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WARSZAWSKI
UNIWERSYTET
MEDYCZNY
OBESITY
Katarzyna Kołakowska
WL I
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
• Definition
• Physiology
• Treatment
What is the obesity?
Abnormal or excessive
fat accumulation
that may impair health
Obesity according to WHO
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
Action on system:
aim:
nucleus arcuatus hipothalami <–> adipocites
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
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