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Anat 1082 Multiple Choice Revision > Obesity > Flashcards

Obesity Flashcards

1
Q

What causes obesity?

A
  • It is the deposition of excess Fat in the body and is caused by the ingestion of greater amounts of food then can be utilised by the body as energy.
  • If there is an imbalance in the amount of food consumed and exercise taken on a daily basis this will lead to obesity.
  • Foods that are high in fat are used for energy is excessive amounts are consumed fat is stored in adipose tissues and carbohydrates are stored in glycogen in the liver and muscles.
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2
Q

What are the effects of obesity on the body?

A
  • They include both obvious and and physical changes due to an increased mass of fatty tissue
  • Changes at the cellular and metabolic level due to an increased production of various products by enlarged fat cells
  • Changed in body dimensions reflect the overall health and welfare of individuals and populations
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3
Q

What is Anthropometry?

A
  • This is used to assess and predict performance health and survival of individuals and reflect the economic and social well being of populations
  • It is widely used, inexpensive, non invasive measure of the general nutritional status of an individual or a population group.
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4
Q

What are the 5 anthropometric indicators?

A
  • Weight for age
  • Weight for height
  • Height for age
  • Mid- Upper arm circumference
  • Body mass index (BMI)
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5
Q

What are the statistics for obesity?

A
  • More then 300 million adults worldwide are obease
  • more then 1 billion are over weight
  • 115 million people suffer with health related problems ranging from premature death to a reduced overall quality of life.
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6
Q

What are the 5 factors of prevalence of obesity in England?

NHS Digital, 2017

A

1- In 2015 58% of women and 68% of men where overweight or obease
2- Obesity prevalence increased from 15% in 1993 to 27% in 2015
3- In 2015/ 16 over 1 in 5 children in reception and over over 1 in 3 children in yr 6 where measured as obese or overweight
4- In 2015/16 there where 525 thousand admissions in NHS hospitals 🏥 where obesity was recorded as a factor
5- Over 3/4 of bariatric surgery patients where aged between 35- 54 and over 3/4 of patients where female

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7
Q

Please explain what an energy imbalance is?

A
  • This is the result from increased intake of calories such as fast foods and reduced physical activities.
  • The combination of a high Calorie diet and a sedentary lifestyle can lead to rapid weight gain an d obesity
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8
Q

Give some examples of medications that can cause wight gain… GO

A
  • Corticosteroids
  • Anti- depressants
  • Anti- psychotics
  • Oral contraceptives
  • Anti- coagulants
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9
Q

3 metabolic factors that have been reported to be predictive of weight gain?

A

1- Low adjusted sedentary energy expenditure (not doing a lot)
2- High respiratory quotient (carbohydrate to fat oxidation ratio)
3- Low levels of spontaneous physical activity.

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10
Q

What is the obstetric perspective of obesity in childbearing women?

A
  • The confidential enquires into maternal and child health (CEMACH) report notes that obesity is an identified risk factor for maternal death.
  • 35% of all mothers who died were obese representing a disproportionate number of deaths associated with obesity in childbearing women
    Maternal obesity is associated with the an increased risk of
  • 1st trimester reoccurrence of miscarriage
  • Infant birth defects such as neural tube defects, ancephaly, abnormalities of the heart and intestinal tract etc
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11
Q

What are the antenatal risks associated with obesity?

A
  • Associated with the increased risk of GDM and hypertensive disorders of pregnancy including pre- eclampsia
  • increased occurrence of cholelithiasis during pregnancy accompanied by an increased risk of cholecystectomy in the 1st year postpartum
  • Causes practical difficulties including inaccuracies of abdominal palpation of the pregnant abdomen to assess the growth lie or presentation of the fetus, potential arrows in sonographic prenatal diagnosis and errors in BP measurement
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12
Q

What are some of the anaesthetic intrapartum and postpartum risk factors?

