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Applied Physiology > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity - Definition

A

Def: Excess body fat
Functional Def: % BF at which increase disease risk
Consuming more than expending

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2
Q

Obesity - BMI

A

> or = 30 kg/m^2

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3
Q

Average Americans will gain __ after age 25

A

1 lb/yr

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4
Q

Overweight and Obesity by BMI (kg/m^2)

A

Underweight: less than 18.5
Normal: 18.5-24.9
Overweight: 25.0-29.9
Obesity Stage 1: 30.0-34.9
Obesity Stage 2: 35.0-39.9
Extreme Obesity Stage 3: 40.0 and higher

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5
Q

Disease risk relative to normal weight and waist circumference

A

Increased disease risk with more central adiposity

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6
Q

BMI & Children Categories and Ranges

A

Underweight: Less than 5th percentile
Healthy weight: 5th percentile to less than 85th percentile
Overweight: 85th to less than the 95th percentile
Obese: Equal to or greater than the 95th percentile

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7
Q

Identify the percentiles

A

Red to Yellow: 95th
Yellow to green: 85th
Tan to green: 5th

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8
Q

BMI & Risk Disease

A

As BMI does up, risk of developing disease increases

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9
Q

BMI & CV Disease Mortality

A

BMI and CV Disease Mortality increases as we gain weight.

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10
Q

Is BMI and Mortality associated?

A

Yes, as BMI increases Mortality increase.

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11
Q

Fitness vs Fatness and All-Cause Mortality

A

Someone who is unfit is 2x more likely to die from all-cause mortality than any BMI

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12
Q

Normal wt & >40/>35” waist has a higher mortality than >30 BMI, what does this mean?

A

Central adiposity is worse than having a higher BMI

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13
Q

Explain the relationship between visceral fat & risk factors

A

Visceral fat is very complex

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14
Q

What is important about the obesity and CV disease?

A

Postitive Relationship

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15
Q

Why is weight gain/weight loss difficult?

A

No simple solution. One of many different factors.

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16
Q

Obesity and Cardiomyopathy

A

Strong relationship

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17
Q

US Women - kcal/wk

A

Physical activity burned in kcals by week has reduced decade to decade

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18
Q

Morbid Obesity

A

When obesity interferes with vital functions
Ex: Breathing

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19
Q

Malignant Obesity

A
  • 60% above desirable weight OR
  • An absolute excess of > or equal 100 lbs
  • Both of these double of all causes of morbidity and mortality
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20
Q

Obesity and Social Stigma

A
  • Ridiculed
  • Discriminated
  • Rejections may cause emotional problems
  • Compounded unrealistic expectations and pressure to look lean

^People who are morbidly obese likely faced these things

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21
Q

Habitual Dieters

A
  • Usually emphasize weight loss rather than fat loss
  • Concentrate on losing weight quickly rather than changing habits (How are society approaches this)
  • Goal: Balance energy intake & energy expenditure
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22
Q

Fat Distribution

A

Upper-body (android) obesity
- Greater fat storage in the upper body and abdominal area (apple shaped)
- Occurs more frequently in men
- Carries and increased risk for CAD, HTN, Stoke and diabetes

Lower-body (gynoid) obesity
- Greater fat storage in the lower body around the hips, buttocks, and thighs (pear shaped)
- Occurs more frequently in women

23
Q

Who is more likely to have an apple body fat distribution?

A

Males

24
Q

What can body composition be split into?

A

Fat-free mass (FFM) & Body Fat (BF)

25
Q

Mean Percentage Body Fat: Men vs Women

A

Women have more essential fat

26
Q

Ideal Body Composition

A
  • Health, aestetics, performance
  • Women: 16 - 25% -> up to 32% BF
  • Men <20% -> up to 22% BF
  • On average men and women fall above the recommended fat % in almost all age categories
  • Essential Fat: Males 2-5%, Females 10-13%
27
Q

Measuring Body Composition

A
  • Body composition based on assumptions from dissections
  • Indirect Methods
    1. Hydrostatic weighing
    2. Dual X-ray Absorptiometry (DXA)
  • Indirect (indirect) Methods
    1. Anthropometric
    2. skinfold techniques
    3. Electrical Impedance
    4. Air Plethysmography

The more indirect we get the more source of error!

