unit 8: weight management

Question 1

fat free mass

Answer 1

body’s non fat tissues: bone, water, muscle, connective tissue, organ tissues, teeth

Question 2

3 types body fat

Answer 2

subcutaneous fat, visceral fat, ectopic fat

Question 3

subcutaneous fat

Answer 3

fat located just beneath the skin
-protective for a variety of diseases
-represents the normal physiological buffer for excess energy intake
-80% of body fat in subcutaneous area

Question 4

visceral fat

Answer 4

-embedded within the mesentery (tissue that connects the intestines to the back of the abdominal wall) surrounding the abdominal organs
-excess linked to cardiovascular and a host of other diseases
-accounts for 10-20% of total fat in men and 5-8% of fat in women
-increases in age

Question 5

ectopic fat

Answer 5

located on or within organs: liver, heart, brain
-increases the risk for metabolic syndrome, heart disease and stroke

Question 6

energy balance

Answer 6

• energy in = energy out to maintain current weight
  -taking in more calories than burning (positive energy balance)
  -taking in fewer calories than burning (negative energy balance (lose stored fat + weight)

-energy in (food cals), energy out (PE: 20-30%, food digestion: +- 10%, resting metabolism: 65-70%)

Question 7

height weight charts

Answer 7

-list a range of ideal or recommended body weights associated w/ lowest morality of a particular sex, age, and height)
-highly inaccurate for some ppl as it provides only an indirect measure of body fat

Question 8

BMI

Answer 8

-useful for classifying the health risks of body weight
-weight should be proportional to height
-frequently use BMI in conjunction w/ waist circumference in studies that examine health risks associated w/ body weight
-doesn’t distinguish fat/fat free weight
-not useful in tracking changes in body comp- muscle mass and loss of fat

18.5-24.9 = normal
25-29.9 = overweight
30-34.9 = obese class I
35-39.99 = obese class II
40+ = class III obese
less than 18.5 = underweight
17.5 or lower = anorexia nervosa

Question 9

hydrostatic weighing

Answer 9

• a person is submerged and weighed underwater
  -% body fat can be calculated from body density
  -muscle has higher density and fat is lower density than water
  -more fat = float and weight less under water
  -lean= sink and weigh more underwater

Question 10

bod pod

Answer 10

like hydro static weighting but uses air
-person sits in a chamber and computerized pressure sensors determine the amount of air displaced by the person’s body –> can calculate body composition

Question 11

skinfold measurements

Answer 11

measures the thickness of fat under the skin
-taken at several sites and plugged into formulas that calculate body fat percentages
-accuracy is highly dependent on expertise of practitioner

Question 12

circumference measures

Answer 12

waist circumference and waist to hip ratio measures abdominal obesity and predict health risk

• waist cir of greater than 40 in for men or greater than 35 in for women is increased risk for chronic disease for most adults

-waist to hip above 0.94 for young men and 0.82 for young women is associated w/ increased risk of heart disease and diabetes

Question 13

electrical impedance analysis

Answer 13

-electrodes are attached to body and a harmless electrical current is transmitted from electrode to electrode
-conduction favours fat free tissues over fat tissues where it is calculated by computer (% and measurements of current)

Question 14

scanning procedures

Answer 14

-expensive equipment
-CT, MRI, dual energy X ray absorptiometry (DEXA), dual photon absorptiometry, infrared reactance (Futrex 1100) and total body electrical conductivity (TOBEC)

Question 15

smart scales

Answer 15

-easy to use
-not as accurate for body composition than body weight
-helps with self monitoring at home

Question 16

health risks of excess body fat

Answer 16

-increased mortality and reduces lifespan by 20 years
-associated w/ unhealthy cholesterol and triglyceride lvls, impaired heart function and death from cardiovascular disease
- hypertension, cancer, impaired immune function, gallbladder and kidney diseases, skin problems, impotence, sleep and eating disorders, back pain, joint pain, arthritis
-psychosocial disorders, depression, low self esteem, body dissatisfaction, weight bias, stigma, bullying
-DIABETES (type 2) –> kidney failure, nerve dmg, circulation problems, amputations, retinal dmg, and blindness, increased rates of heart attack, stroke, and hypertension

Question 17

5A’s of management

Answer 17

ASK for permission to discuss weight and explore readiness
ASSESS obesity-related risks and root causes of obesity
ADVISE on health risks and treatment options
AGREE on health outcomes and behav goals
ASSIST in accessing appropriate resources and providers

Question 18

distribution of body fat

Answer 18

-fat in abdominal areas: men and postmenopausal women
-premenopausal women –> hips, buttocks, and thighs

-risk of abdominal area: high blood psi, type 2 diabetes, early onset heart disease, stroke, certain types of cancer and death
-reason is bc abdominal fat is more easily mobilized and sent into bloodstream

