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Regulation of Body Weight and Appetite Review
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Regulation of Body Weight and Appetite Review

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Questions and Answers

Which of the following statements accurately describes the relationship between caloric expenditure and body weight status?

  • Most obese individuals have a higher basal metabolic rate (BMR) than lean individuals.
  • Obese individuals consistently burn less calories than lean individuals.
  • Caloric expenditure is not influenced by body composition.
  • During weight loss, lean individuals often burn more calories than obese individuals. (correct)
  • What role do adipokines play in insulin receptor sensitivity?

  • They decrease insulin receptor sensitivity with increased NEFA levels.
  • They have no effect on insulin receptor sensitivity.
  • They solely act as pro-inflammatory cytokines.
  • They increase insulin receptor sensitivity and promote NEFA oxidation. (correct)
  • Which cytokines are associated with increased insulin resistance when secreted by fat cells?

  • Adiponectin and leptin.
  • AMP-K and metformin.
  • Resistin and retinol-binding-protein 4.
  • TNF-alpha and IL-6. (correct)
  • What effect do non-esterified fatty acids (NEFA) have on insulin receptor activity?

    <p>They cause serine phosphorylation, leading to inactivation of the insulin receptor.</p> Signup and view all the answers

    Which hormone is primarily released by the stomach during fasting and increases hunger signals?

    <p>Ghrelin.</p> Signup and view all the answers

    What is the primary outcome of visceral adipose tissue activating macrophages?

    <p>Increased secretion of pro-inflammatory cytokines.</p> Signup and view all the answers

    Which of the following is a characteristic of adipose tissue in the context of insulin resistance?

    <p>Releases protein hormones affecting insulin receptor sensitivity.</p> Signup and view all the answers

    Which of the following accurately describes the action of AMP-K in relation to NEFA?

    <p>It promotes increased oxidation of NEFA when activated.</p> Signup and view all the answers

    What is the primary consequence of the activation of DAMPs in cells?

    <p>Increased production of pro-inflammatory cytokines</p> Signup and view all the answers

    Which of the following cytokines is directly mentioned as being produced by the adipocyte?

    <p>Interleukin-6</p> Signup and view all the answers

    How does excessive lipid build-up in adipocytes contribute to systemic inflammation?

    <p>Increases reactive oxygen species (ROS) production</p> Signup and view all the answers

    What is the body mass index (BMI) threshold for defining obesity?

    <p>BMI ≥ 30 kg/m²</p> Signup and view all the answers

    Which ratio is sometimes used to define obesity in addition to BMI?

    <p>Waist to hip ratio</p> Signup and view all the answers

    What component of energy expenditure is considerably larger than exercise activity thermogenesis (EAT)?

    <p>Non-exercise activity thermogenesis (NEAT)</p> Signup and view all the answers

    What detrimental effect does the production of pro-inflammatory cytokines have on the body?

    <p>Development of insulin resistance</p> Signup and view all the answers

    Which component of energy expenditure specifically refers to the increase in metabolic rate after food ingestion?

    <p>Diet-induced thermogenesis (DIT)</p> Signup and view all the answers

    Which area of the brain is primarily associated with the reward pathway for food intake?

    <p>Lateral hypothalamus</p> Signup and view all the answers

    What neurotransmitter is most implicated in the hedonic model of food intake?

    <p>Dopamine</p> Signup and view all the answers

    What does the hedonic pathway primarily influence regarding eating behavior?

    <p>Pleasure derived from food</p> Signup and view all the answers

    How do the hedonic and homeostatic pathways interact?

    <p>The activity in one can modulate the other.</p> Signup and view all the answers

    What common issue is suggested to be present in obese individuals concerning the hedonic model?

    <p>Imbalance between hedonic and homeostatic pathways</p> Signup and view all the answers

    What hypothesis explains the behavior of individuals towards highly palatable foods?

    <p>Reward deficiency hypothesis</p> Signup and view all the answers

    Which neurotransmitters are classified as endogenous opioids that can influence reward pathways?

