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OBESITY
sumo
Why this topic?

• Medical aspects

- connected disorders
- medical care
- epidemic extent
• Non – medical aspects
Why is obesity a problem?
• Heart disease.
• High blood pressure.
• Arthritis.
• Diabetes.
• Indigestion.
• Gallstones.
• Some cancers (e.g. breast, prostate).
• Snoring and sleep apnoea.
• Stress, anxiety, and depression

BACK
COUNTSFacts about overweight and
obesity

WHO’s latest projections indicate that globally in


2005:
• approximately 1.6 billion adults (age 15+) were
overweight;
• at least 400 million adults were obese;
• at least 20 million children under the age of 5 years
are overweight.
WHO further projects that by 2015, approximately 2.3
billion adults will be overweight and more than 700
million will be obese.
Introduction

• Definition
• Physiology
• Treatment
What is the obesity?

Abnormal or excessive
fat accumulation
that may impair health
Obesity according to WHO

The World Health Organization (WHO)


defines

"overweight" as a BMI > 25

"obesity" as a BMI > 30


What is BMI?

Body Mass Index

KG 70kg, 1.75m, man


BMI = M2
BMI = 70/1.75 2

BMI=22.9
BMI CHART
BMI Overweight Adults (%) -
World
BMI Distribution –
Poland, Most recent
BMI Gender Comparison Pre-
Obese - Poland
BMI Gender Comparison
Overweight - Poland
Why do people develop
obesity?

1. Lifestyle
2. Genes
Environmental factors
• Reduced need for physical exertion to survive
• Increased quality and quantity of avaible food
• Nutrition during fetal development on body weight in later life
• Stress
• Sleep deprivation
• Viral infections
• Compositions of benign microbial communities within the body
Inborn factors
Genes may help explain epidemic extent of
obesity to scientists
• FTO gene product
• Ob.gene product
• Adipokines (leptin, adiponectin, resistin,TNF, IL6)
• Gut and pancreas hormones(insulin, ghrelin, CCK)
FTO gene

• one its variationis linked to obesity


• Its carriers are on average 3kg heavier
than the rest of population
• Double greater risk of obesity
• Its role is unknown yet
Ob. gene

Product: leptin (satiety hormone)


Stimulates: angiogenesis, puberty
Action on cell level:
muscles, hepatocites, B cells – syntesis
adipocites – fat breakdown
Ob.gene

Action on system:
aim:
nucleus arcuatus hipothalami <–> adipocites

(leptin in fetus development)


Is there a Fat-o-Stat? -
physiology

Control mechanisms of cell energy uptake


and expenditure
How does it work?
INFORMATION
STORED ENERGY STATUS
• Circulating leptin indicates how much fat body contain

METABOLIC STATUS
• Circulating glucose represents energy immediately available to cells
• Various indicators of liver activity signal that ingested energy is
being processed

FEEDING STATUS
• Neural and chemical signals from the gut indicate whether digestive
organs are full of food
BRAIN – COMMAND CENTER
APPETITE CONTROL
LOCATION:
• nucleus arcuatus

hypothalami
• nucleus solitarius
NUCLEUS HIPOTHALAMI

LEPTIN
Mixed massages
Evolutionary trap

Changes in diet and organism tricks to


maintain stable weight when significantly
alter energy intake
• Sudden food restriction
• Intentional overfeeding
Observation of physiological and behavioral changes
Overriding obesity
SIBUTRAMINE
Raises available serotonin and norepinephrine, brain chemicals that
affect appetite as well as mood and other functions

RIMONABANT
Suppresses activity of CB1 receptors in brain and body tissues,
which stimulate appetite and are involved in cellular fat
processing(not approved in U.S.)

ORLISTAT
Blocks fat absorption in intestines to reduce calorie intake
Overriding obesity

BARIATRIC SURGERY
Reduces and/or bypasses stomach pouch and
part of intestine to decrease the amount of food
taken in and digested. Also lowers appetite by
changing intestine’s hormonal responses to
food
Overriding obesity – new
approaches

APPETITE
• Block activity of the appetite-stimulating neuropeptides
MCH or NPY or gut peptide ghrelin
• Boost appetite-suppressing activity of cellular MC4
receptors or certain serotonin receptor subtypes
• Inhibit neural proteins SOC3 and PTP1B to couteract
leptin resistance
Overriding obesity – new
approaches
ENERGY STORAGE
• Reduce fat cells’ intake of energy and manufacture of
trigliceride by inhibiting 11BHSD1 enzyme

STORED ENERGY USE


Increase rate at which fat cells release trigliceride to
bloodstream for use as fuel by stimulating PPAR
and beta3-adrenrgic cellular receptors in body
tissues
Increase FGF21 protein, which causes liver cells to
burn fat
MANY SUPPORT GROUPS
Opposite problem?
But this is another
topic...
references
• What fuels fat? Sci Am. 2007 Sep;297(3):72-81.
• http://news.bbc.co.uk/2/hi/health/7230065.stm
• http://www.who.int/mediacentre/factsheets/fs311/en/inde
x.html
• http://www.pulsmed.com.pl/document.php?
id=106&pageNo=3&ctgSelect=7&module=menuTree