Obesity

Question 1

Obesity is the basis of many other diseases, such as..

Answer 1

T2 diabetes
CVD
Cancer
Muscoskeletal disorders (especially osteoarthritis)

Question 2

What is the definition of overweight/obesity?

Answer 2

= abnormal or excessive fat accumulation that may impair health

Question 3

How many people were affected by obesity in 2016?

Answer 3

1.9 bil adults (13% of population)

Question 4

What is the double burden of nutrition?

Answer 4

low-and-middle-income countries have both under- and overnutrition

Question 5

How is obesity assessed?

Answer 5

1. Calculating BMI (weight in kg/height in m^2). –> BMI ≥ 25 = overweight, ≥30 = obesity
2. Distribution of bodyfat is a measure for health: waist-to-hip ratio to assess body fatness
   –> >1 = obesity in men, >0.9 for women

Question 6

What hormone is much higher in obese individuals?

Answer 6

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

Question 7

When (in history) did body fat become problematic?

Answer 7

mid 19th century

Question 8

• explain the distinction between being overweight and being obese

Answer 8

= BMI 25 – 29.9 = overweight. >30 = obese (and weight circumference and muscle mass measurements)

Question 9

• describe which factors contribute to becoming obese

Answer 9

= sedentary lifestyle, growing portion sizes, processed foods, persuasive marketing = overeating. Scarce resources and lack of access to healthy, affordable foods

Question 10

• recall the consequences of obesity

Answer 10

= raises chance of diseases like diabetes, heart disease, stroke, high blood pressure, cancer

Question 11

• argue why recovery from obesity is difficult

Answer 11

= 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.

Question 12

What are the harmful effects of excess body fat?

Answer 12

= producing specific hormones and growth factors that affect the way our cells work. Can increase the risk of several diseases including cancer

Question 13

What are differences in distribution of body fat (apple or pear type)?

Answer 13

= Apple = intestinal body fat.
Pear = fat on arms, thighs, buttocks

Question 14

Obesity increases the chance of what types of cancer ?

Answer 14

• Higher risk of Breast, colorectal, pancreatic, oesophageal, gall bladder cancer (not true for pre-menopausal cancer)

Question 15

Causes of obesity?

Answer 15

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

Question 16

Classifications of obesity?

Answer 16

Symptoms: >30 BMI (class 1) >35 (class 2) >40 (class 3)

Question 17

• describe the physical examination and diagnostic tests for obesity

Answer 17

BMI > 30
General ex: vital signs such as heart rate, blood pressure, temp
Blood tests, liver function tests, diabetes screen, thyroid tests, heart tests

Question 18

• describe the treatment options for obesity

Answer 18

Changes in eating habits
Increased phys activity
Behavior changes
Surgery
Weight loss medication

Question 19

Obesity in children:
Definition of overweight and obesity in children < 5 years is:

Answer 19

• 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

Question 20

Definition of overweight and obesity in children 5-19 years =

Answer 20

BMI-for-age > 1 SD above the WHO Growth Reference median = overweight
BMI-for-age > 2 SD above the WHO Growth Reference median = obese

Question 21

1) Symptoms of childhood obesity
2) association with higher chance of..

Answer 21

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.

Question 22

What is a very effective method of treatment for obesity?

Answer 22

Bariatric surgery

Question 23

What are the criteria for bariatric surgery?

Answer 23

• 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

Question 24

What are the lifestyle changes after bariatric surgery?

Answer 24

• Eating limited quantities of food
• Regular exercise
• Vitamins + minerals (folic acid, B12, D, iron)

Question 25

What are the different types of bariatric surgery?

Answer 25

1. Adjustable band
   Band around top portion of stomach to create a pouch, which serves as new smaller stomach. Reversible
2. Gastric bypass
   New smaller stomach using staples instead of band
   Stomach attached to the jejenum
3. Vertical sleeve gastrectomy
   80% of stomach removed. Irreversible

Question 26

 Bariatric surgery could alter the X where much of the digestion of food takes place.

Answer 26

duodenum

Question 27

 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

Answer 27

A-B = 30-39.9
C-D = 25-29.9.

Question 28

 Obesity has … in the last 30 years

Reduced
Doubled
Tripled
Quadripled

Answer 28

Doubled

Question 29

 BMI of a person that weighs 75 kg and is 1.82 m =

Answer 29

22.6

Question 30

 Decrease in sleep time can lead to obesity, because of ..

Answer 30

bc of unbalanced hormones

Question 31

 Dumping syndrome =

Answer 31

the term used to describe rapid emptying of the stomach that is common in people who have undergone bariatric surgery

Question 32

 Main cause of morbid obesity:

Answer 32

poor diet and lack of physical activity