Obesity I and II Flashcards
energy homeostasis is regulated by what mechanisms?
- brain
- GI tract
- adipose tissue
what are the satiety hormones?
- cck
- pyy
- glp-1
- leptin
leptin is released by what tissue?
fat
where does leptin bind?
leptin receptors in hypothalamus
where is CCK produced?
small intestine
PYY is released by what organ?
pancreas PYY
PYY is released in response to elevated levels of what nutrient?
blood glucose
what are the roles of gpl-1?
- increases insulin secretion
- increases insulin sensitivity
- decreases glucagon secretion
- inhibits acid secretion and gastric emptying
where is ghrelin produced?
cells lining fundus of stomach and epsilon cells of pancreas
what is considered successful weight loss?
losing 10% of initial body weight and keeping it off for at least one year
what are the central concepts of motivational interviewing?
identification, evaluation, and resolution of ambivalence
what is the mechanism for orlistat?
lipase inhibitor that blocks fat absorption from the gastric / duodenal mucosa
what is the only obesity medication approved for adolescent use?
orlistat
what is the function of phentermine?
appetite suppression
what is the function of topiramate?
anticonvulsant, appetite suppression, and prolonging of fullness
what is the treatment for stomal ulceration?
PPIs, carafate, abx if infected
what are the symptoms of dumping syndrome?
- hypotension
- tachycardia
- syncope
- flushing
- abdominal cramping, diarrhea
- nausea and vomiting
what is the cause and mechanism of dumping syndrome?
simple sugar ingestion leads to osmotic overload and fluid shift from blood to intestine
what are the nutritional implications of bariatric surgery?
- iron deficiency anemia
- B12 deficiency
- folate deficiency
- calcium and vitamin D deficiency
what is the treatment for iron deficiency?
oral ferrous sulfate or ferrous gluconate
what is the mechanism for iron deficiency following roux-en-y gastric bypass?
- low acid levels prevent iron cleavage from food
- no nutrient exposure to duodenum or proximal jejunum
- decrease in iron rich food due to intolerance
what is the cause of B12 deficiency?
lack of HCl and pepsin in stomach - prevents B12 cleavage from food and affects secretion of intrinsic factor
what is required for folate absorption?
B12
