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Block 3; Week 3 Michelle > Obesity Lecture > Flashcards

Obesity Lecture Flashcards

1
Q

What is obesity?

A

complex, multifactorial, chronic disease
interaction of genotype & environment
excessive accumulation of fat

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2
Q

What is the body mass index?

A

accepted measure of overweight & obesity in children & adults
BMI=Weight/Height

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3
Q

How is the term morbidly obese typically used? What does it really mean? Should we use this term?

A

extremely obese

  • *really means: obese w/ obesity-related comorbidities
  • *shouldn’t use the term b/c it is pejorative
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4
Q

What BMI classifies as underweight?

A

<18.5

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5
Q

What is a normal BMI range?

A

18.5-24.9

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6
Q

What BMI range is considered overweight?

A

25-29.9

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7
Q

What BMI range is considered Obese I? Obese II? Obese III?

A

Obese I: 30-34.9
Obese II: 35-39.9
Obese III: >40

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8
Q

What are the good things about using BMI to classify obesity?

A

It is low cost & easy.
It correlates well with body fat.
It predicts health risk well.
It is a useful screening tool.

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9
Q

What are the drawbacks of using BMI?

A

Old people: for a given BMI may have more fat.
Short People (less than 5’): aren’t as overweight as their BMI may indicate
Well-muscled people: aren’t as overweight as their BMI may indicate
Women: for a given BMI may have more fat.
Asians need a different BMI.

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10
Q

What is considered overweight & obese with the BMI for the asian & south asian population?

A

Overweight: 23-24.9
Obese: >25

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11
Q

Describe how you measure the waist circumference.

A

tape measure in horizontal plane @ the level of the iliac crest.
Snug, but not compressing the skin

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12
Q

If you have a BMI 25-34.9 & a waist circumference greater than ____ for men & ____ for women…you have a greater risk for what?

A 
>102 cm or 40 inches for men.
>88 cm or 35 inches for women
Greater risk for:
HTN
Type II Diabetes
Dyslipidemia
coronary heart disease
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13
Q

How do you define metabolic syndrome?

A 
3/5 risk factors
Abdominal obesity
High fasting glucose
High triglycerides
High cholesterol
High Blood pressure
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14
Q

How do you define obesity for children & adolescents? What are these ranges?

A

BMI in percentiles
Works for ages 2-20
Underweight: 95th percentile
Severe Obesity: >99th percentile

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15
Q

The US Preventative Services Task Force recommends intensive counseling for obese adults. What qualifies as intensive counseling?

A

more than 1 session per month for at least 3 months

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16
Q

T/F Overweight and obese individuals were 40% and 42% less likely in 2008 compared with 1994 to self-diagnose as overweight.

A

True.

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17
Q

Between 1994 & 2008 there was an ___ percentage increase in the prevalence of being overweight. How did this change the odds of being diagnosed as overweight by a physician?

A

69% increase in the prevalence

no change in the odds

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18
Q

What percentage of obese patients are diagnosed?

A

20%

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19
Q

How does the US rank in terms of obesity?

A

ninth most obese country

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20
Q

What fraction of the US adults are obese? Overweight? Normal weight?

A

1/3 obese
1/3 overweight
1/3 normal weight

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21
Q 
There is a greater prevalence in obesity in which of these groups?
Black men/White men
Black women/White women
Hispanic men/White men
Hispanic women/White women
A

White men>Black men
Black women>White women
Hispanic men>White men
Hispanic women >White women

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22
Q

Childhood obesity is most common in which 3 ethnic groups?

A

American Indians
Non-hispanic blacks
Mexican Americans

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23
Q

Having an obese parent increases your risk for obesity by what factor?

A

2-3 fold

24
Q

T/F Obesity is more prevalent in low income populations.

A

True.

25
Q

What 3 things predict whether childhood obesity will persist into adulthood?

A

Age: the older you are when you are obese…the more likely to stay that way
Parental Obesity
Severity of Obesity: the more severe…the more likely to stay obese

26
Q

How can we describe the interaction of genes & environment in determining obesity?

A

Genes load the gun.

Environment/Behavior pulls the trigger.

27
Q

What are the 3 general categories of obesity genetics?

A
  1. Monogenic forms of obesity
  2. Syndromic forms of obesity
  3. Common obesity
28
Q

What are monogenic forms of obesity?
What percentage of people have this?
What effects does this have?

A

rare forms of obesity that are caused by a spontaneous mutation in a single gene (6 known)
occurs in 5-10% of the severely obese
affects appetite control, food intake, energy homeostasis
codes for leptin, leptin receptor, pro-opiomelanocortin, melanocortin-4-receptor

29
Q

Describe what happens with leptin deficiency.