    <p>Enkephalins and endorphins</p> Signup and view all the answers

    Which brain structure is considered the 'master integrator' of information from both hedonic and homeostatic pathways?

    <p>Hypothalamus</p> Signup and view all the answers

    Which of the following is a requirement for measuring Basal Metabolic Rate (BMR)?

    <p>Fasting for at least 12 hours</p> Signup and view all the answers

    How does Resting Metabolic Rate (RMR) typically compare to Basal Metabolic Rate (BMR)?

    <p>RMR is measured at any time of the day.</p> Signup and view all the answers

    What percentage of energy expenditure (EE) does NEAT account for in sedentary individuals?

    <p>6-10%</p> Signup and view all the answers

    What happens to NEAT during periods of underfeeding in inactive individuals?

    <p>NEAT decreases significantly.</p> Signup and view all the answers

    Which model suggests that increased energy expenditure in one area compensates by decreasing expenditure in another area?

    <p>Compensation/allocation model of energy expenditure</p> Signup and view all the answers

    How do compensators react to overfeeding according to energy expenditure literature?

    <p>They increase spontaneous physical activity.</p> Signup and view all the answers

    Which factor contributes significantly to individual variability in spontaneous physical activity (NEAT)?

    <p>Genetic inheritance</p> Signup and view all the answers

    What often happens to skeletal muscles with weight loss due to caloric restriction?

    <p>They become more efficient.</p> Signup and view all the answers

    During what conditions is NEAT commonly assessed?

    <p>From spontaneous daily activities without planned exercise.</p> Signup and view all the answers

    What percentage variation of energy expenditure can occur due to NEAT between two similar-sized individuals?

    <p>Up to 2000 kcal/day</p> Signup and view all the answers

    What role does MSH play in energy regulation when nutrients are present?

    <p>It reduces eating and increases energy expenditure.</p> Signup and view all the answers

    What is the primary effect of AGRP neurons when nutrients are present?

    <p>They promote eating by blocking MSH receptors.</p> Signup and view all the answers

    How does increased serotonin signaling affect AGRP neurons?

    <p>It inhibits them leading to reduced appetite.</p> Signup and view all the answers

    Which mechanism is involved in the satiety effect mediated by MSH signaling?

    <p>Direct MSH release and inhibition of AGRP release.</p> Signup and view all the answers

    What effect does the 5-HTc receptor agonist Lorcaserin have on weight?

    <p>It induces weight loss in obese subjects.</p> Signup and view all the answers

    Which brain region is primarily involved in integrating peripheral and central signals related to energy regulation?

    <p>Arcuate nucleus.</p> Signup and view all the answers

    What happens to AGRP neurons in response to nutrient availability?

    <p>They are inhibited.</p> Signup and view all the answers

    What complication arises from the signaling mechanisms of serotonin in relation to weight regulation?

    <p>They involve receptor modulation and transporter regulation.</p> Signup and view all the answers

    What is the single most important environmental risk factor for insulin resistance?

    <p>Obesity</p> Signup and view all the answers

    Which statement accurately reflects the association between caloric intake and body weight in obese individuals?

    <p>Caloric intake reporting can be inaccurate among obese individuals.</p> Signup and view all the answers

    What is the relationship between genetic factors and body weight variance in the population?

    <p>Approximately 5% of body weight variance is attributed to genetics.</p> Signup and view all the answers

    What is the role of impaired satiety mechanisms observed in obese individuals?

    <p>Leptin resistance leading to overeating</p> Signup and view all the answers

    What aspect of exercise is recognized as a separate risk factor influencing obesity?

    <p>Lack of physical activity</p> Signup and view all the answers

    What is a possible explanation for why obese individuals experience increased eating behavior despite impaired reward pathway activation?

    <p>Increased expectation of reward when anticipating meals</p> Signup and view all the answers

    What is the primary function of MSH in the context of nutrient presence?

    <p>To reduce eating and increase energy expenditure</p> Signup and view all the answers

    Which type of adipose tissue is predominantly associated with triglyceride storage and plays an important endocrine role?

