Chapter Fifteen HUNGER

Question 1

What was the purpose of Francis Benedict’s experiment in 1917?

Answer 1

To determine if humans could adjust to a lower nutritional level and thrive

Benedict’s experiment involved dieters consuming 1400 to 2100 calories a day.

Question 2

What was the average weight loss expected for subjects in Benedict’s experiment?

Answer 2

10 percent in a month

This was followed by maintaining reduced weights for another two months.

Question 3

What were some psychological effects experienced by subjects in Benedict’s experiment?

Answer 3

• Constant hunger
• Feeling cold
• 30% decrease in metabolism
• Decrease in sexual interest

These symptoms were observed even before significant weight loss occurred.

Question 4

What significant physiological changes did subjects in Benedict’s study undergo?

Answer 4

• Decrease in blood pressure
• Decrease in pulse rate
• Anemia
• Marked weakness during physical activity

These changes were linked to the diet rather than weight loss.

Question 5

What was the result of the second squad of men in Benedict’s study after dieting?

Answer 5

They overate and regained all lost weight in less than two weeks

They also gained an average of eight pounds more than their initial weight.

Question 6

What was the goal of Ancel Keys’ experiment in 1944?

Answer 6

To replicate Benedict’s experiment and study the effects of starvation

Keys aimed to understand the physiological and psychological effects of starvation faced by Allied troops.

Question 7

What was the average calorie intake for subjects in Keys’ semi-starvation diet?

Answer 7

1,570 calories per day

This was significantly lower than their previous intake.

Question 8

What were some of the physical effects observed in Keys’ subjects during the experiment?

Answer 8

• Slow nail growth
• Hair loss
• Reduced pulse rates
• Slow healing of cuts

These effects were indicative of the body’s response to starvation.

Question 9

What psychological symptoms were reported by subjects in Keys’ study?

Answer 9

• Loss of ambition
• Depression
• Irritability
• Loss of libido

These symptoms were described as a pattern characteristic of ‘growing old.’

Question 10

What did Keys’ subjects do to manage their hunger during the semi-starvation period?

Answer 10

• Collected recipes
• Studied cookbooks
• Chewed gum and drank coffee excessively

Food became an obsession for the subjects.

Question 11

How did the rehabilitation phase affect Keys’ subjects after the semi-starvation diet?

Answer 11

They remained hungry and gained weight rapidly

Subjects added an average of ten pounds of fat by the end of rehabilitation.

Question 12

What was a common outcome for subjects after both Benedict’s and Keys’ experiments?

Answer 12

They regained weight and body fat quickly after resuming normal eating

This highlighted the challenges of maintaining weight loss.

Question 13

What did the 1998 Handbook of Obesity refer to as ‘conventional reducing diets’?

Answer 13

Diets of eight to twelve hundred calories a day

These diets are considered more restrictive than those used in earlier studies.

Question 14

What did Jules Hirsch’s 1995 experiment reveal about obese subjects on calorie restriction?

Answer 14

They experienced disproportionate reductions in energy expenditure

This indicated the body’s resistance to weight loss.

Question 15

What paradox regarding obesity is highlighted in the text?

Answer 15

The contradiction between the belief that obesity can be easily managed through diet and exercise versus the documented failure of semi-starvation diets

This paradox has been noted for over fifty years.

Question 16

What percentage of subjects in Albert Stunkard’s 1959 analysis lost 20 pounds on semi-starvation diets?

Answer 16

25 percent

This was based on his review of eight reports in the literature.

Question 17

What was the conclusion drawn from Stunkard’s experience with obese patients on semi-starvation diets?

Answer 17

Semi-starvation diets were remarkably ineffective as a treatment for obesity

Only 12% of his patients lost 20 pounds, and only 1 patient lost 40 pounds.

Question 18

What percentage of subjects lost twenty pounds on semi-starvation diets according to the articles discussed?

Answer 18

25%

This figure reflects a small weight loss for the severely overweight individuals in the studies.

Question 19

What percentage of subjects successfully lost forty pounds on semi-starvation diets?

Answer 19

5%

This indicates a significant difficulty in achieving substantial weight loss through this method.

Question 20

What was Stunkard’s experience with weight loss among his patients on balanced diets?

Answer 20

Only 12% lost 20 lb and only 1 patient lost 40 lb

This illustrates the low success rate of weight loss treatments in his study.

Question 21

What conclusion did Stunkard reach about semi-starvation diets as a treatment for obesity?

Answer 21

Adverse effects often outweighed benefits

He noted that attempts at weight reduction can lead to anxiety and depression.

Question 22

According to a 2002 Cochrane Collaboration review, how did low-fat diets compare to calorie-restricted diets in terms of weight loss?

