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Thyroid problems EAR:2 > Obesity 2: control of appetite > Flashcards

Obesity 2: control of appetite Flashcards

1
Q

What is satiation

A

Feeling of fullness that terminates meal

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2
Q

What is satiety

A

Feeling of repletion that inhibits further meals

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3
Q

What controls food intake

A

Hypothalamus

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4
Q

What region of the brain controls hunger and appetite

A

Arcuate nucleus (ARC) within the hypothalamus

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5
Q

What does the release of NPY and AgRP from the arcuate nucleus in the hypothalamus stimulate and what does this do

A

Orexigenic neurons in paraventricular nucleus

-Leads to a stimulation of food intake

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6
Q

What does the release of POMC and CART from the ARC in the hypothalamus stimulate and what does this do

A

Anorexigenic neurones in the paraventricular nucleus (PVN)

-LEads to inhibition of food intake

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7
Q

How can POMC and CART affect orexigenic neutrons

A

Inhibit them

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8
Q

How can NPY and AgRP affect anorexigenic neutrons

A

Inhibit them

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9
Q

What does POMC undergo and where does it act on to inhibit food intake

A

Undergoes post translational modification to generate melanocortins which act at melanocortin receptors

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10
Q

How does AgRP inhibit the effects of POMC

A

Endogenous antagonist of the melanocortin-4 receptor

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11
Q

What effect does Leptin (released from adipose tissue) have on neurotransmitters from the ARC

A

Stimulate release of POMC and CART

Inhibit release of NPY and AgRP

Inhibits appetite

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12
Q

What effect does PYY have on appetite and how does it do this

A

Inhibits appatite

Either acts straight on the ARC
or
Acts on pancreas which releases insulin which acts on ARC and switches off appetite

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13
Q

What effect does CCK have on appetite and how

A

It either acts directly on the brain or stimulates the vagus nerve which acts on the brain and inhibits appetite

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14
Q

Which hormones inhibit appetite

A

Leptin
PYY
CCK

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15
Q

Which hormones increase appetite

A

Ghrelin

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16
Q

What effect does gastric distension have on food intake

A

Leads to a release of gut peptides from the enteroendocrine cells

17
Q

Which hormones are released from the enteroendocrine cells which inhibit food intake when there is gastric distension

A

CCK
Glucagon-like peptide 1 (GLP1)

Oxyntomodulin

Peptide YY (PYY3-36)

Apolipoprotein A-IV

Enterostatin

18
Q

When are leptin levels decreased

A

When there’s decreased food intake

19
Q

Where is ghrelin produced

A

GIT

20
Q

What does Ghrelin do

A

Make you feel hungry

21
Q

Where is PYY secreted from and what is it stimulated by

A

Distal GIT

  • dependent on nutrient intake (more protein than fat or carbs)
  • also stimulated by CCK, gastric acid, bile
22
Q

Where does active PYY act and what does it do

A

NPY Y2 receptors

-MImics the effect of NPY and so stops further release of NPY

23
Q

What does PYY do to food intake in lean and obese people

A

Decreases food intake

24
Q

How is there negative feedback with NPY

A

NPY released from presynaptic neurone and this acts on Y1 and Y2 receptors. NPY goes back to the presynaptic membrane and attaches to the Y2 receptor. This inhibits further release of NPY

25
Q

What inhibits appetite stimulating neurons

A

Leptin
PYY
INsulin

(NPY and AgRP)

26
Q

What stimulates appetite inhibiting neurons

A

Leptin

POMC and CART

27
Q

What stimulates release of NPY and AgRP

A

Grehlin

28
Q

What reward processes are involved in appetite

A

Opioid receptors (endorphins)

Cannabinoid receptors

Dopamine and dopamine receptors

29
Q

What does bupropion do

A

It is a dopamine reuptake inhibitor. Inhibition of this reuptake leads to an increase in the amount of dopamine in the synapse, leading to a prolonged activation of the dopamine receptor.

Aids weight loss

30
Q

How does orlistat act

A

Inhibits gastric and pancreatic lipase which decreases absorption

31
Q

HOw should orlistat be taken

A

Before each main meal

Cobined with a low fat diet

32
Q

What is the side effect of orlistat

A
  • Steatorrhea

- Reduced absorption of fat therefore need to monitor fat soluble vitamin status

33
Q

Who can you give orlistat to

A

BMI>30

BMI>28 if other risk factors e.g. type2 diabetes, hypercholesterolaemia, hypertension

34
Q

What is saxenda and what does it do

A

GLP1 agonist

-Appetite suppression-increased secretion of POMC/CART

35
Q

What can GLP1 do

A

Reduce high fat food intake by suppressing dopamine signalling effect on reward pathway

36
Q

Who can you give saxenda to and when should you be careful

A

If BMI>30 or lower if concurrent disease

Care with type 2 diabetes as patient may already be on a GLP1 agonist

37
Q

What is mysimba

A

Obesity drug which has an effect on reward pathways

Thyroid problems EAR:2 (6 decks)

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