obesity pathophys

Question 1

physiologic response to weight gain

Answer 1

increased leptin secretion (promotes satiety and increases energy expenditure)
insulin increases
suppression of orexigenic hormones (ghrelin- promotes hunger)

Question 2

physiologic response to weigh loss

Answer 2

decreased leptin and insulin levels
increased ghrelin
reduced energy expenditure
persistent hormonal changes

Question 3

set point theory

Answer 3

the body resists changes in weight through hormonal and metabolic adjustments

Question 4

obesity induced morbidities

Answer 4

HF
HTN
CAD
gallstones
cancer
DM
osteoarthritis
dyslipidemia
depression
sleep apnea

Question 5

MOA- catecholamine release
appetite suppression (increase NE and DA release in hypothalamus)
adipose tissue lipolysis

Answer 5

sympathomimetic amines:
phentermine (adipex)
phentermine + topiramate (qsymia)
diethylpropion
phendimetrazine

Question 6

MOA- DA and NE reuptake inhibitor
opioid antagonist
reduces appetite by inhibiting the endogenous opioid beta-endorphin

Answer 6

naltrexone + bupropion (contrave)

Question 7

MOA- inhibits pancreatic lipase
prevents hydrolysis of TG into free FA and monoglycerides

Answer 7

orlistat (alli, xenical)

Question 8

MOA- prevents glucose reabsorption in kidneys and increases water excretion

Answer 8

SGLT2:
dapagliflozin
canagliflozin
empagliflozin

Question 9

MOA- increases satiety
increases insulin release
delays gastric emptying

Answer 9

GLP1:
liraglutide (saxenda)
semaglutide (wegovy)
tirzepatide (zepbound)