Chapter 15 - Final Exam

Question 1

Adolescent Overweight/Obesity

Answer 1

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

Question 2

Assessing weight status

Answer 2

BMI for age/gender is used to assess
BMI ≥ 85th to < 95th % = overweight
BMI ≥ 95% = obese

Question 3

Health implications of adolescent obesity

Answer 3

hypertension
dyslipidemia
insulin resistance/type 2 diabeetus
sleep apnea
orthopedic problems
hepatic disease
body image disturbances
self esteem

Question 4

Screening/treatment of overweight adolescents

Answer 4

screen all adolescents wt-for-ht yearly

overweight/obese individuals require in-depth medical assessments

Question 5

Management therapy for weight management

Answer 5

four stages

1. prevention plus
2. structured weight management
3. comprehensive multidisciplinary intervention
4. tertiary care intervention

Question 6

1. Prevention Plus

Answer 6

BMI ≥ 85th but < 95th%
level of treatment builds upon: basic nutrition and PA
goal: promote health, prevent disease
single health care provider

Question 7

2. Structured Weight Management

Answer 7

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

Question 8

3. Comprehensive Multidisciplinary Intervention

Answer 8

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)

Question 9

4. Tertiary Care Intervention

Answer 9

severely obese youth or those with significant chronic co-morbidity conditions
may include bariatric surgery

Question 10

Bariatric Surgery

Answer 10

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

Question 11

Role of RD in Bariatric Surgery

Answer 11

counsel adherence to:
strict eating guidelines
supplement prescription
reduction of portion size

Question 12

Hypertension Risk

Answer 12

family history, high sodium intake, obesity, hyperlipidemia, inactive lifestyle, tobacco use

Question 13

Nutrition Counseling for Hypertension

Answer 13

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

Question 14

Hyperlipidemia Risk

Answer 14

~1-4 adolescents have elevated cholesterol

family history, cig. smoking, overweight, hypertension, diabeetus, physical inactivity

Question 15

Nutrition Counseling for Hyperlipidemia

Answer 15

<10% cal form sat. fat
cholesterol intake ≤300 mg/d
adequate fruits/veggies/grains/low-fat dairy

Question 16

Dieting (disorders)

Answer 16

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

Question 17

Disordered Eating Behaviors

Answer 17

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

Question 18

Three main eating disorders

Answer 18

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

Question 19

Anorexia Nervosa Diagnosis

Answer 19

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

Question 20

Bulimia Nervosa Diagnosis

Answer 20

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

Question 21

Binge-Eating Disorder Diagnosis

Answer 21

Binge eating not associated with anorexia nervosa or bulimia nervosa, not vomiting, etc.

Question 22

Contributing Factors to Eating Disorders

Answer 22

1. environmental
2. familial factors
3. interpersonal factors
4. personal factors

Question 23

Treating Eating Disorders

Answer 23

multidisciplinary team approach
physician, dietitian, nurse, psychologist, psychiatrist
goal: restore body weight, improve social/environmental well-being, normalize eating behaviors

Question 24

Preventing Eating Disorders

Answer 24

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