Obesity Flashcards
What is obesity?
Obesity is a disease caused by abnormal weight gain carrying risk for further disease
What are 3 components of metabolism?
adaptive thermogenesis
(e.g. shivering)
physical activity
obligatory energy expenditure
How does the BMI scale vary for asian populations?
starts earlier
no clear reason
What affects the trend in obsity levels in females in England and Scotland?
not driven by genetic factors
N and S divide
How does obesity change with age?
obesity is a disease of ageing - with increasing age, number of overweight/obese people increases, as does the associated disease risks
How does obesity affect countries worldwide?
it is a global problem
rise in T2DM associated with obesity
How does obesity vary with social class?
- those in poorest societies have a greater risk of obesity
- depends on environment (food availability)
Which age group has the highest BMI?
55-64
What ethnic group has highest BMI?
highest in Caucasian and Bangladeshi
How does BMI vary regionally?
Scotland and North England highest
What is the trend for BMI in smokers?
lower BMI but greater central obesity
How do genes influence obesity?
60% is inheritable but explain only 5% of obesity
What important genes in CNS regulate body weight?
Anabolic/orexigenic molecules
- Neuropeptide Y
- MCH
- dopamine
Catabolic/anorectic molecules
- leptin receptor
- POMC
- CRH
- GLP-1R
What is the average caloric intake per year?
900,000kcal
What is the projected cost of obesity per year by 2022?
£30 billion / year
How does obesity affect the rest of the body?
hypertension diabetes - insulin resistance arthritis depression sleep apnoea stroke gallstone cancer infertility IHD
What disease has the strongest influence from obesity?
T2DM - steep rise in relative risk of T2DM with rising BMI
Obesity –> insulin resistance –> more fat stored in liver and pancreas which is toxic –> greatly increases risk of T2DM
How does location of fat affect risk?
Where you store fat changes risk of disease - subcutaneous of internally (omentum or fat associated with intestines/ around liver or heart)
Fat dictates metabolism as blood supply connects fat supply from gut to liver
Immune cells trapped in fat are inflamed when increase body fat
Greatly affects liver metabolism
android - apple
gynoid - pear
How does insulin need change with increasing waist circumference?
increases with greater waist circumference
pancreas must work harder to control the same blood glucose []
How can you monitor risk of T2DM?
monitor insulin sensitivity by assessing waist circumference
What is 10% weight los associated with?
fall in LDL, TGs, total cholesterol, FBS
rise in HDL
improvement of BP
reduction in mortality risk by 20-25%
30-40% reduction in diabetes risk
40-50% reduction in some cancers
What does NICE recommend for obese individuals?
diet exercise behavioural therapy drugs surgery
Why do people feel more hungry after initial loss of weight?
body avoids loss of weight - tries to boost hunger
What is the problem with pharmaceutical management?
body weight increases as soon as drug removed
side effects
- SIBUTRAMIDE (depression, hypertension)
What surgical intervention has a significant impact on reducing obesity?
gastric bypass
What system is used to manage obesity?
TIER system with appropriate lifestyle advice
