(PM3B) Obesity Flashcards
Is obesity considered acute or chronic?
Chronic
What is obesity?
An excessive accumulation of body fat sufficient to impair health
How many common health conditions are associated with obesity?
> 30
What are the different categories of obesity with increasing severity?
(1) Normal
(2) Overweight
(3) Obese
(4) Severe obese
(5) Morbidly obese
What waist circumference is considered obese for men?
> 102cm
What waist circumference is considered obese for women?
> 88cm
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
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
Define ‘aetiology’.
The cause(s) of a disease or condition
What does ‘energy balance’ refer to?
When the energy intake from food/ drink matches the energy expended
What is a positive energy balance? What does it lead to?
Energy in > Energy out
Weight gain
What is a negative energy balance? What does it lead to?
Energy in < Energy out
Weight loss
What is ‘yo-yo dieting’?
(1) Diet
(2) Metabolism slows
(3) End of diet
(4) Normal eating
(5) Weight gain
What is the Barker hypothesis?
- Suggest foetal origins of an adult disease
- Adverse foetal/ infant environments establish increased risk in adult life
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
What is metabolic syndrome?
A combination of health conditions
(1) Type 2 diabetes mellitus
(2) Hypertension
(3) Weight gain
What are the effects of a patient with metabolic syndrome?
Increased risk of:
- Cardiovascular disease
- Obesity
- Glucose intolerance
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
