Obesity/Metabolic Syndrome Flashcards
Three hormonal factors that affect weight:
Leptin
Insulin
Thyroid
How much energy goes into maintaining the BMR?
70%
What does BMR mean?
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.
What factors contribute to obesity?
Excess energy intake (calories) are stored as fat Decreased energy expenditure Appetite Gastrointestinal filling Hormonal factors Emotions
Obesity increases the risk of ?
Morbidity
Mortality
What provides energy?
Nutrients
How much energy does physical activity account for?
5-10%
What does Leptin do?
Inhibits hunger to regulate energy balance
What are risk factors for obesity?
Heredity (25-40% of obesity) Physical inactivity Cultural factors Environmental Socioeconomic Psychological (depression, stress, guilt) Addiction Coping mechanism
What is the difference between mature and immature adipose tissue?
Mature adipose cells do not multiply and
Immature adipose cells DO multiply
When do immature adipose cells multiply?
In presence of estrogen during puberty and late adolescents
During breastfeeding
Overweight middle aged adults
What is BMI?
And how is it calculated?
Body Mass Index
Weight-to-height ratio
Calculated by dividing weight (kg) by height (m)
BMI is used an indicator for what?
Obesity and underweight
BMI: Underweight
> 18.5 kg/m^2
BMI: Normal
18.5-24.9 kg/m^2
BMI: Overweight
25-29.9 kg/m^2
BMI: Obese
And what are the classes?
30-39.9 kg/m^2
Class I Obese: 30-34.9 kg/m^2
Class II Obese: 35-39.9 kg/m^2
BMI: Morbid obesity
> 40 kg/m^2
Class III
What ratio is used to determine upper body obesity?
Men?
Women?
Waist : hip
> 1 in men
0.8 in women
In upper body obesity there are increased levels of what?
Circulating free fatty acids
With upper body obesity, there is an increased risk of what?
HTN Dyslipidemia Heart disease Stroke Hyperinsulinemia
What ratio is used for lower body obesity?
Waist : hip
With lower body obesity there is decreased risk of what?
Hyperlipidema
Abnormal lipids
Heart disease
What is more difficult to treat upper/lower?
Lower
What are possible complications of obesity?
HTN Coronary heart disease Heart failure Stroke Metabolic syndrome Insulin resistance DM2 Sleep apnea Gallstones Cancer Joint pain/OA
What is possible reproductive impairment complication for men?
Androgen
What is possible reproductive impairment complication for women?
Menstrual irregularity
Polycystic ovary syndrome
What is polycystic ovary syndrome?
Hormonal disorder causing enlarged ovaries with small cysts on the outer edges
What are some ways obesity can be managed?
Diet Exercise Behavior modification Pharmacotherapy Surgery Education
What are some diagnostic tests used for obesity?
BMI Skin folds Hydrodensitometry Bioelectrical impulse Waist circumference Dual energy xray absorptiometry Labs
What two methods of diagnostic tests are most accurate?
Hydrodensitometry
Dual energy xray absorptiometry
What is dual energy xray absorptiometry?
Measuring bone mineral density
What is hydrodensitometry?
Underwater displacement
What labs can be used to diagnose obesity?
Thyroid panel
Serum glucose
Lipid profile
Electrocardiography
What are some pharmacologic interventions for obesity?
Phentermine: stimulant
Orlistat (Xenical): fat absorption inhibitor
Contrave: Opioid antagonist, bupropion, antidepressant
Sibutramine (Meridia): appetite suppressant: removed from market, increased risk of heart attacks
What are some amphetamine and non-amphetamine appetite suppressants?
And what does it do?
Phentermine
Stimulate CNS
What are some appetite suppressants?
And what does it do?
Sibutramine (Meridia)
Lowers cholesterol and triglycerides: increases metabolic rate
What are some fat absorption inhibitors?
Orlistat (Xenical)
What should be the daily calorie intake for men and women managing obesity?
1,000-1,200 kcal/day for women
1,200-1,600 kcal/day for men
