Obesity Definitions and Epidemiology

The rate at which obesity occurs in a specific population, often measured by Body Mass Index (BMI).

A measure of body fat based on height and weight.

A condition characterized by excess body fat that has adverse health effects.

Surgical procedures to treat severe obesity by reducing the size of the stomach or intestines

A medical device used to aid in weight loss by increasing fullness.

Using medications to assist in the treatment and management of obesity.

Methods to manage obesity that don't involve surgery, like diet and exercise.

Medical attention given to patients after undergoing bariatric surgery.

Dosage of vancomycin should be based on total body water (TBW) despite no effect on vancomycin's volume of distribution (Vd) by obesity, to account for increased clearance.

Currently approved for diabetes, not weight loss, though higher doses in trials (like OASIS and PIONEER PLUS) are exploring potential weight loss benefits.

A new oral GLP-1 agonist in clinical trials; specifically designed for weight loss and reducing weight by up to 15% after 36 weeks in the ACHIEVE trial.

A new oral GLP-1 agonist in clinical trials currently studied for diabetes.

A dual GLP-1 and glucagon receptor agonist currently under study; preliminary results show that 40% of participants achieved at least a 20% weight reduction.

A dual GLP-1 and glucagon receptor agonist studied for obesity and NASH (non-alcoholic steatohepatitis); unlike most GLP-1 agonists, it has a neutral effect on glucose and thus won't be used for diabetes.

A triple-hormone receptor agonist (GLP-1, GIP, and glucagon) aiming to be the most effective weight loss medication, showing a 25% weight reduction after 48 weeks in the TRIUMPH trial.

Current medications typically result in 5-10% weight reduction; the new drug Retatrutide shows significantly larger results.

Surgical procedures that can lead to poor absorption of nutrients, including fats.

A condition where the body doesn't get enough vitamin A, potentially causing eye problems.

Obesity can alter how the body processes drugs, affecting their distribution and overall effect.

The theoretical volume of body fluid in which a drug distributes.

These drugs tend to accumulate in fat tissue, and thus their dosage calculation need to consider total body weight (TBW).

The total weight of a person's body.

A standard weight calculation based on height, often used as a benchmark.

Some drugs may require dose modifications based on body composition, to ensure adequate drug levels and response.

The amount of energy the body uses at rest to maintain basic functions.

The total amount of energy used by the body in a day, including BMR and activity.

A condition where energy intake exceeds energy expenditure, leading to fat storage and weight gain.

The process of storing excess energy as triglycerides in fat cells.

The breakdown of triglycerides into free fatty acids for energy use.

The process of synthesizing triglycerides from carbohydrates, fats, or proteins.

The underlying mechanisms contributing to the development of obesity.

Obese individuals have a higher risk of high blood pressure (hypertension) due to increased angiotensinogen production, blood volume, and viscosity.

High blood pressure in obese individuals can lead to atherosclerosis, enlarged heart, ischemia, and thickened heart walls.

Central obesity increases the risk of hypertension, high cholesterol, and type 2 diabetes – which are all linked to heart and stroke risks.

Many obese individuals don't seek medical help until serious health issues or complications arise.

Regular checks for obesity-related problems like high blood pressure should be part of healthcare.

Frequent blood pressure checks are crucial for obese patients.

Obese individuals produce more angiotensinogen, a substance leading to blood vessel constriction.

Higher blood viscosity in obese individuals can make blood thicker and harder for the heart to pump.

Obese individuals often show increased blood volume, contributing to hypertension.

Hormonal medications used for birth control.

Crucial for accurate blood pressure measurement.

Method to categorize weight status (overweight/obese).

Conditions like hypothyroidism, Cushing's syndrome, PCOS & depression.

Certain medications can cause weight gain, vital to identify.

Evaluating a patient's eating habits.

Method for calculating a person's Body Mass Index.

A condition where the lungs don't ventilate adequately.

A crucial element in success planning for losing weight.

A measure of body fat based on height and weight.

Drugs that stimulate the release of norepinephrine (NE), leading to increased adrenergic receptor activity in the central nervous system (CNS).

Phentermine is primarily metabolized by CYP3A4, with a significant portion (70%) remaining unchanged and excreted in urine.

Diethylpropion is extensively metabolized in the liver to active metabolites, then excreted in urine.

Prolonged, abnormal dilation of the pupil, a side effect of adrenergic stimulation that can worsen glaucoma symptoms.

Appetite suppression; a key effect of drugs that enhance norepinephrine release, likely due to hypothalamic stimulation.

An appetite suppressant medication available in various oral formulations.

Drugs affecting the neurotransmitter norepinephrine, often used in weight management.

A combination medication used for weight management, with a black box warning.

A warning on a drug label indicating a serious risk of side effects.

Another appetite suppressant medication available in immediate-release and controlled-release forms.

The physical form of a drug, like tablets, capsules, or disintegrating tablets.

A type of tablet that dissolves quickly in the mouth.

Conditions or situations where a drug should not be used due to potential harm.

Neurotransmitters including catecholamines and non-catecholamines.

