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BPK 417 > Quest 2 > Flashcards

Quest 2 Flashcards

Primary Objective: pass (optional)

1
Q

what is osteoarthritis

A

weardown of the joints, promoted by excess weight and obesity induced inflammation

too much weight=way too much stress on joints and they grind down

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2
Q

what is obstructive sleep apnea

A

narrowing of airways during sleep that can promote snoring and stoppage of breathing

promoted with accumulation of extra adipose tissue in upper respiratory tract

treated with weight loss or breathing machine

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3
Q

what are some comorbities associated with increased intraabdominal pressure

A

gastroesophageal reflux disorder

stress urinary incontinence

abdominal hernia

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4
Q

what are the 2 categories of comorbidities

A

adiposopathies - altered physiology that occurs when fat cells grow and adipokines get released in different patterns to promote a pro-inflammatory state

fat mass diseases - related to extra strain on body due to excess fat mass

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5
Q

how does obesity affect polycystic ovarian syndrome

A

increased androgen production, disordered gonadotropin secretion, multiple cyst formations in ovaries

can cause infertility

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6
Q

how does obesity affect major depressive disorder

A

requires a change in eating pattern and sleep disturbance (results in increased appetite)

increases cortisol through HPA axis

lowers adiponectin

drugs to treat depression cause weight gain

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7
Q

what is an eating disorder

A

psychological disorder that results in altered eating behaviour

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8
Q

what are the 3 recognized eating disorders that exist

A

anorexia nervosa

bulimia nervosa

bing eating disorder

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9
Q

what is bulimia nervosa

A

lack of control of eating, followed by a severe compensatory behavior to prevent weight gain

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10
Q

what is binge eating disorder

A

lack of control over eating during the episode (2 hr eating window)

no compensatory behaviors as in bulimia

more common in men as age increases, more common in women as age decreases

causes higher risks of becoming obese, having depression, and drug/alcohol abuse

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11
Q

what is night eating disorder

A

disorder people may have where they eat hella food at nighttime

categorized by having:
morning anorexia
evening hyperphagia
insomnia

associated w obesity and a normal BMI

also associated with functional impairment and depression

is you if :
eat 25% of calories post dinner
this happens at least twice a week
must believe that they gotta eat before going to bed
must have been happening for like 3 months

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12
Q

what is trauma

A

events that result in emotional/physical hurt

pain.

big T - something big that someone went thru and it hit the person hard

small T - smaller less traumatic events that leave lasting impressions

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13
Q

how does obesity relate to trauma

A

higher risk of CVD, diabetes, drug abuse

higher adverse childhood experience score=higher BMI risk

need to approach topics with sensitivity

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14
Q

what does a higher ACE score indicate

A

higher inflamation/higher IL6
higher stress and cortisol
depression
less reward center development (more food needed to give reward)

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15
Q

What was the overfeeding study done with monozygotic twins

A

each individual ate 1000 calories extra, there was low variability between the twins but high variability between groups of twins

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16
Q

what are monogenic changes

A

caused by single gene mutation

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17
Q

what are polygenic changes

A

caused by multiple mutations in different genes

harder to analyze/detect

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18
Q

what are some monogenic causes of obesity

A

leptin deficiency

defect in melanocortin-4 receptor (appetite regulation) (most common)

POMC deficiency (appetite regulation)

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19
Q

what are epigenetics

A

how DNA is expressed/affects life

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20
Q

what are some epigenetic tags

A

DNA methylation - altering transcription, showing up thru covalent gene modification

histone modification - proteins that package DNA into nucleosomes, making it more compact and can alter transcription

non-coding RNA is RNA that’s fucked and it wont properly code for a gene product, so it cant be translated into a protein

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21
Q

how does pregnancy affect epigenetics of obesity

A

obese mothers make obese children basically

FTO locus codes for DNA methylation enzyme (caused when there’s increased fat consumption and reduced MC4R gene from mum)

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22
Q

What happened with the obesity Agouti mice study

A

when the gene was unmenthylated the mouse was obese with a yellow coat (same as offspring)

when gene was methylated with a methyl group diet, offspring were brown and lean with less obesity risk

depends on the degree of methylation - some were a mix of yellow and brown

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23
Q

what is hunger mf

A

physiological desire to eat

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24
Q

what is appetite

A

desire/cravings to eat food

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25
Q

What organs regulate hunger

A

short term:stomach, large intestine, small intestine

long term: adipose tissue

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26
Q

what is optogenetic activation

A

targeting of specific nerve cells to cause a depolarization or repolarization of feeding pathways

27
Q

What is POMC

A

produces A-MSH that activates the periventricular nucleus, which goes thru MC4R receptors, which causes satiety effect

leptin receptors are also triggered by leptin, which are located on the POMC neurons

28
Q

What is CART

A

cocaine and amphetamine regulated transcript

reward center stim can cause satiety, stress, and addiction

connected to the POMC pathway

29
Q

What protein is known to block MC4R receptors

A

Agouti protein - causes a lack of satiety, but when decreased there is a disinhibition of MC4R and decreased feeding

too much agouti = inhibited MC4R and increased feeding

too little agouti = less inhibition of MC4R and less feeding

30
Q

what is NPY

A

neuropeptide Y

released by arcuate nucleus and promotes uncontrollable eating

31
Q

what is leptin

A

anorexigenic hormone that inhibits agouti and leads to increased satiety and decreased feeding

stimulates POMC pathway as well

32
Q

what is ghrelin

A

high ghrelin levels associated with obesity, causes hunger

less sleep = more ghrelin

33
Q

what is CCK

A

cholecystokinin

promotes satiety by activating vagal afferents

inhibition of CCK causes a delayed response in nutrient trigger from SI to be perceived leading to more food consumed

