Obesity

Question 1

Obesity increases risk for?

Answer 1

Type 2 diabetes, cardiovascular disease, HT, cancer, arthritis, dyslipidemias, gallstones, gout, urinary incontinence, fatty liver disease, sleep apnea
-stronger associations <55 yo (younger obesity, stronger correlation)

Question 2

How is BMI calculated?

Answer 2

Weight (kg)/Height (m^2)

Question 3

What is a healthy BMI?

Answer 3

18.5-24.9

Question 4

What is an overweight BMI?

Answer 4

25-29.9

2/3 of americans

Question 5

What is an obese BMI?

Answer 5

> =30

Question 6

What is a morbidly obese BMI?

Answer 6

> =40 (or 100 lbs overweight)

Question 7

Which is worse: apple (android) or pear (gynoid)?

Answer 7

Apple (upper body obesity)

Question 8

Which is worse: subcutaneous or visceral fat

Answer 8

Visceral (fat around organs)

Question 9

What is characteristic of gluteal-femoral (lower body) subcutaneous adipocytes?

Answer 9

• Larger
• Very efficient at TAG deposition
• Mobilize FAs more slowly (pro-inflammatory so good that it is slow)

Question 10

What is characteristic of visceral adipocytes?

Answer 10

Most metabolically active

Question 11

What 2 hormones are important for endocrine fx of adipose tissue?

Answer 11

1) Leptin

2) Adiponectin

Question 12

What does leptin do and where is it made?

Answer 12

Regulates appetite

• Made by adipose tissue
• Levels increases w/ body weight

Question 13

What does adiponectin do?

Answer 13

Reduces levels of FFAs in blood

• Levels decrease as body weight increases
• Improves lipid profiles, increased insulin sensitivity -> better glycemic control, reduced inflammation

Question 14

What happens in weight loss?

Answer 14

Fat cell size reduced, number not affected

-Easier to gain weight if you were once overweight

Question 15

What are adipocytes good at?

Answer 15

Expanding, 2-3x

Question 16

What does prolonged overnutrition lead to?

Answer 16

Pre-adipocytes proliferate -> further weight gain

Question 17

What can obese adipocytes have?

Answer 17

5x normal fat cell numbers

Question 18

What happens to excess FAs in obesity?

Answer 18

Spill over into other tissues -> “ectopic fat” (associated w/ insulin resistance)

Question 19

What genetic contribution is there to obesity?

Answer 19

Weight is stable

-biologically predetermined “set point”

Question 20

In adopted children what is their weight correlated with?

Answer 20

Biologic rather than adoptive parents

Question 21

What environmental/behavioral contributions are there?

Answer 21

Energy-dense foods, sedentary lifestyles, eating behaviors

Question 22

What is metabolic syndrome?

Answer 22

Abdominal obesity associated w/ cluster of metabolic abnormalities

Question 23

How does metabolic syndrome affects inflammatory sx?

Answer 23

Low-grade, chronic systemic inflammation -> pathogenesis of insulin resistance/atherosclerosis
-Adipocytes release proinflammatory IL-6

Question 24

What are some of the metabolic abnormalities?

Answer 24

Hyperglycemia, insulin resistance, hyperinsulinemia, dyslipidemia (low levels of HDL and elevated TAGs), hypertension