Chapter 15 - Final Exam Flashcards
Adolescent Overweight/Obesity
factors that contribute to increase include:
having one or more overweight parent
low income family
african american, hispanic, american indian, native alaskan descent
condition that limits mobility
inadequate PA
diets high in calories, sugars, fats
Assessing weight status
BMI for age/gender is used to assess
BMI ≥ 85th to < 95th % = overweight
BMI ≥ 95% = obese
Health implications of adolescent obesity
hypertension dyslipidemia insulin resistance/type 2 diabeetus sleep apnea orthopedic problems hepatic disease body image disturbances self esteem
Screening/treatment of overweight adolescents
screen all adolescents wt-for-ht yearly
overweight/obese individuals require in-depth medical assessments
Management therapy for weight management
four stages
- prevention plus
- structured weight management
- comprehensive multidisciplinary intervention
- tertiary care intervention
- Prevention Plus
BMI ≥ 85th but < 95th%
level of treatment builds upon: basic nutrition and PA
goal: promote health, prevent disease
single health care provider
- Structured Weight Management
BMI ≥ 85th but < 95th%
level of treatment builds upon: basic nutrition and PA
goal: promote health, prevent disease, emphasize nutrient-dense foods, monthly follow-ups
single health care provider
- Comprehensive Multidisciplinary Intervention
goal: promote health, prevent disease, emphasize nutrient-dense foods, monthly follow-ups
single health care provider
more structured eating/PA plans
logs for monitoring behavior, weekly follow-ups for 8-12 weeks
multidisciplinary teams (M.D., pediatric nurse, councilor, RD, exercise specialist)
- Tertiary Care Intervention
severely obese youth or those with significant chronic co-morbidity conditions
may include bariatric surgery
Bariatric Surgery
only if obesity has medical co-morbidities
must have completed growth spurt and have either; BMI > 35 with major complications, or BMI > 40 with minor complications
long-term success not established
Role of RD in Bariatric Surgery
counsel adherence to:
strict eating guidelines
supplement prescription
reduction of portion size
Hypertension Risk
family history, high sodium intake, obesity, hyperlipidemia, inactive lifestyle, tobacco use
Nutrition Counseling for Hypertension
limit sodium intake, limit fat to 30% of calories, consume adequate fruits/veggies/whole grains/low-fat dairy, weight loss if overweight, dietary recommendations even with meds
Hyperlipidemia Risk
~1-4 adolescents have elevated cholesterol
family history, cig. smoking, overweight, hypertension, diabeetus, physical inactivity
Nutrition Counseling for Hyperlipidemia
<10% cal form sat. fat
cholesterol intake ≤300 mg/d
adequate fruits/veggies/grains/low-fat dairy
Dieting (disorders)
most common
dieting/unhealthy weight control may increase chance of future overweight/obesity
nutritional messages should focus on lifestyle changes
low body satisfaction is more likely to lead to unhealthy weight control
Disordered Eating Behaviors
results of 2011 youth risk behavior surveillance:
12% have fasted > 24 hours
5% use diet pills or other diet formulate
4.3% vomit or use laxatives to control wt
Three main eating disorders
Anorexia Nervosa - extreme weight loss, poor body image, irrational fear of wt gain
Bulimia Nervosa - recurrent episodes of rapid eating of large amounts in short time followed by purging
Binge-Eating Disorder - periodic binge eating not associated with vomiting, laxatives or exercise
Anorexia Nervosa Diagnosis
intense fear of gaining weight or becoming fat, even though underweight
self image dissatisfaction
refusal to maintain body weight at or above minimally normal weight for age and height
~ 10-15% die from disease
~ 40-50% recovery rate
Bulimia Nervosa Diagnosis
recurrent episodes of binge eating (eating a lot in a short period of time and without control)
followed by use of vomiting, laxatives or other meds, or excessive exercise
occurs at least twice a week for 3 months
does not occur exclusively during episodes of anorexia nervosa
~ 2-3% die from disease
up to ~48% recovery rate
Binge-Eating Disorder Diagnosis
Binge eating not associated with anorexia nervosa or bulimia nervosa, not vomiting, etc.
Contributing Factors to Eating Disorders
- environmental
- familial factors
- interpersonal factors
- personal factors
Treating Eating Disorders
multidisciplinary team approach
physician, dietitian, nurse, psychologist, psychiatrist
goal: restore body weight, improve social/environmental well-being, normalize eating behaviors
Preventing Eating Disorders
programs that focus on changing weight-related attitudes, promote healthy weight-control strategies were found to be most successful
to be successful: target high-risk groups, trained interventionists, multiple sessions, integrated interactive learning