Obesity

Question 1

Negative Effects of Obesity

Answer 1

Mechanical
Metabolic
Monetary
Mental

Question 2

Leptin

Answer 2

Signals hypothalamus to suppress hunger

Adipose Tissue
- Resistance = Failure to surpress hunger

Question 3

Ghrelin

Answer 3

Stimulates appetite

Stomach
- Dysregulation = Increased hunger

Question 4

Insulin

Answer 4

Released in response to food

Pancreas
- Resistance = Impaired glucose metabolism and promotes fat storage

Question 5

GLP-1

Answer 5

Slows gastric emptying
Promotes satiety

Gut-Derived Hormone
- Blunted = Reduces feeling of fullness

Question 6

Peptide YY

Answer 6

Slows gastric emptying
Promotes satiety

Gut-Derived Hormone
- Blunted = Reduces feeling of fullness

Question 7

Pre-Clinical

Answer 7

Physical Phenotype
- Excess adiposity
- No signs of organ dysfunction due to obesity yet

Question 7

Clinical Obesity

Answer 7

Fulfills the two main criteria
1. Anthropometric Criteria
2. Clinical Criteria

Question 7

Anthropometric Criteria

Answer 7

At least one of:
- Waist Circumference
- Direct measure of body fat

Question 8

Clinical Criteria

Answer 8

At least one of:
- Signs of ongoing organ dysfunction
- Limitations of basic activities

Question 9

Impact of Genetics

Answer 9

BMI (40-70%)
Food preference
Energy regulation
Lipid metabolism
Neurogenic pathways

Question 10

Impact of Environment

Answer 10

Medications

Food Sercurity
Education
Finances
Health Care Access

Question 11

Impact of Epigenetics

Answer 11

Prenatal / Early influence
Diet and lifestyle
Transgenerational
Microbiome

Question 12

The 5As

Answer 12

Ask
Assess
Advise
Agree
Assist

Question 13

Ask

Answer 13

Explore readiness for change
- Safe weight friendly practice

Question 14

Assess

Answer 14

• Root causes of weight gain
• Obesity class

Question 15

Advise

Answer 15

Inform patients on health risks and treatment options

Question 16

Agree

Answer 16

• Address drivers of weight gain
• Measure improvements

Question 17

Assist

Answer 17

• Identify drivers and barriers
• Provide education and resources
• Arrange follow up

Question 18

Medical Nutrition Therapy

Answer 18

• Eating pattern
• Food quality
• Healthy relationship with food
• Increase micronutrient deficiencies
• Caloric restrictions is not sustainable

Question 19

Physical Therapy

Answer 19

Regular aerobic exercise (30-60 mins of moderate to vigorous intensity)
- Favours weight maintenance rather than weight loss

Question 20

Psychological Therapy

Answer 20

Cognitive Behavioural Therapy
- Address emotional eating and self-stigma

Question 21

Indication for Pharmacotherapy

Answer 21

Depends on obesity management goals
- Consider early

BMI > 30 or BMI > 27 with comorbidities

Question 22

Medications approved for obesity management

Answer 22

Orlistat
Liraglutide
Semaglutide
Naltrexone/Bupropion

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