Obesity Flashcards

Question

Sleeve Gastrectomy (SG)

Answer 1

Removes large portion of the stomach and staples it closed so the volume is greatly reduced No insertion of foreign objects Reduces food intake (removes ghrelin cell mass: lower hunger) Low potential for leakage Reduced Ghrelin and potential increase in GLP-1 RESTRICTIVE NO MALABSORPTION NOT REVERSIBLE Average Weight loss of just under 30%

Answer 2

Changes passage of food so that a large amount of food is not absorbed in the beginning of the small intestine by bypassing it and connecting to a later part of the SI. Greatly controls food intake Reversible in an emergency - though this procedure should be though of as permanent Minimal Diet restriction Slightly better weight loss maintenance or reversal of T2DM compared to SG Vomiting if food is not chewed or eaten too quickly Staple line failure or ulcers Risk of deficiencies in vitamins (B12), iron and Calcium RESTRICTIVE MALABSORPTIVE NON REVERSIBLE Average weight loss of just OVER 30%

Answer 3

Combines the SG with significant intestinal bypass Best reversal of T2DM Partially reversible in an emergency - though should be thought of as permanent Staple line failure or Ulcers Risk of deficiencies in vitamins (B12), iron and calcium RESTRICTIVE MALABSORPTIVE NON-REVERSIBLE Average weight loss of just over 40%

Answer 4

Duodenal Switch and Roux-en-Y Gastric Bypass Lead to improved appetite/metabolic hormones like GLP-1 and PYY (food introduced to distal intestine) - Gets to distal SI quicker so GLP-1 and PYY is released more rapidly, reducing appetite

Answer 5

Sugary food leaves the stomach quickly Intestine swells causing cramping and pain Symptoms: Fast HR, Sweating, Nausea, diarrhea or vomiting Can be caused by any of the surgeries that lower the size of the stomach

Answer 6

Brand Name = Xenical Lipase inhibitor - stops your intestine from breaking down triglycerides in food so you don't absorb fatty acids 30% of the fat you consume will not be absorbed - fat ends up in the feces - interaction between the body's natural high coefficient of digestibility of fat via the drug Orlistat (xenical) needs a low fat diet otherwise side effects of the drug would be too great - reason why orlistat (xenical) placebo will also lose weight Long term adherence (1-year after) is low (30%) Side Effects - Oily Stools (more fat in stools) - Anal leakage - Gas with discharge - Urgent bowel movements - Diarrhea - Cramping or pain - Reduced absorption of vitamins AVERAGE WIGHT LOSS 10% vs 6% placebo

Answer 7

Brand Names = Victoza and Saxenda GLP-1 Receptor Agonists - causes weight loss by slowing gastric emptying, effect on satiety (brain)... not causing hypoglycemia Side effects - Gastrointestinal side effects - nausea - vomiting - pancreatitis AVERAGE WEIGHT LOSS = 8.6% vs 2.6% placebo

Answer 8

Brand Names = Ozempic (injection), Rybelsus (oral), Wegovy GLP-1 Receptor agonists - slows down gastric emptying lowers hypoglycemia Different from Liraglutide that it is a once weekly injection, rather than daily oral medication. Side Effects - MAIN, gastrointestinal issues - Nausea - vomiting - pancreatitis AVERAGE WEIGHT LOSS = 15% vs 2.4% placebo

Answer 9

Brand Name = Contrave Just Naltrexone BN = ReVia (opiod agonist) Just Bupropiod BN - Wellbutrin (Antidepressant) Naltrexone: - used for treatment for alcohol or opiod dependence Bupropion: - reduces uptake of norepinephrine and dopamine Either alone does not cause weight loss, but together, weight loss of ~5kg more than placebo Mechanism seems related to reductions in food cravings Side Effects: - birth defects - headaches - dry mouth - dizziness AVERAGE WEIGHT LOSS = 6.1% vs 1.3% placebo

Answer 10

Sum of food and drink an individual habitually consumes

Answer 11

<30% of EI from Fat (some say 10-15%) Maybe - <10% EI from saturated Fat - NO trans fats Can be "ad libidum" or with concomitant emphasis on energy restriction Looking at just reducing fat or looking to reduce EI all together

Answer 12

Many high fat foods are very energy dense (less volume, high calories) - if you can eat foods with lower calorie content, you can consume till you feel full, while still lowering EI Body is very effective at turning food fat into body fat. Eating non-high fat foods will reduce the effectiveness of turning foods into body fat

Answer 13

Palatability - low fat food often doesn't taste as good. Won't eat as much and may not adhere for long term Potential High CHO/Sugar Content - If replacing high-fat with processed sugar foods, you're not going to get ideal goal of low fat dieting

