Obesity

Obesity

Normal
1. physiology of appetite
  1. Feeding
    1. LNH
    2. DMN
    3. NPY-AGRP in Arcuate
    4. if these centers increased activity
      1. Obesity
  2. Satiety
    1. VMH
    2. PVN
    3. Pro-opimelanocortin Neurons in Arcuate
      1. if there is decreased activity
        Obesity
causes
1. Genetic
  1. Leptin Deficiency
  2. leptin receptor mutation
  3. POMC mutation
  4. mutation in MC4R
2. Environmental
  1. Sedentary Life Style
  2. Familial Influences
  3. High Calorie food
  4. Cultural Influences
management
1. Pharmacological
  1. drug therapy
    1. Orlistat
  2. Surgery
    1. Bariatric Surgery
  3. Euqropian Guidelines
2. Non-Pharmacological
  1. Diets
    1. Aktins diet
    2. Nutrisystem
    3. Bevery hills diet
complications
1. osteoarthritis
2. Diabetes
3. CVS diseases
4. Metabolic Syndrome
  1. WHO Definition
    1. Insulin Resistance
      1. + 2 of these 4
        +Triglycerides
        +BMI
        Antihypertensive medication
        -HDL
  2. IDF Definition
    1. Central Obesity
      1. + 2 of these 4
        +Triglycerides
        - HDL
        +fasting Glucose
        +BP(>130SP)
5. Non-alcoholic fatty liver disease
  1. Lab investigations of obesity and liver disease
    1. +HCO3
      1. +Glu Fasting
        +AST
        +ALT
    2. +Hb
      1. +Hct
        +Cholesterol
        +LDL
    3. -HDL
      1. +Triglycerides
        -Uric Acid
Epidemiology
1. affects 43 million pre-school children
  1. nearly 30% of the world are obese
2. UAE is number 4 in obesity rates
  1. USA is the most obese Country
behavioral therapy
1. self-monitoring
  1. Stimulus Control
    1. Goals Settings
2. Education
  1. Slower Eating
    1. Behavioral contracting

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