- regulates appetite by inhibiting leptin - thought to play a part in complusive eating - non obese person ( ghrelin high when they are hungry and decrease after eating )

Obesity Flashcards by Brina Quintanilla Reyes

What does obesity mean ?

Excessively high amount of body fat or adipose tissue

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In how many children is obese?

1 in 10

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Who has the highest rates of obesity?

Hispanic & African Americans

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Higher rates if obesity comes from?

Low educated & low income patients

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Who is more at risk? South or north?

South

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Etiology and pathophysiology
For obesity is (2)?

Body weight beyond physical requimenrs

Abnormal increase and accumulation of fat cells

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Those who have obesity problems increased the risk of (3)?

Increase in number ( hyperplasia ) and size ( hypertrophy ) of adipocytes ( fat cells )

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Adipocytes can hold up to how much of their volume? And why do they grow?

1000x

In order to accommodate large increases in lipid storage

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There are two types of obesity? What are they?

Primary & secondary

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Primary obesity is what?

Increase calories in > than calories used

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What is secondary obesity? (4)
This one is mainly what?

Chromosomal/congenital anomalies
Metabolic problems
CNS lesions & disorders
Drugs

Medical problem caused the weight gain

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Genetic predisposition is what percentage of obese patients?

70%

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There has been evidence that the gene ___ and body mass index has increased chances of getting obesity

FTO
( fat mass and obesity associated gene )

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What part of the brain play a huge part in triggering appetite and energy for a person?

Hypothalamus

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The hypothalamus, gut and adipose tissues help synthesis (2) that stimulate or inhibit appetite

Hormones & peptides

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Neuropeptides Y is very dangerous because it’s a powerful what?
And causes what if it’s imbalanced?

Appetite stimulant
Leads to overeating and obesity

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What are the 2 hormones that we will be talking about regarding the hypothalamus?

Leptin & Ghrelin

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What does leptin do?!(2)

Suppresses appetite
Increase fat metabolism

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Since leptin helps suppresses appetite and increase fat metabolism, how does this effect obese patients?

Obese patients will have high leptin levels meaning that have leptin resistance

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What is ghrelin (3)

regulates appetite by inhibiting leptin
thought to play a part in complusive eating
non obese person
( ghrelin high when they are hungry and decrease after eating )

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What are two major consequences of obesity?

Increase in fat mass
Production of adip okines

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What is adiopokines?
Contribute to (3)
They may disrupt (2)

They are substance made from adipocytes

Insulin resisitance, dyslipidemia, hyerptension

Immune factors & predispose to certain cancers

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What are environmental factors that effect obesity?

Less access to nutritionally food
Lack of physical exercise
Low socioeconomic status
Holiday
sense of satiety
Mindless eating

Turkey sandwich’s
40 years ago
Today

Bagel
40 year ago
Today

Cheeseburger
40 year ago
Today

Soda
40 year ago
Today

320 calc
820 calc

3in diameter 140 calc
6 in diameter 350 calc

333 calc
590 calc

6.5 85cal
20oz - 250 calc

What are the problems obesity can cause (7) Think of the systems & conditions

Cardiovascular Diabetes GI & liver Respiratory / sleep Musculoskeletal Cancer Psychosocial

How does obesity cause cardiovascular problems? Andriod obesity are greater risk for (3)

Significant risk factor for cardiovascular disease and stroke Increase LDL high triglycerides Decrease HDL

Obesity is a major risk factor for developing which type of diabetes ? Excess weight makes drug treatment less effective ; why? (3)

2 Hyperinsulinemia Insulin resistance Glucose intolerance

GI and liver problems can cause (3) The last one can lead to what? And how do we fix the last one?

Gastroesophageal reflux disease ( GERD ) Gallstones Nonalcoholic steathohepatitis ( NASH ) ( cirrhosis ) ( Weight loss )

Respiratory and sleep problems from obesity are? (2) (1)(3) And what can improve lung function?

Sleep apnea - snoring & hypoventilation Obesity hypoventilation syndrome - reduced chest wall compliance - increase work of breathing - decreased total lung capacity Weight loss can improve lung function

Musculoskeletal problems of obesity are? Which can cause what? Like what^ (2) Increased body fat triggers ___ and contributes to what deterioration We have a higher incidence of hyperuricemia & gout ( notes )

Osteoarthritis Stress on weight bearing joints Knees and hips Triggers inflammatory mediators Cartilage deterioration

Obesity is one of the most important preventable causes of ?

Cancer!!

Psychosocial problems are for obesity? ( don’t over think it )

Social isolation Depression Low self esteem

What’s the first step in the treatment of obesity ( assessment )

Determine if conditions may be causing or contributing to obesity

When you’re determining if conditions may be casuing or contributing to obesity you want to be? (2) Examples of this?

Sensitive & nonjudgmental Clarify reasons ( exercises & diet ) Explore genetic & endocrine factors

Next in the nursing assessment for obesity, after you determine conditions what would be the next step? (2)

Lab results ( liver; thyroid, glucose, lipid ) Physical exam ( height ; weight ; waist circumference, bmi )

What are the 4 patient assessments we can do to determine obesity?

Body mass index Waist circumference Waist to hip ration Body shape

Waist to hip ratio is what? How do you solve for it? WHR optimal measurement ? Greater than = health complications?

Method of describing distribution of subcutaneous and visceral adipose tissue Divide waist by hip 8.0 8.0+ health complications

What are the two body shapes in obesity?

Apple and pear

Apple shaped body fat is normally where and it’s found in who?

Abdominal area Android obesity

Pear shape body fat is located where? In who?

Upper legs Gynecoid

Andriod (8) vs Gynecoid ( 5)

Heart disease DM cancers Decrease insulin High tridg Low HDL High BP -^ Free fatty acid release Osteoporosis Varicose veins Cellulite Subcutaneous fat stores dietary fat Trapped fatty acids stores as trig

What’s the planning or overall goal for these patients (4)?

Modify eating patterns Take part in a regular physical activity program Achieved and main weight loss Minimize or prevent health problems

The overall ideology behind nursing implement is that the patient will?

Have successful weight loss and maintains it

Treatment for obese patients begin with patients who?

Understand their weight history and decide on a plan

Most weight loss plans result in a __ loss?

10%

Successful weight loss requires a what ? Successful weight control requires what?

Short term energy deficit Long term behavior changes

Nutritional therapy There is no magic diets ( this means what) Goals to be ___?

Anything can work as long if it reduces calorie intake Realistic & healthy

2/3 diet should be ? 1/3 diet should be ?

2/3 - plant 1/3 animal protein

1 portion of animal protein should be 1 portion of chopped vegs should be

3oz 1/2 cup

Lastly it’s super important that the patients drinks a lot of?

WATER!!

Exercise is an essential part of a weight loss program Daily exercise should be? It may reduce what (2) Helps maintain? It’s provides what benefits?

30mins Appetitive & waist to hip Weight loss Psychological

Behavior modification Assumption behind behavior modifications for obesity should be avoided why?

Cause it may be condition,or outside factors

We want patients to monitor there intake by? (3)

Food life Stimulus control No food rewards weight loss ( motivate )

Drug therapy should never be ? And if it’s being used, what should it be included with?

Alone Calorie reduction diet, exercise, behavior modification

Lastly we want to evaluate and teach our patient, how will we do this? (3)

Drugs will not cure obesity Changed in food intake and exercise Proper administration & side effects of drugs