Obesity

• عضلة lean mass


  Lean muscle mass
• دھوت


  Fat mass
• غالباً environmental
• وحدات وراثياً
• obesity:


  • If body fat
  • أطول) / وزن : BMI
  • 18 = under weight
  • 20-25 = normal
  • 25-300 ver weight
  • 35 = obese
  • 44.9 morbid obesity
  • 750 + Super obesity
• CVS أمراض -


  • DM « خصوصاً 2 »
  • sleep apnea
  • Cancer
  • asthma
• obesity paradox : obesity
• الاشخاص الـ ese, والـ lean يكون عدهم gut floral مختلفات
• Adipocytokines


  • Lepting <satiety hormone>
  • ghrelin & hunger
• Leptin


  1. Secreted from white adipose tissue, brown adipose tissue, stomach, skeletal muscle, ovaries, placenta, bone marrow

  2. Regulates hunger through hypothalamus
• Leptin resistance


  Leads to uncontrolled obesity
• Adiponectin


  Protein hormone secreted from adipose tissue, regulates fatty acid oxidation and glucose levels
• High resistin levels


  Leads to insulin resistance, high LDL cholesterol, increased risk of heart disease
• Ghrelin


  Hunger hormone secreted from stomach, stimulates appetite and gastric motility
• Orlistat


  Inhibits lipase enzyme, prevents fat absorption, treats obesity, prevents onset of type 2 DM, affects FAS in cancer
• Side effects of Orlistat


  • Steatorrhea
  • Acute kidney injury
  • Reduced absorption of cyclosporin, amiodarone, antiviral, antiarrhythmic drugs
• Lorcaserin


  Selective 5-HT2C receptor agonist in hypothalamus, promotes satiety
• Phentermine


  Psychostimulant, suppresses appetite short-term, increases monoamines like dopamine and serotonin
• Side effects of Phentermine


  • CNS overstimulation
  • Cardiovascular effects
  • GI effects
• Sibutramine


  Monoamine reuptake inhibitor, increases serotonin and satiety
• Sibutramine has low bioavailability and short half-life
• GIP


  Glucose-dependent insulinotropic polypeptide, increases insulin secretion
• Other anti-obesity medications


  • Metformin
  • Liraglutide
  • Semaglutide
• Anti-obesity vaccination


  Uses adipose tissue antigen to induce antibodies that reduce waist circumference and improve lipid profile
• GIP antagonist


  Reduces fat accumulation and increases energy expenditure
• Ghrelin antagonist


  Reduces food intake and improves glucose tolerance