Obesity & Undernutrition Flashcards
What is primary obesity ?
most prevalent
- excess calorie intake over expenditure for the body’s metabolic demand
What is secondary obesity ?
due to a medical problem
- Ex.) endocrine disorders, CNS lesions/disorders/meds, chromosomal/congenital anomalies
What is Leptin ?
our appetite suppressant
- increases fat metabolism
- a deficiency or resistance to this can cause obesity
What is the Hypothalamus linked to obesity ?
our appetite stimulant
- if there is an imbalance (Neuropeptide Y) then it can cause overeating
What is Ghrelin ?
inhibits leptin
- found in the gut
- gastric bypass surgery decreases ghrelin
What can obesity cause ?
- increases fat mass (adipocytes) which increases adipokines
- increases adipokines contribute to insulin resistance and atherosclerosis, disrupts immune factors and predispose to certain cancers
What are the values for BMI ?
- > 25: overweight
- > 30: obese
- > 40: extreme obesity
What are the values for waist circumference for obesity ?
> 35 inches in women and >40 in men
- bigger adverse outcomes for heart attacks and other cardiac events
What is the waist-to-hip ratio for determining obesity ?
waist measurement/hip measurement
- < 0.8 is optimal and >0.8 indicates truncal fat
What types of diseases can an apple body shape cause ?
carries fat more above waist
- heart disease
- DM
- breast cancer
- endometrial cancer
- HTN
- hyperlipidemia
What types of conditions can a pear body shape cause ?
carries fat more below waist
- osteoporosis
- varicose veins
- cellulitis
What are some health risks associated with obesity ?
- sleep deprivation from obstructive sleep apnea can lead to overeating (cause of decrease in leptin)
- reduced chest wall compliance
- increase work of breathing
- cancers due to increase estrogen
- colorectal cancer due to hyperinsulin
- insulin and adipolines can stimulate cancer call proliferation
What conditions must be met to have medication intervention for weight loss ?
- adults with a BMI 27 or greater with at least 1 weight-related condition
- BMI of 30 of greater
What are some considerations for a nutrient absorption-blocking med ?
Orlistat: Xenical: Alli
- blocks fat breakdown and absorption in the GI tract
- can cause: diarrhea, bloating, flatulence, liver damage, and fatty stools
What are some consideration for use of Bupropion/Naltrexone (Contrave) ?
an antidepressant/opioid antagonist
- works on the brain to decrease cravings
- can cause: dry mouth, HA, and constipation
How does Plenity aid in weight loss ?
increases volume of stomach and small intestine contents
- gel pieces taken with meals
What are some consideration for use of Qysmia ?
Phenermine (sympathomimetic) & Topiramate (anti-seizure/migraine med)
- (phenermine) increases metabolism and (topiramate) decreases appetite
- addictive
- can cause: restlessness, tachycardia, palpations and insomnia
What is Semaglutide used for in weight loss ?
Wegovy
- induces satiety by slowing gastric motility
- same as Ozempic but a higher dose
- weekly injection
- can cause: hypoglycemia if used with other diabetic meds, gastroparesis and GI distress
- can slow food down so much it can cause paralytic ileus
What is the criteria for Bariatric surgery ?
- BMI 40 or greater
- BMI 35 with 1 or more severe obesity-related medical condition
- psychological screening to ensure patient can commit to lifelong behavior change and screen for depression and addiction and ability to cope with new body image
- no advanced cancers, liver and kidney disease and cardiopulmonary disease
What is the lap band technique ?
band goes around top part of stomach which causes food to go through the stomach but slower
- will feel full longer
- port is under skin
What is the gastric sleeve technique ?
- portion of stomach is cut out so causes decreased absorption of food
What is the gastric plication ?
similar to gastric sleeve
- but stomach is folded and not cut
- reversible
What is the intragastric ballon ?
ballon is inserted into the stomach that is filled with about 400-700 mL saline
- leads to feeling of fullness
What is the Gastric Bypass 1 (with duodenum) ?
majority of stomach is cut out and left with a tiny stomach
- food passes through duodenum as usually but smaller stomach leads to feeling full faster
