Unit 2: Weight Flashcards
____ blocks the effect of ____ at melanocotin receptors.
AgRP; alpha-MSH
Define the criteria for metabolic syndrome
3 of the following: BP systolic >130/diastolic >85, Waist circumference >35/40, Fasting glucose >100, Triglycerides >150, HDL less than 40(m)/50(f)
Ghrelin levels are generally ______ after bariatric surgery
decreased
Knockout of NPY results in increased ______ (hunger/satiety).
satiety
Knockout of the POMC gene results in loss of ___ and increased ______ (hunger/satiety)
alpha-MSH; hunger
Leptin inhibits _____ neurons and activates _____ neurons
NPY/AgRP; alpha-MSH/CART
Name 4 categories of drugs with weight-gain side effects
Anti-diabetic, anti-psychotic/mood stabilizing, contraceptives, glucocorticoids
Name 5 national weight control registry interventions.
Moderately low fat/high carb diet, frequent self-monitoring, eat breakfast, large amounts of physical acitivty, limit TV viewing
Name a dermatologic complication of pediatric obesity.
Acanthosis nigricans
Name cancers that have increased risk with obesity. (6)
Breast, endometrial, prostate, colon, gallbladder, kidney
Name endocrine complications of pediatric obesity.
T2D, Polycystic Ovarian Syndrome, Hypothyroidism
Name GI complications of pediatric obesity.
NAFLD, constipation
Name hormone(s) derived from the GI tract that promote feeding.
Ghrelin
Name hormone(s) derived from the GI tract that promote satiety
CCK, GLP-1, Peptide YY
Name neurologic and psychiatric complications of pediatric obesity.
Pseudotumor cerebri, depression/anxiety, eating disorders
Name orthopedic complications of pediatric obesity
Blount Disease, Slipped Capital Femoral Epiphysis
Name pulmonary complications of pediatric obesity.
Obstructive Sleep Apnea, Obesity Hypoventilation Syndrome
Name the BMI criteria for when medical therapy is indicated.
BMI>27 + comorbidities or BMI>30
Name the BMI criteria for when surgical therapy is indicated.
BMI>35 + comorbidities or BMI>40
Name two factors involved in long-term body mass regulation.
Leptin, insulin
What factors are produced by neurons in the arcuate nucleus that promote feeding behaviors?
Neuropeptide Y (NPY) and Agouti-Related Peptide (AgRP)
What factors are produced by neurons in the arcuate nucleus that promote satiety?
alpha-Melanocortin Stimulating Hormone (alpha-MSH) and Cocaine and Amphetamine Related Transcript (CART)
What factors are produced by the lateral hypothalamus to mediate feeding behaviors?
Melanin Concentrating Hormone (MCH) and orexins
What is the prevalence of sleep apnea in obese individuals?
40% (m) / 3% (f)
What region serves as the “hunger center” in the brain?
Lateral Hypothalamus
What region serves as the “satiety center” in the brain?
Ventromedial Nucleus of the Hypothalamus
Which surgical weight loss procedure has the highest effectiveness and highest risks?
Roux-en-Y Gastric Bypass
Which surgical weight loss procedure has the intermediate effectiveness and intermediate risks?
Sleeve Gastrectomy
Which surgical weight loss procedure has the lowest effectiveness and least risks?
Laparoscopic Banding
Which therapy technique/tool/theory? Behavior change only occurs if the patient perceives real, serious risk/harm, has experienced a compelling cue to action, and has confidence they can perform a behavior change they deem effective
Health Belief Model
Which therapy technique/tool/theory? Involves examination and resolution of ambivalence
Motivational Interviewing
Which therapy technique/tool/theory? Involves identification of ideas that lead to undesired behaviors, focusing more on behaviors than values. Motivation, or ambivalence
Cognitive Behavioral Therapy
Which therapy technique/tool/theory? Tries to connect an individual’s core values with their need to change a health behavior
Value-Based Counseling
Which therapy technique/tool/theory? Used diagnostically to determine where a patient is in their decision to make a change
Stages of Change model
Which therapy technique/tool/theory? Useful when the patient does not agree with the provider or does not think change is necessary
Health Belief Model
Which weight loss drug? $100/month, available OTC
Orlistat
Which weight loss drug? 10-12% weight loss; greatest weight loss
Phentermine/Topiramate
Which weight loss drug? 4-5% weight loss, mildest side effects: headache/dizziness/nausea (minimal)
Lorcasarin
Which weight loss drug? Cheapest, only approved for three months of use
Phentermine
Which weight loss drug? Decreases BP, glucose, and insulin; increases HDL
Phentermine/Topiramate
Which weight loss drug? Highly teratogenic
Phentermine/Topiramate
Which weight loss drug? Increases norepinephrine in the brain
Phentermine
Which weight loss drug? Inhibits pancreatic lipase, 5-8% weight loss
Orlistat
Which weight loss drug? Intermediate effectiveness and side effect profile
Bupropion/Naltrexone
Which weight loss drug? Safest weight loss medication
Orlistat
Which weight loss drug? Serotonin 2C agonist
Lorcasarin
Which weight loss drug? Side effects: dry mouth, paresthesias, insomnia, dizziness, anxiety, irritability, attention disturbance
Phentermine/Topiramate
Which weight loss drug? Side effects: HTN, headache, nervousness
Phentermine
Which weight loss drug? Side effects: nausea, constipation, diarrhea, dry mouth, headache
Bupropion/Naltrexone
Which weight loss drug? Stimulates hypothalamic POMC neurons, alters reward pathway
Bupropion/Naltrexone
