Obesity and Regulation of Appetite (DJ) Flashcards

1
Q

BMI = formula

A

kg/m2

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2
Q

BMI for:
overweight
obese
morbidly obese

A

Overweight = 25-29.9
Obese < 30
Morbidly obese < 35

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3
Q

____ measures visceral fat (which is more toxic than fat in other places) which is correlated to in increase in morbidity

A

waist circumference

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4
Q

What waist circumferences in men and women are assc with obesity/inc morbidity

A

men >40 in

women >35 in

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5
Q

term for energy burned during rest

A

basal metabolic rate

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6
Q

term for energy spent digesting food

A

thermic effect of food

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7
Q

fidgeting/extra movement assc with daily activity that increase energy expenditure

A

NEAT

non-exercise activity thermogenesis

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8
Q

What we spend the most amt of energy doing during the day?

A

basal metabolic rate

greater than normal physical activity and thermic effect of food

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9
Q

basal metabolic rate increases with ___ and decreases with ____

A

Decreases with age and increases with obesity

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10
Q

What are the main strategies for effective weight control

A

Restriction of food intake and physical activity

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11
Q

Afferent and Efferent signals that maintain energy balance favors weight (loss or gain)

A

gain

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12
Q

What integrates afferent signals to determine appetite/efferent signals/energy intake

A

arcurate nucleus in hypothalamus

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13
Q

secreted in stomach → stimulates food intake (and GH)

A

ghrelin

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14
Q

Acts on Y1 and Y5 receptors to induce hunger

A

NPY

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15
Q

antagonizes MC4 receptor and reverses alpha MSH effect

A

AgRP

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16
Q

When is ghrelin expressed and when in NPY expressed?

A

both peak before meal and are present during fasting

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17
Q

What are the orexigenic substances expressed in the PVN?

A

NPY and AgRP

18
Q

Decreases expression of NPY

A

leptin

19
Q

binds MC4R and inhibits food intake

A

alpha-MSH

20
Q

What activates alpha-MSH?

A

leptin

21
Q

What is alpha-MSH derived from?

A

POMC (it is cleaved)

22
Q

Co-localized in same neurons as POMC

Activated by leptin to inhibit food intake

A

CART

cocaine and amphetamine regulated transcript

23
Q

Suppresses glucagon secretion and prolongs gastric emptying

A

glucagon-like-peptide-1

24
Q

gut derived substance that promotes satiety? promotes hunger?

A
satiety = glucagon-like peptide 
hunger = ghrelin
25
Q

Obese people are often “____ resistant” (not insulin)

A

leptin

26
Q

centrally acting; levels increase in response to exercise, neuroglyucopenia, and enforced wakefulness –> hunger

A

Hypocretin

27
Q

Serotonin, orexigenic or anorexigenic?

A

anorexigenic

28
Q

TNF-alpha, orexigenic or anorexigenic?

A

anorexigenic (cachexia!!)

29
Q

secreted from fat cells of insulin sensitive people but it is deficient in pts with obesity or insulin resistance

A

adiponectin

30
Q

similar to insulin in that it increases in conc after meals and is anorexigenic

A

pancreatic polypeptide

31
Q

released with feeding and serves as an anorectic/sateiy signal to intestinal cells

A

peptide YY

32
Q

terminates meal rather than inhibits meal initiation
best known for stim of pancreatic enzyme secretion and gallbladder contraction but also involves regulation of portion size

A

Cholecystokinin

33
Q

has been noted in obese pts and can be INDUCED BY OVERFEEDING

A

Overreactivity of endocannabinoid system (ECS)

34
Q

ECS is normallt silent but it can be activated to …

A
increase appetite 
reduce pain and anxiety
extinguish adverse memories
inhibit motor behavior
modulate temp, hormone release, smooth muscle tone
35
Q

Centrally, what is happening when ECS is overreactive?

A

overactivation of CB1 receptor → DA released → increased motivation to eat

36
Q

Peripherally, what does overreactive ECS cause?

A
dyslipidemia
insulin resistance
glc intolerance 
increased cardiometabolic risk 
Increased lipolysis in fat and liver 
Dec satiey feelings in GI 
Decreases glc uptake in skeletal muscle
37
Q

selective antagonist to CB1 receptor. What effect would this molecule have on weight?

A

Rimbonaband, weight loss

38
Q

What gene? 2 mutated alleles causes pts to never feel full

A

FTO

39
Q

Affected are always hungry, never get signal to stop eating.

A

leptin deficiency

40
Q

Feel the need to eat more frequently but still can get full

A

MC4 receptor mutation

41
Q

Is leptin deficiency or MC4 receptor mutation more common

A

leptin deficiency

42
Q

Causes decreased inter-prandial intervals

A

MC4 receptor mutation