Zusammenfassung der Ressource
obesity
- definition: increase in
body fat
- epidemiology
- The prevalence of overweight among
children and adolescents aged 5-19 has risen
dramatically from just 4% in 1975 to just
over 18% in 2016.
- Once considered a high-income country problem, overweight and
obesity are now on the rise in low- and middle-income countries.
In Africa, the number of overweight children under 5 has
increased by nearly 50 per cent since 2000.
- clarifying
terms:
- Hunger
- Craving for food (need to eat) Associated with other physiological factors
e.g release of ghrelin, rhythmical contractions of stomach. Seeking an
adequate food supply.
- appetite
- desire for food *not associated with hunger*
and associated with sensory control like smell,
sight...
- satiety
- feeling full after a
meal
- starvation
- depletion of food and energy in
our body
- physiology
- vagal nerve ascending tract receives inputs from GI and adipose tissue then goes to
NTS in brain stem then to dorsomotor nucleus in medulla where they become
integrated into arcuate nucleus in hypothalmus
- then arcuate nucleus have 2 set of neurons: anorexigenic neuron ex: POMC THAT Releases CART AND
ALPHA-MSH that will bind to MC receptor located in Paraventricular nucleus.
- then impulses will travel into feeding center in hypothalmus which is Lateral nucleus of hypothalamus
- then to efferent tract of vagus nerve and then to adipose tissue or
GIT
- but for satiety it follows the same path but they have orexogenic neuron that will release
neuropeptide Y and AGRP that will stimulate satiety center in hypothalamus.
- this pathway is also regulated by
hormones
- Risk
Factors:
- modifiable
- lifestylle
- Social and economic issues.
- Unhealthy diet.
- Pregnancy.
- medications
- cortisol
- anti-seziures
- anti-depressants
- oral contraceptive
drugs
- non-modifiable
- genetics
- age
- causes
- Complications of
obesity
- NASH/NAFLD=cirrhosis=liver failure…
- Investigations of
NAFLD/NASH
- Blood tests: aspartate aminotransferase [AST] and
alanine aminotransferase [ALT] are elevated
- Imaging procedures: ultrasound, CT scan, [MRI]) may reveal
fat accumulation in the liver
- Liver biopsy: determine the severity of
inflammation, detect liver scarring , provide
clues about the future course of the
condition
- Pulmonary diseases (restrictive lung
disease)
- dyslipidemia
- hypertension
- Insulin resistence=diabetes type
2=diabetic fatigue
- Heart diseases
- Cancer
(Hepatocellularcarcinoma…)
- management
- pharmacology
- Orlistat
- Orlistat blocks the action of pancreatic lipase,
reducing triglyceride digestion and, thus,
absorption.
- Adverse effects include flatulence, fatty/oily
stool, increased defecation, and fecal
incontinence.
- Lorcaserin
- surgery
- Bariatric surgery
- Complications
- Indigestion and malabsorption
- gallstones
- Hair loss and dental problems
- Gastric
Banding