Another name for norepinephrine, a neurotransmitter.

A medication that increases satiety, slows gastric emptying, and decreases body weight by acting on GLP-1 receptors in the pancreas and brain.

Similar to liraglutide, but with a longer half-life, allowing for weekly dosing, acting on GLP-1 receptors in the pancreas and brain.

A medication that enhances glucose-dependent insulin secretion and reduces appetite by stimulating both GLP-1 and GIP receptors.

A medication that inhibits fat absorption by blocking gastric and pancreatic lipases.

Reduces appetite and cravings by acting on the hypothalamus and mesolimbic reward system, through opioid antagonism and dopamine/norepinephrine reuptake inhibition.

Suppresses appetite by releasing norepinephrine in the central nervous system (hypothalamus).

Reduces appetite by enhancing norepinephrine release in the central nervous system (CNS) via adrenergic receptors.

Suppresses appetite and enhances satiety by targeting different CNS areas: phentermine (hypothalamus) and topiramate (GABA and glutamate receptors).

Reduces hunger and boosts satiety in patients with genetic obesity by targeting melanocortin 4 receptors (MC4R) in the brain.

A medication that increases satiety, slows gastric emptying, and reduces weight by targeting GLP-1 receptors in the pancreas and brain.

Similar to liraglutide but with a longer lasting effect, allowing for weekly dosing, and also targeting GLP-1 receptors in the pancreas and brain.

A medication boosting glucose-dependent insulin secretion and reducing hunger by stimulating both GLP-1 and GIP receptors.

A medication hindering fat absorption by blocking gastric and pancreatic lipases.

Reduces appetite and cravings by affecting the hypothalamus and reward system, using opioid antagonism and dopamine/norepinephrine reuptake inhibition.

Suppresses appetite by releasing norepinephrine in the central nervous system (hypothalamus).

Reduces appetite by boosting norepinephrine release, using adrenergic receptors in the central nervous system (CNS).

Suppresses appetite and enhances satiety using phentermine (hypothalamus) and topiramate (GABA and glutamate receptors) on the central nervous system.

Reduces hunger and increases satiety in patients with genetic obesity by targeting melanocortin 4 receptors (MC4R) in the brain.

The energy expenditure the body needs at rest for basic functions.

Total energy used in a day, combining BMR, physical activity, and diet-induced thermogenesis.

Condition when calorie intake exceeds energy expenditure, leading to fat storage.

Proteins are broken down into amino acids for tissue building or energy.

Fats are stored as triglycerides in adipose tissue for energy use later.

Triglycerides are made from free fatty acids or excess glucose.

The body converts carbohydrates into fatty acids for storage as triglycerides.

The breakdown of triglycerides into free fatty acids for energy during fasting or exercise.

Glucagon, ACTH, and the sympathetic nervous system stimulate hormone-sensitive lipase for fat breakdown.

Appetite and body weight are controlled by hormonal signals (like leptin and ghrelin) and hypothalamic peptides.

Obesity involves genetic predisposition, environment, activity level, and medical conditions like hypothyroidism.

Imbalances in nutrition and activity, coupled with certain medical conditions, lead to obesity.

Obesity can lead to hypertension, type 2 diabetes, cardiovascular problems, and osteoarthritis.

Key signs are high BMI, waist circumference, breathing difficulties, and joint issues.

BMI is calculated by dividing weight (kg) by height squared (m²).

Weight categories are normal (18.5–24.9 kg/m²), overweight (25–29.9 kg/m²), and obese (≥30 kg/m²).

Waist circumference over 40 inches in men and 35 inches in women increases cardiovascular risk.

Intervention options include lifestyle changes (diet, exercise), medications (for high BMIs), and bariatric surgery (for very high BMIs).

Safe weight loss, preventing weight gain, and reducing risks associated with obesity are treatment objectives.

This includes dietary changes, increased physical activity, and behavioral therapy.

Weight loss products have varying mechanisms (e.g., lipase inhibitors) and side effects.

Amphetamines and noradrenergic drugs stimulate norepinephrine release, suppressing appetite by impacting the hypothalamus.

Phase I metabolism involves oxidation and reduction reactions to make drugs more water-soluble.

Phase II combines the drug with water-soluble molecules to facilitate excretion.

Drug effectiveness and removal rely on metabolism; obesity can alter metabolic rates and impact drug levels.

Obesity affects drug distribution and elimination. Dosage adjustments might be needed.

Stimulates hunger by signaling the hypothalamus to increase food intake.

Stimulates appetite and reduces energy expenditure in the hypothalamus.

Enhances food-seeking behavior and stimulates feeding and arousal.

Induce satiety by suppressing further food intake after a meal.

Reduces appetite and increases energy expenditure, maintaining weight.

Promotes satiety, reducing food intake and supporting long-term weight regulation.

Inhibits appetite and provides long-term feedback about energy storage.

Food intake controlled by hormones like ghrelin, NPY, CCK, and GLP-1.

Energy balance maintained by leptin, MSH, and insulin.

