Obesity Flashcards

1
Q

Define obesity

A

Abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy

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2
Q

How many girls and boys are obese in 2016

A

Girls= 50 million

Boys=74 millions

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3
Q

How many children in tower hamlets are obese when they start school

A

1 in 8

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4
Q

How many children in tower hamlets are obese when they leave primary school

A

1 in 4

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5
Q

What % of weight issues are related to medication

A

10-15

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6
Q

Name some drugs that can cause weight issues

A

Mood stabilisers
Diabetes medicines
Corticosteroids
Beta blockers

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7
Q

Define lipohypertrophy

A

Enlargement of fat cells where insulin is injected

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8
Q

What T2D drugs increase insulin levels

A

Insulin
Sulfonylureas
TZD

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9
Q

What T2D drugs stabilise insulin levels

A

Metoformin

DPP IV inhibitors (januvia, onglza, trajenta)

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10
Q

What T2D drugs decrease insulin levels

A

SGLT-2 inhibitor

Acarbose

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11
Q

What is meant by the thrifty gene hypothesis

A

Genes that predispose to obesity would have had a selective advantage in populations that frequently experience starvation
People who have these genes may be obese now

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12
Q

What is syndromic monogenic obesity

A

Characterised by mental retardation, dysmorphic features, organ specific abnormalities in addition to obesity

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13
Q

How many genes have been identified to cause syndromic monogenic obesity

A

12

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14
Q

What pathway is thought to be affected in syndromic monogenic obesity

A

Leptin-melanocortic pathway

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15
Q

What is the role of primary cilium

A

Key role in differentiation of adipocytes

Mediates leptin receptor signalling

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16
Q

How many genetic variants have been identified in polygenic obesity

17
Q

Which niological pathways have been identified as part of the problem of polygenic obesityq

A
Central nervous system
Food sensing and digestion
Adipocyte differentiation
Insulin signalling
Lipid metabolism
Muscle and liver biology
Gut microbiota
18
Q

2 ways that adipocyte differentiation dysfunction can lead to obesity

A

Ciliopathies

Multations in PPARγ2 (

19
Q

What is PPARγ2

A

Transcription factor that has a key role in adipocyte differentiation

20
Q

What drugs can target mutation in PPARγ2

A

Thiazolidinediones

21
Q

Describe the concept of metabolic programming in development of obesity

A

Concept that environmental and nutritional influences during critical periods of development can have an effect of an individuals predisposition to obesity

22
Q

What is meant by bonafide endocrine organ?

A

An organ in which defects can originate in the tissue iteself/ ability to communicate with brain/ downstream events

23
Q

Where is the main site of thermogenesis

A

Brown adipose tissue

24
Q

Are people with an apple or a pear shaped body at a higher risk of a weight related health problem?

25
What are the key features in linking obesity and type 2 diabetes (4)
Chronic inflammation Altered adipokine levels (high leptin) Breakdown of fat metabolism Breakdown of regulation of glucose metabolism
26
Who is non alcoholic fatty liver disease
Build up of fat in the liver
27
2 ways to prevent obesity
Inform people about lifestyle | Promote/develop non-obesogenic environment
28
Is diet or exercise more important in weight loss
Diet
29
Mechanism of action of phentermine
NE transporter inhibitor | Appetite suppresion mediated by activation of POMC
30
Mechanism of orlistat
Gastric and pancreatic lipase inhibitor
31
Mechanism of action of lorcaserin
Selective 5-HT2c agonist
32
Mechanism of liraglutide
GLP-1 agonist
33
What is the main prescribed form of weight loss drug in UK
Orlistat
34
When should weight loss surgery performed laparoscopically
``` Morbid obesity (BMI>40kg/m2) BMI> 35kh/m2 and obesity related complications ```
35
Aim of restrictive surgery procedures
Restrict ability for stomach to contain food
36
Aim of malabsorptive procedures
Reduce ability to absorb nutrients causes nutrient deficiencies, malnutrition and sometimes anastomic leaks