obesity and the regulation of appetite

Question 1

leptin made where

Answer 1

adipose tissue

Question 2

obesity

Answer 2

biological response to modern environment where body regulates to. a set point to high

Question 3

what are the two types of adipose tissue

and the two types of white adipose tissue

Answer 3

brown and beige adipose e- white contaisn white adipocytes and is most common type ( large vacuole that stores lipids produced via lipogenesis and from food consumed)

white
Subcutaneous white adipose tissue SWAT found under the skin throughout the body and has several functions
and acts a layer of insulation

visceral white adipose tissue VWAT is located around the internal organs and is the main type of adipose tissue used for energy storage

Question 4

brown adipose tissue BAT contains brown adipocytes

Answer 4

many small vacuoles holding lipids - abundant in mitochondria contributing to brown appearance. main function being to oxidise lipids for heat production through a process known as non-shivering thermogenesis

Question 5

beige adipose tissue if found scattered throughout SWAT deposits. ( beige or brite ( white undergo browning )

what can WAT browning be intimated by

Answer 5

atherogenic stimulus such as prolonged exposure to the cold

Question 6

what type of adipocytes have the ability to revert back to white adipocyte once the body reaches normal temp again

Answer 6

beige adipocytes

Question 7

how does fat increases cancer risk

Answer 7

too much body fat can trigger inflammation - producing too much insulin from beta cells and oestrogen from the fat cells - these all causes cells divide more than usual - potentially increasing the risk of amber

Question 8

being overweight can block blood vessels in brain leading to

Answer 8

stroke or vascular dementia

Question 9

visceral fat is the fat you need to watch as this causes

Answer 9

raise in blood cholesterol
increase in blood pressure
increase risk of type 2 diabetes

apple shaped - visceral round abdominal - pear shaped is SC around bottom

Question 10

NICE guidance for obesity treatment

Answer 10

encourage life style change and integrate activities

then identified by bmi - Asians and africans more at risk

treatment then includes
morlistate
liragltuide

Question 11

stages of obesity vmi

Answer 11

healthy is 18.5-24.9 
overweight 25-29.9
obesity I - 30-34.9 
Obesity II - 35-39.9
Obesity III- 40 or more

Question 12

short term energy storage

Answer 12

liver as glycogen

Question 13

long term energy storage

Answer 13

white adipose tissue ( triglyceride

Question 14

atypical spill over storage

Answer 14

liver

muscle and bone

Question 15

brown adipose tissue is more metabolically active than white adipose tissue and is richly vascularised and packed with mitochondria

where do you find brown adipose tissue in neonates

Answer 15

shoulder and sternum and between shoulder blades and kidney area

Question 16

function of WAT

Answer 16

Triglyceride storage
Heat insulation
Mechanical cushion
Adipokine production

Question 17

reasons for obesity causes cancer

Answer 17

Proposed molecular mechanisms:
Chronic low grade inflammation
Adipose production of oestrogen (altered aromatase)
Increased levels of insulin and bioavailable insulin like-growth factor (IGF)
Oxidative stress

Question 18

genetic causes of obesity

Answer 18

polymorphisms in different genes and interaction between that and the environment.

melanocortin-4 receptor
POMC mutuations
BDNF mutations
leptin mutations

prayer will syndrome - multiple defects

Question 19

strategies to reduced bodyweight

Answer 19

Lifestyle interventions
Diet & exercise
Sleep

Pharmacological interventions (see BNF)
Orlistat: Lipase inhibitor. Prevents fat absorption. Used in combination with lifestyle interventions

Liraglutide: GLP-1 agonist.

Naltrexone–bupropion (off label): Bupropion = Norepinephrine-dopamine reuptake inhibitor and nicotinic acetylcholine receptor antagonist; Naltrexone = Opioid receptor antagonist

Bariatric Surgery (see LSRC Obesity Surgery)
Gastric bypass
Gastric band
Sleeve gastrectomy

Question 20

which cell types are found in WAT

Answer 20

adipocytes
fibroblasts
endothelia cells
immune cells

Question 21

reason for why obesity increase risk of cancer

Answer 21

causes oxidative stress
increases production of growth factors
results in chronic tissue inflammation