Obesity Flashcards

Question

describe normal control of appetite?

Answer 1

following a meal satiation occurs which depends on gastric and duodenal distension and release of substances peripherally and centrally After a meal CC, bombesin, GLP-1, enterostatin and somatostatin are released from small intestine and glucagon and insulin from the pancreas. Centrally the hypothalamus plays a role in integrating signals involved in appetite and bodyweight regulation

Answer 2

- central appetite stimulating (orexigenic) pathway - central appetite suppressing (anorexigenic pathway or leptin melanocortin pathway) - These pathways interact with each other and feed into lateral hypothalamus which influences ANS and ingestive behavior. The central pathways are influenced by a variety of peripheral signals

Answer 3

In ventromedial part of arcuate nucleus which expresses NPY and AgRP. This pathway decreases energy expenditure

Answer 4

Dorsolateral part of arcuate nucleus which expresses POMC/CART. In this pathway alpha-MSH, formed by cleavage of POMC by PC1, exerts appetitie suppressing affect via Mc4R in areas of brain that regulate food intake and autonomic activity. Increases energy expenditure

Answer 5

- stages 0-4 - each stage has obesity related risk factors - each stage has different level of physical symptoms, functional limitations etc

Answer 6

- no obesity related risk factors | - no physical symptoms

Answer 7

- subclinical obesity related risk factors (borderline hypertension, impaired fasting glucose, elevated liver enzymes) - mild physical symptoms

Answer 8

- established obesity related risk factors (hypertension, T2DM, sleep apnoa, osteoarthritis, reflux, pcos, anxiety - moderate physical symptoms

Answer 9

- established obesity related risk factors of end organ damage (MI, HF, diabetic complications) - significant physical symptoms

Answer 10

- severe disabilities of obesity related risk facotrs (end stage) - severe physical symptoms

Answer 11

``` Fatty acid deficiency Stress and adrenal fatigue Hormonal imbalances Dehydration and mineral imbalances Brain chemistry deficiency Unstable blood sugar Digestive problems Food sensitivities Yeast overgrowth Toxin overload Genetics Junk food Food addiction Western diet promotes insulin resistance Medications sugar ```

Answer 12

``` healthy weight: 18.5–24.9 kg/m2 overweight: 25–29.9 kg/m2 obesity I: 30–34.9 kg/m2 obesity II: 35–39.9 kg/m2 obesity III: 40 kg/m2 or more ```

Answer 13

the underlying causes of being overweight or obese need to be assessed the person has complex disease states or needs that cannot be managed adequately in tier 2 (for example, the additional support needs of people with learning disabilities) conventional treatment has been unsuccessful drug treatment is being considered for a person with a BMI of more than 50 kg/m2 specialist interventions (such as a very-low-calorie diet) may be needed surgery is being considered

Answer 14

self-monitoring of behaviour and progress stimulus control goal setting slowing rate of eating ensuring social support problem solving assertiveness cognitive restructuring (modifying thoughts) reinforcement of changes relapse prevention strategies for dealing with weight regain.

Answer 15

Tailor dietary changes to food preferences and allow for a flexible and individual approach to reducing calorie intake. Do not use unduly restrictive and nutritionally unbalanced diets, because they are ineffective in the long term and can be harmful. Encourage people to improve their diet even if they do not lose weight, because there can be other health benefits.

Answer 16

Consider pharmacological treatment only after dietary, exercise and behavioural approaches have been started and evaluated. Consider drug treatment for people who have not reached their target weight loss or have reached a plateau on dietary, activity and behavioural changes.

Answer 17

They have a BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2 and other significant disease (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight. All appropriate non-surgical measures have been tried but the person has not achieved or maintained adequate, clinically beneficial weight loss. The person has been receiving or will receive intensive management in a tier 3 service[10]. The person is generally fit for anaesthesia and surgery. The person commits to the need for long-term follow-up

Answer 18

In obese persons, cells of fat tissues have to process more nutrients than they can manage. The stress in these cells triggers an inflammation that releases a protein known as cytokines. Cytokines then block the signals of insulin receptors, thus gradually causing the cells to become resistant to insulin. Insulin allows your cells to use glucose (sugar) for energy. When you are resistant to insulin, your body is unable to convert the glucose into energy and you end up with a persistently high blood glucose level. Besides suppressing normal responses to insulin, the stress also triggers inflammation in cells that can lead to heart disease

Answer 19

``` psychological osteoarthritis varicose veins hiatus hernia gallstones postoperative proplems back strain accident proneness obstructive sleep apnoea hypertension breathlessness ischaeic heart disease stroke T2DM hyperlipidaeia menstrual abnormalities morbidity and mortality cancer risk heart failure ```