Obesity

Question 1

What is obesity?

Answer 1

Chronic adverse condition due to XS body fat: BMI ≥ 30

Question 2

Describe the aetiology of obesity

Answer 2

Genetics
Monogenic conditions (e.g. leptin deficiency, Prader-Willi syndrome)
Environmental (sedentary lifestyle + poor dietary habits)
Common obesity; energy intake > energy usage
Other conditions e.g. Hypothyroidism, Cushing’s, Drugs (Steroids, Antidepressants, Antipsychotics)

Question 3

Give 3 hormones involved in control of appetite. Describe each.

Answer 3

Leptin: secreted by adipose; increases satiety (long-term)
Ghrelin: secreted by stomach; hunger hormone
Peptide YY: secreted by distal intestine; decreases appetite

Question 4

Describe epidemiology of obesity

Answer 4

Increasing prevalence
M > F
More people getting obese younger

Question 5

What sign indicates obesity?

Answer 5

Increased waist + hip circumference

Symptoms of complications

Question 6

Obesity increases the risk of developing which 10 co-morbidities?

Answer 6

T2DM
OSA
IHD
HTN
Hyperlipidaemia
Cancer (Breast + Bowel)
Stroke
NASH
Osteoarthritis
Depression

Question 7

What investigations may be performed in patients with obesity?

Answer 7

Clinical exam: calculate BMI: weight (kg)/ height2(m)
Check for other causes of obesity e.g. TFTs, dexamethasone suppression test
Check lipid levels + BP
ECG if heart disease is suspected
Abdo USS if NASH is suspected
Sleep study (polysomnography) if OSA is suspected