B5-013 CBCL: Obesity Flashcards by Felicia Jones

excess body weight compared to set standards

overweight

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specific to having an abnormally high proportion of body fat

obesity

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calculation of BMI

weight (kg)/height (m)^2

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BMI of 30-34.9

what class of obesity

Class I

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BMI of 35.0-39.9

what class of obesity

class II

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BMI of 40+

what class of obesity

class III

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fat stored in the […] is more harmful and associated with heart disease or diabetes

abdomen

apple shaped

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fat under the skin that lines the entire body

subcutaneous fat

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the fat in the abdomen below the intra-abdominal wall, most linked to metabolic and CV disease

omental/visceral fat

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fat stored in the wrong places

ectopic fat

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abnormal retention of lipids in a cell

steatosis

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larger fat cells lead to increased

inflammation

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gastric restrictive operations help people lose weight by

producing early satiety
decreasing appetite

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in order for a gastric restrictive operation to be successful, the patient must also

restrict calorie intake

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a reduction of […]% of initial body weight reduces the risk of diabetes in an at risk person

5-10%

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inhibits gastric and pancreatic lipases

orlistat

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which weight loss medication causes steatorrhea

orlistat

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the rate of heritability of BMI ranges from

40-70%

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less than […]% of individual variation in BMI and adiposity traits can be accounted for by over […] indentified loci

5%
300

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insulin secretion in the fasting and fed states increases linearly with

BMI

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main cell type found in human adipose tissue

white adipocytes

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energy yielding TGs and cholesterol ester are stored in

intracellular lipid droplets

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leptin, adiponectin, and adipokines are secreted by

white adipocytes

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when are medications indicated to treat obesity?

after 6 months of diet/exercise fail
BMI greater than 30 OR
greater than 27 with 2 comorbid conditions

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when is bariatric surgery indicated?

* after 6 months of diet/exercise fail * patients with BMI > 40 OR * greater than 35 with 1 serious comorbid condition

elevated waist circumference increases the risk of

hyperlipidemia hyperinsulinemia atherogenesis

abdominal waist circumference | differentiate men and women

men >40 women > 35

waist circumference corresponds with [...] fat

abdominal visceral

what type of fat is more metabollically active and releases FFA into the portal system?

visceral

successful common behaviors among weight loss maintainers | 2

* frequent weighing * 60+ min of exercise a day

AT browning can be achieved by

diet and exercise

the "fat but fit" hypothesis can be attributed to an increase in...

AT browning

brown adipocytes are differentiated primarily by the expression of

UCP1

phenomenon of fat stored in the wrong places is called

ectopic fat deposition

where is ectopic fat commonly distributed?

* heart * liver * skeletal muscle * visceral adipose

BMI calculation

weight (kg)/m2

which surgical option provides the best chance of long term weight reduction with the least morbidity?

small pouch gastric bypass

which intervention has been shown most likely to produce a weight loss of 4-7 kg over a 12 month period?

high intensity intervention visits | 12-26/year

orlistat is associated with a [...]% reduction in body weight

3-4

more important for maintenance of weight loss rather than active weight loss

exercise

diet composition is generally less important than

total calories consumed

current dietary recommendations include a balanced diet with a negative caloric balance of

500-1000 kcal/d

what amount of weight loss/ week is optimal?

1-2 lbs per week

weight loss is typically regained following the cessation of [...] therapy

pharmacologic

how many off the NCEP-ATP III criteria does a patient need to have to have metabolic syndrome?

what should be done to evaluate for DM and impaired glucose tolerance?

fasting glucose and glycosylated hemoglobin

least invasive and safest weight loss surgery

gastric banding

why is gastric banding less commonly used in the US?

concerns about efficacy and high reoperation rates

predictors of the risk of developing metabolic and CVD | 3

body composition fat distribution adipose tissue function

among equally overweight individuals, the amount of [...] is predictive of increased risk of cardiometabolic disease

visceral fat

most common cause of obesity

simple exogenous

consuming more calories than are used, which are then stored as fat

exogenous obesity

adipocyte hypertrophy is due to

increased triglyceride storage

a moderate weight loss is likely to be associated with selective loss of

visceral fat

the majority of patients with obesity exhibit an impaired expandability of

subcutaneous adipose tissue

a sequence of pathogenic factors causing impaired adipose tissue function can be initiated by

impaired expandability of subcutaneous adipose tissue

BMI does not take into account

body fat distribution or distinguish lean mass from fat mass

the association of obese patient with systolic heart failure or post percutaneous coronary intervention having a better prognosis is called

the obesity paradox | only exists as a function of BMI

while visceral fat is positively associated with CVD risk, subcutaeous fat accumulation is

modestly/negatively related to cardiometabolic and mortality risk

the obesity paradox does not exist when what indices are used over BMI? | 2

waist circumference waist hip ratio | indicates limitations of BMI as obesity index

well-established independent predictor of CVD risk and total mortality

fitness

having good fitness levels reduces mortality risk by | %

44%

in the presence of metabolic abnomalities, there is an increased risk of CVD in | normal or obese individuals

both normal and obese individuals

why is BMI problematic in predicting CVD risk?

does not account for central adiposity

strong predictor of the insulin resistant obese phenotype

macrophage infiltration into omental adipose tissue

could represent the mechanistic link between adipose tissue dysfunction and whole body insulin resistance

macrophage infiltration into adipose tissue

UCP1 is a marker of

browning

causes muscle cells to secrete a molecule than can induce a thermogenic gene program in cells

PGC1-a

what is the most changeable aspect of adipocyte cellularity?

size

weight loss from caloric restriction increases the [...] and decreases [...]

internal drive to eat total daily energy expenditure

dieting lowers resting metabolic rate, which causes an overall reduction in

caloric expenditure | upregulates drive to eat

dieting upregulates the internal drive to eat, which can cause

regression

B5-013 CBCL: Obesity Flashcards

(72 cards)