Answer 14

Reduced Carb Diet: <130g of carbs per day, up to 45% of total calories Low carb diet: 30-130gg of carbs per day Very low carb diet: <30g of carbs/day; will usually permit ketosis to occur Ad libidum intake of fat and animal protein

Answer 15

Body promotes adipose tissue metabolism when CHO absent - **need to store CHO for the brain Rapid weight loss due to: - Appetite suppression. Protein and fats effect on CCK, GLP-1 Water loss (1-2kg in 1-2 weeks) - Glycogen reserves go down on a low carb diet if your exercising - Every gram of Carb stored in the muscle/liver, stores about 3g of water

Answer 16

Too restrictive Unlikely to be adhered long term Concerns with high meat consumption Can be discouraging after initial success slows down Potential for nutritional inadequacies

Answer 17

At 6 months: - Low Carb has 3.3kg greater weight loss than Low fat - low CHO better for HDL and TG - Sometimes better for blood glucose, blood pressure lowering (indicators of metabolic syndrome) - Low fat better for LDL and total cholesterol levels -- some low carb diets increase LDL 12 months: - Similar body weight - Body composition was better in low fat diets - Low carb had greater improvement in HDL at 2 years

Answer 18

Not consistently Defined, often hard to distinguish from low carb diet Relative terms - >25% of kcal from protein - >1.2g of protein / kg of BW

Answer 19

High satiety Very energy demanding to store excess - Excess protein can be difficult to store due to low transferability of protein to amino acids Restrictive Can taste good Preserve FFM

Answer 20

Concerns with high meat consumption - Health perspective - Potentially costly

Answer 21

Evidence shows may help in prevention of regaining weight after weight loss intervention High protein - low glycemic index diet was only diet in study shown to stop regaining weight

Answer 22

<800 kcal or <50% of RMR (<900 kcal according to health canada)

Answer 23

Simple to follow - No food prep - No calorie counting Large energy defecit Rapid weight loss can be motivating Could be a starting point to other changes Help break eating habits of "addictions"

Answer 24

Not a long term solution No changes in behaviours... once VLCD is finished people simply return to old behaviours (Opra) Very Very costly ~3000-3500 US per treatment plan (12 weeks) Must be medically supervised

Answer 25

Gallstones (up to 25% of patients) Old intolerance, hair loss, headache, fatigue, dizziness, volume depletion, muscle cramps, constipation VLCD's deaths occurred in the 1970s when dieters consumed products that contained low-quality protein and were deficient in vitamins and minerals

Answer 26

Aerobic PA (30-60 minutes o f moderate to vigorous intensity most days of the week) can be considered for adults who want to: - achieve small amounts of body weight and fat loss - achieve reductions in abdominal visceral fat and ectopic fat such as liver and heart fat, even in the absence of weight loss - favour weight maintenance after weight loss - favour the maintenance of FFM during weight loss - Increase cardiorespiratory fitness

Answer 27

For Adults living with overweight or obesity, resistance training may promote weight maintenance or modest increases in muscle mass or FFM and mobility

Answer 28

Increasing exercise intensity, including high-intensity interval training, can achieve greater increases in cardiorespiratory fitness and reduce the amount of time required to achieve similar benefits as from moderate-intensity aerobic work

Answer 29

Regular PA, with and without weight loss, can improve many cardiometabolic risk factors in adults who have overweight or obesity, including: - hyperglycemia and insulin sensitivity - High blood pressure - Dyslipidemia

Answer 30

Regular PA can improve health-related QOL, mood disorders and body image in adults with overweight or obesity

Answer 31

Obesity management interventions that incorporate exercise generally report either maintenance or gain in FFM Exercise alone is effective in reducing abdominal visceral fat Interventions that include diet and exercise have the most benefit. Reducing the most fat mass and preserving FFM than diet alone.

Answer 32

While greater intensity requires less time to complete a given volume and leads to greater improvements in cardiorespiratory fitness. It is not associated with statistically significant greater reductions in weight or fat mass

Answer 33

This where the absolute most fat is being oxidized, as the muscle triglycerides are being called on more. 55-65% - However, No evidence that exercising at fat-max increases fat loss compared to working at higher intensity Greater RELATIVE fat oxidization occurs at 25% of maximum oxygen uptake - higher percentage of cal/kg/min is coming from fat, but less absolute kcal being burned

Answer 34

Not very effective - BUT can contribute to change in body comp (retain FFM) Improved metabolism Maintenance of Function STRONGEST PREDICTOR OF IF SOMEONE WILL DIE IS LEVEL OF FITNESS <5 MET fitness level is high predictor of different mortalities

Obesity Flashcards

Midterm 2