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.