Obesity Flashcards
how do we burn calories
Basal metabolism (60-75%) Thermogenesis (10%) Physical activity (15-30%)
a variant in which gene can be associated with high BMI
FTO gene - can predispose to childhood and adulthood obesity
what are the main health consequences of obesity (can be associated with increase in insulin and oestrogen)
cancer gallbladder disease renal failure stroke heart failure atherosclerosis NIDDM Hypertension
what are health consequences of diabetes due to carrying more weight than the skeleton is designed to
osteoarthritis
back pain
sleep apnoea
asthma
how does obesity lead to type 2 obesity
obese people are resistant to insulin leading to a compensatory rise in insulin by the pancreas
eventually the pancreas can’t keep up leading to hyperglycaemia and diabetes
what happens to leptin in obesity
if you have plenty of fat stores leptin doesn’t do the opposite - theres a max amount of leptin you can get to that doesn’t decrease appetite as you keep getting bigger
what does leptin do
tells your body how fat you are/ how thin you are
no leptin means the brain thinks you’re starving and greatly increases your appetite
what does adipose tissue secrete
leptin adiponectin CRP TNF alpha IL-6 PAI-1 Oestrogen Cortisol Free fatty acids
what happens to macrophages in obesity
as they overlap with fat cells they take in fat in obesity and fat cells secrete cytokines causing inflammation
fat filled macrophages are called foam cells and are found in atherosclerotic plaques
what can trigger inflammation in obesity
cellular stress in particular adipocytes can’t clap with the metabolic demands placed on it as part of an expanding fat mass
in then activated pathways leading to inflammation and insulin resistance
what are the management options for obesity
dietary measures
exercise/physical activity
drugs
surgery
what are some options for hypo caloric diets
portion control/calorie burning low carbs low fat Very Low Calorie Diet (most extreme and not sustainable) Meal replacement eg. Slim fast
what drug is used for obesity
Orlistat
inhibition of lipases blocks absorption of dietary fat leading to up to 1/3 od fat being excreted into faeces
what surgery is used for obesity
Bariatric surgery- restrictive versus malabsorption procedures
good long term outcomes
types of bariatric surgery
adjustable gastric band
roux-enY gastric bypass
Vertical sleeve gastrectomy
