Phar 1821 (2022) week 5 lecture note
Week 5 – Nutrition & Obesity
LO 1. Identify the prevalence of overweight and obesity, and identify high
risk groups in Australia
2. Describe factors contributing to overweight and obesity
3. Identify the diseases associated with obesity
4. Explain the benefits of lifestyle change and weight loss
5. Define and interpret overweight or obesity
6. Discuss each step of the 5As approach to weight management
7. Outline the treatment pathways involved in weight management,
including referral
8. Discuss the three aspects of lifestyle intervention
9. Describe the principal recommendations of the Australian Dietary
Guidelines
10. Discuss OTC weight loss options including VLEDs and orlistat
11. Discuss important counselling points for VLEDS and orlistat
12. Use appropriate resources about healthy eating and managing
weight
Prevalence in - 67% of adults were overweight/obese (63.4% in 2014-2015)
Australia (2017- - 24.9% of children (5-17 years) were overweight/obese
2018) - By 2025, more than 75% of Australians will be overweight/obese
High risk groups - Aboriginal and Torres Strait Islander Peoples
of obesity - Adults born in southern & eastern Europe; and those from the
Oceania region
o The adults who migrate into Australia as migrants – there is
a change in lifestyle, behaviour, food => this puts them in
higher risk of obesity
- Socioeconomic disadvantage
, - Regional & remote areas
o In 2014-2015, 61.1% of adults living in Major Cities were
overweight/obese compared with 69.2% in Regional &
Remote Australia
Energy balance - Regulation of energy homeostasis & body weight
o Is a complex process
o Involving food, CNS, gut hormones, the gut microbiome, &
adipose tissue
- Weight gain req that energy intake be increased over energy
expenditure over an extended period of time
i.e., weight gain = MORE energy intake (E in) than energy expenditure for a
long period of time
More energy intake => disturbs energy homeostasis/energy balance =>
weight gain
,Factors
contributing to
obesity
- Bottom – complex biology involved
o e.g., Dif CNS regulators, adipose tissues, peripheral
regulators, ghrelin
- Left – social environment
o e.g., Fewer meals at home; dining out a lot; eating
considered as recreation (eating on the fun); pressure to be
sedentary; eating on the run; society of spectators instead
of participant; powerful & constant advertising; pressure to
consume
- Center top – physical environment
o e.g., building design; absence of sidewalks (rather promotes
sedentary lifestyle); easy access to transportation (which
minimizes the need for incidental physical activity); urban
sprawl (rapid expansion of geographic extent of cities &
towns); pollutants; population density; automobile
dependence
- Right – behaviour
o e.g., less physical activity; more sedentary behaviour,
working from home (during pandemic); larger portions
(food intake); calorie-dense foods; maternal-fetal nutrition;
more sedentarism; lactation; larger portions; certain
medications; high fat diets; corn fructose sytrup; smoking
cessation
Medicines Class/Classification Medications
associated with Glucocorticoids Prednisone
Weight gain
, Diabetes medications Insulin, sulfonylureas,
thiazolidindiones, meglitinides
First-generation antipsychotics thioridazine
Second-generation antipsychotics Risperidone, olanzapine, clozapine,
quetiapine
Neurologic & mood stabilizing Carbamazepine, gabapentin,
agents lithium, valproate
Antihistamines Esp cyproheptadine
Antidepressants Paroxetine, citalopram,
amitriptyline, nortriptyline,
imipramine, mirtazapine
Hormonal agents Esp progestins, e.g.,
medroxyprogesterone
Beta-blockers Esp propranolol
Alpha-blockers Esp terazosin
Diseases
associated with
obesity
Diseases due to...
