Endocrine Weight Loss Cortisol, Stress Hormones, and Body Composition

Question 1

Chronic elevation of cortisol promotes central (visceral) obesity primarily through which mechanism?

Accepted Answer

Activating glucocorticoid receptors in visceral adipocytes, promoting fat uptake and inhibiting lipolysis

Answer

Stimulating adiponectin release from visceral fat

Answer

Increasing leptin synthesis in subcutaneous adipose tissue

Answer

Suppressing insulin secretion from pancreatic beta cells

Question 2

Cushing's syndrome due to a pituitary ACTH-secreting adenoma is called Cushing's disease and produces the classic body composition change of:

Accepted Answer

Central obesity with proximal muscle wasting, moon face, and buffalo hump

Answer

Generalized fat loss with muscle hypertrophy

Answer

Peripheral obesity with distal muscle weakness

Answer

Symmetrical subcutaneous fat gain without muscle loss

Question 3

The 1 mg overnight dexamethasone suppression test is used to screen for Cushing's syndrome. An abnormal result is a morning cortisol of:

Accepted Answer

>1.8 mcg/dL (failure to suppress)

Answer

<1.8 mcg/dL (suppressed normally)

Answer

>5 mcg/dL only

Answer

<5 mcg/dL

Question 4

Psychological stress promotes weight gain through cortisol's effect on:

Accepted Answer

Directly inhibiting adipocyte lipolysis and increasing cravings for high-calorie foods

Answer

Stimulating thermogenesis in brown adipose tissue

Answer

Reducing NPY in the hypothalamus and suppressing appetite

Answer

Increasing adiponectin and improving insulin sensitivity

Question 5

Which enzyme locally amplifies cortisol concentration within adipose tissue, particularly visceral fat?

Accepted Answer

11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1)

Answer

Aromatase (CYP19A1)

Answer

17β-hydroxysteroid dehydrogenase

Answer

Cortisol-binding globulin (CBG)

Question 6

Epinephrine (adrenaline) released during acute stress primarily affects body composition acutely by:

Accepted Answer

Activating beta-adrenergic receptors on adipocytes to stimulate lipolysis and mobilize free fatty acids

Answer

Stimulating fat cell differentiation and lipogenesis

Answer

Inhibiting glucagon and promoting glycogen storage

Answer

Increasing leptin secretion from adipocytes