Obesity

Question 1

condition of excess adipose tissue relative to LBM

Answer 1

obesity

Question 2

how do we identify overweight and obesity?

Answer 2

BMI, WC

Question 3

health risks of overweight, obesity:

Answer 3

CVD, type 2 diabetes, non alcoholic fatty liver disease

Question 4

known causes of obesity explain ____% of cases

Answer 4

<1

Question 5

examples of known causes of obesity:

Answer 5

genetic syndromes (Prader-Willi), endocrine (Cushing’s), hypothalamic dysfunction (tumours), medications

Question 6

meds that cause obesity:

Answer 6

glucocorticoids, many psychiatric meds, insulin/thiazolidinediones/sulfonylureas

Question 7

genes influence:

Answer 7

appetite (leptin), susceptibility to hunger, taste preferences, level of disinhibition, REE (uncoupling proteins), TE of food, nonexercise activity thermogenesis, etc.

Question 8

early studies of gene influence vs current:

Answer 8

twins and adopted children; obesity gene variants

Question 9

assessing for risk of chronic disease steps:

Answer 9

assess BMI, measure WC, classify for disease risk, combine info with other risk determinants, FPG, lipid profile, liver enzymes, BP, assess for mood disorders

Question 10

major depression and mood disorders occur in ___% of women aged 40+ with BMI > 30 kg/m^2

Answer 10

20-60

Question 11

common barriers to wt loss?

Answer 11

all or nothing mindset, lack of time, loss of motivation, dislike exercise/disability, lack of knowledge, yoyo dieting, low self-efficacy, lack of personal interest

Question 12

3 components to lifestyle modification:

Answer 12

nutrition, physical activity, CBT

Question 13

behaviour modification techniques:

Answer 13

self monitoring, stimulus control, modify specific eating behaviours and stimuli, reinforcement management, also stress management

Question 14

successful wt loss maintenance defined as :

Answer 14

> 5% wt loss from baseline maintained 12 months

Question 15

why is deficit of 500 kcal/day=1-2 lb a week of wt loss a crude estimate?

Answer 15

assumes that it will be pound in fat (also losing water, protein structure supporting fat)

Question 16

obesity class 1 , 2, and 3 BMIs:

Answer 16

30-34.9, 35-39.9, 40+

Question 17

disease risk increased for women of WC > __ cm and men WC > ____cm

Answer 17

88; 102

Question 18

traditional meds for combating obesity

Answer 18

stimulants, orlistat, alternative treatments

Question 19

newer approaches combat obesity:

Answer 19

bariatric surgery, brain stimulation (transcranial direct stimulation)

Question 20

safety concerns for stimulants?

Answer 20

raise BP and HR

Question 21

this non-stimulant agent inhibits lipases in GI tract, prevents fat breakdown/absorp, minimal systemic absorption

Answer 21

orlistat (xenical)

Question 22

orlistat also improves;

Answer 22

lipid lvls and BG

Question 23

side effects of orlistat

Answer 23

flatus with discharge, oily spotting, fecal urgency, fatty oily stool, fecal incontinence, increased defecation, probs with vit absorption

Question 24

this class of drugs currently under investigation for wt loss, used for diabetes

Answer 24

GLP-1 receptor agonists (receptors for incretin hormones–stim insulin secretion; found on beta cells, glucagon-like peptide-1)

Question 25

examples of GLP-1 receptor agonists?

Answer 25

liraglutide and exenatide

Question 26

what does liraglutide do?

Answer 26

stim insulin secretion, inhibit glucagon release, delay gastric emptying, reduce food intake, normalize fasting and postprandial insulin secretion

Question 27

drug that died out cuz ^ suicides, CV events

Answer 27

rimonabant

Question 28

outcomes of taking liraglutide?

Answer 28

better HbA1c, reduce FBG, reduce fasting insulin, reduce BP

Question 29

serotonin receptor agonist that affects CNS and reduces appetite

Answer 29

locaserin

Question 30

diabetes meds that cause wt gain:

Answer 30

insulin, sulfonylureas (glyburide, gliclazide), glitinides (repaglinide, nateglinide)

Question 31

why do some diabetes meds ^ wt?

Answer 31

stimulate insulin release which is anabolic

Question 32

why was meridia taken off market?

Answer 32

cuz ^ MI

Question 33

to have metabolic syndrome, must have:

Answer 33

central obesity >94 and 80 for men and women + 2 of following 4: raised TG, reduced HDL, raised BP, raised FPG