- Increased fat cell size & GI microbes
o Diabetes
o NAFLD = Non-Alcoholic Fatty Liver Disease
o CVD = cardiovascular disease
o GB diseases = Gallbladder diseases
o Cancer
o PCOS = Polycystic Ovary Syndrome
- Increased fat mass
o Stigma
o Osteoarthritis
o Sleep apnoea
o GORD = Gastro-Oesophageal Reflux Disease (aka heart burn)
o Stress incontinence
Week 5 – Nutrition & Obesity
LO 1. Identify the prevalence of overweight and obesity, and identify high
risk groups in Australia
2. Describe factors contributing to overweight and obesity
3. Identify the diseases associated with obesity
4. Explain the benefits of lifestyle change and weight loss
5. Define and interpret overweight or obesity
6. Discuss each step of the 5As approach to weight management
7. Outline the treatment pathways involved in weight management,
including referral
8. Discuss the three aspects of lifestyle intervention
9. Describe the principal recommendations of the Australian Dietary
Guidelines
10. Discuss OTC weight loss options including VLEDs and orlistat
11. Discuss important counselling points for VLEDS and orlistat
12. Use appropriate resources about healthy eating and managing
weight
Prevalence in - 67% of adults were overweight/obese (63.4% in 2014-2015)
Australia (2017- - 24.9% of children (5-17 years) were overweight/obese
2018) - By 2025, more than 75% of Australians will be overweight/obese
High risk groups - Aboriginal and Torres Strait Islander Peoples
of obesity - Adults born in southern & eastern Europe; and those from the
Oceania region
o The adults who migrate into Australia as migrants – there is
a change in lifestyle, behaviour, food => this puts them in
higher risk of obesity
- Socioeconomic disadvantage
, - Regional & remote areas
o In 2014-2015, 61.1% of adults living in Major Cities were
overweight/obese compared with 69.2% in Regional &
Remote Australia
Energy balance - Regulation of energy homeostasis & body weight
o Is a complex process
o Involving food, CNS, gut hormones, the gut microbiome, &
adipose tissue
- Weight gain req that energy intake be increased over energy
expenditure over an extended period of time
i.e., weight gain = MORE energy intake (E in) than energy expenditure for a
long period of time
More energy intake => disturbs energy homeostasis/energy balance =>
weight gain
,Factors
contributing to
obesity
- Bottom – complex biology involved
o e.g., Dif CNS regulators, adipose tissues, peripheral
regulators, ghrelin
- Left – social environment
o e.g., Fewer meals at home; dining out a lot; eating
considered as recreation (eating on the fun); pressure to be
sedentary; eating on the run; society of spectators instead
of participant; powerful & constant advertising; pressure to
consume
- Center top – physical environment
o e.g., building design; absence of sidewalks (rather promotes
sedentary lifestyle); easy access to transportation (which
minimizes the need for incidental physical activity); urban
sprawl (rapid expansion of geographic extent of cities &
towns); pollutants; population density; automobile
dependence
- Right – behaviour
o e.g., less physical activity; more sedentary behaviour,
working from home (during pandemic); larger portions
(food intake); calorie-dense foods; maternal-fetal nutrition;
more sedentarism; lactation; larger portions; certain
medications; high fat diets; corn fructose sytrup; smoking
cessation
Medicines Class/Classification Medications
associated with Glucocorticoids Prednisone
Weight gain
, Diabetes medications Insulin, sulfonylureas,
thiazolidindiones, meglitinides
First-generation antipsychotics thioridazine
Second-generation antipsychotics Risperidone, olanzapine, clozapine,
quetiapine
Neurologic & mood stabilizing Carbamazepine, gabapentin,
agents lithium, valproate
Antihistamines Esp cyproheptadine
Antidepressants Paroxetine, citalopram,
amitriptyline, nortriptyline,
imipramine, mirtazapine
Hormonal agents Esp progestins, e.g.,
medroxyprogesterone
Beta-blockers Esp propranolol
Alpha-blockers Esp terazosin
Diseases
associated with
obesity
Diseases due to...
- Increased fat cell size & GI microbes
o Diabetes
o NAFLD = Non-Alcoholic Fatty Liver Disease
o CVD = cardiovascular disease
o GB diseases = Gallbladder diseases
o Cancer
o PCOS = Polycystic Ovary Syndrome
- Increased fat mass
o Stigma
o Osteoarthritis
o Sleep apnoea
o GORD = Gastro-Oesophageal Reflux Disease (aka heart burn)
o Stress incontinence
