Ch 30 - Overweight, Obesity, Weight Control

Question 1

Energy balance equation

Answer 1

Weight change = total energy intake - total energy expenditure

Question 2

Examples of specific targets to alter energy balance in the direction of weight loss

Answer 2

Energy input = Proteins, Lipids, and carbohydrates

Energy Output = TEF(thermic effect of food), Physical activity, resting metabolism

Question 3

Intervention Strategies and targets for weight loss

Answer 3

Strategies: Targets

Drugs: appetite, thermogenesis, resting metabolism

Surgery: Food absorption

Behavior Therapy: Food Intake, Physical Activity

Question 4

Three ways to unbalance the energy balance equation to produce weight loss

Answer 4

1. Reduce caloric intake below daily energy requirements.
2. Maintain normal caloric intake and increase energy expenditure through physical activities
3. Decrease daily caloric intake and increase daily energy expenditure

Question 5

When does weight loss occur?

Answer 5

Weight loss occurs whenever energy output exceeds energy intake regardless of the diet’s macronutrient mixture

Question 6

Is someone creates a larger daily deficit to lose weight more rapidly what tends to happen?

Answer 6

Individuals who create larger daily deficits to lose weight more rapidly they tend to regain the weight if not more; slower weight loss is better

Question 7

What is the key to a successful long-term weight loss function

Answer 7

Successful long-term weight loss maintenance is an inverse function of the initial degree of obesity

Question 8

what percentage of initial BM is lost during a weight loss program?

Answer 8

8-12% of BM in lose initially

Question 9

How much wight lose is returned within the first year?

Answer 9

1/3 -2/3rds of weight loss is returned in the first year

Question 10

Almost all weight loss is returned in ____

Answer 10

5 years

Question 11

What percentage of this who lose weight will regain it?

Answer 11

90-95%

Question 12

1977 article (therapeutic fasting in morbid obesity) by Johnson D, Derrick, EJ looked at 102 subjects who were obese (60 before 21 yoa, 42 after 21 yoa) What percentage of the subjects returned to their original weight?

Answer 12

In Johnson’s Article 50% (60 subjects) returned to their original weight within 2-3 years.

Question 13

Kiem Mi, et al did a descriptive study in 1997 on the individuals successful at long-term maintenance of substantial weight loss. This study looks dat 784 people (629 female, 155 male).

1. what was the average weight loss of the individuals?
2. What method was successful at maintaining long-term weight loss?

Answer 13

1. Participants averaged a 66 lb weight loss for an average of 5 years
2. 89% of participants modified food intake as well as had a high level of physical activity (2800 kcal/wk)

This indicates that heredity alone does not destine someone to be obese

Question 14

In 1999, Detchuneit HH et al did a study on metabolic and weight loss effects of a long-term dietary intervention in obese patients.

1. During the first 3 month of the intervention what did Group A do verse Group B?
2. How did the intervention change during Phase 2?
3. What was the average precent change from initial body wight of patients during 27 month treatment?
4. What does this information tell us?

Answer 14

1. Group A ate 1200-1500kcal/d of self selected food.
   Group B had the same caloric intake but substituted 2 meals and 2 snake replacements
2. At the end of phase 1 both groups consumed self-selected food and 1 meal and 1 shake replacement
3. At the end of phase 1 there was a 2% change form initial weight in group A and an 8% change in Group B.
   At the end of phase 2 there was a 6% change in weight in group A and a 12% change in group B
4. These findings support modest weight loss can produce long-term health benefits.

Question 15

Set Point Theory

Answer 15

Proponent maintain that
1. All persons have well regulated internal control mechanism located deep within the lateral hypothalamus that maintains a preset level of body weight and or body fat within a small range (+/- 10%)

Question 16

What happens when body mass falls below one’s pre-established set point?

Answer 16

Each time BM decreases below one’s set point internal adjustments that affect food intake and regulatory thermogenesis resist the change and conserve/replenish body fat.

Question 17

Warning Signs of Anorexia Nervos

Answer 17

1. Preoccupation with being too fat despite maintenance of normal body weight
2. Amenorrhea
3. Frequent comments about body weight of shape
4. Significant loss of weight
5. Weight too low for athletic performance
6. Ritualistic concern and preoccupation with dieting, counting calories, cooking and eating meals.

Question 18

Warning Signs of Anorexia Nervos

Answer 18

1. Preoccupation with being too fat despite maintenance of normal body weight
2. Amenorrhea
3. Frequent comments about body weight of shape
4. Significant loss of weight
5. Weight too low for athletic performance
6. Ritualistic concern and preoccupation with dieting, counting calories, cooking and eating meals.
7. Excessive concern about body weight, size, and shape, even after weight loss
8. Feeling of helplessness in the pretense of food
9. Severe shifts in mood
10. Guilt about eating
11. Maintain a skinny look (BW less than 85% of expected weight)
12. Prefers to eat in isolation
13. Wears baggy clothes to disguise thin-looking appearance
14. Episodes of binge eating.

Question 19

Warning signs of Bulimia nervosa

Answer 19

1. excessive concern about body weight, body size, and body composition
2. Frequent gains and losses in body weight
3. Visits to the bathroom following meals
4. Fear of not being able to stop eating
5. Eating when depressed
6. compulsive dieting after binge-eating episodes
7. Severe shifts in mood
8. secretive binge eating but never overeating in front of others
9. More frequent criticism of own body size and shape
10. Personal or family problems with alcohol or drugs
11. Oligomenorrhea