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MET2 > 14 - Obesity > Flashcards

14 - Obesity Flashcards

1
Q

What is obesity (WHO0

A

abnormal or excessive fat accumulation sufficient to adversely affect health and reduce life expectancy

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2
Q

How to work out BMI

A

weight (kg)/ height(metres)2

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3
Q

Underweight BMI

A

<18.5

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4
Q

Normal weight BMI

A

18.5 - 24.9

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5
Q

Overweight BMI

A

25 - 29.9

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6
Q

Obese BMI

A

30 +

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7
Q

Morbidly obese BMI

A

40+

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8
Q

Why take waist circumference

A

Helps to distinguish between muscular and obese people

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9
Q

Contributing factors to obesity

A

Sugar-sweetened bevarages
Increased food intake
Less exercise

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10
Q

Medication that can cause weight gain

A 
Mood stabilizers
Diabetes medicine
Corticosteroids
Beta blockers
allergy relieverss
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11
Q

Why does insulin cause weight gain

A

Inhibits breakdown and decrease from fat cells

  • Decreases rate of lipolysis in adipose
  • Stimulates triacylglycerol synthesis
  • Increases uptake of triglycerides from blood to adipose
  • Decreases rate of FA oxidisation
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12
Q

What is lipohypertrophy

A

Enlargement of fat cells where insulin is injected

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13
Q

Which T2D drugs increase weight

A

Insulin, Sulfonlyureas, TZD (pparg stimulates adipogenesis and uptake)

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14
Q

Which T2D drugs have no effect on weight

A

Metformin, DPP IV inhibitors,

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15
Q

Which T2D drugs decrease weight

A

SGLT-2 Inhibitor

Acarbose

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16
Q

Heritability of obesity

A

> 0.70

higher than HT (0.29) and depression (0.50)

17
Q

Neel’s thrifty gene hypothesis

A

Obesity is more prominent in black and South Asian population

18
Q

Syndromic Monogenic Obesity

A

Rare group of 30 sydromes

- Also causes mental retardation, dysmorphic features and organ specific abnormalities

19
Q

Bardet-Biedl + Alstrom syndrome

A

Ciliopathy

  • Cilium has a role in differentiation of adipocytes
  • Obesity - defect in adipogeneseis
20
Q

What receptor signalling does Cilia mediate

A

Leptin receptor signalling

LEPR

21
Q

Non-syndromic monogenic obesity

A

Single gene disorder that leads to highly penetrant form of obesity
12 genes identified with roles inthe leptin-melanocortin pathway

22
Q

Polygenic obesity

A

Using genome wide association

227 genetic variants

23
Q

Causes of adipocyte differentiation

A

Ciliopathies

Mutations in PPARy2 (peroxisome-proliferator-activated receptor gamma 2)

24
Q

What is PPARy2 and what drug targets it

A

TF that has a role in adipocyte differentiation

Targeted by thiazolidinedione druge

25
Q

What sort of organ is adipose tissue

A

Bonafide endocrine organ

26
Q

Brown adipose tissue

A

Site of adaptive thermogenesis

Activity associated with protection against obesity + metabolic disorders

27
Q

How are obesity and t2d linked

A

Chronic inflammation –> altered adipokine levels (high leptin levels) –> Breakdown of fat metabolism –> breakdown of regulation of glucose metabolism

28
Q

Phentermine

A

NE (norepinephrine ) transport inhibitor
Appetite suppressor
Activates POMC

29
Q

Olistat

A

Lipase inhibitor (decreases the amount of fat absorbed) - mainly prescribed in the UK

30
Q

Lorcaeserin

A

Selective 5-HT agonist

Promotes satiety

31
Q

Liraglutide

A

GLP-1 agonist

Decreases appetite

32
Q

When can you be referred for surgery for obesity

A

if morbid obese (BMI >40)

or BMI >35 and obesity related complications

33
Q

Restrictive procedures

A

Restrict the ability to eat

Adjustable gastric banding, vertical banded gastroplasty

34
Q

Malabsorptive procedures

A

Reduces ability to absorb nutrients
Nutrient deficiencies
Malnutrition

35
Q

Restrictive plus malabsorptive procedures

A

Duodenal switch
Roux-en-Y
gastric bypass

MET2 (28 decks)

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