Obesity Flashcards
Define obesity
Abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy
How many girls and boys are obese in 2016
Girls= 50 million
Boys=74 millions
How many children in tower hamlets are obese when they start school
1 in 8
How many children in tower hamlets are obese when they leave primary school
1 in 4
What % of weight issues are related to medication
10-15
Name some drugs that can cause weight issues
Mood stabilisers
Diabetes medicines
Corticosteroids
Beta blockers
Define lipohypertrophy
Enlargement of fat cells where insulin is injected
What T2D drugs increase insulin levels
Insulin
Sulfonylureas
TZD
What T2D drugs stabilise insulin levels
Metoformin
DPP IV inhibitors (januvia, onglza, trajenta)
What T2D drugs decrease insulin levels
SGLT-2 inhibitor
Acarbose
What is meant by the thrifty gene hypothesis
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
What is syndromic monogenic obesity
Characterised by mental retardation, dysmorphic features, organ specific abnormalities in addition to obesity
How many genes have been identified to cause syndromic monogenic obesity
12
What pathway is thought to be affected in syndromic monogenic obesity
Leptin-melanocortic pathway
What is the role of primary cilium
Key role in differentiation of adipocytes
Mediates leptin receptor signalling
How many genetic variants have been identified in polygenic obesity
227
Which niological pathways have been identified as part of the problem of polygenic obesityq
Central nervous system Food sensing and digestion Adipocyte differentiation Insulin signalling Lipid metabolism Muscle and liver biology Gut microbiota
2 ways that adipocyte differentiation dysfunction can lead to obesity
Ciliopathies
Multations in PPARγ2 (
What is PPARγ2
Transcription factor that has a key role in adipocyte differentiation
What drugs can target mutation in PPARγ2
Thiazolidinediones
Describe the concept of metabolic programming in development of obesity
Concept that environmental and nutritional influences during critical periods of development can have an effect of an individuals predisposition to obesity
What is meant by bonafide endocrine organ?
An organ in which defects can originate in the tissue iteself/ ability to communicate with brain/ downstream events
Where is the main site of thermogenesis
Brown adipose tissue
Are people with an apple or a pear shaped body at a higher risk of a weight related health problem?
Apple
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
Who is non alcoholic fatty liver disease
Build up of fat in the liver
2 ways to prevent obesity
Inform people about lifestyle
Promote/develop non-obesogenic environment
Is diet or exercise more important in weight loss
Diet
Mechanism of action of phentermine
NE transporter inhibitor
Appetite suppresion mediated by activation of POMC
Mechanism of orlistat
Gastric and pancreatic lipase inhibitor
Mechanism of action of lorcaserin
Selective 5-HT2c agonist
Mechanism of liraglutide
GLP-1 agonist
What is the main prescribed form of weight loss drug in UK
Orlistat
When should weight loss surgery performed laparoscopically
Morbid obesity (BMI>40kg/m2) BMI> 35kh/m2 and obesity related complications
Aim of restrictive surgery procedures
Restrict ability for stomach to contain food
Aim of malabsorptive procedures
Reduce ability to absorb nutrients causes nutrient deficiencies, malnutrition and sometimes anastomic leaks
