Obesity Lecture Flashcards by michelle granstrom

What is obesity?

complex, multifactorial, chronic disease
interaction of genotype & environment
excessive accumulation of fat

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What is the body mass index?

accepted measure of overweight & obesity in children & adults
BMI=Weight/Height

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How is the term morbidly obese typically used? What does it really mean? Should we use this term?

extremely obese

*really means: obese w/ obesity-related comorbidities
*shouldn’t use the term b/c it is pejorative

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What BMI classifies as underweight?

<18.5

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What is a normal BMI range?

18.5-24.9

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What BMI range is considered overweight?

25-29.9

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What BMI range is considered Obese I? Obese II? Obese III?

Obese I: 30-34.9
Obese II: 35-39.9
Obese III: >40

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What are the good things about using BMI to classify obesity?

It is low cost & easy.
It correlates well with body fat.
It predicts health risk well.
It is a useful screening tool.

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What are the drawbacks of using BMI?

Old people: for a given BMI may have more fat.
Short People (less than 5’): aren’t as overweight as their BMI may indicate
Well-muscled people: aren’t as overweight as their BMI may indicate
Women: for a given BMI may have more fat.
Asians need a different BMI.

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What is considered overweight & obese with the BMI for the asian & south asian population?

Overweight: 23-24.9
Obese: >25

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Describe how you measure the waist circumference.

tape measure in horizontal plane @ the level of the iliac crest.
Snug, but not compressing the skin

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If you have a BMI 25-34.9 & a waist circumference greater than ____ for men & ____ for women…you have a greater risk for what?

>102 cm or 40 inches for men.
>88 cm or 35 inches for women
Greater risk for:
HTN
Type II Diabetes
Dyslipidemia
coronary heart disease

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How do you define metabolic syndrome?

3/5 risk factors
Abdominal obesity
High fasting glucose
High triglycerides
High cholesterol
High Blood pressure

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How do you define obesity for children & adolescents? What are these ranges?

BMI in percentiles
Works for ages 2-20
Underweight: 95th percentile
Severe Obesity: >99th percentile

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The US Preventative Services Task Force recommends intensive counseling for obese adults. What qualifies as intensive counseling?

more than 1 session per month for at least 3 months

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T/F Overweight and obese individuals were 40% and 42% less likely in 2008 compared with 1994 to self-diagnose as overweight.

True.

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Between 1994 & 2008 there was an ___ percentage increase in the prevalence of being overweight. How did this change the odds of being diagnosed as overweight by a physician?

69% increase in the prevalence

no change in the odds

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What percentage of obese patients are diagnosed?

20%

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How does the US rank in terms of obesity?

ninth most obese country

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What fraction of the US adults are obese? Overweight? Normal weight?

1/3 obese
1/3 overweight
1/3 normal weight

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There is a greater prevalence in obesity in which of these groups?
Black men/White men
Black women/White women
Hispanic men/White men
Hispanic women/White women

White men>Black men
Black women>White women
Hispanic men>White men
Hispanic women >White women

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Childhood obesity is most common in which 3 ethnic groups?

American Indians
Non-hispanic blacks
Mexican Americans

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Having an obese parent increases your risk for obesity by what factor?

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2-3 fold

T/F Obesity is more prevalent in low income populations.

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True.

What 3 things predict whether childhood obesity will persist into adulthood?

Age: the older you are when you are obese...the more likely to stay that way Parental Obesity Severity of Obesity: the more severe...the more likely to stay obese

How can we describe the interaction of genes & environment in determining obesity?

Genes load the gun. | Environment/Behavior pulls the trigger.

What are the 3 general categories of obesity genetics?

