chapter 10 - weight, eating disorders Flashcards
malnutrition
can be OVERnutrition or UNDERnutrition
- contributes to failing health
- can happen even if overweight/obese
factors influencing body weight & composition
genetics & environment
set-point theory
genetically predetermined body weight/fat content
doesn’t effectively explain obesity epidemic
settling point
passive feedback between the size of body stores and aspects of expenditure
settle into a certain, stable weight based on circumstances
factors that encourage body fat/obesity
- aging
- female gender
- high-calorie diet
- sedentary activity level
- weight history
- social factors
- medications
- geographic location
- genetics
limited fat stores: diseases/disorders
caused by:
- anorexia nervosa
- Marfan syndrome
obesity: diseases/disorders
- brain tumors
- ovarian cysts
- hypothyroidism
- Prader-Willi syndrome
treatment for underweight, overweight, obesity
long-term lifestyle modifications
(diets only cause weight cycling)
key features of a GOOD weight loss program
- control energy intake (lose 1-2 lbs/week)
- perform regular physical activity
- behavior modification (maintenance of healthy lifestyle)
weight loss feature 1
control energy intake:
- eat low-density foods
- eat breakfast
weight loss feature 2
regular physical activity
- expend 100-300 cal/day above normal activity
- duration & regularity
- enjoyable activities
weight loss feature 3
behavior modiciation
- chain-breaking
- stimulus control
- cognitive restructuring
- contingency management
- self-monitoring
chain-breaking
try to separate behaviors that occur together (boredom > eating > guilt > more eating)
stimulus control
alter the environment to minimize stimuli for eating
cognitive restructuring
change frame of mind regarding eating
contingency management
prepare for situations that can trigger overeating
self-monitoring
- track your food
- track when you eat, why you eat, how you feel
- track exercise
- track weight
fad diet
unhealthy, unrealistic eating plan
monotonous and/or restrictive
may cause immediate, dramatic weight loss but this RARELY lasts
intermittent fasting
eating pattern with extended periods of time with little to no food intake (16-48 hours)
periodic fasting
fasting lasting from 2 to 21 days
non-diet approach
recognizes that media, the diet industry, and some doctors encourage an unhealthy preoccupation with weight/size
- highlights diversity, self-esteem, body image
diet detriments
- low rates of sustained weight loss
- low compliance
- eating disorder prevalence
- dangers with many weight loss methods
non-diet principles
- respect others’ bodies even if they’re different from ours
- each person is only responsible for their own body
- good health is defined by physical, mental, and social well-being, not by body size
- people of all shapes & sizes can reduce risk of poor health by adopting a healthy lifestyle
non-diet approach to weight management
- best treatment for obesity = prevention
- steady weight loss instead of fast weight loss
recommendations to achieve healthy weight loss
- STEADY weight loss: 0.5 to 2 lbs/week for first 6 months
- the next six months = maintaining the loss
- 5-10% weight loss
5-10% weight loss benefits
- decrease BP, total cholesterol, LDL, TG, insulin resistance
- increase HDL
- decrease risk of some cancers
- decrease arthritis pain (hip, leg)
most common EDs
- anorexia
- binge-eating (this one is the MOST common)
- bulimia
anorexia presentation
weight loss, distorted body image
dry/brittle nails, thin hair, discolored teeth, dry skin
may involve severe restriction, compulsive exercise, purging and/or binge-eating
anorexia treatment
multidisciplinary teams: physicians, dietitians, psychologists
ideal setting = medical center
sudden death can be caused by electrolyte imbalances and cardiac arrest
bulimia presentation
cycle of bingeing & compensatory behaviors
- bingeing = triggered by dieting, stress, boredom, loneliness, depression
- food = not enjoyed or tasted
- turn toward food when faced with problems
- at or above normal weight
bulimia physical effects
- demineralization of teeth
- low potassium
- swelled salivary glands
- stomach ulcers
- teared espophagus
- constipation
bulimia treatment
- nutrition therapy = develop regular eating habits without restriction, correct misconceptions about food
- psychological therapy = improve self-acceptance, correct all-or-none thinking
binge-eating disorder presentation
- eat large amounts of food frequently, rapidly, alone, until uncomfortably full
- not necessarily obese
- often triggered by stress, depression, anxiety
binge-eating disorder treatment
- health risks come from obesity, weight stigma, weight cycling
- treatment = usually requires professional help
- nutrition therapy = same as with bulimina
- psychological therapy = identify/express emotions
- self-help groups
protein-energy malnutrition
- deficiency in both protein & kcal (these usually coincide)
- serious public health concern in developing areas (stunted growth & immune function)
kwashiorkor
severe protein deficit
characterized by mild/moderate weight loss, edema, growth impairment, fatty liver
marasmus
severe energy AND protein deficit
characterized by severe weight loss, severe growth impairment
develops gradually
etiology-based nutrition diagnoses
- starvation-related malnutrition
- chronic disease-related malnutrition
- marked inflammatory response
starvation-related malnutrition
- no inflammation
- pure chronic starvation, anorexia
chronic disease-related malnutrition
- mild to moderate inflammation
- organ failure, pancreatic cancer, sarcopenic obesity
acute-disease or injury-related malnutrition
- severe inflammation
- major infection, burns, trauma