-abdominal obesity and any 2 other risk factors associated w/ cardiovascular health put an individ at risk for metabolic syndrome

Question 19

body image

Answer 19

• the collective picture of the body as seen through the minds eye, consisting of perceptions, images, thoughts, attitudes, and emotions

-negative: dissatisfaction w/ body in general or some parts

Question 20

problems associated w/ very low lvls of body fat

Answer 20

• reproductive, circulatory, immune system disorders (8-12% for women) and 3-5% for men
  -muscle wasting, fatigue, dangerous eating disorders
  -female athlete triad: abnormal eating patterns, lack of menstrual periods, decreased bone density

Question 21

factors contributing to excess body fat

Answer 21

-genetic, physiological, lifestyle, psychosocial factors

Question 22

nutrigenomics (genetics)

Answer 22

study of how nutrients and genes interact and how genetic variations can cause ppl to respond differently to nutrients in food

-40-70% heritability in children
-50+ genes associated w/ obesity
- if both parents have obesity, children have 80% risk
-one parent, 40% risk
-must be balanced with environmental factors
–> TENDENCY is inherited but expression is affected by environment and behav

Question 23

physiological factors

Answer 23

metabolism: sum of vital processes by which food energy and nutrients are made available to and used by the body

-resting metabolic rate (RMR): energy required to maintain vital body functions (heart rate, body temp, blood psi at rest)
-counts for 65-70% of daily energy expenditure
-energy required to digest food accounts for additional +- 10% of daily energy expenditure
-20-30% is expended through physical activity

-heredity and behav affect metabolic rate as well as weight loss/gain

-higher rmr burns more cals at rest and can take in more cals without gaining weight

-losing weight decreases RMR and energy required and reverse happens when weight is gained

-exercise has positive effect –> increase RMR and increase muscle mass–? higher metabolic rate, burns cals, raises total energy energy expenditure

Question 24

hormones

Answer 24

-leptin (bodys fat cells) lets brain know how big or small the body’s fat stores are which lets brain regulate appetite and metabolic rate accordingly

-ghrelin: released by stomach, responsible for increasing appetite

Question 25

fat cells

Answer 25

more visceral and ectopic fat = greater chances of developing insulin resistance, metabolic syndrome, type 2 diabetes, heart disease -metabolically active subcutaneous fat carries little or no health risk. lies under skin and tends to be soft and flabby -lower body (gynoid obesity) --> hips, upper thighs and buttocks "pears" -visceral + ectopic --> upper body "apples" (android obesity) -apples bad and pears good

Question 26

lifestyle factors

Answer 26

-increased eating (cal intake, high sugar, high fat, high cal, big portion, fast food, low in nutrients), decreased physical activity (cut PE and recess, technology, increased sedentariness, sleep (short sleep, increased snacking and overall energy intake)

Question 27

obesogenic environment

Answer 27

promotes overconsumption of cals and discourages physical activity -food and activity are influenced by socio economy status, religion and culture and geographic location -ppl w/ few opp for physical activity/ healthy lifestyle dont have the same options as some do in more enriched environments -vending machines, consession stands, sports areas promotes unhealthy processed foods at minimal cost and full convenience and higher pref for younger age and thus making unhealthy lifestyle choices -endocrine disrupting chemicals ( EDCs) disrupt the bodys control over fat production and energy balance, and increase one's susceptibility to diseases such as obesity and diabetes --> diethylstilbestrol, bisohenol, phthalates, organotins, obesogens found in manufactured products (cosmetics, plastics, lubricants, champoos, pesticides, and paints -

Question 28

how to curb neg influence of obesogenic environment

Answer 28

-cal count on menus -banned hydrogenated oils -changing food pricing to promote healthful options -limiting advertising of unhealthy foods targeting children -fund strats to promote physical activity by creating more walkable communities, parks, and recreational facilities

Question 29

diet

Answer 29

daily food choices

Question 30

health halo effect

Answer 30

when we overestimate how healthy an item is based on a single claim such as being organic, fat-free, or low in cals. we overconsume the item and often feel less guilty doing so bc we perceive it to be good for us

Question 31

energy density

Answer 31

the number of cals per gram of food

Question 32

how to reduce energy density

Answer 32

-eat fruit w/ breakfast and for desert -add extra veggies to sandwiches casseroles, stir fry dishes, pizza, pasta dishes, and fajitas -start meals w/ a bowl of broth-based soup and includes a green salad or fruit salad -snack on fresh fruits and vegetables rather than crackers, chips, or other energy-dense snack foods - limit energy dense foods (fried, high in added sugars)