1. Monogenic forms of obesity 2. Syndromic forms of obesity 3. Common obesity

What are monogenic forms of obesity? What percentage of people have this? What effects does this have?

rare forms of obesity that are caused by a spontaneous mutation in a single gene (6 known) occurs in 5-10% of the severely obese affects appetite control, food intake, energy homeostasis codes for leptin, leptin receptor, pro-opiomelanocortin, melanocortin-4-receptor

Describe what happens with leptin deficiency.

leptin deficiency is inherited in an aut recessive manner...produces extreme, early-onset obesity with intense hyperphagia hypogonadotrophic hypogonadism w/ spontaneous puberty **can be fixed w/ leptin treatments

What is hyperphagia?

abnormally increased appetite, usu b/c of an issue w/ the hypothalamus

Describe what happens with human leptin receptor deficiency.

``` aut recessive extreme obesity hyperphagia delayed puberty normal basal temp & resting metabolic rate **different than leptin deficiency: mild growth retardation impaired Growth hormone secretion hypothalamic hypothyroidism ```

Describe what happens with melanocortin 4 receptor deficiency.

inherited co dominant manner early onset hyperphagia, increased fat mass, lean mass, bone density, linear growth & hyperinsulinemia Responsible for 1-6% of severe cases of obesity

What is the most common monogenic form of obesity?

melanocortin 4 receptor deficiency

What is syndromic obesity?

obesity caused by a syndrome often accompanied by mental retardation, reproductive issues, other health problems 25 types known

What is the most common form of syndromic obesity?

Prader Willi Syndrome | due to genomic imprinting (matters which parent you inherit it from)

What are the symptoms of PW?

``` hyptonia poor feeding @ infancy extreme hyperphagia later & central obesity at 3-8 years of age hypogonadism short stature (not enough GH) behavioral problems cognitive issues ```

What is Bardet-Biedl Syndrome?

``` can be caused by 15 different genes-->similar presentation w/ all obesity microorchidism in men mental retardation retinal dystrophy-->blindness polydactyly renal issues ```

What does the twin study suggest about common obesity?

Monozygotic twins have a much higher correlation for obesity than dizygotic twins. This suggests that genetics plays a factor. Hard to identify the genes that factor in tho...environment is a huge deal!!

T/F Portion size affects consumption!

TRUE. | this is simply true. studies show that a bigger plate of food-->even if you don't eat it all-->you'll eat more.

T/F You should drink your calories as you will become fuller faster.

FALSE people who drank their calories in one study ended up consuming more calories that day b/c it didn't satisfy their appetite.

T/F Being obese reduces your life expectancy.

True.

T/F Having metabolic syndrome reduces your life expectancy.

True.

Focusing on the head...what are some health implications of obesity?

cataracts idiopathic intracranial hypertension stroke

What are some pulmonary complications of obesity?

abnormal fcn sleep apnea hypoventilation syndrome

What are some liver complications of obesity?

nonalcoholic fatty liver disease steatosis steatohepatitis cirrhosis

What are some gynecological complications of obesity?

abnormal menses infertility polycystic ovarian syndrome

What is the effect of obesity on risk of cancer?

increase in risk of breast, uteris, cervix, colon, esophagus, pancreas, kidney, prostate cancer

What are some complications of obesity that can be seen in your extremities?

``` phlebitis venous stasis skin issues gout osteoarthritis ```

What are some other complications of obesity?

``` coronary heart disease Type II Diabetes Dyslipidemia HTN Severe pancreatitis Gall bladder disease ```

What percentage of Type II Diabetes cases is attributable to excess weight?

90% of the cases!!

What percentage of cases of HTN could be due to excess weight? For every 1 kg lost...what reduction is seen in systolic & diastolic mmHg?

26-28% of the cases | 1kg=1mmHg

What percentage of cancer deaths in men & in women are accounted for by obesity?

Men: 14% Women: 20%

How common is weight discrimination? What is the number 2 source of stigma?

It is the 4th most common form of discrimination, right up there with race & age. Health care providers

What are bad terms to use with obese patients?

``` Bad terms: fatness excess fat obesity large size ```

What are better terms to use with obese patients?

``` Better terms: weight heaviness BMI excess weight unhealthy body weight weight problem unhealthy BMI ```

T/F More healthcare dollars are spent on obesity than smoking.

TRUE

Obesity Lecture Flashcards

(56 cards)