    <p>Visceral adipose tissue</p> Signup and view all the answers

    Which peripheral signal is known for its orexigenic effect and is secreted from the stomach?

    <p>Ghrelin</p> Signup and view all the answers

    Which statement accurately reflects the role of AGRP neurons when nutrients are available?

    <p>AGRP neurons are inhibited, leading to reduced signaling for food intake</p> Signup and view all the answers

    What mechanism allows brown fat to contribute to thermogenesis without producing ATP?

    <p>Leaky proton channels through uncoupling protein</p> Signup and view all the answers

    Which neurotransmitter's signaling is crucial for activating MSH neurons as per the content provided?

    <p>Serotonin</p> Signup and view all the answers

    How do peripheral signals interact with the central nervous system in regulating energy balance?

    <p>They can influence other brain areas via transport across the blood-brain barrier</p> Signup and view all the answers

    What effect does the 5-HTc receptor agonist Lorcaserin have on obese individuals?

    <p>It induces weight loss</p> Signup and view all the answers

    How does the inhibition of AGRP neurons contribute to satiety signaling?

    <p>By reducing signals that promote food intake</p> Signup and view all the answers

    What evidence suggests that lean subjects have an advantage over obese subjects in terms of reward pathway activation?

    <p>Higher striatal dopamine release in lean subjects</p> Signup and view all the answers

    What role does the hypothalamus play in the homeostatic system involving peripheral signals?

    <p>It integrates peripheral signals and regulates energy balance</p> Signup and view all the answers

    What mechanism is described as mediating satiety through MSH signaling?

    <p>Inhibition of AGRP release when nutrients are present</p> Signup and view all the answers

    What impact does visually palatable food stimuli have on those who are obese compared to lean subjects?

    <p>Greater activation of the corticolimbic system</p> Signup and view all the answers

    What is the role of serotonergic neurons located in the midbrain regarding energy regulation?

    <p>They project to both the arcuate nucleus and the hedonic pathway</p> Signup and view all the answers

    What is the consequence of increased MSH signaling in the presence of nutrients?

    <p>Enhanced inhibition of AGRP neurons leading to reduced appetite</p> Signup and view all the answers

    What is the primary effect of excessive lipid build-up in adipocytes on pro-inflammatory cytokine production?

    <p>It leads to increased production of pro-inflammatory cytokines.</p> Signup and view all the answers

    Which mechanism is primarily responsible for the development of insulin resistance related to pro-inflammatory cytokines?

    <p>Serine phosphorylation of the insulin receptor.</p> Signup and view all the answers

    What is a potential role of free fatty acids in high concentrations within adipocytes?

    <p>They may bind to PAMP-R and trigger inflammatory responses.</p> Signup and view all the answers

    How does the ratio of waist to hip measurements contribute to the assessment of obesity?

    <p>It is a less precise measure than BMI but provides additional health context.</p> Signup and view all the answers

    Which component of energy expenditure accounts for the largest part of an individual's daily energy needs?

    <p>Resting metabolic rate (RMR)</p> Signup and view all the answers

    What is the potential consequence of chronic activation of DAMPs in cells?

    <p>It contributes to systemic insulin resistance.</p> Signup and view all the answers

    Which statement best describes the relationship between insulin resistance and type II diabetes?

    <p>Insulin resistance is a precursor that contributes to type II diabetes.</p> Signup and view all the answers

    What role does non-exercise activity thermogenesis (NEAT) play in overall energy expenditure?

    <p>It significantly contributes to energy expenditure beyond dedicated exercise activities.</p> Signup and view all the answers

    Which statement best explains how increased gut permeability in obesity influences insulin sensitivity?

    <p>Increased gut permeability allows LPS to trigger a proinflammatory state.</p> Signup and view all the answers

    What role do short-chain fatty acids (SCFAs) play in regulating food intake?

    <p>They increase secretion of anorexigenic signals.</p> Signup and view all the answers

    In which manner does vagotomy impact body weight regulation?