A
  • Weight gain, larger breasts, raised diaphragm oedema and obesity make ventilation and intubation difficult in pregnancy
  • Obese women are at increased risk of intrapartum complications induction of labour, c- sections, failed instrumental deliveries, perineal tears and PPH
  • Increased risk of pulmonary embolism, urinary infections and postpartum anaemia
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13
Q

What are the main consequences of childhood and adolescent obesity?

A
  • Increased risk of premature mortality
  • Reduced quality of life
  • Chronic inflammation
  • Fatty liver
  • Asthma
  • Poor long term educational and economic attainment
  • Increased risk or poor psycho- Social health
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14
Q

People with severe mental illness such as depression and bi polar are at an increased risk of physical illness.
What are some of these illnesses?

A
  • Coronary heart disease
  • Diabetes
  • Infections
  • respiratory disease
  • Greater levels of obesity.
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15
Q

What are the recognised side effects of obesity?

A
  • All causes of death at any given age
  • Coronary heart disease, stroke, hypertension, type 2 diabetes
  • High LDL cholesterol and low HDL cholesterol
  • Sleep apnoea
  • Breast, endometrial, ovarian, liver and colon cancer
  • Gallbladder disease
  • Musculoskeletal disorders (osteoarthritis)
  • Infertility, sexual dysfunction, urinary incontinence
  • Non- alcoholic liver disease
  • it is indirectly related to anxiety, low self esteem, impaired social interactions and clinical depression
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16
Q

How does obesity impact the circulatory system?

A
  • Raised BMI increases the risk of hypertension (high BP) which itself is a risk for coronary heart disease and stroke which can contribute to other conditions such a serenade failure.
  • The risk of coronary heart disease including heart attacks heart failure and stroke are substantially increased
  • Risks of deep vein thrombosis and pulmonary embolism are increased.
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17
Q

How does obesity cause high BP?

A
  • Additional fat tissue in the body needs O2 and nutrients in order to live, which requires the blood vessels to circulate more blood to the fat tissue
  • This increases the workload of the heart because it must pump more blood. It also means there is more pressure on the artery walls
  • Higher pressure of the artery walls increases the BP in addition extra weight can raise the heart and reduce the bodies ability to transport blood through vessels.
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18
Q

what is the relation between heart disease (atherosclerosis This os the hardening of arteries) and obesity ?

A
  • It is present 10 times more often in obese people compared to those who are not obese
  • Coronary heart disease is also more prevalent because fatty deposits build up in the arteries that supply the heart
  • Narrowed arteries and reduced blood flow to the heart can cause chest pain (angina)
19
Q

What is the relation between obesity and type 2 diabetes?

A
  • Obesity can cause resistance to to insulin the hormone that regulates blood sugar when obesity causes insulin resistance the blood sugar levels become elevated.
  • Even moderate obesity dramatically increases your chance of developing type 2 diabetes
  • Studies suggest that abdominal fat causes cells to release pro- inflammatory chemicals which can make the body less sensitive to the insulin it produces by disrupting the function of the insulin responsive cells and their ability to respond to insulin.
20
Q

What is type 2 diabetes

A
  • A person with type 2 has insulin resistance meaning their pancreas doesn’t produce enough insulin or the body doesn’t react properly to insulin
  • Glucose transport into most tissues is achieved by the action of molecules called glucose transporters (GLUT- 4 is an example of this)
  • These molecules transport glucose via diffusion down a concentration gradient.
  • Insulin resistance in fat cells (adipose cells) if associated with a a decrease in GLUT - 4 transporter number and activity.
21
Q

What is osteoarthrosis and how can diabetes cause this?

A
  • This is a non inflammatory joint disease characterised by degeneration of the joint cartilage
  • Obesity can affect the knees and hips because of the stress placed on the joints by the extra weight.
  • Joint replacement surgery may not be an available option for an obese person because the artificial joint has a higher risk of loosening and causing further damage
22
Q

What is the relation between gastrointestinal disease and obesity?