Question 33

5 key principles for obesity management

Answer 33

-it is a chronic disease that requires long-term management -management is more than just reducing #'s on a scale- its about improving overall health and well being over the long term -an important part of obesity management is identifying and addressing root causes for weight gain and removing road blocks -every individ defines success differently -work towards your "best" weight -recommended diet should be safe and balanced, include all food groups and meet the daily recommended intakes (DRI's) for all nutrients. reg physical activity and exercise should be strongly encouraged

Question 34

BDD

Answer 34

-body dysmorphic disorder -extreme dissatisfaction of body image and develop disordered eating -underrecognized and underdiagnosed begins before age 18 but can occur in adulthood -overly concerned w physical appearance, focusing on slight flaws that are not obv to others -low self esteem -related to ocd and leads to depression, social phobia, and suicide

Question 35

muscle dysmorphia

Answer 35

-distorted body image -exp by body builders and athletic ppl seeing themselves as small and out of shape when they are muscular -may let obsessive bodybuilding interfere w work and relationships -may also use steroids and other potentially dangerous muscle building drugs

Question 36

eating disorder

Answer 36

a srs disturbance in eating patterns or eating related behav, characterized by a neg body image and concerns abt body weight or body fat -anorexia, bulimia, binge-eating, other specified feeding or eating disorder (OSFED) -central feature: dissatisfaction w/ body image and body weight --> distorted thinking, perfectionistic beliefs, unreasonable demands for self control, excessive self-criticism -heredity plays a role (more than 50% of risk) tendency of this expression is explained by home environment, cultural factors, how one views oneself, turning points in life (stresses)

Question 37

anorexia nervosa

Answer 37

-characterized by the refusal to maintain body weight at a minimally healthy lvl and an intense fear of gaining weight or becoming fat; self starvation -1% of north americans, 90% are female -appears during puberty/late teenage years characteristics: -may binge and purge -vigorous and prolonged exercise -own diet is extreme but may view food with interest -may hide or hoard food w/o eating it -typically introverted, emotionally reserved and socially insecure -entire sense of self esteem may be tied up in evaluation of body shape and weight health risks: -females stop menstruating, intolerant to cold, low blood psi and heart rate, dry skin, swelling of feet and hands and may take on a blue tinge -body turns to its own organs for a desperate search for protein -death can occur from heart failure caused by electrolyte imbalances -1/10 die from starvation, cardiac arrest or other medical complications --> highest death rate for any psychiatric disorder -33-50% have a comorbid mood disorder (depression), 20 % of fatalities have been suicides

Question 38

bulimia nervosa

Answer 38

-recurrent episodes of binge eating and purging - overeating and then using behavs such as vomiting, laxatives, and excessive exercise to prevent weight gain characteristics: - binge: may rapidly eat thousands of calories -feel as thought they have lost control and cannot stop or limit how much they eat (some occasionally; others do so many times every day) - very uncomfortable around food but appear to eat normally -food acts as an anesthetic and blocks all feelings and afterwards feel physically drained and emotionally spent -stress may trigger binge/purge cycle (major life changes) health risks of bulimia nervosa - vomited stomach acids erode tooth enamel -dmg to liver and kidneys due to repeated vomiting --> arrythmia -chronic hoarseness and esophageal tearing w bleeding -(rarely) rupture of stomach - women: weight loss can cause menstrual problems increased depression, excessive preoccupation w/ food and body image, disturbances in cog functioning

Question 39

binge eating disorder

Answer 39

-lack of control over eating behav in general characteristics: -uncontrollable eating --> feelings of guilt and shame w/ weight gain - eating more rapidly than normal , eating until uncomfortably full, eating when not hungry, and preferring to eat alone -see rigid dieting as the only solution to their problem -food is used as a means of coping w stress, conflict, other disorder -begins in childhood -disordered feelings w family and how they reward/punish w food health risk -obesity --> face all health risks of obesity -higher rates of depression and anxiety

Question 40

other patterns of disordered eating

Answer 40

-OSFED (other specified feeding or eating disorder) - include individuals who did not meet explicit diagnostic criteria for anorexia nervosa or bulimia nervosa but still experienced a marked eating disorder. -ex. atypical anorexia, bulimia limited duration, purging disorder, night eating syndrome -avoidant restrictive food intake disorder (ARFID) selective eating disorder --> similar to anorexia but dont share the same fears of body shape and weight --> new dsm 5 diagnosis -orthorexia: extremely obsessed with healthy eating that its dmging -not in the dsm -compulsive about checking ingredient lists and nutritional labels and exhibit an inability to eat anything not on their narrow list of foods that they have deemed "pure" or "acceptable"

Question 41

treating eating disorders

Answer 41

- anorexia: averting a medical crisis by restoring body weight then address psychological aspects -bulimia/ binge eating: stabilizing eating patterns then identifying and changing the patterns of thinking that led to disordered eating/improving coping skills then address depression and anxiety -timely professional treatment -combo of psychotherapy and medical management - support or self help group -hospitalization may be necessary