    <p>It alters hormonal responses affecting energy balance.</p> Signup and view all the answers

    How do Bifidobacterium and Lactobacillus impact hunger and satiety hormones?

    <p>They positively correlate with leptin and negatively correlate with ghrelin.</p> Signup and view all the answers

    Why have intervention studies on SCFAs shown limited benefits on weight management in metabolic syndrome?

    <p>Because the physiological mechanisms of SCFAs are complex and not entirely understood.</p> Signup and view all the answers

    Study Notes

    Regulation of Body Weight and Appetite

    • Obese individuals can have a higher overall calorie usage than lean individuals but may burn fewer calories during weight loss.
    • Basal metabolic rate (BMR) varies; many obese people exhibit a reduced BMR.

    Satiety and Hunger Signals

    • Key satiety hormones:
      • Leptin, GLP-1, CCK, PYY, and vagal afferents.
    • Hunger hormone:
      • Ghrelin, released during fasting.

    Insulin Resistance and Visceral Fat

    • Non-esterified fatty acids (NEFA) are linked to increased insulin resistance, especially from central fat stores.
    • Adipokines, protein hormones from fat cells, can enhance insulin receptor sensitivity.
    • Pro-inflammatory cytokines from adipose tissue can impair insulin receptor function.

    Visceral Obesity and Inflammation

    • Visceral fat can recruit macrophages, producing pro-inflammatory cytokines such as TNF-alpha and IL-6.
    • Increased IL-6 levels lead to systemic inflammation and increased CRP production by the liver.
    • Insulin resistance in visceral fat elevates free fatty acids and further stimulates pro-inflammatory pathways.

    Definitions of Obesity

    • Overweight is defined as BMI ≥ 25 kg/m², while obesity is BMI ≥ 30 kg/m².
    • Waist-to-hip ratios also classify obesity risk differently for men (>0.90) and women (>0.85).

    Energy Expenditure Components

    • Total energy expenditure comprises resting metabolic rate (RMR), activity-related energy expenditure (AEE), and diet-induced thermogenesis (DIT).
    • Basal metabolic rate (BMR) is measured under strict conditions; RMR is slightly more variable depending on daily activities.

    Non-Exercise Activity Thermogenesis (NEAT)

    • NEAT represents spontaneous physical activities not categorized as deliberate exercise and can vary significantly among individuals.
    • NEAT can account for 6-10% of energy expenditure in sedentary lifestyles, increasing to 50% in highly active individuals.

    Dietary Impact on NEAT

    • Overfeeding may increase NEAT in some, but most do not compensate calorically through increased activity.
    • Underfeeding results in decreased RMR and NEAT, particularly in inactive individuals.

    Energy Expenditure Models

    • The independent model suggests that increases in NEAT and EAT lead to higher total energy expenditure.
    • The compensation model indicates increased expenditure in one area may reduce expenditure in another.
    • Genetic factors significantly influence spontaneous physical activity levels.

    Insulin Resistance and Exercise

    • Weight loss from caloric restriction may enhance muscle efficiency, impacting metabolic markers.
    • The CNS plays a significant role in energy regulation through various hypothalamic signals.

    Serotonin and Energy Regulation

    • Serotonin influences satiety by activating MSH neurons that inhibit food intake-promoting neurons.
    • Lorcaserin, a 5-HTc receptor agonist, has been shown to induce weight loss.

    Hedonic Pathway in Food Intake

    • Food intake is driven by reward pathways, with decreased focus on nutrient availability.
    • Key brain areas involved include the lateral hypothalamus and nucleus accumbens, regulated by neurotransmitters like dopamine.

    Interaction of Hedonic and Homeostatic Pathways

    • Hedonic and homeostatic pathways are interrelated; each can influence the other regarding energy regulation.
    • Hypothalamus acts as a master integrator, balancing signals from both pathways to dictate eating behavior.

    Reward Deficiency Hypothesis

    • People may experience less satisfaction from food due to a deficit in the brain's reward system, leading to increased food consumption.