A potentially life-threatening condition that can occur when malnourished individuals are re-fed too quickly. It involves electrolyte imbalances, fluid shifts, and organ dysfunction.

Bariatric surgery reduces nutrient absorption, requiring daily supplementation to prevent deficiencies.

The effectiveness and safety of weight loss medications are evaluated regularly, typically monthly for the first 3 months, then every 3 months.

Treatment guidelines recommend a combination of diet, exercise, and behavioral modifications for all overweight and obese individuals. Pharmacotherapy and bariatric surgery are considered for specific cases with higher BMI or comorbidities.

Conditions often associated with obesity include hypertension, dyslipidemia, coronary heart disease, type 2 diabetes, and obstructive sleep apnea.

First-line treatment for obesity, involving dietary changes, exercise, and behavioral therapy.

Crucial factor for successful weight loss, as the individual's commitment to change greatly influences outcomes.

Various non-conventional treatments, like herbal products or supplements, not subject to rigorous testing like prescription drugs.

A banned herbal stimulant previously used for weight loss, known for its serious side effects, such as hypertension and heart problems.

The National Institutes of Health discourages the use of herbal products for obesity treatment due to potential risks and lack of scientific evidence.

A recommended approach for weight loss, incorporating dietary changes, physical activity, and behavioral therapy for at least 6 months.

Thorough assessment that includes not just prescription medications, but also over-the-counter drugs and supplements.

A professional trained to provide guidance and support during lifestyle intervention for weight management.

A state where you burn more calories than you consume, leading to weight loss.

A blood test measuring average blood sugar levels over a few months, indicating long-term blood sugar control in diabetics.

A hormone produced in the stomach that signals hunger to the brain.

The buildup of fat around internal organs, linked to increased risk of heart disease, diabetes, and other health problems.

For obese patients, aiming to lose 5-10% of body weight in the first six months of treatment.

Ghrelin is a hormone primarily responsible for stimulating appetite, promoting hunger pangs, and increasing food intake. It acts on the hypothalamus in the brain, triggering signals that make you feel hungry.

Peptide YY3-36 (PYY3-36) slows down gastric emptying, which means food stays in your stomach longer, leading to a feeling of fullness and reducing appetite. This is a key mechanism for promoting satiety (feeling full).

Leptin, a hormone primarily produced by adipose tissue (fat cells), acts as a signal to the brain indicating energy sufficiency, or that your body has enough energy stored.

Neuropeptide Y (NPY) is a powerful appetite stimulant produced in the brain. It increases food intake and promotes energy storage by acting on the hypothalamus, the control center for appetite regulation.

Cholecystokinin (CCK) is a hormone released in the gut after meals. It signals satiety (fullness), slows down gastric emptying, and promotes digestive processes.

Hormone-sensitive lipase (HSL) is the primary enzyme responsible for breaking down triglycerides stored in fat cells, releasing free fatty acids that can be used for energy.

Orlistat, a weight loss medication, works by blocking the absorption of dietary fat. It inhibits the activity of lipases, enzymes that break down fat in the digestive tract.

Phentermine/Topiramate combines two mechanisms: Phentermine suppresses appetite by boosting norepinephrine in the brain, while Topiramate acts on brain areas linked to hunger, making you feel full and reducing cravings.

A hormone secreted by the stomach that stimulates appetite. It's like a hunger signal that tells your brain it's time to eat.

A hormone released by the intestines that promotes satiety (feeling full) by inhibiting neuropeptide Y (NPY) in the hypothalamus.

A hormone released by the intestines that increases insulin secretion, delays gastric emptying, and promotes satiety.

A hormone secreted by adipose tissue (fat cells) that signals energy sufficiency and decreases appetite. It's like a "full tank" signal that tells your brain you're good to go.

A hormone secreted by the pancreas that regulates blood glucose levels and promotes glucose uptake. It also reduces appetite by signaling nutrient availability to the hypothalamus.

A hormone released by the hypothalamus that stimulates appetite and increases wakefulness.

Reduced sensitivity to leptin in the hypothalamus, resulting in an inability to respond to the "full tank" signal, leading to increased appetite and weight gain.

A powerful appetite stimulant produced by the hypothalamus, it plays a key role in increasing food intake.

Medications like semaglutide that mimic a naturally occurring hormone, glucagon-like peptide-1 (GLP-1), helping regulate blood sugar and promote weight loss.

A medication that suppresses appetite and increases satiety by interacting with norepinephrine and GABA in the brain.

A Body Mass Index (BMI) of 40 or higher qualifies for bariatric surgery even without other medical conditions.

A waist circumference greater than 40 inches in men is linked to increased cardiovascular risk.

Regular physical activity raises your lean body mass, which in turn increases your basal metabolic rate (BMR).

Consuming fewer calories than you burn creates a caloric deficit, leading to weight loss.

Higher A1C levels indicate poor control of blood sugar, making GLP-1 agonists particularly helpful due to their dual action on both weight and glucose.

Leptin and PYY3-36 are hormones that work together to suppress appetite and promote satiety by acting on the hypothalamus.