Obesity

Question 1

What is the direct method of measuring body composition?

Answer 1

In-vivo neutron activation analysis

Question 2

What are the indirect methods of measuring body composition?

Answer 2

• Densiometry
• Deuterium oxide dilution
• Dual energy X-ray absorptiometry (DEXA)

Question 3

What are the doubly indirect methods of measuring body composition?

Answer 3

• Skinfold thicknesses
• Bioelectrical impedance
• Waist circumference
• BMI-based prediction equations for the percentage of body fat

Question 4

What is the equation for calculation of BMI?

Answer 4

Question 5

What are the effects of metabolic syndrome?

Answer 5

• Insulin resistance
  
  • Obesity
  • Hypertension
  • Dyslipidaemia
  • Glucose intolerance
  • Raised inflammatory markers
  • Abnormal blood clotting
• Atherosclerosis

Question 6

What are the respiratory effects of obesity?

Answer 6

• Sleep apnoea
• Hypoventilation

Question 7

What are the rheumatological effects of obesity?

Answer 7

• Osteoarthritis

Question 8

What is the effect of obesity on the liver?

Answer 8

Question 9

What are the effects of obesity on the kidneys?

Answer 9

• Worsening chronic kidney disease
  
  • Hypertension
  • Diabetes
  • Renovascular disease
• Focal sclerosing glomerulosclerosis
  
  • Nephrotic syndrome

Question 10

What are the effects of obesity on mental health?

Answer 10

• Psychosocial effects
• Depression

Question 11

Which cancers are associated with obesity in women?

Answer 11

• Breast
• Colon
• Gallbladder
• Uterus

Question 12

Which cancers are associated with obesity in men?

Answer 12

• Colon
• Prostate

Question 13

Describe the properties of Prader-Willi syndrome.

Answer 13

• Paternal deletion chromosome 15
• Profound hyperphagia
• Hypotonia
• Delayed sexual maturation
• Mild to moderate learning difficulties

Question 14

Describe the properties of Klinefelter’s syndrome in childhood, adolescence and adulthood.

Answer 14

• XXY
• In childhood
  
  • Shyness and low self-confidence
  • Mild dyslexia and/or dyspraxia
  • Low energy levels
  • Difficulty socalising or expressing feelings
• In teenagers
  
  • Taller than expected with long arms and legs
  • Broad hips
  • Poor muscle tone
  • Slower than usual muscle growth
  • Reduced facial and body hair
  • Small penis and testicles
  • Enlarged breasts (gynaecomastia)
• In adulthood
  
  • Infertility
  • Low sex drive

Question 15

List other genetic syndromes of obesity.

Answer 15

• Bardet-Biedl syndrome
• Alstrom syndrome
• Cohen syndrome
• Albright’s hereditary osteodystrophy (pseudohypoparathyroidism)
• Carpenter syndrome
• MOMO syndrome
• Rubenstein-Taybi syndrome
• Maternal uniparental disomy of chromosome 14
• Fragile X syndrome
• Börjeson-Forssman-Lehman syndrome

Question 16

Desribe the characteristics of Cushing’s syndrome.

Answer 16

• Weight gain and more body fat
  
  • Centripetal
• ‘Buffalo hump’
• Red, puffy, rounded face
• Skin that bruises easily
• Large purple stretch marks
• Weakness in the upper arms and thighs
• Low libido and fertility problems
• Depression and mood swings

Question 17

Describe the hypothalamic control of energy balance.

Answer 17

• Crucial role in modulating appetitive behaviour
• Critical nodes in the control of body weight
  
  • Arcuate proopiomelanocortin
  • NPY/AgRP
• Possibly direct targets for leptin

Question 18

What are the medications which could potentially be used in treating obesity?

Answer 18

• Orlistat (xenical)
• Lorcaserin (Belviq)
  
  • 5-HT2C receptor agonist
• Phentermine and topiramate (Qsymia)
• Buproprion
  
  • Noradrenaline-dopamine reuptake inhibitor / nicotinic receptor antagonist
• Naltrexone (contrave)
  
  • Opioid receptor antagonist
• Liraglutide
  
  • Saxenda

Question 19

What are the surgical options for the treatment of obesity?

Answer 19

• Gastric bypass (Roux-en-Y gastric bypass)
• Laparoscopic adjustable gastric banding
• Bioliopancreatic diversion with duodenal switch
• Gastric sleeve