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RE > Physiology of appetite and weight > Flashcards

Physiology of appetite and weight Flashcards

1
Q

Food intake should = what?

A

Energy expenditure

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2
Q

What is the average amount of calories needed per day?

A

Women - 2000
Men - 2500

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3
Q

How many calories per gram are in carbs, fat and proteins?

A
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4
Q

What are the parameters for BMI?

A
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5
Q

What is a more accurate parameter for healthily weight in asians?

A

Waist circumference

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6
Q

What are the hunger hormones in the stomach called?

A

Ghrelin

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7
Q

What is the name of the axis in the GI tract that generates neuronal and hormonal signals of hunger?

A

Gut-brain axis

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8
Q

What are the satiety hormones?

A

Peptide YY in gut
Cholecystokinin
Leptin in fat tissues

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9
Q

Where is the feeding centre in the brain?

A

In the lateral nuclei of the hypothalamus

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10
Q

Where is the satiety centre in the brain?

A

Ventromedial nuclei of the hypothalamus

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11
Q

Lesions in which parts of the hypothalamus can affect appetite and feeding?

A

Paraventricular nuclei
Dorsomedial nuclei
Arcuate nuclei

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12
Q

What does anorexigenic mean?

A

Something that causes a loss of appetite

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13
Q

What does orexigenic mean?

A

Something that causes an increase in appetite

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14
Q

Which molecules can decrease feeding (anorexigenic)?

A
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15
Q

Which molecules can increase feeding (orexigenic)?

A
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16
Q

How does Ghrelin affect appetite?

A

Ghrelin interacts with AGRP neurons –> produce agouti related protein and neuropeptide Y.
AGRP stimulation increases food intake.

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17
Q

How is POMC involved in appetite?

A

Insulin/Leptin/CCK interact with POMC neurons. POMC produces a-MSH (Melanocyte stimulating hormone) and cocaine and amphetamine-regulating transcript (CART).
POMC stimulation decreases food intake.

18
Q

How does a-MSH affect appetite regulation?

A

a-MSH (Melanocyte stimulating hormone) stimulates neuronal melanocortin receptors (MCR-3 and MCR-4) which then increases energy expenditure.

19
Q

How does AGRP affect appetite regulation?

A

AGPR is an antagonist to MCR-4. MCR-4 is stimulated by a-MSH and increases energy expenditure.
AGRP prevents this increase in energy expenditure.

20
Q

Which hormones can block AGPR?

A

Insulin
Leptin
CCK

21
Q

Which neuronal mutations have been linked to obesity in children?

A

POMC
MCR-4

22
Q

What affects satiety?

A

Meal quality
Meal quantity
Nutritional status
Energy balance

23
Q

Where is leptin produced and expressed?

A

Produced in adipose cells
Expressed in white adipose tissue

24
Q

What is the function of leptin?

A

Regulates energy homeostasis - provides energy storage signal to hypothalamus.
Neuroendocrine functions, metabolism and immune functions

25
Q

A deficiency of leptin in mice led to what?

A

obesity

26
Q

Does increased amounts of adipose tissue produce more of less leptin?

A

More

27
Q

What effect does leptin receptor stimulation have on fat?

A

It decreases fat storage.

28
Q

Which factors override the effect of increased adipose leptin in the regulation of food intake?

A

Society and culture

29
Q

Above which BMI is someone considered morbidly obese?

A

> 40

30
Q

Which genetic syndromes are associated with obesity?

A

Prader-Willi
Bardet-Biedl

31
Q

Which neuroendocrine disorders can cause obesity?

A

Hypothalamic lesions
Cushing’s syndrome
Hypothyroidism

32
Q

How much weight should those with obesity aim to lose?

A

10%
0.5-1kg per week

33
Q

What is the MOA of lipase inhibitors?

A

Inhibits lipases in the lumen of the gut.
It prevents the hydrolysis of dietary fat inso absorbable FFAs/glycerol.

34
Q

What are the adverse effects of lipase inhibitors?

A

Flatulence, oily faecal leakage, diarrhoea.
Reduction in the absorption of fat soluble vitamins - ADEK

35
Q

Which drug is a lipase inhibitor?

A

Orlistat

36
Q

What is the MOA of GLP-1 agonists?

A

Stimulates POMC to reduce hunger, energy intake and food cravings.
Inhibits AGRP to increase satiety.

37
Q

What are the side effects of GLP-1 agonists?

A

Pancreatitis

38
Q

What is an example of GLP-1 agonists?

A

Liraglutide
Semaglutide

39
Q

What are the pharmacological treatments for obesity?

A

Lipase inhibitors
GLP-1 agonists

40
Q

What are the different tiers of weight management?

A

Tier 1 - Universal services
Tier 2 - Lifestyle management
Tier 3 - Specialist management. Assessment for surgery, medications.
Tier 4 - Pre-op assessment

41
Q

What are the advantages to bariatric surgery?

A

25-20% weight loss
Life-long treatment cost savings
Improve co-morbidities

RE (18 decks)

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