34
Q

WHat is GLP-1

A

satiety response thru intestine cells in response to food intake

obese mfs may be resistant

promotes glucose induced insulin secretion to increase POMC pathway activity, while also inhibiting NPY pathways and decreasing time of gastric emptying

35
Q

how do microbiomes affect appetite

A

fermentation of insoluble fiber can change secretions of the satiety hormones

36
Q

What can impact uncontrolled eating

A

altered reward sensitivity
-when people learn from pleasurable stimuli, and the dopaminergic response increases the want of food

cognitive control
-low cognitive control increases the risk for uncontrolled eating
-low willpower over decisions and resisting temptations

negative affect
- personality that causes negative emotions and affects mood

37
Q

how is reward sensitivity related to obesity

A

higher dopamine when food is presented (even pictures)

sweetness is more rewarding (rats like it more than coke, the snorting kind not the drinking)

fats and sugar combo the most rewarding

38
Q

how does dorsomedial PFC and dorsolateral PFC differ

A

medial=upregulation of food
lateral = downregulation of food

39
Q

what is the orbitofrontal cortex responsible for

A

taste responsiveness

predicts how rewarding food will be depending on influence of motivation from person to eat it

40
Q

what is impulsivity

A

rash/spontaneous behaviour

seeking behaviours that will give same reward/pleasure in the brain without thinking about the consequences

higher delayed gratification (opposite of impulsivity) have a lower BMI (-0.2 BMI per min)

41
Q

how is negative affect and obesity related

A

heightened sensitivity to negative stimuli and more likely to experience negative emotions, leading to eating more food

42
Q

what is emotional eating

A

tendancy to overeat because of negative emotions

higher anxiety and cortisol have higher risk of this after acute stress

43
Q

how does the hippocampus affect appetite

A

can inhibit hypothalamus and adjust cortisol levels

use previously learned experience to make decisions on when and how much to eat

craving/imagining food caused by hippocampus

44
Q

What is the obesity algorithm

A

slide deck that goes over how to treat and manage obesity

gives info on causes and complexity

focuses on evaluating and assessing the individual for what we looking at

45
Q

what is the edmonton staging system

A

staging tool to group people into 4 stages rather than just the BMI

looked at relative to the BMI

46
Q

add the 4 fuckin edmonton stages here u dumbass (everyone else ignore this just a reminder for myself to add the stages as a question)

A
47
Q

what is the best weight for a pt

A

the weight they achieve while enjoying life

48
Q

what are the 5 As of obesity

A

Ask - chills if we talk about weight?

assess - assess eating behaviour/ relationship w food

advise -tell em what to do

agree/assist - make goals that yall trynna hit and identify shit that might come in the way

49
Q

what are physiological adaptations to energy deficits

A

pro-appetite state - want to eat more

metabolic adaptation = RMR lower than expected at that rate leading to a lower energy expenditure

50
Q

what happened in teh optifast diet study

A

mfs only allowed to drink some shakes

16 people couldnt get thru all 10 weeks

significant weight drop, but the weight was gained back after study

ghrelin was higher for a year after

satiety was less

more hunger and appetite

51
Q

what was the minnesota starvation experiment

A

32 mfs halved their caloric intake, and during refeeding they ate hella and returned to original weight or higher

52
Q

what is the biggest loser study

A

RMR was dropped by 610 kcal per day

participants gained the weight back

after 6 years, participants had a lower RMR even with weight gain

53
Q

how much a reduction in weight is needed to have a significant effect on health

A

5% change

54
Q

what are some clinical guidelines set by obesity canada?

A

Nutritional recommendations are individualized to a person

individualize approach, especially if pt is suffering from multiple comorbidities

55
Q

what are satiety promoting foods?

A

protein - more satiating and higher TEF, also help with management of hunger

fibre - reduces BMI and good for gut health

56
Q

What is intuitive eating

A

fixing relationship with food and listening to body cues to determine diet

57
Q

how much moderate-vigourous activity is recommended daily?

A

30-60 min

58
Q

what is motivational interviewing

A

shifting focus to client focused approach

uses OARS (open ended qs, affirming, reflecting, and summarizing)

principles include empathy expression, developing discrepancy, avoiding argumentation, rolling w resistance, and supporting self efficacy

59
Q

what is cognitive behavioural theory

A

thoughts create feelings, feelings create behaviours, and behaviors create thoughts

goal is to intervene and adjust

60
Q

what is acceptance and commitment therapy

A

about mindfulness and commitment while moving towards goal

focus on allowing feelings/emotions and accepting that ehy are there

acknowledging negative behaviours

61
Q

what is mindful eating

A

being present and aware when u are eating and putting distractions away

62
Q

how does sleep affect obesity risk

A

less sleep = higher ghrelin and lower GLP1,

increase of 1hr of sleep associated with decrease of fat mass by 0.7 kg

63
Q

what are the 5 health canada approved weight loss drugs

A

semaglutide (ozempic)
-GLP1 receptor agonist that increases insulin and slows gastric emptying
- higher amounts needed due to lower incretin effect
-causes vomiting and diarrhea
-only works while taking

tirzepatide
-uses incretin effect, loses 18-20% weight, higher doses for larger results

liraglutide
- uses incretin effect

bupropion
-less food noise and less reward desire to eat, usually for people with dependancy related eating

orlistat
-blocks lipase so fats cant be absorbed, reduces vitamin absorption tho

blocks lipase activity so we cannot breakdown fat to absorb it

64
Q

what are our thoughts on diana

A

i fucking hate her i wanna slash her tires fr

BPK 417 (2 decks)

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