Obesity and Regulation of Appetite (DJ)

Question 1

BMI = formula

Answer 1

kg/m2

Question 2

BMI for:
overweight
obese
morbidly obese

Answer 2

Overweight = 25-29.9
Obese < 30
Morbidly obese < 35

Question 3

____ measures visceral fat (which is more toxic than fat in other places) which is correlated to in increase in morbidity

Answer 3

waist circumference

Question 4

What waist circumferences in men and women are assc with obesity/inc morbidity

Answer 4

men >40 in

women >35 in

Question 5

term for energy burned during rest

Answer 5

basal metabolic rate

Question 6

term for energy spent digesting food

Answer 6

thermic effect of food

Question 7

fidgeting/extra movement assc with daily activity that increase energy expenditure

Answer 7

NEAT

non-exercise activity thermogenesis

Question 8

What we spend the most amt of energy doing during the day?

Answer 8

basal metabolic rate

greater than normal physical activity and thermic effect of food

Question 9

basal metabolic rate increases with ___ and decreases with ____

Answer 9

Decreases with age and increases with obesity

Question 10

What are the main strategies for effective weight control

Answer 10

Restriction of food intake and physical activity

Question 11

Afferent and Efferent signals that maintain energy balance favors weight (loss or gain)

Answer 11

gain

Question 12

What integrates afferent signals to determine appetite/efferent signals/energy intake

Answer 12

arcurate nucleus in hypothalamus

Question 13

secreted in stomach → stimulates food intake (and GH)

Answer 13

ghrelin

Question 14

Acts on Y1 and Y5 receptors to induce hunger

Answer 14

NPY

Question 15

antagonizes MC4 receptor and reverses alpha MSH effect

Answer 15

AgRP

Question 16

When is ghrelin expressed and when in NPY expressed?

Answer 16

both peak before meal and are present during fasting

Question 17

What are the orexigenic substances expressed in the PVN?

Answer 17

NPY and AgRP

Question 18

Decreases expression of NPY

Answer 18

leptin

Question 19

binds MC4R and inhibits food intake

Answer 19

alpha-MSH

Question 20

What activates alpha-MSH?

Answer 20

leptin

Question 21

What is alpha-MSH derived from?

Answer 21

POMC (it is cleaved)

Question 22

Co-localized in same neurons as POMC

Activated by leptin to inhibit food intake

Answer 22

CART

cocaine and amphetamine regulated transcript

Question 23

Suppresses glucagon secretion and prolongs gastric emptying

Answer 23

glucagon-like-peptide-1

Question 24

gut derived substance that promotes satiety? promotes hunger?

Answer 24

satiety = glucagon-like peptide 
hunger = ghrelin

Question 25

Obese people are often “____ resistant” (not insulin)

Answer 25

leptin

Question 26

centrally acting; levels increase in response to exercise, neuroglyucopenia, and enforced wakefulness --> hunger

Answer 26

Hypocretin

Question 27

Serotonin, orexigenic or anorexigenic?

Answer 27

anorexigenic

Question 28

TNF-alpha, orexigenic or anorexigenic?

Answer 28

anorexigenic (cachexia!!)

Question 29

secreted from fat cells of insulin sensitive people but it is deficient in pts with obesity or insulin resistance

Answer 29

adiponectin

Question 30

similar to insulin in that it increases in conc after meals and is anorexigenic

Answer 30

pancreatic polypeptide

Question 31

released with feeding and serves as an anorectic/sateiy signal to intestinal cells

Answer 31

peptide YY

Question 32

**terminates meal rather than inhibits meal initiation** best known for stim of pancreatic enzyme secretion and gallbladder contraction but also involves regulation of portion size

Answer 32

Cholecystokinin

Question 33

has been noted in obese pts and can be INDUCED BY OVERFEEDING

Answer 33

Overreactivity of endocannabinoid system (ECS)

Question 34

ECS is normallt silent but it can be activated to ...

Answer 34

``` increase appetite reduce pain and anxiety extinguish adverse memories inhibit motor behavior modulate temp, hormone release, smooth muscle tone ```

Question 35

Centrally, what is happening when ECS is overreactive?

Answer 35

overactivation of CB1 receptor → DA released → increased motivation to eat

Question 36

Peripherally, what does overreactive ECS cause?

Answer 36

``` dyslipidemia insulin resistance glc intolerance increased cardiometabolic risk Increased lipolysis in fat and liver Dec satiey feelings in GI Decreases glc uptake in skeletal muscle ```

Question 37

selective antagonist to CB1 receptor. What effect would this molecule have on weight?

Answer 37

Rimbonaband, weight loss

Question 38

What gene? 2 mutated alleles causes pts to never feel full

Answer 38

FTO

Question 39

Affected are always hungry, never get signal to stop eating.

Answer 39

leptin deficiency

Question 40

Feel the need to eat more frequently but still can get full

Answer 40

MC4 receptor mutation

Question 41

Is leptin deficiency or MC4 receptor mutation more common

Answer 41

leptin deficiency

Question 42

Causes decreased inter-prandial intervals

Answer 42

MC4 receptor mutation