Chapter 12 - Considerations for Obesity

Question 1

Obesity Considerations

Answer 1

Obesity is a complex interaction among environmental, behavioral, genetic, hormonal factors. Behavior is the major contributing factor. Stress is another factor.

Question 2

Genetics and Obesity

Answer 2

Genetic predisposition to obesity can be reduced by 40% by being physically active

Question 3

Stress and Obesity

Answer 3

Stress stimulates hunger but regular exercise can reduce stress and empower someone to reduce their stress level.

Question 4

Hormones and Obesity

Answer 4

Hormones affect energy expenditure regulation

Question 5

Sleep and Obesity

Answer 5

Sleep apnea affects quality of sleep and can release stress hormones which then raise heart rate and risk of hypertension, MI, stroke and arrhythmias.

Question 6

Components of Weight Loss Program

Answer 6

1. Portion control
2. Eating frequency - throughout day, not just evening
3. Consuming foods with high nutrient density not high energy density

Question 7

Resting Energy Expenditure (REE)

Answer 7

A way to estimate the daily energy needs of clients. Measured at rest in the morning and represents 60-70% of the body’s total energy expenditure (TEE). Can be measured by Indirect Calorimetry (most accurate). This equation is best estimate:
Men:
kcal/day = 10 x weight (kg) + 6.25 x height (cm) - 5 x age (yrs) + 5
Women:
kcal/day = 10 x weight (kg) + 6.25 x height (cm) - 5 x age (yrs) - 161
Convert pounds to kg - divide by 2.2
Convert inches to centimeters - multiply by 2.54

Question 8

Evaluating Diets

Answer 8

1. How does the diet cut calories
2. What is the nutrient density of the diet
3. Does the diet recommend exercise?
4. Does it make sense?
5. Where is the evidence?
6. Does it meet individual needs?
7. How much does it cost?
8. What kind of social support is provided?
9. How easy is it to adhere to?

Question 9

FITT Recommendations for Obesity

Answer 9

Frequency - cardio work up to >=5days/wk, strength 2-3days/wk
Intensity - moderate highest level comfortable, 60-70% of 1 RM
Time - 30-60 min per day (150-250min/wk), 2-4 sets 8-12 reps
Type - low impact-rhythmic-large muscle, various

Question 10

Changes after 13 Weeks of Exercise

Answer 10

Minimum - Maximum - Average
Weight -.5 lb -13.5 lb -4.0 lb
Waist -.25 in -2.25 in -1.0 in
Body Fat - 2.0 -8.0 -3.5

Question 11

Weight Maintenance

Answer 11

Weight maintenance is likely to be associated with approximately 60min of physical activity per day such as walking at a moderate intensity.

Question 12

Fitness vs Fatness

Answer 12

Emphasize healthy lifestyle that includes more physical activity over weight loss alone. Fitness is more important than fatness. Focus on improving behaviors (physical fitness and diet) that positively impact fitness, fatness and health.

Question 13

American Dietary Association (ADA) Recommendations for Obesity

Answer 13

A comprehensive weight management program should make maximum use of multiple strategies for cognitive behavioral therapy (i.e. self monitoring, stress management, stimulus control, problem solving, contingency management, cognitive restructuring, and social support).

Question 14

Pharmacological Interventions

Answer 14

Lifestyle modifications should be the main component of weight loss program. Pharmacological intervention should be considered when BMI is >30 (or>27 with a comorbidity) if other weight loss measures haven’t been successful.

Question 15

Bariatric Surgery

Answer 15

Associated with greater success and greater risks. Recommended for persons with BMI >40 ( or >35 with a comorbidity). It is expensive and can have short and long term complications. High morbidity rates are associated with BMI of 35-39.