Obesity Flashcards
Obesity is the basis of many other diseases, such as..
T2 diabetes
CVD
Cancer
Muscoskeletal disorders (especially osteoarthritis)
What is the definition of overweight/obesity?
= abnormal or excessive fat accumulation that may impair health
How many people were affected by obesity in 2016?
1.9 bil adults (13% of population)
What is the double burden of nutrition?
low-and-middle-income countries have both under- and overnutrition
How is obesity assessed?
- Calculating BMI (weight in kg/height in m^2). –> BMI ≥ 25 = overweight, ≥30 = obesity
- Distribution of bodyfat is a measure for health: waist-to-hip ratio to assess body fatness
–> >1 = obesity in men, >0.9 for women
What hormone is much higher in obese individuals?
Leptin. This is because in some obese people, the brain does not respond to leptin, so they keep eating despite adequate (or excessive) fat stores
When (in history) did body fat become problematic?
mid 19th century
- explain the distinction between being overweight and being obese
= BMI 25 – 29.9 = overweight. >30 = obese (and weight circumference and muscle mass measurements)
- describe which factors contribute to becoming obese
= sedentary lifestyle, growing portion sizes, processed foods, persuasive marketing = overeating. Scarce resources and lack of access to healthy, affordable foods
- recall the consequences of obesity
= raises chance of diseases like diabetes, heart disease, stroke, high blood pressure, cancer
- argue why recovery from obesity is difficult
= hormonal and metabolic changes reduce the body’s response to overeating. Burns less calories during the same exercise as someone that is naturally the same weight, making it difficult to lose excess fat. Damage to signalling pathways makes it increasingly difficult for the brain to measure food intake and fat storage.
What are the harmful effects of excess body fat?
= producing specific hormones and growth factors that affect the way our cells work. Can increase the risk of several diseases including cancer
What are differences in distribution of body fat (apple or pear type)?
= Apple = intestinal body fat.
Pear = fat on arms, thighs, buttocks
Obesity increases the chance of what types of cancer ?
- Higher risk of Breast, colorectal, pancreatic, oesophageal, gall bladder cancer (not true for pre-menopausal cancer)
Causes of obesity?
Cause = eating more calories than you burn through exercise/daily activity. Stored as fat.
- Sedentary lifestyle
- Unhealthy eating
- Lack of sleep (hormonal changes: cravings)
- Genetics
- Pregnancy
- Ageing: decreased muscle mass, slower metabolic rate
- Medications
- Medical conditions
Classifications of obesity?
Symptoms: >30 BMI (class 1) >35 (class 2) >40 (class 3)
- describe the physical examination and diagnostic tests for obesity
BMI > 30
General ex: vital signs such as heart rate, blood pressure, temp
Blood tests, liver function tests, diabetes screen, thyroid tests, heart tests
- describe the treatment options for obesity
Changes in eating habits
Increased phys activity
Behavior changes
Surgery
Weight loss medication
Obesity in children:
Definition of overweight and obesity in children < 5 years is:
- weight-for-height Growth Standards >2 SD above the WHO Growth Reference median = overweight
- weight-for-height Growth Standards >3 SD above the WHO Growth Reference median = obese
Definition of overweight and obesity in children 5-19 years =
BMI-for-age > 1 SD above the WHO Growth Reference median = overweight
BMI-for-age > 2 SD above the WHO Growth Reference median = obese
1) Symptoms of childhood obesity
2) association with higher chance of..
1) breathing difficulties
increased risk of fractures
hypertension
early markers of cardiovascular disease
insulin resistance
psychological effects
2) associated with a higher chance of obesity, premature death and disability in adulthood.
What is a very effective method of treatment for obesity?
Bariatric surgery
What are the criteria for bariatric surgery?
- Diagnosed as severely obese/medical condition related to obesity
- letter from family doctor or specialist
- BMI > 40 without comorbidities or >35 with comorbidities
- Tried to lose weight by other means
- Needs to attend classes to understand the body and lifestyle changes after surgery
- 18-65 years (upper limit not strict)
- Meeting important criteria in screening
What are the lifestyle changes after bariatric surgery?
- Eating limited quantities of food
- Regular exercise
- Vitamins + minerals (folic acid, B12, D, iron)
What are the different types of bariatric surgery?
- Adjustable band
Band around top portion of stomach to create a pouch, which serves as new smaller stomach. Reversible - Gastric bypass
New smaller stomach using staples instead of band
Stomach attached to the jejenum - Vertical sleeve gastrectomy
80% of stomach removed. Irreversible
Bariatric surgery could alter the X where much of the digestion of food takes place.
duodenum
Person who is obese differs from overweight person, as a person is considered obese if their BMI is A-B while a person is considered overweight if their BMI is C-D
A-B = 30-39.9
C-D = 25-29.9.
Obesity has … in the last 30 years
Reduced
Doubled
Tripled
Quadripled
Doubled
BMI of a person that weighs 75 kg and is 1.82 m =
22.6
Decrease in sleep time can lead to obesity, because of ..
bc of unbalanced hormones
Dumping syndrome =
the term used to describe rapid emptying of the stomach that is common in people who have undergone bariatric surgery
Main cause of morbid obesity:
poor diet and lack of physical activity
