Obesity and Eating Disorders

Question 1

What is obesity?

Answer 1

It is abnormal or excessive fat accumulation, presenting a risk to health. BMI: 25+ = OW. BMI: 30+ = Obese.

Question 2

How does exercise reduce obesity?

Answer 2

It increases cellular AMPK increasing GLUT 4 activation, glucose uptake and mitochondrial activity with enhanced ATP production.

Question 3

How does sleep increase weight gain?

Answer 3

Reduced glucose tolerance and insulin sensitivity, disrupting the balance of ghrelin and leptin.

Question 4

How does Chronobiology drive obesity?

Answer 4

Shift work, sleep deprivation and exposure to light at night increase weight gain prevalence.
Dysregulation of triglycerides and cholesterol, abdominal obesity and T2DM.

Late night eating causes higher peak post-prandial glucose levels, reduced lipolysis, circadian rhythm misalignment.

Question 5

How does processed food drive obesity?

Answer 5

Strong dopamine stimulators (fat, salt, starch alcohol, caffeine) activate rewarding brain circuits to trigger anticipatory cravings for more.

Question 6

How does long-term high cortisol exposure play a role in obesity?

Answer 6

Cortisol levels are elevated in obese people and associated with fat deposition.
Factors influencing HPA-Axis include high GI consumption, chronic stress, chronic pain, alcohol, sleep dep.

Question 7

How does the microbiome drive obesity?

Answer 7

Gut flora produces carbohydrate-active enzymes to digest complex polysaccharides = produces SCFA = fuel for intestinal cells. Low plant fibre foods shift gut flora to a mucous-utilising bacteria with a lack of Akkermansia linked to obesity.

Question 8

How do genetics play a role in obesity?

Answer 8

SNPs in fat mass and obesity-associated gene is a strong predictor of obesity.
VDR SNPs play a role in obesity associated with ongoing inflammation.

Question 9

What is adipose tissue?

Answer 9

Metabolically active organ which regulates whole-body energy homeostasis.

Question 10

What is ‘white adipose tissue’

Answer 10

Long term energy storage - subcutaneous adipose tissue sits under the skin. (SAT) Visceral adipose tissue (VAT) is intra-abdominal (angry).

Question 11

What is ‘brown adipose tissue’

Answer 11

BAT abundant in early life

Question 12

What happens when you have energy surplus?

Answer 12

WAT grows.
Chronic energy imbalances with increased storage result in increased adipocyte no.s (hyperplasia) and size (hypertrophy) which is associated with T2DM, NAFLD.

Question 13

What is satiety?

Answer 13

The physiological state at the end of a meal when further eating is inhibited by fullness.

Question 14

What are the mechanical factors involved in satiety?

Answer 14

1. Stretch of the stomach via the vagus nerve
2. Adipocyte hormones: Gherlin, Leptin,
3. Hormone and peptides: GLP-1 and CCK
4. Neuropeptides and neurotransmitters
5. Other hormones e.g. thyroid/cortisol/insulin.

Question 15

What is the name of the satiety hormone produced by adipocytes?

Answer 15

Leptin

Question 16

What is leptin resistance?

Answer 16

Reduced sensitivity / failure in response of the brain to leptin.

Question 17

What is gherlin?

Answer 17

Appetite stimulating signal.

Question 18

What does Adiponectin do?

Answer 18

increases glucose uptake and oxidation of fats.

Question 19

What causes insulin resistance?

Answer 19

1. High oxidative stress
2. Reduced physical activity
3. Chronic stress
4. Mitochondria dysfunction
5. Poor methylation
6. Dysbiosis

Question 20

What is the naturopathic approach to IR?

Answer 20

1. Stabilize blood sugars
2. Reduce inflammation
3. Optimise insulin sensitivity

Question 21

How can you reduce obesity?

Answer 21

Smaller portions
Protein at every meal
Simple meals
Fasting
Chewing & Mindful eating
Address micronutrient deficiency
Exercise

Question 22

What happens when you restrict calories?

Answer 22

Reduced leptin during weight loss tells the brain to increase eating and reduce energy expenditure
Increase in fat storage
Changes in circulating gut hormones involved in homeostatic regulation of body weight.

Question 23

Which nutrients can reduce obesity?

Answer 23

1. 5-HTP (50-100 mg)
   Increases feeling of satiety
   Promotes sleep by enhancing melatonin
   Free radical scavenging activities
2. Green Tea (600-900 mg)
   Polyphenols (EGCG) stimulate thermogenesis and fat oxidation
3. L’Carnitine (2000 mg)
   Oxidises fatty acids in mitochondria
   Essential for utilization of fats for energy
   Improves leptin resistance
4. Chromium (200-1000 mg)
   Lowers body weight yet increases lean body mass via increased insulin sensitivity
   Can reduce carb cravings.

Question 24

Name three types of clinical eating disorders

Answer 24

1. Anorexia Nervosa
2. Bulimia Nervosa
3. Feeding/Eating Disorders (Orthorexia/Compulsive eating/binge eating

Question 25

Describe Anorexia Nervosa

Answer 25

When body is deprived of nutrients it changes the brain chemistry = depression and anxiety due to tryptophan depletion.
Starvation, vomiting, purges and laxatives
Self induced vomiting/dehydration

Question 26

What are pyrroles?

Answer 26

A byproduct of haemoglobin synthesis with no known function in the body and should be excreted in the urine.
They block receptor sites for B6 and Zinc
Symptoms: nervousness, anxiety, depression, memory problems and anger.

Question 27

What is the serotonin - oestrogen link?

Answer 27

Aromatase is expressed in adipose tissue
Adipose tissue is a key site for production and metabolism of oestrogen
Oestrogen deficiency reduces serotonin
Low serotonin = low mood, anxiety, depression, sleep problems
Carb consumption, acting via insulin secretion increases serotonin release.
This is why a lot of anorexics are on antidepressants

Question 28

Which supplement should be included in any therapeutic protocol for anorexia?

Answer 28

Zinc

Question 29

What precipitates a binge?

Answer 29

Food deprivation patterns
Stress and stress responses
Adaptions within t