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Year Two - Endocrine System > Obesity > Flashcards

Obesity Flashcards

1
Q

What is obesity?

A

A complex disease involving an excessive amount of body fat

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2
Q

What four complications are associated with obesity?

A

Heart disease

Diabetes

High blood pressure

Certain cancers

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3
Q

How do we calculate an individual’s BMI?

A

We divide the patient’s weight (kg) by their height (m2)

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4
Q

What is an underweight BMI?

A

BMI below 18

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5
Q

What is a normal BMI?

A

BMI between 18.5 to 24.9

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6
Q

What is an overweight BMI?

A

BMI between 25 to 29.9

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7
Q

What is an obesity class I BMI?

A

BMI between 30 to 34.9

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8
Q

What is an obesity class II BMI?

A

BMI between 35 to 39.9

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9
Q

What is an obesity class III BMI?

A

BMI greater or equal to 40

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10
Q

What do we aim to achieve when managing obesity patients?

A

To stabilise the patient at a healthy weight

This improves their overall health and lowers their risk of developing complications related to obesity

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11
Q

What weight loss % do we aim for in obesity patients?

A

The initial treatment goal is to achieve a weight loss 5% to 10% of the patient’s total body weight

However, the more weight a patients loses, the greater the benefits

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12
Q

How do we conservatively treat obesity?

A

Dietary modifications

Regular exercise

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13
Q

What dietary modifications do we advise in obesity patients?

A

To reduce calorie intake and make healthier eating choices

It is important that they make gradual, realistic changes so that they can maintain any weight loss permanently.

We encourage patients to participate in a comprehensive weight loss program for at least six months and in the maintenance phase of a program for at least a year to boost their odds of weight loss success

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14
Q

How much exercise should obesity patients take part in a week?

A

At least 150 minutes a week of moderate-intensity physical activity

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15
Q

How much exercise should obesity patients take part in a week to achieve significant weight loss?

A

300 minutes or more a week

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16
Q

What is the function of anti-obesity medications?

A

To help patients stick to a low-calorie diet by decreasing their appetite.

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17
Q

When would we consider pharmacological treatment of obesity?

A

If patients have a BMI over 30

If patients have a BMI greater than 28 with associated medical complications

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18
Q

What is the main anti-obesity medication?

A

Orlistat

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19
Q

What is the function of orlistat?

A

It inhibits fat absorption through inhibition of pancreatic and gastric lipases

20
Q

What dose of orlistat can be bought over the counter? What two criteria must patients meet to purchase it?

A

60mg

BMI greater than 28 and be over the age of eighteen

21
Q

What is the prescription dose of orlistat?

A

120mg three times daily, before each meal

22
Q

What happens when patients consume a high quantity of fat whilst taking orlistat?

A

Fatty diarrhoea

23
Q

How long do we prescribe orlistat for?

A

A trial period of twelve weeks

It is only continued if the patient has lost at least 5% of their initial body weight since starting the treatment

24
Q

What is the function of bariatric surgeries?

A

They either limit the amount of food the patient can comfortably eat or decreases their absorption of food

25
Q

How much weight can individual loose from bariatric surgery?

A

35% or more of their excess body weight

26
Q

When do we consider bariatric surgery in obesity patients?

A

BMI greater than 40

BMI over 35 with associated medical complications

27
Q

Which patients do we prioritise bariatric surgery in?

A

Patients aged between 18-44 with a BMI between 35-40kg/m2 and recent (less than five years) onset of type two diabetes

28
Q

What are the three types of bariatric surgery?

A

Gastric band surgery

Gastric bypass surgery

Sleeve gastrectomy surgery

29
Q

What is gastric band surgery? How does it encourage weight loss?

A

In gastric band surgery, an inflatable band separates the stomach into two pouches

This means that only a small distension of the stomach will result in nerve fibres sending signals to the brain that the stomach is full

The patient will therefore feel less hungry and stop eating after a small consumption of food

30
Q

What are the complications of gastric band surgery?

A

The gastric band becoming too tight or too loose

If the band is too tight, patients will have a liquid-based diet, which will therefore result in weight gain

31
Q

What two bariatric surgeries are more common?

A

Gastric bypass surgery

Sleeve gastrectomy surgery

32
Q

What is gastric bypass surgery? How does it encourage weight loss?

A

In gastric bypass surgery, the surgeon anastomoses the small intestine to the fundus opening of the stomach

This means that food can only enter a small pouch of the stomach before entering the small bowel

33
Q

How much weight loss can patients loose with gastric bypass surgery?

A

30% of total weight loss

34
Q

What is a complication of gastric bypass surgery?

A

Dumping syndrome

35
Q

What is the pathophysiology of Dumping syndrome?

A

It occurs as a result of hyperosomolar load rapidly entering the proximal jejunum

The process of osmosis drags water into the lumen, resulting in luminal distension then diarrhoea

36
Q

What are the three clinical features of Dumping syndrome?

A

Crampy abdominal pain

Diarrhoea

Vertigo

37
Q

What is sleeve gastrectomy surgery? How does it encourage weight loss?

A

In sleeve gastrectomy surgery, the surgeon removes the majority of the fundus of the stomach

Grehlin is a hormone produced by the fundus, which causes a feeling of hunger

Therefore, by removing the fundus less of this hormone is produced and patients therefore don’t feel hungry as often

38
Q

What syndrome results in children having a reduced tone, hypogonadism and obesity?

A

Prader-Willi syndrome

39
Q

Where is the leptin hormone released?

A

Adipose tissue

40
Q

What is the function of leptin? What is the mechanism behind this action?

A

It decreases appetite

It increases secretion of melanocyte-stimulating hormone (MSH) and corticotrophin-releasing hormone (CRH) from the hypothalamus

41
Q

In which two locations is the gherlin hormone released?

A

P/D1 cells lining the fundus of the stomach

Epsilon cells of the pancreas

42
Q

What are the two functions of gherlin?

A

It increases appetite

It increases growth hormone secretion

43
Q

What two cancers are associated with obesity?

A

Breast cancer

Endometrial cancer

44
Q

What is metabolic syndrome?

A

It is a clustering of cardiovascular disease risk factors

The underlying pathophysiology is related to insulin resistance and visceral/central obesity

45
Q

What is the diagnostic criteria for metabolic syndrome?

A

The criteria consists of three or more….

Increased waist circumference (dependent on ethnicity) or a BMI >30

Dyslipidaemia with raised triglycerides >150 mg/dL or reduced HDL-cholesterol

Hypertension

Impaired glucose tolerance

Year Two - Endocrine System (17 decks)

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