Obesity

Question 1

What is the definition of obesity?

Answer 1

A multifactorial metabolic disorder of energy balance in which calorie intake over the long term exceeds energy output, resulting in an abnormally high BMI

Question 2

What is the definition of ideal weight?

Answer 2

One which maximises life expectancy

Question 3

What are thru main three cause that are thought to have caused obesity?

Answer 3

Excessive food energy intake

Lack of physical activity

genetic susceptibility

Psychological factors (behaviours)

Question 4

What is overweight?

Answer 4

Relatively higher water/bone/muscle and or fat content

Question 5

What is obese?

Answer 5

Higher body fat content

Question 6

What is the equation for BMI?

Answer 6

Mass/height x height (units= kg/m2)

Question 7

What does BMI not measure?

Answer 7

Body fat content

Body fat distribution

Question 8

What kind of disorder is obesity?

Answer 8

Its a metabolic disorder resulting from chronic imbalance between energy uptake and expenditure

Question 9

What are co-morbid conditions with obesity?

Answer 9

Hypertension
Dyslipidaemias
Type 2 diabetes mellitus

Question 10

What CV diseases are linked to obesity?

Answer 10

IHD & MI, angina, congestive heart failure

Hypertension, dyslipidaemias, DVT

Question 11

What endocrinology disorder is linked to obesity?

Answer 11

Diabetes Type 2 (excess body fat leads to 77% cases)

Question 12

What neurology disorders are linked to obesity?

Answer 12

stroke, migraine, dementia, cancer

Question 13

What psychiatry disorder is linked to obesity?

Answer 13

Depression

Question 14

What rheumatology disorder is linked to obesity?

Answer 14

osteoarthritis

Question 15

What respiratory disorder is linked to obesity?

Answer 15

Asthma, obstructive sleep apnoea

Question 16

What % do genes account for BMI variance?

Answer 16

50-90%

Question 17

What is leptin?

Answer 17

A hormone released from adipose tissue which acts on the hypothalamus to regulate food intake

Question 18

What are inducers of leptin?

Answer 18

glucocorticoids, insulin & oestrogen

Question 19

What reduces leptin expression?

Answer 19

beta-3 adrenoceptor agonists

Question 20

What are the aims of obesity treatment?

Answer 20

Prevent further weight gain
Gradually lose weight through a combination of calorie-controlled diet and regular exercise

Avoid regaining any lost weight

Improve your general state of health and reduce your risk of obesity-related complications

Question 21

What is there optimal fat content for females?

Answer 21

20-30%

Question 22

What is the optimal fat content for males?

Answer 22

12-20%

Question 23

What is skin fold test?

Answer 23

Non invasive, compared to standard young adults

Question 24

What is underwater weighing?

Answer 24

Outside & immersion weight compared. Obese person weights less in water

Question 25

What is bioelectric impedance analysis?

Answer 25

Fat slows passage of electricity through the body (body compositions scales measure rates)

Question 26

What is dual energy X-ray absorptivity?

Answer 26

2 low dose x-ray beams, determines amount of energy absorbed (depends on content of bone, lean tissue mass & fat

Question 27

What is a better predictor of disease risk than total fat mass?

Answer 27

visceral fat

Question 28

What is someone non-pharmacological obesity treatment?

Answer 28

Calorie controlled diet + exercise Improve quality of diet

Question 29

What are some bariatric surgeries & devices for obesity?

Answer 29

Gastric balloon | Stomach stapling, bowel segmentation

Question 30

What does bariatric surgeries & devices allow?

Answer 30

Early satiety | Reduced capacity to absorb nutrients

Question 31

What side effects does Phentermine have?

Answer 31

CV and CNS

Question 32

What is Orlisatat (Xenical)?

Answer 32

A pancreatic lipase inhibitor

Question 33

What are the effects of Orlisatat?

Answer 33

``` 3kg loss (1-4 yrs) GI side effects ```

Question 34

What is Lorcaserin?

Answer 34

5HT agonist

Question 35

What are the side effects of Lorcaserin?

Answer 35

Headache, dizziness, nausea, CV side effects

Question 36

What is Topiramate?

Answer 36

A anticonvulsant

Question 37

What is the mechanism of Orlistat?

Answer 37

Complexes with serine residues on active site of gastric & pancreatic lipase Impairs fat breakdown Increases faecal fat excretion

Question 38

What is the clinical efficacy of Orlistat?

Answer 38

3% greater body weight loss than placebo

Question 39

What are side effects of Orlistat?

Answer 39

Flatulence Faecal incontinence May change efficacy of oral contraceptives Supplements with fat soluble vitamins, A, D & E

Question 40

What is Bupropion?

Answer 40

inhibitor of DA/NA reuptake inhibitor

Question 41

What is Naltrexone?

Answer 41

Mu-opioid antagonist

Question 42

What are the side effects of Naltrexone?

Answer 42

Nausea, constipation, vomiting, dry mouth, potential CV risk

Question 43

What do animal models of obesity involve?

Answer 43

rats ventromedial hypothalamus (+ arcuate nucleus) lesions

Question 44

How can energy expenditure be increased?

Answer 44

increase in thermogenesis | Modulate metabolism

Question 45

What is involved in increasing thermogenesis?

Answer 45

Beta- 3 agonists Uncoupling protein 3 modulator Thyroid hormone beta agonist

Question 46

What is involved in modulating metabolism?

Answer 46

Inhibit triglyceride formation ACC2 inhibitors 11 beta HSD1- inhibitors Increase beta-oxidation ACC2 inhibitors Adipose complement related protein (Adiponectin)

Question 47

How can you decrease energy intake?

Answer 47

Supress appetite by stimulating anorexigenic pathway Modulate metabolism Alter adipocyte differentiation Mimic caloric restriction

Question 48

What is brown fat?

Answer 48

``` Specialised fat cells Distinct focal distribution Thermogenic & calorie burning 300 x heat /g than any other tissue Mitochondria produce thermogenin (UCP1) BFC heat & capsaicin activated Decrease in aging & obesity ```

Question 49

What is Mirabegron?

Answer 49

A beta-3 adrenoceptor agonist Increases human BAT glucose uptake Increases human WAT lipolysis Increases metabolic activity Activates brown adipose tissue

Question 50

What does a gastric sleeve do?

Answer 50

75% stomach out Tube holding 2-3 ounces Tissue containing ghrelin gone Irreversible

Question 51

What are gastric bands and what do they do?

Answer 51

Silicone band with access port for inflation Decreases food volume in stomach increases time for food to be digested 1-2 lbs lost per week

Question 52

What do gastric balloons do/involve?

Answer 52

Occupy space Inserted via endoscopy Fluid filled: saline + methylene blue Remove 6 months

Question 53

What are electrical stimulator systems and what do they do?

Answer 53

Pacemaker interrupts hunger signals from brain to stomach (abdo vagus nerve) Decreases hunger, promotes earlier fullness feelings

Question 54

What is a simple way to prevent obesity?

Answer 54

Educate people on food nutrient