Obesity/Metabolic Syndrome

Question 1

Three hormonal factors that affect weight:

Answer 1

Leptin
Insulin
Thyroid

Question 2

How much energy goes into maintaining the BMR?

Answer 2

70%

Question 3

What does BMR mean?

Answer 3

Basal metabolic rate
Minimum rate at which the body uses energy while at rest to keep vital functions going, such as breathing and keeping warm.

Question 4

What factors contribute to obesity?

Answer 4

Excess energy intake (calories) are stored as fat 
Decreased energy expenditure 
Appetite 
Gastrointestinal filling 
Hormonal factors 
Emotions

Question 5

Obesity increases the risk of ?

Answer 5

Morbidity

Mortality

Question 6

What provides energy?

Answer 6

Nutrients

Question 7

How much energy does physical activity account for?

Answer 7

5-10%

Question 8

What does Leptin do?

Answer 8

Inhibits hunger to regulate energy balance

Question 9

What are risk factors for obesity?

Answer 9

Heredity (25-40% of obesity)
Physical inactivity 
Cultural factors 
Environmental 
Socioeconomic 
Psychological (depression, stress, guilt)
Addiction 
Coping mechanism

Question 10

What is the difference between mature and immature adipose tissue?

Answer 10

Mature adipose cells do not multiply and

Immature adipose cells DO multiply

Question 11

When do immature adipose cells multiply?

Answer 11

In presence of estrogen during puberty and late adolescents
During breastfeeding
Overweight middle aged adults

Question 12

What is BMI?

And how is it calculated?

Answer 12

Body Mass Index
Weight-to-height ratio
Calculated by dividing weight (kg) by height (m)

Question 13

BMI is used an indicator for what?

Answer 13

Obesity and underweight

Question 14

BMI: Underweight

Answer 14

> 18.5 kg/m^2

Question 15

BMI: Normal

Answer 15

18.5-24.9 kg/m^2

Question 16

BMI: Overweight

Answer 16

25-29.9 kg/m^2

Question 17

BMI: Obese

And what are the classes?

Answer 17

30-39.9 kg/m^2
Class I Obese: 30-34.9 kg/m^2
Class II Obese: 35-39.9 kg/m^2

Question 18

BMI: Morbid obesity

Answer 18

> 40 kg/m^2

Class III

Question 19

What ratio is used to determine upper body obesity?
Men?
Women?

Answer 19

Waist : hip

> 1 in men
0.8 in women

Question 20

In upper body obesity there are increased levels of what?

Answer 20

Circulating free fatty acids

Question 21

With upper body obesity, there is an increased risk of what?

Answer 21

HTN 
Dyslipidemia 
Heart disease 
Stroke 
Hyperinsulinemia

Question 22

What ratio is used for lower body obesity?

Answer 22

Waist : hip

Question 23

With lower body obesity there is decreased risk of what?

Answer 23

Hyperlipidema
Abnormal lipids
Heart disease

Question 24

What is more difficult to treat upper/lower?

Answer 24

Lower

Question 25

What are possible complications of obesity?

Answer 25

``` HTN Coronary heart disease Heart failure Stroke Metabolic syndrome Insulin resistance DM2 Sleep apnea Gallstones Cancer Joint pain/OA ```

Question 26

What is possible reproductive impairment complication for men?

Answer 26

Androgen

Question 27

What is possible reproductive impairment complication for women?

Answer 27

Menstrual irregularity | Polycystic ovary syndrome

Question 28

What is polycystic ovary syndrome?

Answer 28

Hormonal disorder causing enlarged ovaries with small cysts on the outer edges

Question 29

What are some ways obesity can be managed?

Answer 29

``` Diet Exercise Behavior modification Pharmacotherapy Surgery Education ```

Question 30

What are some diagnostic tests used for obesity?

Answer 30

``` BMI Skin folds Hydrodensitometry Bioelectrical impulse Waist circumference Dual energy xray absorptiometry Labs ```

Question 31

What two methods of diagnostic tests are most accurate?

Answer 31

Hydrodensitometry | Dual energy xray absorptiometry

Question 32

What is dual energy xray absorptiometry?

Answer 32

Measuring bone mineral density

Question 33

What is hydrodensitometry?

Answer 33

Underwater displacement

Question 34

What labs can be used to diagnose obesity?

Answer 34

Thyroid panel Serum glucose Lipid profile Electrocardiography

Question 35

What are some pharmacologic interventions for obesity?

Answer 35

Phentermine: stimulant Orlistat (Xenical): fat absorption inhibitor Contrave: Opioid antagonist, bupropion, antidepressant Sibutramine (Meridia): appetite suppressant: removed from market, increased risk of heart attacks

Question 36

What are some amphetamine and non-amphetamine appetite suppressants? And what does it do?

Answer 36

Phentermine | Stimulate CNS

Question 37

What are some appetite suppressants? | And what does it do?

Answer 37

Sibutramine (Meridia) | Lowers cholesterol and triglycerides: increases metabolic rate

Question 38

What are some fat absorption inhibitors?

Answer 38

Orlistat (Xenical)

Question 39

What should be the daily calorie intake for men and women managing obesity?

Answer 39

1,000-1,200 kcal/day for women | 1,200-1,600 kcal/day for men