A

leptin deficiency is inherited in an aut recessive manner…produces extreme, early-onset obesity with intense hyperphagia
hypogonadotrophic hypogonadism w/ spontaneous puberty
**can be fixed w/ leptin treatments

30
Q

What is hyperphagia?

A

abnormally increased appetite, usu b/c of an issue w/ the hypothalamus

31
Q

Describe what happens with human leptin receptor deficiency.

A 
aut recessive
extreme obesity
hyperphagia
delayed puberty
normal basal temp & resting metabolic rate
**different than leptin deficiency:
mild growth retardation
impaired Growth hormone secretion
hypothalamic hypothyroidism
32
Q

Describe what happens with melanocortin 4 receptor deficiency.

A

inherited co dominant manner
early onset hyperphagia, increased fat mass, lean mass, bone density, linear growth & hyperinsulinemia
Responsible for 1-6% of severe cases of obesity

33
Q

What is the most common monogenic form of obesity?

A

melanocortin 4 receptor deficiency

34
Q

What is syndromic obesity?

A

obesity caused by a syndrome
often accompanied by mental retardation, reproductive issues, other health problems
25 types known

35
Q

What is the most common form of syndromic obesity?

A

Prader Willi Syndrome

due to genomic imprinting (matters which parent you inherit it from)

36
Q

What are the symptoms of PW?

A 
hyptonia
poor feeding @ infancy
extreme hyperphagia later & central obesity at 3-8 years of age
hypogonadism
short stature (not enough GH)
behavioral problems
cognitive issues
37
Q

What is Bardet-Biedl Syndrome?

A 
can be caused by 15 different genes-->similar presentation w/ all
obesity
microorchidism in men
mental retardation
retinal dystrophy-->blindness
polydactyly
renal issues
38
Q

What does the twin study suggest about common obesity?

A

Monozygotic twins have a much higher correlation for obesity than dizygotic twins.
This suggests that genetics plays a factor. Hard to identify the genes that factor in tho…environment is a huge deal!!

39
Q

T/F Portion size affects consumption!

A

TRUE.

this is simply true. studies show that a bigger plate of food–>even if you don’t eat it all–>you’ll eat more.

40
Q

T/F You should drink your calories as you will become fuller faster.

A

FALSE
people who drank their calories in one study ended up consuming more calories that day b/c it didn’t satisfy their appetite.

41
Q

T/F Being obese reduces your life expectancy.

A

True.

42
Q

T/F Having metabolic syndrome reduces your life expectancy.

A

True.

43
Q

Focusing on the head…what are some health implications of obesity?

A

cataracts
idiopathic intracranial hypertension
stroke

44
Q

What are some pulmonary complications of obesity?

A

abnormal fcn
sleep apnea
hypoventilation syndrome

45
Q

What are some liver complications of obesity?

A

nonalcoholic fatty liver disease
steatosis
steatohepatitis
cirrhosis

46
Q

What are some gynecological complications of obesity?

A

abnormal menses
infertility
polycystic ovarian syndrome

47
Q

What is the effect of obesity on risk of cancer?

A

increase in risk of breast, uteris, cervix, colon, esophagus, pancreas, kidney, prostate cancer

48
Q

What are some complications of obesity that can be seen in your extremities?

A 
phlebitis
venous stasis
skin issues
gout
osteoarthritis
49
Q

What are some other complications of obesity?

A 
coronary heart disease
Type II Diabetes
Dyslipidemia
HTN
Severe pancreatitis
Gall bladder disease
50
Q

What percentage of Type II Diabetes cases is attributable to excess weight?

A

90% of the cases!!

51
Q

What percentage of cases of HTN could be due to excess weight?
For every 1 kg lost…what reduction is seen in systolic & diastolic mmHg?

A

26-28% of the cases

1kg=1mmHg

52
Q

What percentage of cancer deaths in men & in women are accounted for by obesity?

A

Men: 14%
Women: 20%

53
Q

How common is weight discrimination? What is the number 2 source of stigma?

A

It is the 4th most common form of discrimination, right up there with race & age.
Health care providers

54
Q

What are bad terms to use with obese patients?

A 
Bad terms:
fatness
excess fat
obesity
large size
55
Q

What are better terms to use with obese patients?

A 
Better terms:
weight
heaviness
BMI
excess weight
unhealthy body weight
weight problem
unhealthy BMI
56
Q

T/F More healthcare dollars are spent on obesity than smoking.

A

TRUE

Block 3; Week 3 Michelle (9 decks)

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