Obesity and Fructose Metabolism

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Questions and Answers

Given how much obesity, diet, and lifestyle increase the risk of NAFLD, & _ counselling are foundational interventions.

nutritional, lifestyle

Galactose is a common constituent in ___________.

glycolipids & glycoproteins

In what ways is metabolism of fructose considered 'unregulated'?

Transport and metabolism do not require insulin.

Which tissues have the capacity to metabolize fructose?

Liver, intestines, kidney, adipose, muscle tissue Signup and view all the answers

Because so few tissues can metabolize fructose, what happens to the majority of it?

It is transported to and metabolized by the liver into glycogen or TAGs. Signup and view all the answers

How is fructose absorbed?

Passively, by GLUT 5 transporters. Signup and view all the answers

How does a high fructose diet impact absorption?

It amplifies absorption by up-regulating additional transport mechanisms. Signup and view all the answers

Why can fructose overburden the liver?

Processing of fructose in the liver is not controlled by hormone or allosteric mechanisms. Signup and view all the answers

What happens to excess metabolites of fructose metabolism?

They enter various other pathways like fatty acid synthesis and cholesterol synthesis. Signup and view all the answers

Indigestible polysaccharides are known as __________.

dietary fiber Signup and view all the answers

What is the best diet for preventing and treating NAFLD?

Mediterranean diet Signup and view all the answers

Reducing weight by to % can result in important health benefits.

5, 10 Signup and view all the answers

Which of the following drugs are associated with weight gain? (Select all that apply)

Lithium Signup and view all the answers

Which drugs are associated with the greatest amount of weight gain?

Antipsychotics and lithium Signup and view all the answers

Appetite suppressants may include:

Naltrexone Signup and view all the answers

What is bupropion?

A sympathomimetic drug used as an antidepressant and appetite suppressant. Signup and view all the answers

What are some adverse effects of bupropion?

Dry mouth Signup and view all the answers

What adverse effects are associated with bupropion + naltrexone?

Constipation Signup and view all the answers

Bupropion + naltrexone is contraindicated with concurrent __________.

opioid therapy Signup and view all the answers

Bupropion + naltrexone suppress appetite by mediating __________.

hormones involved in appetite & reward Signup and view all the answers

What is orlistat's drug class?

Lipase inhibitor Signup and view all the answers

What is orlistat's mechanism of action?

Pancreatic and gastric lipase inhibitor that reduces intestinal dietary fat absorption by 30%. Signup and view all the answers

What are some adverse effects of orlistat?

Decreased absorption of fat-soluble vitamins Signup and view all the answers

Orlistat is contraindicated in patients with __________.

chronic malabsorption syndrome or cholestasis Signup and view all the answers

What are the two main incretin hormones responsible for glucose-induced insulin secretion?

GLP-1 Signup and view all the answers

What is the role of GLP-1?

Increases satiety, decreasing gastric emptying, affects reward-related systems in the brain. Signup and view all the answers

What is the role of GIP?

Delays gastric emptying and seems to play a role in insulin secretion. Signup and view all the answers

Study Notes

Obesity & Lifestyle Counselling

Obesity and sedentary lifestyles increase the risk of NAFLD.
Nutritional and lifestyle counselling are essential interventions to manage NAFLD.

Fructose Metabolism

Galactose is a common constituent of glycolipids and glycoproteins.
Fructose metabolism is unregulated, meaning its transport and metabolism do not require insulin.
Liver, intestines, kidneys, adipose tissue, and muscle tissue are capable of metabolizing fructose.
The majority of fructose is transported to and metabolized by the liver, where it is converted into glycogen or TAGs.
Fructose absorption is passive and facilitated by GLUT 5 transporters.
A high fructose diet increases absorption by upregulating additional transport mechanisms.
Excess fructose metabolites can lead to various metabolic pathways, including fatty acid synthesis and cholesterol synthesis.

Dietary Considerations

Indigestible polysaccharides are known as dietary fiber.
The Mediterranean diet is recommended for preventing and treating NAFLD.

Weight Management

Reducing body weight by 5-10% can improve overall health.

Medications Associated with Weight Gain

Antidepressants, especially TCAs, antipsychotics, corticosteroids, antihyperglycemic drugs, and lithium are associated with weight gain.
Antipsychotics can cause a significant weight gain of 9–12 kg, along with insulin resistance changes.
Lithium (treats mania) can cause weight gain of 10 kg or more.

Appetite Suppressants

Bupropion, alone or in combination with naltrexone, can be used as appetite suppressants.

Bupropion

Sympathomimetic (stimulant-like) drug used for antidepressant, smoking cessation aid, and appetite suppression.
Adverse effects include dry mouth, constipation, agitation, insomnia, anxiety, and rarely, seizures (contraindicated in those with seizure history).

Bupropion + Naltrexone

Adverse effects include nausea & vomiting, constipation, headache, dizziness, insomnia, and dry mouth.
Contraindicated with concurrent opioid therapy due to the risk of precipitating opioid withdrawal.
Suppresses appetite by mediating hormones involved in appetite and reward.

Orlistat

Lipase inhibitor.
Inhibits pancreatic and gastric lipase, reducing intestinal dietary fat absorption by 30%.
Adverse effects include oily spotting, flatus with discharge, fecal urgency, and decreased absorption of fat-soluble vitamins.
Contraindicated in patients with chronic malabsorption syndrome or cholestasis.

Incretin Hormones

GLP-1 and GIP are the two main incretin hormones responsible for glucose-induced insulin secretion.

Role of GLP-1

Increases satiety, decreases gastric emptying, and affects reward-related systems in the brain.

Role of GIP

Delays gastric emptying and plays a role in glucose homeostasis.

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Description

This quiz covers the relationship between obesity, lifestyle counselling, and fructose metabolism. It addresses key aspects such as the risks of non-alcoholic fatty liver disease (NAFLD) and the metabolic pathways affected by high fructose intake. Explore how dietary considerations and interventions can impact overall health.