Answer 22

Induced no more weight loss than calorie-restricted diets

The weight loss achieved in both cases was clinically insignificant.

Question 23

What was the average weight loss reported in trials of low-fat diets identified by the U.S. Department of Agriculture?

Answer 23

Not quite nine pounds over six months

This reflects the limited effectiveness of calorie-restricted diets.

Question 24

What did the Women’s Health Initiative find regarding weight loss after eight years on a low-fat diet?

Answer 24

Participants weighed only two pounds less than when they started

Their average waist circumference increased, indicating no effective fat loss.

Question 25

What do obesity researchers recommend despite evidence against semi-starvation diets?

Answer 25

Dietary therapy remains the cornerstone of treatment ## Footnote This reflects a contradiction in the recognition of poor long-term results.

Question 26

What is considered the cornerstone of therapy for obesity according to Joslin’s Diabetes Mellitus?

Answer 26

Reduction of caloric intake ## Footnote However, achieving this is noted to be quite difficult.

Question 27

What deficit is predicted to produce a weight loss of 2.2 pounds?

Answer 27

A deficit of 7500 calories ## Footnote This highlights the challenge in achieving significant weight loss through small caloric reductions.

Question 28

True or False: Moderate exercise has been shown to lead to significant increases in energy expenditure.

Answer 28

False ## Footnote Moderate exercise typically results in insignificant increases in energy expenditure.

Question 29

What did Russell Wilder note about weight loss and physical exercise in 1932?

Answer 29

Patients tended to lose more weight with bed rest ## Footnote He observed that strenuous exercise slowed the rate of weight loss.

Question 30

According to Louis Newburgh, how many flights of stairs would a 250-pound man need to climb to burn the calories of one slice of bread?

Answer 30

Twenty flights of stairs ## Footnote This illustrates the inefficiency of exercise for significant weight loss.

Question 31

What is a common consequence of more strenuous exercise according to Hugo Rony?

Answer 31

Significant increase in appetite ## Footnote This can counteract the calorie deficit created by exercise.

Question 32

Who was a prominent proponent of exercise for weight control in the 1950s?

Answer 32

Jean Mayer ## Footnote He challenged previous beliefs regarding exercise and weight management.

Question 33

What did Mayer's studies in the 1960s reveal about the energy expenditure of overweight high-school girls?

Answer 33

They spent only a third as much time in physical activity as lean girls ## Footnote This suggests a relationship between inactivity and obesity.

Question 34

What phenomenon did Mayer observe in infants regarding obesity and activity levels?

Answer 34

Fatter babies were quiet and placid, while thinner babies cried a lot and moved a lot ## Footnote This indicates that innate activity levels may influence obesity.

Question 35

What major societal change did Mayer attribute to the increase in obesity in the mid-twentieth century?

Answer 35

Increased sedentary lifestyles ## Footnote He noted that modern conveniences made lives more inactive.

Question 36

What did Mayer claim about the relationship between physical activity and obesity?

Answer 36

Reduced physical activity is the most important factor in obesity ## Footnote This perspective was controversial and had its shortcomings.

Question 37

What did Hugo Rony suggest about the relationship between obesity and physical activity?

Answer 37

Obesity may affect the impulse to be physically active ## Footnote This raises questions about causality between inactivity and obesity.

Question 38

What is Mayer's hypothesis regarding physical activity and obesity?

Answer 38

Mayer's hypothesis suggests that reduced physical activity leads to obesity, but it does not clarify cause and effect.

Question 39

What observation did Hugo Rony make about obese individuals?

Answer 39

Many obese persons show decreased impulse to muscle activity, suggesting obesity may affect physical activity levels.

Question 40

What alternative explanation exists for the relationship between obesity and inactivity?

Answer 40

Both obesity and physical inactivity may be symptoms of the same underlying cause.

Question 41

How does poverty relate to obesity?

Answer 41

Obesity is associated with poverty, where manual laborers, who are less advantaged, often have higher obesity rates.

Question 42

What is the caloric balance issue related to exercise and diet?

Answer 42

Exercise accomplishes little in tilting the caloric balance compared to modest dietary restrictions.

Question 43

What did Mayer claim about the caloric expenditure of exercise?

Answer 43

Mayer claimed that even small caloric expenditures from exercise accumulate over time, leading to weight reduction.

Question 44

What was Mayer's stance on the relationship between exercise and appetite?

Answer 44

Mayer suggested that exercise does not necessarily increase appetite.

Question 45

What findings did Mayer's studies with rats and mill workers in India report?

Answer 45

Mayer claimed that exercised rats ate less than sedentary rats and that more active mill workers weighed more and ate more.