28
Q

Hydrostatic weighing

A
  • Measures body density; we measure BF % but using the body density to calculate it)
  • Body Composition Technique
  • Errors (Residual Volume - lungs, intestinal gas, density of water - temp)
29
Q

Body Density

A

= Body mass/Body volume
- Mass measure on a normal scale (kg)
- Volume via hydrostatic weighing

30
Q

Body Fat %

A

= (495/body density) - 450

31
Q

Somatotype

A
  • Very subjective, assessment requires extensive training
  • 3 Types:
  • Endomorph: corpulence & roundness
  • Mesomorph: muscularity
  • Ectomorph: Linearity and Fragile
32
Q

Types of Anthropometrics (study of measurments and proportions of body)

A
  • Skinfolds
  • Experienced tester
  • Equation derived from similar population (Ex: College age, use college age equations)
  • Dehydration (can affect skinfold measurments)
  • Body Mass Index (BMI)
33
Q

BMI equation and r

A
  • Weight/height^2
  • Used in large epidemiological studies
  • Correlated with body fat (r=0.8)
34
Q

Waist to Hip Ratio

A
  • Abdominal fat is a predictor for risk factors
  • Increased risk of MI, Angina, Diabetes, Gall bladder disease and stroke
  • Men >0.95 (Heart Disease)
  • Women >0.86 (Insulin resistance)
35
Q

Waist Circumference

A

Positively correlated with abdominal fat
Men > 40 inches
Women > 35 inches

36
Q

Dual Energy X ray Absoptiometry (DXA)

A
  • Osteoporosis risk
  • Soft tissue assessment
  • New gold standard
  • Accuracy differs in parts of body
  • Weight limitation (typically 350 lbs)
37
Q

Bioelectrical Impedance

A
  • Impedance to electrical flow is measured
  • Impedance is greater in people with more fat
  • Affected by hydration status
  • About as accurate as skinfolds
  • Less accurate in very thin and very obese
38
Q

Air Plethysmography (Bod Pod)

A

Measures air pressure and body volume to estimate density
Density = body mass/body volume

39
Q

Control of Food Intake

A

Hypothalamus is the control center
- Ventral = hunger center
- Ventromedial = satiety center
- Satiety center usually dominates (except when nutrient status is low)
- Satiety can be repressed over time. Important to focus on what you are eating
- Physiological and Physiological Factors regulate hunger/satiety

40
Q

What are the 3 energy expenditure components?

A
  • Resting Metabolic Rate (RMR)
  • Thermogenesis
  • Physical Activity
41
Q

RMR

A
  • 70% of Daily Energy Expenditure
  • Declines with age (% BF increases, lean body mass decreases)
  • Higher in men
42
Q

Thermogenesis

A

Stimulating Factors:
- Food intake (5-10% of Total Energy Expenditure)
- Cold Exposure
- Psychological Stress
- Accounts for 15% of daily expenditure

43
Q

Physical Activity and Obesity

A

Physical activity in combination w/ dietary restriction improves early and long term outcomes
- Helps preserve lean body mass
- Increases total energy output
- Affects substrate utilization

44
Q

Evidence categories

A

A - Many Randomized control studies (RCT)
B - Fewer RCT; meta-analysis of RCT; pop. dif from target pop.
C - Non-RCT; Observational studies
D - Panel consensus judgement (people talking)

45
Q

Dietary Therapy

A
  • Low Cal Diet (A)
  • Reducing dietary fats alone without a reduction in calories is not sufficent for weight loss (A)
  • Goal deficit 500-1000 kcal/day, 1-2 lbs per week (A)
46
Q

Physical Activity and Obesity - Long Term

A

At least 30 min or more of moderate int PA on most days of week (B)

47
Q

Physical Activity and Diet

A

Combination of reduced cals and increased PA (A)
- May produce weight loss and less abdominal fat
- Increase cardiorespiratory fitness

48
Q

Behavior Therapy

A
  • Useful add-on when used to reinforce changes in diet and PA
49
Q

Weight loss and weight management should be a comdbination of: ….

A

Dietary Therapy (Low cal diet)
Physical Activity
Behavior Therapy

50
Q

Pills and Obesity

A

Weight loss pills can be used as part of weight loss program (B)

51
Q

Current Meds for Obesity

A

Orlistat (inhibitor of gastric and pancreatic lipase prevents intestinal fat metabolism and absoprtion)
Phentermine-ER topiramate (enhances satiety)
Lorcaserin (selective agonist of serotonin decreases food intake and enhances satiety

52
Q

When is it okay to get weight loss surgery?

A

BMI > 40
BMI > 35 with comorbid conditions
Less invasive strategies don’t work and at risk for mortality (B)

53
Q

Weight loss and Management

A

*For a person with a BMI 27-35
* Initial goal is to reduce BW by 10% in 6 months
– Ex: 150 lbs -> lose 15 lbs in 6 months
* Reduce 300-500 kcal/day
* 1/2 to 1 lb per week

Greanys Friend: Loss of lymphatics can cause edema in the lower body

54
Q

Biggest Losers Show - Why did they gain weight back?

A
  • Dramatic weight loss may not be the awnser to long term weight loss

Applied Physiology (11 decks)

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