Obesity Flashcards
What diseases are linked to obesity?
- Type II diabetes
- Hypertension
- Cancer deaths amongst non-smokers (10% of which attributed to obesity)
- Coronary heart disease and stroke (obesity is a contributing factor)
- Reproductive function (6% of primary infertility in women due to obesity)
- Respiratory effects (obstructive sleep apnoea, pulmonary hypertension)
- Osteoarthritis
- Angina pectoris, congestive heart failure
- Hyperinsulinaemia, insulin resistance, glucose intolerance
- High blood cholesterol, dyslipidemia
- Bladder control problems, uric acid nephrolithiasis
- Psychological disorders (depression, eating disorders, low self esteem)
Describe the epidemiological pattern of obesity
In the past obesity affected the rich, nowadays obesity is associated with poverty
social gradient - 18% professionals/managers are obese
28% unskilled/manual workers are obese
Name some causes of obesity
The causes are complex, multi-factorial, rooted in social, economic and cultural factors:
a) “Americanization” of diet and society
b) Increasing dominance of car culture, less walking
c) Numerous technical advances minimising physical work
d) More commuting
e) Longer working hours
f) Greater availability of energy dense food, cheaper, better promoted
g) Replacing water by sugary drinks
- Is it more about the increased energy intake or reduced energy expenditure?
What is the definition of obesity
Abnormal or excessive fat accumulation resulting from chronic imbalance between energy intake and energy expenditure that presents a risk to health. It is a state of positive energy balance.
What are diagnostic measures of obesity
- MRI
- Dual-Energy X-ray Absorptiometry
- Waist circumference
- WHR (waist to hip ratio)
- Skinfold thickness
- BMI (Body Mass Index)
What are the ranges for BMI?
• 40.0
What are the seven key domains of energy balance
- Food environment (energy intake – population level)
- Food consumption (energy intake – individual level)
- Individual activity (energy expenditure)
- Activity of the environment
(ee – population level) - Societal influences (both intake and expenditure)
- Individual psychology (both intake and expenditure)
- Individual biology (both intake and expenditure)
What is the aetiology of obesity?
AETIOLOGY OF OBESITY
The causes of obesity are:
• Multifaceted and complex
• Causes are an interaction between biology and behaviour
What is Prader Willi syndrome?
i Short statue, almond shaped eyes, small hands and feet
ii Intelectual impairment, hyperphagia (over-eating), infertile, hypotonia,
iii rare genetic disorder -Chromosome 15 deletion (paternal)
What are polygenic diseases?
Obesity is a polygenic disease, it depends on the simultaneous presence of several genes, (along with other environmental influences), they are not inherited as simply as are single-gene diseases.
What is leptin?
Leptin the “satiety hormone,” is a hormone made by adipose cells that helps to regulate energy balance by inhibiting hunger.
• Mutations of the leptin and melanocortin receptors can result in obesity
• Congenital leptin deficiency = obesity
i Extreme adiposity and uncontrollable appetite
ii Monogenic obesity is very rare!
Give an example of how western environment can lead to a higher chance of obesity
THE OBESOGENIC ENVIRONMENT
• The Pima Indians – showing a dramatic increase in obesity when exposed to western
environment (the majority of Arizonian Pima are now severely obese, 95% have diabetes)
What behaviours are associated with weight gain?
• EMPLOYMENT i Shift work, lack of sleep, upset circadian rhythm ii Reduced physical activity iii Cortisol, leptin, ghrelin • DIETARY PATTERNS • LEISURE AND ACTIVITIES
What developmental factors are linked to obesity
- Rapid infant weight gain (in the first 2yrs of life = increased risk)
- Breast feeding (associated with protective mechanisms from obesity)
- Early introduction of solid foods (
What are the direct and indirect control of meal size
• Direct: all the factors relating to the direct contact of the food with the GI mucosal
receptors
• Indirect: metabolic, endocrine, cognitive individual differences -> indirect controls can
override the direct controls
