Obesity Flashcards
(33 cards)
What is the definition of Obesity?
Obesity is the deposition of excess fat in the body and is caused by ingestion of greater amounts of food than can be utilised by the body as energy.
Imbalance between food consumed and exercise taken
High
Where is fat stored?
Adipose tissue / fat tissue
What happens to excess carbohydrates?
Stored as glycogen in the liver and muscle
Effects of obseity (2 x)
Physical changes due to increased mass of fatty tissue
Changes at cellular and metabolic level due to increased production of various products by enlarged fat cells, e.g. inflammatory mediators, cytokines
Anthropometry
Used t assess and predict performance, health and survival of individuals and reflect the economic and social well being of populations
Widely used, inexpensive, non-invasive measure of the general nutritional status of an individual or population group
Commonly used anthropometry assess:
Height/weight chart
BMI
Key
Weight for age
Weight for height
Height for age
Mid upper arm circumference
Definition of obesity (Ref)
A disorder of excess body fatness that is associated with an increased risk of disease (WHO, 2000)
Based on BMI score
BMI score - how calculated?
weight in kilograms divided by height in meters squared
Classification of underweight, normal weight, overweight
<18.5 18.5-24.9 >25 25-29.9 Pre obese 30-34.9 Class 1 Obese 35.0-39.9 class 2 Obesity >40 Class 3
Relevance - stats - worldwide
> 300 million adults worldwide
Assoc with reduced qual of life and health issues
Enormous public health issue with serious physical, psychological and social effects on the population
Relevance - stats - UK
In 2015, 58% of women and 68% of men were overweight or obese
Obesity prevalence increased from 15% in 1993 to 27% in 2015
In 2015/16, over 1 in 5 children in reception and over 1 in 3 children in year 6 were measured as obese or overweight
In 2015/16 there were 525,000 admissions where obesity was recorded as a factor
Bariatric surgery - 3/4 patients were 35-54, 3/4 were female
Aetiology of Obesity
Energy imbalance - increased food/ calorie intake and reduced physical activity
Medications - steroids, antipsychotics, some antidepressants, contraceptives, valproate
3 x metabolic factors predictive of weight gain:
Low adjusted sedentary energy expenditure
High respiratory quotient (carbohydrate to fat oxidation ratio)
Low levels of spontaneous physical activity
Relevance - obstetric perspective
Prevalence of maternal obesity carries significant maternal risk to child and mother
Practical difficulties with examination can cause knock on problems
Make ventilation and intubation difficult - failed intubation is the leading cause of maternal death in relation to anasthesia
++ so much info in lectures
Health consequences
Increased risk
Reduced quality of life
Chronic inflammation
Presence and clustering of cardiovascular and metablic risk factors
Fatty liver
Asthma exaccerbations
Long term persistence
Poor long term educational and economic attainment
Increased risk of poor psychosocial health
MH Relevance?
Those diagnosed with severe and enduring mental illnesses such as schizophrenia and bipolar disorders are at increased risk for a range of physical illnesses and conditions including coronary heart disease, infections, respiratory disease and obesity
2 x likely to die from coronary heart disease
4x more likely to die from respiratory disease
/in many cases, weight gain is a clear side effect from
LD Relevance?
Obesity is unusually high, increased risk of heart diease, t2 diabetes etc…
Genetic - Down’s syndrome and Prader-Willi syndrome
prevalnce of obesity amoung adults (reference)
Health Survey for England 2012-2014:
Overweight:
Almost 7/10 men are overweight or obese (66.4%)
Almost 6/10 women are overweight or obese (57.5%)
Obese:
One in 4 men is obese (24.9%)
One in 4 women is obese (25.2%)
Trend - obesity is increasing in the population
It is widely recognised that obesity increases the risk of…?
- All causes of death at any given age
- Coronary heart disease, stroke, hypertension hyperlipidemia, and type 2 diabetes
- High LDL cholesterol or low HDL cholesterol
- Sleep apnoea
- Breast, endometrial, ovarian, liver and colon cancer
- Gallbladder disease
- Musculoskeletal disorders / osteoarthiritis
- Infertility
- Non alcoholic liver disease
- Pain and difficulty with physical functioning
Indirectly related to MH - low SE, anxiety, clinical depe
Impact of Obesity on Major Body Systems…
Circulatory System!
- Blood Pressure
. More fatty tissues mean more circulatory blood is required to perfuse tissues. This increases the workload of the heart and puts more pressure on the artery walls.
Obesity can therefore raise heart rate and reduce ability to transport blood through the vessels.
Strong relationship between Obesity -> Hypertension
Hypertension is a risk factor for CHD, stroke and renal failure
High BP damaged nephrons
Cardiovascular lecture - artherosclerosis
Risk of deep vein thrombosis and pulmonary embolisms also increased
**HIGH BLOOD PRESSURE ** shear stress damages inner lining of arteries - narrows and hardens.
If arteries narrow - red cells bump into lumen, break up RBC fragments (schistocytes)…can travel and cause damage
Heart Disease - ARTHEROSCHLEROSIS is present 10 x more often in obese people compared to non obese
CORONARY HEART DISEASE due to more fatty deposits in arteries that supply the heart.
Narrowed arteries and reduced blood flow to the heart can cause chest pain (stable or non-stable angina) or an myocardial infarction (ST elevation or non-ST elevation)
Subsequent blood clots can cause stroke or pulmonary embolism
Impact of Obesity on Major Body Systems…
Circulatory System!
- Diabetes
DIABETES - obesity as major cause
Occurring more in children
Causes insulin resistance (pancreas doesn’t produce enough or body reacts unusually to insulin) blood sugar levels become elevated
Even moderate obesity dramatically increases the risk of diabetes
Sugary environment - good for bacteria, increases infection
How? Abdominal fat causes fat cells to release ‘pro-inflammatory’ chemicals, which disrupts function of insulin responsive cells.
Normal health - glucose via glucose transporters, these transport glucose by diffusion down concentration gradients
Glut4 receptor - allows glucose to enter cells, activated by insulin
Insulin resistance in fat cells is associated with decrease glut4 transporter number and activity.
Acanthosis Nigricans - dark patches caused by poor perfusion due to elevated glucose in bloodstream
Impact of Obesity on Major Body Systems…
Joints
Including osteoarthrosis
Non-inflammatory joint disease characterised by degeneration of the joint cartilage
Obseity can affect kneews and hips because of the stress placed on the joints by extra weight
Joint replacement surgery, while commonly performed on damaged joints, may not be an advisable option because artificial joint has a higher risk of causing further damage.
Impact of Obesity on Major Body Systems:
Gastro
Asthma - Inflammatory mediators
Independent reading? Relationship between obesity & service user outcomes…?
Obesity assoc. with increased risk of gastro-oesophageal reflux
Due to direct abdominal pressure on diaphragm
Acid in trachea
Aspiration luminitis/?
