essay 6 - obesity - definition, types, pathogenesis

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Last updated 9:03 AM on 6/12/26
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4 Terms

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what is obesity

  • defined as excessive accumulation of body fat due to an imbalance between energy intake and expenditure

  • a BMI of >/= 30 kg/m² is considered obesity

  • obesity has negative effects on health and is related to decreased life expectancy and or health problems such as heart disease, kidney disease, hypertension and type 2 diabetes

  • factors leading to obesity are lifestyle choices, genetics and environment

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types of obesity based on etiology

  1. primary obesity

  • alimentary = due to excess caloric intake

  • regulatory = hypothalamic dysfunction e.g leptin resistance

  • metabolic = decreased BMR or defective lipolysis

  1. secondary obesity

  • endocrine = hypothyroidism, Cushing’s syndrome, PCOS

  • Iatrogenic = corticosteroids, antidepressants, anti-psychotics (clozapine)

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types of obesity based on location

  1. Central obesity

  • fat accumulates in abdominal region around internal organs

  • strongly associated with insulin resistance, metabolic syndrome, type 2 diabetes and cardiovascular disease

  1. peripheral obesity

  • fat accumulates in hips, thighs and buttocks

  • metabolically less harmful, lower risk of metabolic syndrome

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pathogenesis of obesity

  1. energy imbalance = excess energy stored in adipose tissue as triglycerides

  2. neurohormonal regulation = the hypothalamus integrates signals controlling hunger and satiety. Leptin, secreted by adipocytes, normally reduces appetite and increases energy use, but many obese individuals develop leptin resistance, so appetite suppression fails. insulin also contributes by acting on hypothalamic receptors; in obesity, insulin resistance impairs this regulation

  3. adipocyte hypertrophy, hyperplasia and dysfunction = with persistent caloric surplus, adipocytes enlarge (hypertrophy) and multiply (hyperplasia). Hypertrophied adipose tissue behaves as an endocrine organs, releasing excess pro-inflammatory cytokines. this shift promotes inflammation and reduces insulin sensitivity

  4. insulin resistance = increased free fatty acids and inflammatory mediators impair glucose uptake in skeletal muscle and increase hepatic glucose output, setting the stage for insulin resistance and type 2 diabetes

  5. metabolic and cardiovascular consequences = over time, this increases the risk of type 2 diabetes mellitus, coronary artery disease, stroke, non-alcoholic fatty liver disease and certain cancers