obESTIY

Question 1

Obesity classifications by BMI

Answer 1

BMI units: weight in kilograms/height in meters squared.

less than 18.5, underweight

18.5-25 is target weight

25-30, overweight

30-35 obesity class 1

35-40 obesity class 2

abover 40, obesity class 3 morbid obsity.

Question 2

Types of obesity based on distribution

Answer 2

Android/Central/Visceral/apple- much more associated with disease

Diffuse subcutaneous fat, gynoid, (pear) is not as bad

Question 3

Conditions associated with obesity

Answer 3

• Primary obesity - intake and genetics.
• Cushings
• Hypothyroidism
• Hypothalamic damage
• Prader-Willi
• Metabolic syndrome

Question 4

What is the satiety hormone

Answer 4

Satiety hormones

• Leptin. Reduces food intake, secreted by adipocytes, correlates with levels of adipose tissues.
  
  • Leptin resistance is associated with obesity.
• Peptide YY

Pro-hunger, obesity hormones

• Neuropeptide Y - hypothalamic
• AgRP
  
  • both are hypothalamic NTs
• Ghrelin

Question 5

What defines metabolic syndrome

Answer 5

having at least 3 of these 5 symptoms

1. Hypertension >130mmHg
2. High blood TAGs
3. High fasting glucose Above 5.6mmol/L
4. Low HDL
5. Central obesity above 102cm males above 88cm females.

Question 6

Consequences of obesity

Answer 6

Metabolic syndrome
T2DM, insulin resistance

Non-alcoholic fatty liver
Ischemic heart disease
Stroke

Cholesterol stones

Hyperuricemia, Gout -

• “hyperuricemia is probably a marker for comorbid risk factors rather than a causative factor of obesity”
• Decreased tubular secretion of urate occurs in patients with acidosis (eg, diabetic ketoacidosis)

Adipose tissue expresses aromatase and converts androgens to estrogens-

• Breast cancer,
• Endometrial cancer
• Colorectal cancer
• Polycystic ovarian syndrome

Sleep apnea
Asthma
Depressed respiration, hypoventilation syndrome, lung infections
Depression
Fatigue

Vertebral compression,
Hernia

Question 7

Obesity treatments

Answer 7

Diet

150 minutes exercise a week weith no more than 2 days rest in betwee,

walking or running to acheive a submaximal heart rate. 220 bpm minust age.

Extreme cases, gastrectomy

Orlistat: inhibits pancreatic lipase in the intestine, decreasing fat absorption

Sibutramine: monamine reuptake inhibitor, increasing central action of norepinephrine, dopamine, and 5HT. Increases satiety like a stimulant. Many strong contraindications and increases risk for ischemic cardiac events.

if there is significant hyperlipidemia

• Bile acid sequestrants
• Statins
• Niacin
• Fibrates