Patho - Obesity

Obesity is best defined as

an excessive accumulation of fat in the body

Obesity contribues to

numerous chronic diseases

early mortality & morbidity

Most studies use one of three commonly accepted measures to define obesity of adults. Which of the following is not a typical accepted measure?

Volumetric scale

BMI < 18.5:

underweight

BMI 18.5-24.9:

normal

BMI 25.0-29.9:

overweight / preobese

BMI 30-34.9:

class 1

BMI 35.0-39.9

class 2

BMI ≥ 40.0

class 3

Waist circumference is used to determine

an individual’s measure of abdominal fat and to elucidate disease risk

Excess abdominal fat is a predictor of

cardiovascular disease

Waist circumference provides an independent prediction of risk beyond

BMI

Increased risk for premature death and disability when men have wait circumference

>40 in

Increased risk for premature death and disability when women have wait circumference

> 35in

Waist circumference has a

ceiling effect

Waist circumference is NOT linked to

hyperthyroidism

Waist to hip ratio is

Graded and highly associated w/ MI

Waist-to-Hip Ratio for women

85% of higher

Waist-to-Hip Ratio for men

90% or higher

Waist-to-Hip Ratio takes into account differences in

body conformation and distribution of adiposity

Obesity is considered

a pandemic

What is the global prevalence of obesity?

affects 300 million across the world

Obesity has begun to replace

other known causes of mortality

Obesity is second to _______ as leading cause of preventable deaths

cigarette smoking

What is the prevalence of obesity in the US?

65% of adults`

Over time obesity prevalence has

increased

Growth in percentage of people who are now overweight/obese is occurring across

all ages

___ % of children 2 to 5 are obese

13.9

____% of children 6 to 11 are obese

18.4

_____ of adolescents 12 to 29 are obese

20.6

There is a strong link between ______ and ______.

physical inactivity; body weight

Obesity is ultimately an imbalance between

energy intake and energy expenditure

What are known contributors to obesity?

inactivity and energy dense-diet

Which of the following is not a typical environmental factor of obesity?

INC cost of unhealthy food

Which of the following is not a risk factor of obesity?

low glycemic diet

Which of the following best explains how neuroendocrine dysfunction can affect body weight regulation?

It disrupts CNS signaling pws that regulate food intake & BW

Metabolic changes in which structure are associated with obesity?

hypothalamic-pituitary-adrenal (HPA) axis

Changes in the hypothalamic-pituitary-adrenal (HPA) axis results in all of the following except

fewer ATPase pumps

The metabolic events associated with obesity causes all of the following except:

decreased blood pressure

Energy Regulation Systems involves dysfunction of all of the following except

Ca2+ pumps

It is thought that individuals who are obese have

fewer ATPase pumps

Na+/K+/ATPase pump dysfunction resutls in individuals with obesity

utilizing less energy and expending fewer calories.

Chronic sleep deprivation is defined as

sleeping only 4-5 hours/24-hour cycle

Chronic sleep deprivation alters levels of

leptin and ghrelin

Leptin regulates

long-term food intake

Ghrelin stimulates

appetite

Increased wake time might lead to

increased calorie consumption

Which three leading causes of death is obesity associated with?

CVD, cancer, diabetes

Which type of diabetes is often associated with obesity?

type 2

Excessive food intake stimulates

hyperinsulinemia

Excess glucose in circulation is stored in one of two places:

Liver as glycogen

Fat as triglycerides

Obesity + DM results in

hypertrophy & hyperplasia of fat cells

Rising ____ rates and poor management of the disease are linked to obesity

asthma

Link to inability of the person with obesity to take a deep breath results in

reactive airways / asthma

Women with obesity may be more likely to develop

asthma

Functional impairments of obesity includes all of the following except

DEC risk for falls

Individuals with a BMI greater than 59 have been documented with

lymphedema

BMI of >59 is the threshold where

lymphatic flow becomes impaired

Why are the lymphatic concerns with BMI of 59 and above?

Lymphatic vessels become

compressed / inflamed

Women who are obese face high risk of developing health problems during

prenatal development

Complications of obesity include increased risk of all of the following except:

Brief labor

Maternal obesity linked to

higher risk of child developing obesity

Which of the following statements is not true about the other clinical manifestations of obesity?

Individuals will have no difficulty becoming pregnant.

What is key for the treatment of obesity?

prevention

prevention of obesity involves a combo of

healthy eating, reg PA, and maintaining healthy weight

A physcial exam of obesity should include all of the following except:

Assessment of body mechanics

In addition to BMI, Waist circumference, and waist-to-hip ratio, what are measurements can be used for obesity?

Skinfold measurements

Bioelectrical impedance analysis

In bioelectrical impedance analysis, greater fat mass =

Larger impedance

Commonly used BIA machines lack

reliability

What is a major aspect in treatment for the person who is obese?

weight loss

A 10% loss in body weight is regarded as

the standard that improves health (variable)

What are interventions used for weight loss?

regular exercise, support groups, dietary changes, weigh ins

What medications are used for the management of obesity?

OTC and prescription

Which of the following is not a goal of mediations for obesity?

increase appetite

Medications for obesity is Highly controversial and provides

short-term benefits

Medications for obesity should be paired with

exercise, diet, and behavior change

Which of the following is not a MOA for GLP-1 Receptor Agonists (Ozempic)?

Fast gastric emptying, making people feel fuller longer

GLP-1 Receptor Agonists (Ozempic) is a proven benefit for

Reduction in blood glucose levels.

WL

Prevention of metabolic diseases

Which of the following is not a criteria when bariatric surgery is considered?

Minor attempts have failed

What is the gold standard for obesity surgery?

Laparoscopic Roux-en-Y gastric bypass

Potential benefits of weight loss

Potential complications of weight loss

What deficiencies is associated with surgery for obesity?

vitamin and mineral

Obesity post-operative complications can include all of the following except:

Acute inflammation of UE

behavioral and lifestyle changes are the foundation of

prevention and intervention

While lifestyle programs are the most successful in creating durable change, it is still affected by

intrapersonal and environmental factors that are hard to control

Obesity requires a treatment that addresses

the person as a whole

Treatment confined to dietary measures alone

prognosis is not good

An incremental change like10-20lb decreased can provide

substantial changes in risk factors

Addition of exercise can reduce _____ fat to a greater degree than _______ fat loss.

visceral; subcutaneous

A relationship between obesity and back pain has

not been established

Severe obesity (BMI >40) is consistently link with

back pain

Increased odds ratio of 1.7 to 9.9 of work-restricting pain in

obese subjects as compared to general populatio

There is an association between

obesity and knee OA

NO association between

obesity and hip or general OA

Individuals with moderate and severe obesity have decreased

mobility

While not statistically associated, there is a trend for individuals with higher BMIs being unable to

complete static balance tests

Muscle has to apply greater force to move

a larger mass (make exercises more challenging)

Exercises that require lower VO2max may have

greater adherence

Exercise should be prescribed with

same principles as when prescribing for healthy individuals