Obesity Flashcards
Why can’t some obese patients lose weight?
Some have MCR-4 polymorphisms which lead to a lack of satiety, some have psychotic illness or are on drugs which lead to weight gain such as pioglitazone, insulin, resperidone and steroids.
Define obesity
The abnormal or excessive fat accumulation that is sufficient to adversely affect health and reduce life expectancy
What BMI indicates underweight?
Less than 18.5
What BMI is normal?
18.5-24.9
What BMIs would represent overweight?
25-29.9
What BMI would represent obesity?
> 30
What BMI would represent morbid obesity?
> 40
Why may waist circumference measurement be useful?
To distinguish between obesity and muscularity in an elevated BMI
What medications can influence weight?
Mood stabilisers, corticosteroids, beta blockers, allergy relievers, anti-seizure medications and diabetic medications
How do insulin and sulfonylurea drugs given in diabetes affect weight?
Increase insulin levels so increase weight
How do metformin and DPP IV inhibitors given in diabetes affect weight?
Stabilise insulin levels so stabilise weight
How do SGLT-2 inhibitors and acarbose given in diabetes affect weight?
Decreases insulin levels further leading to a decrease in weight
How can Bardet–Biedl & AlstrÖm syndrome (ciliopathy) lead to obesity?
Cilia mediate the leptin receptor signalling, and therefore in the absence of this an individual will lack the feeling of satiety
How may the ‘thrifty gene hypothesis’ explain obesity?
Genes that predispose to obesity would have has a selective advantage in populations that frequently experienced starvation, however, when these predisposed individuals reside in today’s obesogenic environment, they may ‘overreact’ and not just become slightly overweight, but extremely obese.
What kind of disorder is Bardet–Biedl & AlstrÖm syndrome (ciliopathy)?
A syndromic monogenic obesity
