Flashcards in Obesity and Eating Disorders Deck (27)
What is the longterm effectiveness of weight loss programs according to the NIH?
Of those who lose 10% of their body weight,
66% regain all in 1 year,
95% regain all in 3 to 5 years
What is the safe and effective guideline for weight loss in adults?
1-2 pounds per week
What waist circumferences in men and women represented a higher risk for CVD and DM? At what threshold is weight loss recommended for diabetic patients?
>40 inches for men
>35 inches for women
Weight loss for diabetic patients with 2 risk factors is recommended at >25 inches
What is meant by the "toxic environment" which causes obesity?
The availability and types of foods which are always available from fast food restaurants -> high in fat and energy, low in fibers and protective nutrients
How does the ease of obtaining fast food play into the toxic environment vs our ancestors?
There is a low energy cost for our daily routine and to obtain food. Everything is automated and we no longer have to fight for our food like hunter-gatherers
What is screen time linked to?
Inactivity, obesity, dyslipidemia, significant energy intake while eating
What has happened to portion sizes?
They've increased everywhere, especially pop
What has happened to the American ideal body image?
Skewed downward and less realistic for women, men are more muscular
Society has become more stigmatizing of obesity (Biggest loser effect), including physicians, employers, and adolescents (bullying predicted disordered eating)
What does restrained eating cause generally? On an individual level? Why?
Disordered eating -> where you do not pay attention to your body's hunger / satiety signals. Includes restraint and binge.
On an individual level: Daughters of moms who had restricted eating were more likely to be obese. Dieting predicted higher future body weight and bingeing, because we then have an abnormal fixation on food
What can disordered eating patterns cause?
Anorexia > Bulimia > Obesity
What is the 2013 recommendation on when to recommend weight loss?
BMI of 25 + 1 co-morbidity + high waist circumference, or higher than 30
What is the treatment recommendation for weight loss?
Address lifestyle first: diet, exercise, and behavioral therapy. Pharmacotherapy has no evidence but is admissable
How many calories should a person trying to lose weight consume? What factors determine this? What type of diets have the most success?
Determine a maintenance energy, then adding or subtracting depending on activity level of lifestyle (job) and exercise.
Add exercise calories, subtract 500 cal / week for every pound of fat you want to lose a week. Protein diets are the highest success, high fat diets you can't eat much food.
What are some comorbidities of obesity?
Diabetes Type 2, heart deisease, hypertension, dyslipidemia, OSA, Fatty liver disease, GI disorders, osteoarthritis
What is the current guideline for recommendation of bariatric surgery without comorbidity? With?
BMI > 40 (Class 3 obesity)
BMI > 35 with 2 comorbidities
What are the components of a comprehensive bariatric eating program?
Balanced, small meals every 3-4 hours which are low in sweets to prevent hypertonic dumping syndrome. Keep a daily record, eating slowly while chewing. Drink 64 oz of fluid a day, optimal protein, drink 15 min before or 30 min after a meal, and take vitamin supplements as recommended
Why should women gain weight during pregnancy?
The appropriate amount of weight gain prevented low birth weight / small for gestational age babies which can be just as bad as premature. If you gain too much weight, however, you increase risk of an overweight child
How much weight should a woman <18.5 BMI gain in pregnancy?
How much weight should a woman 18.5-24.9 BMI gain in pregnancy?
How much weight should a woman 25.0-29.9 BMI gain in pregnancy?
How much weight should a woman >30 BMI gain in pregnancy?
What are underweight mothers at highest risk for? What particular subgroup is more impacted?
Low birth weight babies. Women who are underweight and were restricted eaters tended to gain less weight, also influenced by fear of weight gain and cultural ideals for female body weight.
What are the obese and underweight percentiles based on BMI for children (2-20 years)?
>95th = obese
<5th = underweight
What are the healthy weight and overweight percentiles based on BMI for children (2-20 years)?
85 to 95th = overweight
5 to 85 = healthy weight
How much more soup did people consume in the endless soup bowl study?
73% more! wowzers in my trousers!
What should a physician role model be?
Someone who's healthy and leads healthy lifestyles