(PM3B) Obesity Flashcards by thurica jeyaselan

Is obesity considered acute or chronic?

Chronic

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What is obesity?

An excessive accumulation of body fat sufficient to impair health

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How many common health conditions are associated with obesity?

> 30

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What are the different categories of obesity with increasing severity?

(1) Normal
(2) Overweight
(3) Obese
(4) Severe obese
(5) Morbidly obese

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What waist circumference is considered obese for men?

> 102cm

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What waist circumference is considered obese for women?

> 88cm

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What are some of the common health conditions associated with obesity?

Cardiovascular disease
HTN
Type 2 Diabetes
Sleep apnoea
Stroke
Depression + anxiety
Cancer
Liver disease
Reproductive complications (infertility)
Asthma
Osteoarthritis

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What are some generic factors which could be a cause of an individual’s obesity?

(1) Personal fault - eating too much + exercising too little
(2) Societal fault - cheap processed food abundance
(3) Genetic fault - determined by genetic factors

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Define ‘aetiology’.

The cause(s) of a disease or condition

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What does ‘energy balance’ refer to?

When the energy intake from food/ drink matches the energy expended

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What is a positive energy balance? What does it lead to?

Energy in > Energy out

Weight gain

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What is a negative energy balance? What does it lead to?

Energy in < Energy out

Weight loss

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What is ‘yo-yo dieting’?

(1) Diet
(2) Metabolism slows
(3) End of diet
(4) Normal eating
(5) Weight gain

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What is the Barker hypothesis?

Suggest foetal origins of an adult disease

- Adverse foetal/ infant environments establish increased risk in adult life

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What are the stages to the Barker Hypothesis?

(1) Suboptimal maternal nutrition
(2) Changes in foetal gene expression
(3) Altered foetal metabolism
(4) Reduced birth weight
(5) Metabolic syndrome

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What is metabolic syndrome?

A combination of health conditions

(1) Type 2 diabetes mellitus
(2) Hypertension
(3) Weight gain

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What are the effects of a patient with metabolic syndrome?

Increased risk of:

Cardiovascular disease
Obesity
Glucose intolerance

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What is familial aggregation?

Clustering of a health condition (i.e. obesity) in families

What have studies regarding obesity in twins shown?

Monozygotic twins are more likely to be similar than dizygotic twins

What is the estimated probability of inheriting obesity?

40-60%

What can genetic factors influence, regarding obesity?

(1) Body shape + size
(2) Body fat distribution
(3) Metabolic rate
(4) Brain chemistry

What does the thrifty metabolism gene do?

Increases fat storage to protect against famine

What is a thrifty metabolism?

The ability to store and utilise fat

What is the likelihood of a child with no obese parents developing obesity?

10%

What is the likelihood of a child with 1 obese parent developing obesity?

40%

What is the likelihood of a child with 2 obese parents developing obesity?

80%

What is the FTO gene?

A gene involved in appetite regulation - High-risk variants make people more vulnerable to becoming obese with age

What are the types of feedback relating to energy homeostasis? What do they do?

(1) Short-term: - Determination of amount of food ingested in a meal - Satiation determination by nervous signals triggered in the GIT (2) Long-term: - Periods of weeks/ years of regulating energy intake vs output - Modulation by adipose tissue mass

What is leptin?

Hormone produced by adipose tissue (fat cells) - adipocytes Primary method of brain determining fat storage in the body

How does adipose tissue (fat) function as an active endocrine organ?

Produces the hormone leptin

What does leptin do?

- Increases with increased fat storage (weight gain) - Decreases with decreases fat storage (weight loss) ø Leptin increases energy expenditure ø Leptin decreases food intake

What is ghrelin? Where is it produced?

Peptide hormone Secreted by the gastric mucosa

What are the effects of ghrelin?

- Increases food intake

What are the effects of snoring and sleep apnoea compared to normal breathing at night?

(1) Snoring - Restriction of airway, noise production | (2) Sleep apnoea - Complete restriction of the airway

What are the effects of COVID-19 on obese patients?

Significant increases in morbidity and mortality

What are the two types of treatment options for obesity?

(1) Behavioural model | (2) Medical model

What is the behavioural model?

Treatment plan for changing behaviour of an obese patient - includes diet + exercise plans

What is the medical model?

Treatment plan for the medical management of an obese patient - includes surgical/ pharmacological management

What medication has been proven to be safe and effective in weight management?

Orlistat (Alli)

What is orlistat?

Currently, the only proven weight loss medication

How does orlistat work?

(1) Eating fat causes anal leakage

How effective is orlistat?

Effective Can cause substantial weight loss

What is 'Alli'?

Brand name for orlistat (weight-loss drug)

What types of surgical management for obesity is there/

(1) Vertical sleeve gastrectomy (2) Adjustable gastric band (Lap band) (3) Gastric bypass