A
  • Obesity is associated with increased risk of gastro- oesophageal reflux
    Caused by direct abdominal pressure on the diaphragm
23
Q

What is sleep apnoea and how is obesity related to respiratory problems?

A
  • Sleep 💤 apnoea causes people to stop 🛑 breathing for brief periods, it interrupts sleep throughout the night and causes sleepiness 😴 during the day it also causes heavy snoring 😴 .
  • Respiratory problems associated with obesity occur when added weight of the chest all squeezes the lungs 🫁 causing restricted 🚫 breathing
24
Q

What is the relation of obesity and cancer?

A
  • Each year cardiovascular 🫀 disease (CVD) are responsible for more then 200, 000 deaths in the uni and cancer is a further 156 000 deaths
  • It is accepted that at least part of the cause of these diseases are due to people being overweight and obese
  • ## Currently around 18000 Britons a year develop cancer because they are to overweight.
25
Q

The international agency for research on cancer (IRAC) working group recently revealed epidemiological data and concluded that excess body fat causes cancer of the…?

A
  • Colon and rectum
  • Liver
  • Pancreas
  • Kidney
  • Thyroid
  • Breast
  • Endometrium
  • Ovary
  • Oesophagus
  • Gastric cardia
  • This potentially makes excess body fat the 2nd most important modifiable cancer risk after tobacco use.
26
Q

Why does being overweight cause cancer?

A
  • Fat cells attract immune cells to body tissue
  • These immune cells release chemicals that cause long lasting inflammation which can raise the risk of cancer
  • Excess fat change the levels of sex hormones like oestrogen and testosterone in the body. This can also increase the risk of cancer
  • The hormone insulin is a very important part of how the body uses energy from food.
  • When people are overweight or obese there is much more insulin present in the body.
  • It is nit clear hie this could lead to cancer though it could be because insulin effects the levels of growth factors available to the cells which tell them divide.
27
Q

What is non- alcoholic fatty liver disease (NAFLD)

A
  • Refers to a range of of conditions resulting from the accumulation of fat in cells inside the liver
  • It is int of the most common forms of liver disease in the uk
  • If left un treated it may progress to severe forms of cirrhosis
  • It has also been linked to severe forms of liver cancer
28
Q

What are some of the normal functions of the liver?

A
  • Production of bile and bile salts
  • Storage of minerals, vitamins A, D, E, B12, copper and iron
  • Glucose conversion, storage and release
  • Storage of glucagon
  • Amino acid conversion into glucose with deamination of amino acids into urea
  • Lipid metabolism
  • Excretion of steroid hormones
  • Production of clotting factors
  • Production of plasma proteins
  • Production of cholesterol
  • Heat generation
  • Destroys red blood cells
29
Q

How can obesity lead to the development of oesophageal varices (Dilated veins)?

A
  • Obesity can cause liver cirrhosis
  • Liver cirrhosis can cause portal hypertension
  • Portal hypertension can cause oesophageal varices
  • oesophageal varices can cause severe bleeding
    To is a classic symptom of liver disease
    Jaundice is another classic symptom of liver dysfunction
30
Q

What is ascites ?

A
  • This is the abnormal accumulation of serious fluid in the spaces between tissue and organs in the cavity of the abdomen
  • many disorders can cause this but the most common is high BP in the veins that bring blood to the liver which is usually due to cirrhosis
  • If large amounts of fluid accumulate rage abdomen becomes very large sometimes making people loose their appetite and feel short of breath
31
Q

What are the causes of ascites?

A
  • In people with liver disorders the fluid leaks from the surface of the liver and intestine and accumulates within the abdomen.
  • Albumin usually leaks from blood vessels into the abdomen. Normally albumin is the main protein that keeps fluid from leaking out of blood vessels. So when albumin leaks out fluid also leaks out.
32
Q

Obesity in relation to gall stones.

