Obesity/Metabolic Syndrome Flashcards

1
Q

Three hormonal factors that affect weight:

A

Leptin
Insulin
Thyroid

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2
Q

How much energy goes into maintaining the BMR?

A

70%

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3
Q

What does BMR mean?

A

Basal metabolic rate
Minimum rate at which the body uses energy while at rest to keep vital functions going, such as breathing and keeping warm.

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4
Q

What factors contribute to obesity?

A
Excess energy intake (calories) are stored as fat 
Decreased energy expenditure 
Appetite 
Gastrointestinal filling 
Hormonal factors 
Emotions
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5
Q

Obesity increases the risk of ?

A

Morbidity

Mortality

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6
Q

What provides energy?

A

Nutrients

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7
Q

How much energy does physical activity account for?

A

5-10%

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8
Q

What does Leptin do?

A

Inhibits hunger to regulate energy balance

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9
Q

What are risk factors for obesity?

A
Heredity (25-40% of obesity)
Physical inactivity 
Cultural factors 
Environmental 
Socioeconomic 
Psychological (depression, stress, guilt)
Addiction 
Coping mechanism
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10
Q

What is the difference between mature and immature adipose tissue?

A

Mature adipose cells do not multiply and

Immature adipose cells DO multiply

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11
Q

When do immature adipose cells multiply?

A

In presence of estrogen during puberty and late adolescents
During breastfeeding
Overweight middle aged adults

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12
Q

What is BMI?

And how is it calculated?

A

Body Mass Index
Weight-to-height ratio
Calculated by dividing weight (kg) by height (m)

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13
Q

BMI is used an indicator for what?

A

Obesity and underweight

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14
Q

BMI: Underweight

A

> 18.5 kg/m^2

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15
Q

BMI: Normal

A

18.5-24.9 kg/m^2

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16
Q

BMI: Overweight

A

25-29.9 kg/m^2

17
Q

BMI: Obese

And what are the classes?

A

30-39.9 kg/m^2
Class I Obese: 30-34.9 kg/m^2
Class II Obese: 35-39.9 kg/m^2

18
Q

BMI: Morbid obesity

A

> 40 kg/m^2

Class III

19
Q

What ratio is used to determine upper body obesity?
Men?
Women?

A

Waist : hip

> 1 in men
0.8 in women

20
Q

In upper body obesity there are increased levels of what?

A

Circulating free fatty acids

21
Q

With upper body obesity, there is an increased risk of what?

A
HTN 
Dyslipidemia 
Heart disease 
Stroke 
Hyperinsulinemia
22
Q

What ratio is used for lower body obesity?

A

Waist : hip

23
Q

With lower body obesity there is decreased risk of what?

A

Hyperlipidema
Abnormal lipids
Heart disease

24
Q

What is more difficult to treat upper/lower?

A

Lower

25
Q

What are possible complications of obesity?

A
HTN 
Coronary heart disease
Heart failure 
Stroke 
Metabolic syndrome
Insulin resistance 
DM2
Sleep apnea 
Gallstones 
Cancer
Joint pain/OA
26
Q

What is possible reproductive impairment complication for men?

A

Androgen

27
Q

What is possible reproductive impairment complication for women?

A

Menstrual irregularity

Polycystic ovary syndrome

28
Q

What is polycystic ovary syndrome?

A

Hormonal disorder causing enlarged ovaries with small cysts on the outer edges

29
Q

What are some ways obesity can be managed?

A
Diet 
Exercise 
Behavior modification 
Pharmacotherapy 
Surgery 
Education
30
Q

What are some diagnostic tests used for obesity?

A
BMI 
Skin folds
Hydrodensitometry 
Bioelectrical impulse 
Waist circumference
Dual energy xray absorptiometry
Labs
31
Q

What two methods of diagnostic tests are most accurate?

A

Hydrodensitometry

Dual energy xray absorptiometry

32
Q

What is dual energy xray absorptiometry?

A

Measuring bone mineral density

33
Q

What is hydrodensitometry?

A

Underwater displacement

34
Q

What labs can be used to diagnose obesity?

A

Thyroid panel
Serum glucose
Lipid profile
Electrocardiography

35
Q

What are some pharmacologic interventions for obesity?

A

Phentermine: stimulant
Orlistat (Xenical): fat absorption inhibitor
Contrave: Opioid antagonist, bupropion, antidepressant
Sibutramine (Meridia): appetite suppressant: removed from market, increased risk of heart attacks

36
Q

What are some amphetamine and non-amphetamine appetite suppressants?
And what does it do?

A

Phentermine

Stimulate CNS

37
Q

What are some appetite suppressants?

And what does it do?

A

Sibutramine (Meridia)

Lowers cholesterol and triglycerides: increases metabolic rate

38
Q

What are some fat absorption inhibitors?

A

Orlistat (Xenical)

39
Q

What should be the daily calorie intake for men and women managing obesity?

A

1,000-1,200 kcal/day for women

1,200-1,600 kcal/day for men