BPK 110 Human Nutrition: Current Issues
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1 BPK 110 Human Nutrition: Current Issues Topics for Lecture 9b: 1. Weight Loss 2. Carbohydrate Restriction 3. Weight Gain 4. Drugs & Surgery for Weight Loss
2 Learning Objectives To understand and explain how weight loss and weight gain occur in humans To understand and clearly describe different surgical methods that can be employed in extreme cases of obesity to assist in weight loss plus to give advantages and limitations of each of these methods To understand and clearly describe different pharmacological; methods that can be employed in extreme cases of obesity to assist in weight loss plus to give advantages and limitations of each of these pharmacological methods 2
3 1) Weight Loss a) Fasting- one approach to weight loss & its stages (i) liver s glycogen is depleted in 3-6 hrs but central nervous system (CNS) normally only uses glucose; fat is not important energy source for CNS (ii) lean tissue protein is broken down & used for gluconeogenesis (iii) fat & some protein ketosis ketone bodies ketone bodies used by CNS during starvation upsets acid/base balance; loss of lean tissue
4 Moderate Weight Loss versus Rapid Weight Loss Gradual weight loss is preferred. This will spare lean tissue, and fat is lost. Fasting: Early Deprivation The nervous system cannot use fat as fuel. Body fat cannot be converted to glucose. Body protein can be converted to glucose. Fasting: Later Deprivation Ketone bodies help feed the nervous system and so help spare tissue protein. Copyright 2015 by Nelson Education Ltd. 9-4
5 Figure 9-11 Feasting & Fasting Copyright 2015 by Nelson Education Ltd. 9-5
6 2) Low CHO diets- Metabolic Hocus-Pocus?? e.g. Atkins Diet, The Zone Diet, Calories Don t Count Diet etc a) 1 st some wt due to H 2 0 with cal diets loss in hunger possible are just calorie diets nothing else sorry no metabolic hocus-pocus b) Risks of such diets include ketosis fat + cholesterol intake heart disease fiber cancer of the colon, constipation fasting without protein sparing CHO may cause heart failure
7 3) Weight Gain-1 What happens to excess food ingested? CHO stored as glycogen, burned off or stored as fat fat is broken down to glycerol & fatty acid components & easily stored protein broken down to amino acids (tissue repair); stored as fat or glucose after nitrogen is removed alcohol stored as fat
8 3) Weight Gain-2 Figure 9-11 Feasting & Fasting 9-8 Copyright 2015 by Nelson Education Ltd.
9 4. Drugs & Surgery for Weight Loss to wt in extreme cases (BMI >40) surgery. success of these surgeries not overwhelming a) Gastric Bypass Surgery b) Gastric banding = surgically stomach size c) Lipectomy (Liposuction) cosmetic only fat on return is lumpy & dimply lots of lawsuits
10 4. Drugs & Surgery for Weight Loss a) Gastric Bypass Surgery-creates surgical route from stomach to small intestine- creates life-long state of mal-absorption Normal route is to the left, the bypass route is to the right through the moved small intestine In one common surgery, a small stomach pouch restricts the outlet from stomach to the intestine. b) Gastric Band: Can be alone or together w/ bypass small intestine FIG 9-15 SWP
11 4. Drugs & Surgery for Weight Loss d) Pharmaceutical Treatment of Obesity? I II III IV Suppressants Fat Uptake Inhibition or Replacement Herbal Weight Loss Products Metabolic Stimulants
12 4. Drugs & Surgery for Weight Loss I. Appetite Suppressants: many suppressant drugs: (+) serotonin prod. or (-) its reuptake serotonin is a neurotransmitter (NT) that inhibits appetite i. Phentermine (Phen) & Fenfluramine (Fen): Phen/Fen = serotonin release in brain controlled experiment in obese versus thin mill. prescriptions of Phen/Fen Result? cardiac valve problems & elevated blood pressure (BP) in lungs (pulmonary hypertension) ii. Sibutramine inhibits re-uptake of serotonin Side Effect: + Blood Pressure
13 4. Drugs & Surgery for Weight Loss II. Fat Uptake Inhibition or Replacement i. Orlistat - (-) to production of fat digesting enzymes - loss of fat soluble vitamins - also diarrhea & anal leakage (get out those diapers) ii. Olestra -artificial fat; not digested - also anal leakage with olestra... (more diapers please ) iii. Herbal Weight Loss Products - sold as dietary supplements - don t need screening by FDA in USA or other regulatory bodies (e.g. Health Canada)
14 4. Drugs & Surgery for Weight Loss Ephedra III. Metabolic Stimulants: i. Ephedrine ( ) cellular metabolism via sympathetic pathway acting on ß 1 & ß 2 receptors & is an appetite suppressant found naturally in Ephedra / ma huang ; often with caffeine still available; WHO called for regulation & control of these products 15 deaths, 800 victims; head-aches, heart attacks, brain hemorrhage ii ß 3 agonists (+) sympathetic pathway via ß 3 receptor & uncoupling proteins to EE (see brown fat lecture) not yet used extensively in humans
15 Figure 9-11 Pharmaceutical Treatments of Obesity 15 Copyright 2015 by Nelson Education Ltd.
16 BPK 110 Human Nutrition: Current Issues Summary Lecture 9b 1. Weight Loss 2. Carbohydrate Restriction 3. Weight Gain 4. Drugs & Surgery for Weight Loss
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