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4 Cards in this Set
- Front
- Back
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1. Give an account on physiology of body weight regulation.
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*Control of appetite: substances that increase or decrease appetite by acting on hypothalamus
-Subtances that increase appetite: Neuropeptide Y, orexene, opioids -Substances that decrease appetite: dopamine, GABA, serotonine, gherlin -Increased sympathetic stimulation of hypothalamus by adrenalin and noradrenalin could have both effects *Role of leptin: produced from adipose tissue so increased adipose tissue mass increases leptin. Acts on hypothalamus and decreases appetite. Obese patients develop leptin resistance *Role of gherlin: produced from stomach. Stimulates secretion of growth hormone which increases appetite and causes weight gain. -Levels of gherlin increase in: starvation, fasting, anorexia -Levels of gherlin decrease in: periods of feeding In obesity (high BMI) gherlin level is low. Gherlin increases as BMI decreases |
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2. Give short notes on complications of obesity.
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*Cardiovascular: -Widespread atherosclerosis causing ischemic heart disease, peripheral vascular disease, cerebrovascular disease
-Hypertension -Varicose veins -Cardiomyopath *Increased insulin resistance and type 2 diabetes mellitus *GIT:-Nonalcoholic fatty liver, nonalcoholic steatohepatitis -Hiatus hernia -Increased incidence of gall bladder stones *Musculoskeletal: -Osteoarthritis -Back strain *Respiratory: -dyspea due to restrictive lung effect -Sleep apnea *Hyperlipedemia *Menstrual and fertility abnormalities *Increased incidence of certain malignancies (breast, colon) *Psychological: may lead up to depression |
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3. Give short notes on non-pharmacological management (life style measures) of obesity.
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Diet, Exercise and Behavioral therapy.
*Diet: -Low caloric intake to decrease energy intake below expenditure -The aim is to reduce body weight by 10% over 6 months (1- 1.5 kg/week) -Weight loss is rapid in 1st 3-4 weeks due to loss of glycogen, protien breakdown and high metabolic rate with high fat content *There are two types of diet: -Very low calorie diet: 400-600 kcal/ day. For rapid weight loss over short period of time 1-2 months. Contraindications include: pregnancy, hepatic disease, myocardial infarction, uncontrolled psychiatric illness and cerebrovascular disease. -Low calorie diet: >800 kcal/ day. Can be used for long duration with no contraindications Diet should contain adequate amounts of proteins, vitamins and trace elements. *A 1000 kcal/ day diet should include: -100 g (50%) complex carbohydrates as fruits and vegetables, rather than simple sugars -50 g proteins -40 g fats *Exercise: Aim is to increase energy expenditure above intake. Should be introduced gradually and under medical supervision * Behavioral therapy: -Educate patient about right way of therapy -Teach patient the hazards of overweight -Help patient to adhere and complete therapy course |
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4. Give short notes on indications of surgery.
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*Morbid obesity defined as BMI>40 kg/m2
*BMI of 35 kg/m2 with associated co-morbidities *Repeated failure of life style measures and medical methods. |
