obesity

Question 1

define obesity

Answer 1

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

Question 2

what is a measure of obesity?

Answer 2

BMI

Question 3

how do you measure BMI?

Answer 3

weight (kg)/square of height in metres

Question 4

why is waist circumference used as an indicator of obesity?

Answer 4

helps distinguish muscular people

Question 5

when was the sugar tax introduced and why?

Answer 5

• Evidence suggests that sugar-sweetened beverages is an important contributor to the development of obesity in some individuals
• Hence the sugar tax which started in April 2018

Question 6

what are the 2 bands of the sugar tax?

Answer 6

o Drinks with >5g of sugar per 100ml

o Drinks with >8g per 100ml.

Question 7

what medications can contribute to weight gain?

Answer 7

Mood Stabilizers, Diabetes Medicines, Corticosteroids, Beta Blocker, Allergy Relievers, Drugs That Prevent Seizures and Migraines

Question 8

how does insulin make you gain weight?

Answer 8

• Insulin inhibits breakdown and release from the fat cells
• Decreases the rate of lipolysis in adipose tissue (lowers plasma fatty acid level)
• Stimulates fatty acid and triacylglycerol synthesis in tissues
• Increases uptake of triglycerides from the blood into adipose tissue
• Decreases the rate of fatty acid oxidation in muscle and liver
• Lipohypertrophy: Enlargement of fat cells local to where the insulin is injected

Question 9

what is syndromic monogenic obesity characterised by?

Answer 9

mental retardation, dysmorphic features and organ specific abnormalities in addition to obesity

Question 10

why is the primary cilium important?

Answer 10

has a key role in the differentiation of adipocytes

Question 11

what are the genetics of non-syndromic monogenic obesity?

Answer 11

currently 12 genes have been identified to date that have roles in energy maintenance as part of the leptin-melanocortin pathway

Question 12

if you are apple shape how much visceral fat do you have? what is your risk of health problems?

Answer 12

More visceral fat

o Higher risk of weight-related health problem

Question 13

if you are pear shaped then how much visceral fat do you have? what is your risk of health problems?

Answer 13

less

less risk of weight-related health problems

Question 14

what is obesity a major risk factor for?

Answer 14

• cardiovascular diseases
• pulmonary diseases (such as sleep apnoea)
• metabolic diseases (diabetes & dyslipidaemia)
• osteoarticular diseases
• for several of the commonest forms of cancer
• for serious psychiatric illness

Question 15

what are medical complications of obesity?

Answer 15

• Pulmonary disease – obstructive sleep apnea, abnormal function
• Stroke, Cataracts, Idiopathic intracranial hypertension
• Non-alcoholic fatty liver disease – steatosis, steatohepatitis, cirrhosis
• Gall bladder disease, Osteoarthritis, Gout, Phlebitis, Cancer, Severe pancreatitis

Question 16

what are key features of obesity in T2D?

Answer 16

• Chronic inflammation
• Altered adipokine levels (high level of leptin)
• Breakdown of fat metabolism (accumulation of lipids in the tissue)
• Breakdown of the regulation of glucose metabolism

Question 17

what is non-alcoholic fatty liver disease?

Answer 17

build up of fat in the liver

Question 18

who usually develops NAFLS?

Answer 18

• Usually seen in people who are overweight or obese.
• Also associates with high cholesterol / high BP / T2D.
• Estimated to affect up to 5% of the UK population

Question 19

what is the best treatment for obesity?

Answer 19

prevention through educate and to develop a non-obesogenic environment

Question 20

what drug treatments are there for obesity and how do they work?

Answer 20

Lipase inhibitor - Reduces the amount of fat absorbed from food eaten. Main prescribed treatment.

Question 21

what must happen before you have surgery for weight loss?

Answer 21

• no one gets surgery without undertaking a weight management course where they’re taught about nutrition, fitness and exercise

Question 22

how is weight loss surgery performed?

Answer 22

laparoscopically

Question 23

who gets weight loss surgery?

Answer 23

o Morbid obesity (BMI >40 kg/m2)
o BMI >35 kg/m2 AND obesity-related complications
o (after conventional medical treatments have failed)

Question 24

what types of surgeries can you get for weight loss?

Answer 24

restrictive procedures
malabsorptive procedures
restrictive + malabsorptive procedures

Question 25

what can malabsorptive procedures cause?

Answer 25

Causes nutrient deficiencies, malnutrition and, in some cases, anastomotic leaks and the dumping syndrome – (rapid gastric emptying)