Question 46

What criticism did Mayer's studies face regarding their validity?

Answer 46

Mayer's studies were criticized for lacking replicability and for drawing conclusions without solid evidence.

Question 47

What was the conclusion of the NIH conferences on obesity regarding exercise?

Answer 47

The NIH concluded that the importance of exercise in weight control is less than believed, as it tends to increase food consumption.

Question 48

What did Judith Stern note about the contribution of exercise to weight-loss programs?

Answer 48

Stern noted that the scientific literature shows a minor contribution of exercise to most weight-loss programs.

Question 49

What did reports from the USDA recommend about physical activity?

Answer 49

Reports recommended increased physical activity for adults, up to ninety minutes a day, despite unimpressive evidence for weight loss.

Question 50

What did the Finnish review reveal about clinical trials on exercise and weight maintenance?

Answer 50

The review found only a few clinical trials with inconsistent results regarding exercise's effectiveness in maintaining weight.

Question 51

What inconsistency did the Finnish investigators find in their analysis of exercise studies?

Answer 51

Some studies suggested physical activity might inhibit weight gain, others indicated it could accelerate it, or have no effect.

Question 52

What was the outcome of long-term research on Mayer's hypothesis?

Answer 52

Research over forty years failed to support Mayer's hypothesis that physical activity induces weight loss or inhibits weight gain.

Question 53

True or False: Mayer believed that exercise could lead to a decrease in appetite without any exceptions.

Answer 53

False

Question 54

Fill in the blank: Mayer's advocacy of exercise for weight control faced ____ from physicians working with obese patients.

Answer 54

criticism

Question 55

What did the 1977 New York Times Magazine article question about exercise?

Answer 55

It questioned whether exercise prolongs life and provides protection against heart disease.

Question 56

What did Jane Brody claim about exercise in relation to weight loss in 1989?

Answer 56

She claimed exercise increases metabolism, acts as an appetite suppressant, and builds muscle tissue that burns more calories.

Question 57

What did Mayer assert in his syndicated column about exercise and weight loss?

Answer 57

Mayer asserted that exercise makes weight melt away faster and does not stimulate appetite.

Question 58

What did the 1989 New York Times suggest when exercise isn't enough for weight loss?

Answer 58

It suggested ensuring that you don't overeat.

Question 59

What did the studies on laboratory animals reveal about exercise's effect on appetite?

Answer 59

Rats forced to exercise might limit intake, but tended to eat more on non-exercise days.

Question 60

What was the conclusion regarding the effectiveness of exercise in weight control?

Answer 60

Exercise has not been shown to have a significant impact on weight control as Mayer suggested.

Question 61

What was the relationship between exercise and weight change according to the Finnish investigators?

Answer 61

The association between physical activity and weight change was found to be more complex than initially assumed.

Question 62

What is the association between physical activity and weight change according to the research?

Answer 62

The association is more complex than assumed.

Question 63

What hypothesis did Mayer propose regarding physical activity?

Answer 63

Physical activity induces weight loss or inhibits weight gain.

Question 64

What has the analysis of Mayer's hypothesis devolved into over the decades?

Answer 64

Analysis of whether an exercise program inhibits weight gain by three ounces or accelerates it by two.

Question 65

What happens to appetite when physical activity increases?

Answer 65

Appetite and thus calories consumed will increase to compensate.

Question 66

How did clinicians and public-health authorities perceive hunger?

Answer 66

As a phenomenon exclusive to the brain and a question of willpower.

Question 67

What is the relationship between physical activity and hunger?

Answer 67

Hunger increases in proportion to the calories we expend.

Question 68

What happens when calorie intake is restricted?

Answer 68

It will leave us hungry until we make up the deficit.

Question 69

What observation is fundamental to understanding weight gain and loss?

Answer 69

The increase in appetite proportional to calories expended.

Question 70

What constituted the diet mentioned in the text?

Answer 70

Roughly 400 calories of protein, 270 calories of fat, and 900 calories of carbohydrates.

Question 71

What was the perception of Stunkard's analysis regarding dietary treatment of obesity?

Answer 71

It was seen as a condemnation of all methods of dietary treatment.

Question 72

What does Walter Willett and Meir Stampfer note about physical activity's impact on energy intake?

Answer 72

Physical activity is the primary determinant of variation in energy intake.

Question 73

According to Willett and Stampfer, how can energy intake be interpreted?

Answer 73

As a crude measure of physical activity.

Question 74

What impression did Mayer give about the studies he referenced?

Answer 74

That they included multiple studies in animals and humans.

Question 75

How many studies had Mayer actually performed on humans and animals?

Answer 75

One study of each.