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

Obesity constraints

A

Healthy = 18.5-24.9
Overweight=25-29.9
Obese=30-34.9
Obese II/ Extremely obese = 35-39.9
Obesity III=40+

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3
Q

What drives obesity?

A

Sedentary lifestyle
Food intake - sugar, salt and fat + cheap
No access to parks
Car use
Screen time
Educational level
Educational achievement
Poverty
Social deprivation

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4
Q

What are the comorbidities associated with obesity?

A

Depression
Sleep apnoea
Bowel cancer
Osteoarthritis
Gout
Peripheral vascular disease
Diabetes
Hypertension
Myocardial infarction
Stroke

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5
Q

What diseases is obesity a risk factor for?

A

Type II diabetes
Cardiovascular diseases
Cancer
Gallbladder disease
Obstructive sleep apnoea
Aggravated arthritis
Gout
Infertility

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6
Q

How to assess and manage obesity in adults

A

Determine degree of
overweight or obesity

Assess lifestyle,
comorbidities and
willingness to change

Management:
lifestyle changes;
drug treatment
OR
Consider referral
to specialist care

Specialist assessment
and management;
surgery and follow up

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7
Q
A

Leptin is released from fat
A way that the adipose tissue tells the brain what kind of energy stores you have

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8
Q

What does leptin deficiency result in

A

Infertility.
Stunted linear growth.
Decreased body temperature.
Decreased energy expenditure.
Decreased immune function

Same as starvation

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9
Q

Why is leptin necessary for normal physiological function

A

Leptin receptors that manage food intake, endocrine systems and reproduction

Helps regulate the synthesis of thyroid hormones
Decreases glucose stimulated insulin secretion
Increases heart rate
Regulates bone mass
Regulating the menstrual cycle
Regular appetite, control of metabolism and energy homeostasis
Activation of immune cells
Increases blood pressure

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10
Q

What does leptin administration in children do

A

Reduces appetite and body weight

Restores LH pulsatility

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11
Q

What does leptin administration do in women

A

Restores LH pulsatility in women with amenorrh

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12
Q

What drug to use for obesity?

A

Orlistat

Derivative of an endogenous lipstatin produced by Streptomyces toxytricini.

Gastric and pancreatic lipase inhibitor

Reduces dietary fat absorption by around 30%.

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13
Q

What does GLP-1 do

A

Decrease body weight, blood pressure, plasma glucose and lipids

Reduces appetite and increases satiety

Increases insulin and decreases glucagon

Decreases liver fat, inflammation and insulin resistance

Increases sodium excretion and diuresis

Increase endothelial function and decreases arterial stiffness and inflammation

Increases myocardial contractility, reduces glucose uptake and increases ischaemic preconditioning

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14
Q

What does Liraglutide/Saxenda do

A

Long-acting glucagon-like peptide-1 receptor agonist from Novo Nordisk.

Daily injection.

Double the dose used for T2DM.

4-5% weight loss.

-Causes GI problems sometimes

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15
Q

Who should bariatric surgery be considered for?

A

Consider surgery for patients with:

BMI of 40 kg/m2 or more
BMI of 35-40 kg/m2 and other co-morbidities
BMI of 30-34.9 kg/m2 for newly diagnosed T2DM.

– non-surgical measures have failed to achieve or maintain 	adequate clinically beneficial weight loss for at least 6 months
– receiving or will receive intensive specialist management
– generally fit for anaesthesia and surgery
– commit to the need for long-term follow-up.

Consider surgery as a first-line option for adults with a BMI >50 kg/m2.

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16
Q

What does gastric bypass involve?

A

The top part of your stomach is joined to the small intestine, so you feel fullersooner and do not absorb as many calories from food

17
Q

What does gastric banddo

A

A band is placed around your stomach, so you do not need to eat as much to feel full

18
Q

What does sleeve gastrectomydo

A

Some of your stomach is removed,soyou cannot eat as much as you could before and you’ll feelfull sooner.

19
Q

What is semaglutide

A

Long-acting glucagon-like peptide-1 (GLP-1) receptor agonist.

15% weight loss

20
Q

What does tirzepatide do

A

Long-acting glucagon-like peptide-1 (GLP-1) receptor and glucose-dependent insulinotropic Polypeptide (GIP) receptor co-agonist.

20% weight loss