A
  • Obesity increases the amount of cholesterol in bile which can cause gall stones to form
  • Gall stones develop on the gall bladder as a result of a chemical imbalance of the bile
  • In 4 out of 5 cases excess cholesterol crystallises and grows to form stones
  • 1 in every 5 gallstones is form from excessive levels of bilirubin
33
Q

Obesity in relation to Acne

A
  • Insulin and growth hormone are frequently elevated in obese patients and have been demonstrated to activate the sebaceous glands and influence the severity of Acne
  • Sebaceous glands produce oil called sebum that moves up Hair follicles to the surface of the skin where the oil lubricates the skin an the hair.
34
Q

How does obesity impact the lymphatic system?

A
  • Obesity impedes the lymphatic flow which leads to the collection of protein rich lymphatic fluid in the subcutaneous tissue
  • The accumulation frequently results in lymphedema and fluid accumulation
  • Lymphedema is associated with reduced tissue oxygenation
35
Q

What are the genetic 🧬 causes of obesity?

A
  • Nearly 400 genes have been associated with human obesity
    Genetic defects can be divided into Two groups:
    1- The rare genes that produce significant obesity.
    1- Or a group of (more common) susceptibility genes that underlie the propensity to develop obesity
36
Q

What is the biology behind weight regulation ( Gene controlled)

A
  • Genes regulate an individuals appetite and metabolism to maintain weight for survival
    It is controlled by long and short term signals
  • Short term = regulate the size of a meal and daily consumption of calories
  • Long term = regulate weight over a life time

Short and long term signals interact with each other in the central nervous system to protect the body’s supply of adipose tissue for metabolism.

37
Q

What is the feeding centre?

one of the genetic abnormalities that may also be important in the development of obesity.

A
  • located in the lateral hypothalamus
  • They are inactivated by increased impulses from the satiety centre in the the ventromedial nucleus of the of the hypothalamus due to mutations
38
Q

What is the glucostatic theory ?

one of the genetic abnormalities that may also be important in the development of obesity.

A
  • hunger postulates that when the glucose levels fall feeding will occur until the blood glucose level increases
39
Q

What is the lipostatic theory?

one of the genetic abnormalities that may also be important in the development of obesity.

A
  • Theory of feeding regulation works in a manner similar to that for glucose
40
Q

What does the hypothalamus do in relation to obesity?

A

It protects adipose (fat) tissue stores by responding to the signals from anabolic and catabolic neurotransmitters.

41
Q

What are anabolic neurotransmitters?

A
  • Anabolic neuropeptides are released when anabolic neurones are stimulated
  • Anabolic neuropeptides stimulate food intake and decrease metabolism
42
Q

What are catabolic neurotransmitters?

A
  • These reduce the food intake and increase the metabolism resulting in mobilisation and use of adipose tissue
  • obesity is an abnormality of the feeding mechanism
    This can result from psychogenic factors such as the belief that eating three meals per day is healthy and that each meal must be filling.
  • Over eating may be associated with stressful situations servers illness or mental trauma
43
Q

When may an abnormality of fat metabolism occur?

A
  • May occur when the concentration of lipase and adipose tissue is reduced so that little fat is removed and may be associated with hyper insulinism which promotes fat storage.
44
Q

What are the long term signals associated with the main ten episodes of weight.

A
  • Leptin and Insulin are long term signals that relay the adequacy of adipose tissue stores to the hypothalamus.
  • Leptin is released from adipocyetes on proportion to adipose tissue stores in the body low levels of adipose tissues are associated with low levels of Leptin
  • low levels of Leptin communicated with the hyperthalamus via the anabolic neurones and appetite is stimulates.
  • Adequate levels of Leptin are associated with higher levels of Leptin. Higher liberals of Leptin communicate with the hypothalamus via catabolic neurones and food intake decreases
  • Insulin circulates at levels proportionate to adipose tissues stores.
  • As adipose tissue stores increase insulin levels also increase and catabolic pathways are stimulated
  • As adipose stores decrease insulin levels decrease and anabolic pathways are stimulated

Anat 1082 Multiple Choice Revision (20 decks)

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