Obesity

Question 1

Obesity is defined as a BMI over?

Answer 1

30kg/m2

Question 2

Hormonal imbalance is often incriminated in women after menopause or when on the contraceptive pill however most of this weight gain is?

Answer 2

Small and often due to water retention

Question 3

Which hormone is secreted from fat cells is thought to act as a feedback mechanism between adipose tissue and the brain acting as a lipostat and controlling fat stored through the regulation of hunger and satiety?

Answer 3

Leptin

Question 4

A 10.5kcal daily excess would lead to how much weight gain over 20 years?

Answer 4

10kg

Question 5

Following a meal which hormones are secreted from the small intestine?

Answer 5

Cholecystokinin, bombesin, glucagon-like peptide 1 (GLP-1), enterostatin and somatostatin

Question 6

Following a meal which hormones are secreted from the pancreas?

Answer 6

Glucagon and insulin

Question 7

Which gland in the body is the main regulatory of body weight?

Answer 7

Hypothalamus

Question 8

Which peripheral appetite suppressing signals act centrally to activate the appetite suppressing pathway (while also inhibiting the appetite stimulating pathway) following a meal?

Answer 8

Insulin and Leptin

Question 9

Insulin and Leptin hormones circulate in proportion to what?

Answer 9

Adipose tissue mass

Question 10

Peptide YY (PYY) is produced by L cells by which organs in proportion to the energy ingested?

Answer 10

Distal small bowel and large bowel

Question 11

PYY is thought to ____ appetite?

Answer 11

Decrease

Question 12

Other than PYY which other appetite suppressing signals are produced y the gut in a nutrient dependent manner?

Answer 12

Oxyntomodulin and Glucagon-like peptide 1

Question 13

How many amino acids does Ghrelin contain?

Answer 13

28-amino-acetylated peptide

Question 14

Where is Ghrelin produced in the body?

Answer 14

Oxyntic cells in the fundus (top dome) of the stomach

Question 15

Is the circulatory concentration of Ghrelin high or low before a meal?

Answer 15

High and is reduced following the consumption of energy or glucose - Unlike PYY which inreases after a meal

Question 16

Unlike insulin and leptin, Ghrelin is ______ related to the individuals BMI?

Answer 16

Inversely related - lower BMI means more Ghrelin

Question 17

Which situations cause the increase in Ghrelin?

Answer 17

long term exercise, very low calorie diets, anorexia nervosa and both cancer and cardiac cachexia

Question 18

Which peptide produced by the same gene that encodes ghrelin counteracts the increase in food intake induced by ghrelin?

Answer 18

Obestatin

Question 19

What are the two main pathways in the arcuate nucleus?

Answer 19

1. The central appetite stimulating (orexigenic) pathway which expresses Neuropeptide Y (NPY) and agouti pathway-related protein (AgRp)
2. The central appetite suppressing (anorexigenic) pathway in the upper arcuate nucleus which stimulates and proopiomelanocortin/cocaine-and-anfetamine-regulated transcript (POMC/CART)

Question 20

Is BMR higher in obese or lean individuals

Answer 20

Obese because they are associated with a higher lean body mass

Question 21

Do lean or obese individuals exert more energy during physical activity?

Answer 21

Obese because they have more mass to move

Question 22

Do lean or obese individuals have a reduced dietary-induced thermogensis?

Answer 22

Obese which also means they tend to favour energy deposition

Question 23

When stimulated by cold or food, brown adipose tissue in animals dissipates the energy derived from ingested food into?

Answer 23

Heat

Question 24

What are considered normal tricep skinfold thickness measurements in a man and a woman?

Answer 24

20mm in a man, and 30mm in a woman

Question 25

Fat located centrally, especially inside the abdomen are more sensitive to?

Answer 25

Lipolytic stimuli

Question 26

What should be amended on a sphygmomanometer if measuring an individual with a large arm circumference?

Answer 26

A larger cuff - to reduce artefacts in the data

Question 27

Which criteria has lower cut-off points for waist circumference (~25kg/m2) and lower fasting blood concentrations meaning it identifies at-risk patients at an earlier stage?

Answer 27

International Diabetes Foundation Criteria

Question 28

Which factors are measures to determine metabolic syndrome?

Answer 28

Waist circumference, Triglycerides, HDL cholesterol, Blood pressure and fasting glucose

Question 29

Many obese individuals oscillate in weight meaning they regain the lost weight and then lose it again in a cycle which increases their risk in the development of?

Answer 29

Coronary Artery Disease

Question 30

Many dietary regimens aim to produce a weight loss of approximately ___ per week?

Answer 30

1kg

Question 31

Initial weight loss is greater due to?

Answer 31

Accompanying glycogen and protein breakdown and consequent water loss

Question 32

After 3-4 weeks weight loss may be small due to?

Answer 32

Only adipose tissue being broken down and less accompanying water loss

Question 33

Short term weight loss is faster on which type of diet?

Answer 33

Low carbohydrate diet due to greater loss of body water, which is regained when the diet stops

Question 34

Very low fat diets are often deficient in which vitamins and mineral?

Answer 34

E and B12 and in zinc

Question 35

What effect does a low fat diet have on HDL and LDL?

Answer 35

Increased HDL and decreased LDL

Question 36

What effect does a low carb diet have on HDL and LDL?

Answer 36

Greater decrease in HDL and triglyceride and no change on LDL

Question 37

Are liquids more or less satiating than solid foods?

Answer 37

Less

Question 38

Which drug, licensed for obesity in 2015 is a pancreatic | and gastric lipase inhibitor?

Answer 38

Orlistat

Question 39

Bariatric or metabolic surgery is a treatment option for those with BMI?

Answer 39

>40kg/m2 or >35kg/m2 with obesity-related complications

Question 40

What are the main three groups of gastrointestinal surgical procedures?

Answer 40

1. Restrictive (gastric banding) 2. Malabsorptive (reduce ability to absorb nutrients) 3. Restrictive + Malabsorptive