Obesity Flashcards
What is obesity?
Having a high amount of body fat. A person is considered obese if they have a body mass index (BMI) of 30 or more.
What are the effects of obesity?
Depression Stroke Sleep apnoea Ischaemic Heart disease Gallstones Hypertension Diabetes Cancers Infertility Oestoarthritis Gout
What does NICE recommend for obesity treatment
Diet Exercise Behavioural therapy Drug therapy Surgery if BMI > 40
What are pharmalogical managements of obesity?
Liraglutide
Lorcaserin
Phenteremine
Naltrexone
Why are people getting fatter?
Over the last 20 years, FAT portion of our diets got larger leading to misbalance in energy homeostasis
What are three things that take up the energy intake in the body
Physical Activity
Thermogenesis
REE - resting energy expenditure
What is REE proportional to?
Lean fat body mass so its harder to lose weight the more you lose
What is the majority of energy expenditure in the form of?
REE/BMR So exercise etc will only affect a small proportion of our energy expenditure and REE represents like 65-70%
What are the two ways of assessing energy stores
Weight and height measurements aka BMI
Regional adiposity/energy partitioning
What is the problem with using BMI as a measure
Measurements vary depending on ethnicity - asians have lower bounds
Muscle weighs more than fat so values can be misleading
What is central adiposity associated with
CVD
What increases chances of metabolic syndrome
High waist circumference
Diabetes
High cholesterol
Hypertension
What are causes of obesity
Energy intake Energy usage Genes Brain and endocrinology Behaviour and culture
What does lorcaserin do?
Serotonin agonist that supresses appetite
What does phenteremine do?
Suppress appetite
What does naltrexone do?
Suppress appetite with side effects on heart and depression
What are different surgical procedures for obesity
Adjustable band
Sleeve gastrectomy
Gastric bypass
Duodenal-jejunal sleeve
What is an adjustable band procedure?
Fluid injected into subcutaneous bag to increase or decrease food into stomach
What does a gastric bypass do
Duodenum and ileum only see bile and no food
Why is a gastric bypass believed to be most successful?
Change in insulin resistance and secretion
Changes gut microbiota
Change in bile salt secretion
What does the duodenal jejunal sleeve do
Less food digested so improve glycaemic control
