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16
Q

What is the impact of visceral fat?

A
  • Visceral fat (fat at the waist), feeds the most into co-morbidities
  • worse in men
17
Q

What dietary recommendations should be made?

A
  • 3 portions of fruit+veg (minimum)

- more fruit+veg the better

18
Q

What drugs are used to treat obesity?

A
  • Orlistat
  • Gastric and pancreatic lipase inhibitor
  • prevents fat absorption by 30%
  • less than 3% change in weight
  • low adherence (due to uncomfortable side effects)
    (have to be safe, because used as a preventative measure)
    -GLP1 antagonist
19
Q

What about Bariatric surgery?

criteria

A
BMI>40
BMI35-40
BMI30-34.9 (T2DM)
BMI>50 : first line option
- non-surgical failed to achieve/maintain clinically beneficial weight-loss (at least 6 months) 
- receive intensive specialist treatment
- fit for anaesthesia and surgery
- commit to long-term follow up
20
Q

What are the 3 types of Bariatric surgery?

A
  • Gastric Bypass
  • Gastric Band
  • Sleeve Gastrectomy
21
Q

What is the effectiveness of Bariatric surgery?

A
  • most effective: Gastric Bypass (25% body weight - long term)
  • least effective: Gastric Band
22
Q

Impact of treatment of leptin deficiency?

A
  • puberty
  • increased educational treatment
  • lose weight
23
Q

Risks of bariatric surgery?

A
  • risk of gambling

- risk of risky sex

24
Q

What is the process of a Gastric Bypass surgery?

A

the top part of the stomach is joined to the small intestine, feel fuller faster, less calories consumed

25
Q

What is the process involved in a Gastric Band?

A

band is placed around the stomach, therefore less food is required to feel hungry

26
Q

What is the process involved in a Sleeve Gastrectomy?

A

removal of some of the stomach, therefore unable to eat as much as you could before - feel full sooner