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Endocrinology and Gastrointestinal Pharamacology > Obesity > Flashcards

Obesity Flashcards

1
Q

What is the definition of obesity?

A

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

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2
Q

What is the definition of ideal weight?

A

One which maximises life expectancy

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3
Q

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

A

Excessive food energy intake

Lack of physical activity

genetic susceptibility

Psychological factors (behaviours)

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4
Q

What is overweight?

A

Relatively higher water/bone/muscle and or fat content

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5
Q

What is obese?

A

Higher body fat content

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6
Q

What is the equation for BMI?

A

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

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7
Q

What does BMI not measure?

A

Body fat content

Body fat distribution

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8
Q

What kind of disorder is obesity?

A

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

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9
Q

What are co-morbid conditions with obesity?

A

Hypertension
Dyslipidaemias
Type 2 diabetes mellitus

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10
Q

What CV diseases are linked to obesity?

A

IHD & MI, angina, congestive heart failure

Hypertension, dyslipidaemias, DVT

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11
Q

What endocrinology disorder is linked to obesity?

A

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

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12
Q

What neurology disorders are linked to obesity?

A

stroke, migraine, dementia, cancer

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13
Q

What psychiatry disorder is linked to obesity?

A

Depression

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14
Q

What rheumatology disorder is linked to obesity?

A

osteoarthritis

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15
Q

What respiratory disorder is linked to obesity?

A

Asthma, obstructive sleep apnoea

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16
Q

What % do genes account for BMI variance?

A

50-90%

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17
Q

What is leptin?

A

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

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18
Q

What are inducers of leptin?

A

glucocorticoids, insulin & oestrogen

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19
Q

What reduces leptin expression?

A

beta-3 adrenoceptor agonists

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20
Q

What are the aims of obesity treatment?

A

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

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21
Q

What is there optimal fat content for females?

A

20-30%

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22
Q

What is the optimal fat content for males?

A

12-20%

23
Q

What is skin fold test?

A

Non invasive, compared to standard young adults

24
Q

What is underwater weighing?

A

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

25
Q

What is bioelectric impedance analysis?

A

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

26
Q

What is dual energy X-ray absorptivity?

A

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

27
Q

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

A

visceral fat

28
Q

What is someone non-pharmacological obesity treatment?

A

Calorie controlled diet + exercise

Improve quality of diet

29
Q

What are some bariatric surgeries & devices for obesity?

A

Gastric balloon

Stomach stapling, bowel segmentation

30
Q

What does bariatric surgeries & devices allow?

A

Early satiety

Reduced capacity to absorb nutrients

31
Q

What side effects does Phentermine have?

A

CV and CNS

32
Q

What is Orlisatat (Xenical)?

A

A pancreatic lipase inhibitor

33
Q

What are the effects of Orlisatat?

A 
3kg loss (1-4 yrs) 
GI side effects
34
Q

What is Lorcaserin?

A

5HT agonist

35
Q

What are the side effects of Lorcaserin?

A

Headache, dizziness, nausea, CV side effects

36
Q

What is Topiramate?

A

A anticonvulsant

37
Q

What is the mechanism of Orlistat?

A

Complexes with serine residues on active site of gastric & pancreatic lipase

Impairs fat breakdown

Increases faecal fat excretion

38
Q

What is the clinical efficacy of Orlistat?

A

3% greater body weight loss than placebo

39
Q

What are side effects of Orlistat?

A

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

40
Q

What is Bupropion?

A

inhibitor of DA/NA reuptake inhibitor

41
Q

What is Naltrexone?

A

Mu-opioid antagonist

42
Q

What are the side effects of Naltrexone?

A

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

43
Q

What do animal models of obesity involve?

A

rats ventromedial hypothalamus (+ arcuate nucleus) lesions

44
Q

How can energy expenditure be increased?

A

increase in thermogenesis

Modulate metabolism

45
Q

What is involved in increasing thermogenesis?

A

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

46
Q

What is involved in modulating metabolism?

A

Inhibit triglyceride formation
ACC2 inhibitors
11 beta HSD1- inhibitors

Increase beta-oxidation
ACC2 inhibitors
Adipose complement related protein (Adiponectin)

47
Q

How can you decrease energy intake?

A

Supress appetite by stimulating anorexigenic pathway

Modulate metabolism

Alter adipocyte differentiation

Mimic caloric restriction

48
Q

What is brown fat?

A 
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
49
Q

What is Mirabegron?

A

A beta-3 adrenoceptor agonist

Increases human BAT glucose uptake

Increases human WAT lipolysis

Increases metabolic activity

Activates brown adipose tissue

50
Q

What does a gastric sleeve do?

A

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

51
Q

What are gastric bands and what do they do?

A

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

52
Q

What do gastric balloons do/involve?

A

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

53
Q

What are electrical stimulator systems and what do they do?

A

Pacemaker interrupts hunger signals from brain to stomach (abdo vagus nerve)

Decreases hunger, promotes earlier fullness feelings

54
Q

What is a simple way to prevent obesity?

A

Educate people on food nutrient

Endocrinology and Gastrointestinal Pharamacology (7 decks)

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