obesity

Question 1

What is the WHO definition of obesity?

Answer 1

abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy

Question 2

How is the BMI calculated?

Answer 2

person’s weight (in kilograms) divided by the square of their height (in metres)

Question 3

Which BMI indicates obesity and morbid obesity?

Answer 3

Obese- >30

Mrobid obesity- >40

Question 4

What is the purpose of using waist circumference to indicate obesity?

Answer 4

Helps distinguish muscular people

Question 5

Name 2 main non genetic factors contributing to obesity

Answer 5

increased food intake

Less exercise

Question 6

Name 6 medications which can cause weight issues

Answer 6

• Mood Stabilizers
• Diabetes Medicines
• Corticosteroids
• Beta Blocker
• Allergy Relievers
• Drugs That Prevent Seizures and Migraines

Question 7

How would insulin used for diabetics result in weight gain?

Answer 7

• It decreases the rate of lipolysis in adipose
• Stimulates the synthesis of fatty acids and triglycerides in tissues
• Increases the uptake of triglycerides from the blood into adipose
• Decreases rate of fatty acid oxidation in muscle and liver

Question 8

What is Lipohypertrophy?

Answer 8

Enlargement of fat cells local to where insulin is injected.

Question 9

Name 3 drugs used for the treatment of type 2 diabetes which increase insulin levels hence weight?

Answer 9

1. Insulin
2. Sulfonylureas (glyburide/glicizide)
3. TZD

Question 10

Name 2 drugs used for the treatment of type 2 diabetes which stabilise insulin levels hence weight?

Answer 10

1. Metformin
2. DPP IV inhibitors
   - Januvia
   - Onglyza
   - Trajenta

Question 11

Name 2 drugs used for the treatment of type 2 diabetes which decrease insulin levels hence weight?

Answer 11

SGLT-2 inhibitors

Acardose

Question 12

What percentage of obesity is heritable?

Answer 12

around 70%

Question 13

What is the thrifty gene hypothesis?

Answer 13

Genes that predispose to obesity would have had a selective advantage in populations that frequently experienced starvation.

People who possess these genes in today’s obesogenic environment might be those that ‘overreact’ not just becoming slightly overweight, but extremely obese

Question 14

What is syndromic monogenic obesity? How many syndromes have been recorded?

Answer 14

A form of obesity which is accompanied by other traits such as mental retardation, dysmorphic features and organ specific abnormalities.

30 syndromes recorded

Question 15

What is a ciliopathy? How does it contribute to obesity?

Answer 15

A defect in primary cilia

Primary cilia (non motile) plays a role in the differentiation of adipocytes. A defect in adipogenesis contributes to obesity.

Cilia also mediates leptin receptor signaling. Leptin inhibits hunger and regulates energy balance. If cilia is damaged leptin function is inhibited

Question 16

Which two syndromes fall under syndromic monogenic ciliopathy syndromes? What is there inheritance type and which gene is affected?

Answer 16

Bardet–Biedl (BBS1) & AlstrÖm (ALMS1) syndrome

Autosomal recessive

Question 17

Give 2 other examples of syndromic monogenic obesity disorders which are not ciliopathies. Name there inheritance pattern and the genes effected

Answer 17

Prader- willi syndrome- SNRPN
Fragile X syndrome- FMR1
Both autosomal recessive

Question 18

What kind or organ is adipose tissue?

Answer 18

Bonafide endorcine organ

Question 19

How does body shape influence weight related problems?

Answer 19

Apple shape = More visceral fat
Higher risk of weight-related health problem

Pear shape = Less visceral fat
Lower risk of weight-related health problem

Question 20

Which other conditions is obesity a risk factor for?

Answer 20

cardiovascular diseases

pulmonary diseases (such as sleep apnoea)

metabolic diseases (diabetes & dyslipidaemia)

osteoarticular diseases

for several of the commonest forms of cancer (breats, cervical,colon, pancreatic)

for serious psychiatric illness

Non- alcoholic fatty liver diease (increased fat, accumulates in the liver)

Type 2 diabetes

Question 21

Where will you find motile cilia?

Answer 21

Fallopian tubes

Lungs

Question 22

Which symptoms are associated with Bardet–Biedl?

Answer 22

physiological and renal defects with retinal dystrophy and hypogonadism

Question 23

Which symptoms are associated with AlstrÖm?

Answer 23

Retinal dystrophe
Diabetes
Neurosensory deafness

Question 24

State 2 hormones of the fed state and which cells produce them

Answer 24

1. Leptin- adipocytes

2. Insulin- B cells of the pancreas

Question 25

Describe the leptin melanocortin pathway

Answer 25

1. Leptin and insulin bind to leptin and insulin receptors on pro-opiomelanocortin neurons
2. POMC is then processed into the mature hormones alpha and beta melanocyte stimulating hormone
3. They then bind to melanocortin 3 receptor and melanocortin 4 receptor in the brain
4. Brain derived neurotrophic factor (BDNF) binds to MCR4
5. Increase in energy expenditure, decrease in food intake

Question 26

Which transcription factor is targeted by Thiazolidinediones (TZD) drugs ?

Answer 26

Peroxisome-proliferator-activated receptor gamma 2 (PPARγ2)

Question 27

Name 2 mustations which can lead obesity? What function do they perform which affects obesity

Answer 27

Primary cilia mutation
Peroxisome-proliferator-activated receptor gamma 2 (PPARγ2)
Function- adipocyte differentiation

Question 28

Describe (non syndromic) Monogenic obesity

Answer 28

Genes that that have roles in energy maintenance as part of the leptin-melanocortin pathway.

Question 29

Describe polygenic obesity

Answer 29

When multiple genes are present which affect different biological pathways

Question 30

Describe Epigenetic variation obesity

Answer 30

gene-environment interactions partly account for the missing heritability in obesity
Environmental and nutritional influences during critical periods in development (particularly during gestation) can have permanent effects on an individual’s predisposition to obesity

Question 31

Which drug is used to treat obesity and what is its function?

Answer 31

Orlistat

gastric and pancreatic lipase inhibitor which reduces the absorption of dietary fats

Question 32

Which surgical procedures are used to treat obesity

Answer 32

Restrictive procedures

Malabsorptive procedures