    Pathogenesis of Obesity

    • Insulin Resistance & Obesity:

      • Obesity is the main environmental risk factor for insulin resistance.
      • Central obesity is particularly crucial, while lack of exercise is an additional risk factor.
      • Most insulin resistance cases arise from a mix of genetic and environmental factors.
      • Type 2 Diabetes Mellitus (T2DM) is highly heritable, with genetic causes accounting for about 5% of body weight variance.
    • Obesity Misconceptions:

      • Obese individuals do not always consume more calories; reporting biases can skew results.
      • Poorly characterized leptin resistance may impair satiety mechanisms in obese individuals.
      • Activation of DAMPs (Damage Associated Molecular Patterns) and increased pro-inflammatory cytokines contribute to insulin resistance.
    • Chronic Inflammation Effects:

      • Excessive lipid accumulation in adipocytes leads to oxidative stress (ROS) and produces inflammatory cytokines like IL-6 and TNF-alpha.
      • These cytokines create a feedback loop that exacerbates insulin resistance and may trigger type II diabetes.

    Definitions of Overweight and Obesity

    • BMI Metrics:

      • Overweight is defined as BMI ≥ 25 kg/m²; obesity is defined as BMI ≥ 30 kg/m².
      • Waist-to-hip ratios are also used to assess obesity: men > 0.90, women > 0.85.
    • Energy Expenditure (EE) Components:

      • Total energy expenditure includes:
        • Resting Metabolic Rate (RMR): energy at rest.
        • Activity-Related Energy Expenditure (AEE): encompasses both Exercise Activity Thermogenesis (EAT) and Non-Exercise Activity Thermogenesis (NEAT).
        • Diet-Induced Thermogenesis (DIT): metabolic rate increase during digestion.

    Homeostatic Regulation of Energy Intake

    • Central Nervous System (CNS) Role:

      • The arcuate nucleus and paraventricular nucleus in the hypothalamus regulate hunger and energy expenditure.
      • MSH release from POMC neurons promotes satiety, while AGRP neurons inhibit it.
    • Serotonin and Eating Behavior:

      • Serotonin signaling increases satiety via MSH activation and AGRP inhibition.
      • Lorcaserin, a 5-HTc receptor agonist, can promote weight loss in obese individuals.

    Peripheral Players in Energy Regulation

    • Key Hormones and Signals:

      • Adipose tissue produces leptin, adiponectin, and resistin, influencing hunger and metabolism.
      • The gastrointestinal tract secretes hormones like ghrelin (hunger stimulant), GLP-1, and CCK (satiety hormones).
      • The pancreas releases insulin, which plays a critical role in energy homeostasis.
    • Hypothalamic Interaction:

      • The hypothalamus’s environment allows peripheral signals to influence appetite regulation.
      • The vagus nerve transmits signals from the gut to the hypothalamus, assisting in energy balance.

    Types of Adipose Tissue

    • White and Brown Fat Differences:

      • White fat is the main form of adipose tissue, storing triglycerides and performing endocrine functions.
      • Brown fat, mainly present in infants, is involved in thermogenesis and decreases with age.
      • Mechanisms of fat burning include uncoupling proteins in mitochondria allowing fat oxidation without ATP production.
    • Gut Microbiota Influence:

      • Obesity correlates with gut microbiota changes leading to increased permeability and systemic inflammation, contributing to insulin insensitivity.
      • High-fat meals increase plasma LPS in obese individuals compared to lean counterparts.

    Gut Microbiota's Impact on Food Intake

    • Role of Short-Chain Fatty Acids (SCFAs):
      • SCFAs influence satiety by increasing PYY and GLP-1 secretion, stimulating the vagus nerve, and promoting leptin production.
      • However, interventions with SCFA supplements have not demonstrated consistent weight loss benefits in metabolic syndrome.
      • Specific gut bacteria like Bifidobacterium and Lactobacillus correlate positively with leptin and negatively with ghrelin, impacting hunger regulation.

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