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ailmentary > obesity > Flashcards

obesity Flashcards

1
Q

energy cause of weight gain

A

E in exceeds E out

increase intake - decrease expenditure

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2
Q

describe components of energy expenditure

A

intake = metabolism and storage
energy is expended by - adaptive thermogenesis (regulated by the brain, temp and diet, occur in brown adipose tissue, skeletal muscle), physical activity, obligatory energy expenditure (basal, for performance)

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3
Q

env/genetic

A

there is a genetic impavct but the main factor is environment #
disease of aging
once you have crossed the weight percentile - chance of getting off is tiny
higher in lower social classes

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4
Q

describe the genetic contribution to obesity

A

200 genes associated with weight gain
genes are there to protect against malnutrition
they are orexigenic/anabolic molecules
or anorectic/catabolic molecules

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5
Q

orexigenic/anabolic molecules that regulate body weight

A 
Neuropeptide Y (NPY)
Agouti gene related peptide (AGRP)
Agouti-related transcript (ART)
Melanin-concentrating hormone (MCH)
Dopamine
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6
Q

anorectic/catabolic molecules that regulate body weight

A 
Leptin receptor (LEPR)
Pro-opiomelanocortin (POMC)
Melanocortin receptor 4 (MCR4)
Corticotropin releasing hormone (CRH)
Serotonin receptor subtype 2C (5-HT2C)
Glucagon-like peptide 1 receptor (GLP-1R)
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7
Q

how many extra calories would be needed for weight gain

A

0.02% increase a year = 3500Kcal/yr = 1lb weight gain a year

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8
Q

financial complications of obesity

A

£49m

because it causes so many other conditions

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9
Q

effects of obesity

A 
depression
IHD
gallstones 
cancers
infertility 
strole 
sleep apnoea 
hyopertension 
diabetes - inmsulin resistance 
osteoarthritis 
gout
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10
Q

effect of bariatric surgery

A

absorb less from food
depression lifts as you lose the weight
sustainable weight loss

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11
Q

how do you measure waist circumference

A

midrib between the lowest rib and iliac crest
1cm above naval
accuracy difficult inf BMI >35

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12
Q

what are the interpretations of waist circumference

A

action level 1 women >=80cm, men >= 94cm - health risk increasing - take personal action to avoid weight gain
action level 2 women 88cm, men 102cm multiple health problems, professional health needed

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13
Q

what is the effect of 10% weight loss

A 
improves all aspects of the metabolic syndrome 
50% fall in 
10% decrease in cholesterol 
15% LDL 
30% triglycerides 
8% rise in HDL 
improvement of BP of 10/120mmHg

20-25% reduced mortality
30-40% reduction in diabetes related mortality
40-50% reduction in cancers

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14
Q

difficulty with such good results at 10% weight loss

A

difference in perception of management - feel like its failure and bounce back

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15
Q

recommendations from NICE

A 
diet 
Exercise
Behavioural therapy
Drug treatment
Surgery (if BMI >40)
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16
Q

what are the weight loss outcomes after interventions

A

weight is lost for 6months and then regained after

this is because the support is stopped after 6months so people find it difficult to carry on

17
Q

what diseases are associated with an increase in BMI

A

T2DM - tightest relationship
cholelithiasis
hypertension
CHD

18
Q

how is T2DM related to obesity

A

genetic fault in pancreas anyway

being obese dribes you over the edge - insulin resistant - more fat stored in the liver and pancreas = toxic

19
Q

2 body shapes casued by obesity

A

android - apple

gynoid - pear

20
Q

how can people with same BMI have different risk

A

fat that is stored around organs = higher chance for CHD and T2DM
affects liver and metabolism
immune cells present - become inflamed because there is a lot of fat
dictate metabolism
blood goes through adipose and to the liver

21
Q

effect of increase of visceral fat

A

deteriation in metabolic disease

many systems go wrong

22
Q

how does the body respond as you try to lose weight

A

nutritional hormones that regulate diet are increased -
peptide YY and ? increases
people feel more hundry - their physiology works against them

23
Q

what happens to the diabetes level when people are given continuous support

A

there is a reduction in T2DM

24
Q

antiobesity drugs

A

most withdrawn - they have effects on other functions

25
Q

antiobesity drug nad its side effects

A

serotonin

depression and hypertension - taken off market

26
Q

best way to tackle obesity

A

need to treat it as a pathway

so that people cant drop off

27
Q

tier 1 of the anti obesity pathway

A

overweight - can exit here
delivery to everyone
behavioural changes

28
Q

tier 2 of obesity path

A

overweight/obese
lifestyle weight management
delivery - community/GP

29
Q

tier 3 of obesity path

A

very obese/morbidly obese individual

MDT

30
Q

tier 4 obesity path

A

very obese/morbidly obese individual
bariatric surgery
supported by MDT pre and post operatively
delivery - MDT

ailmentary (15 decks)

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