obesity lecture

Question 1

obesity

Answer 1

energy intake remains higher than energy expenditure for extended period of time

Question 2

components of energy expenditure

Answer 2

metabolism to storage; variable energy expenditure: adaptive thermogenesis, physical activity; obligatory energy expenditure

Question 3

class 1, 2 and 3 obesity on BMI (exl. Asians)

Answer 3

30-34.9, 35-39.9, 40-50

Question 4

obesity prevalence: rich and poor

Answer 4

more prevalent among poor

Question 5

anabolic molecules expressed in CNS

Answer 5

NPY, dopamine, MCH, AGRP, ART

Question 6

catabolic molecules expressed in CNS

Answer 6

LEPR (leptin receptor), POMC, MCR4, CRH, 5-HT2C, GLP-1R

Question 7

effects of obesity

Answer 7

depression, stroke, sleep apnoea, ischaemic heart disease, hypertension, gallstones, cancers, diabetes, osteoarthritis, infertility, gout

Question 8

android and gynoid obesity based on where fat is stored

Answer 8

android (apple) and gynoid (pear), causing same BMI but different risks (high waist circumference - visceral fat - increases amount of insulin required)

Question 9

measuring waist circumference

Answer 9

mid point between lowest rib and ileac crest, 2cm above naval; accuracy difficult if BMI > 35

Question 10

issue with minor weight loss

Answer 10

depresses people but bounce back despite huge decreass in risks

Question 11

clinical management of obesity

Answer 11

diet, exercise, behavioural therapy, drug treatment, surgery (if BMI > 40)

Question 12

when does weight loss normally occur

Answer 12

first 6 months, then treatment discontinued, patient returns to gaining weight

Question 13

peptide yy

Answer 13

anorectic peptide from colon which reduces appetite

Question 14

bariatric surgery

Answer 14

huge decrease in body weight; sustainable

Question 15

NICE guidelines

Answer 15

tier system based on BMI, with tier 4 (very obese) being bariatric surgery