Chapter 21: MNT in Weight Management and Eating Disorders Flashcards
a pathologic condition when the actual body weight is more than 111-119% of the desirable body weight
overweight
a pathologic condition when the actual body weight is more than 120% than the desirable body weight
obesity
aka quetelet index
body mass index (BMI)
is the ratio of weight in kg to height in m2
this provides a measure of body mass ranging from thinness (chronic energy deficit) to adiposity or obesity
bmi
obesity - types
central body fat distribution
apple-shaped
android
obesity - types
lower body fat distribution
pear-shapes
gynoid or gynecoid
obesity - classification
due to an imbalance of energy intake and expenditure
simple
obesity - classification
ob gene that codes for leptin; the 40% chance of being obese when one parent is obese is responsible for obesities in many cases
genetic
obesity - classification
adult onset obesity; increase in size of fat cells
hypertrophic
obesity - classification
childhood onset obesity; increase in number of fat cells
hyperplastic
obesity - classification
due to Cushing syndrome, hypothyroidism, pregnancy
endocrine-related obesities
etiologic factors - heredity/genetics
ob gene codes that suppresses appetite and increases energy expenditure
leptin
etiologic factors - heredity/genetics
permit only heat loss; no formation of adenosine triphosphate; increase basal metabolic rate (BMR); resist weight gain
uncoupling proteins
etiologic factors - heredity/genetics
releases energy as heat
brown fat
etiologic factors - heredity/genetics
stores the energy
white fat
etiologic factors
fat cells only shrink their sized but not reduce their number
childhood nutrition
etiologic factors
can increase tendency to binge eat; can also cause weight gain after drastic weight loss
stress
etiologic factors
low physical activity increases deposition of fats
activity
overweight/obesity - dietary mgmt
it is reasonable to lose _____ lbs per week
1-2 lbs
overweight/obesity - dietary mgmt
to lose 1-2 lbs per week, a deduction of _____ kcal from the total energy requirement is needed
500-1000 kcal
overweight/obesity - dietary mgmt
basis of estimate
1 g of fat = _____ kcal
9 kcal
overweight/obesity - dietary mgmt
basis of estimate
1 g body fat = _____ kcal
7.7 kcal
overweight/obesity - dietary mgmt
basis of estimate
1 lb body fat _____ g
454.55 x 7.7 = 3500 kcal
3500/7 days = 500 kcal
454.55 g
overweight/obesity - dietary mgmt
TER may be based on
_____ and _____ with the deduction of 500-1000 kcal to effect a 1-2 lbs/week loss
actual body weight and level of PA
overweight/obesity - dietary mgmt
TER may be based on: desirable body weight and level of activity
desirable body wt (kg) with _____ kcal/day
20-25 kcal/day
overweight/obesity - dietary mgmt
TER may be based on: desirable body weight and level of activity
desirable body wt (lb) with _____ kcal/day
10 kcal/day
overweight/obesity - dietary mgmt
meal plan: a high-fat diet contributes to increased food intake because it is palatable, has increased energy value, low satiety, low leptin supply, and efficient metabolism
low-fat diets
overweight/obesity - dietary mgmt
meal plan: controlled because glucose contributed glycerol phosphate for synthesis of fat (for cho-sensitive individuals) and adequate water
cho
overweight/obesity - dietary mgmt
meal plan: vitamin mineral supplementation may be necessary for _____ kcal
1200 kcal
low kcal diet
1200 kcal
very low kcal diet
given to those who are morbidly obese and those who will undergo Bariatric surgery
800 kcal
overweight/obesity - mgmt
build lean mass, regulates appetite, increases energy expenditure, increases BMR and reduces stress
exercise
overweight/obesity - dietary mgmt
meal plan: the cornerstone of lifestyle modification; focuses on restructuring a person’s environment, nutrient intake, and physical activity by using goal setting, stimulus control, cognitive restructuring, and relapse prevention
behavior modification
overweight/obesity - mgmt
tranquilizers, appetite-suppressant, hormones to correct imbalance, diuretics
medical
weight mgmt - issues
espouse exaggerated or false theories of weight loss and advise consumers to follow inadequate diets
fad diets
weight mgmt - issues
lipoprotein lipase (which hydrolyzes fat after delivery to the adipose tissues) is activated causing more weight gain after weight loss
weight cycling
weight mgmt - issues (dangerous drugs)
can cause dry mouth, tachycardia, insomnia, kidney failures, seizures, and strokes), ephedra (death, psychosis, strokes, and seizures
phenylpropanolamine
weight mgmt - issues (dangerous drugs)
cause death, psychosis, strokes, and seizures
ephedra
weight mgmt - issues (dangerous drugs)
increases BMR
triiodothyroacetic acid
refers to the state when the ABW is less than 90% of the DBW
or the BMI is less then 18.5 kg/m2
underweight
causes:
-low food intake
-increased activity
-malabsorption
-increased metabolism
underweight
underweight - dietary mgmt
calculate TER based on: ABW and level of PA with the addition of _____ kcal to effect 1-2 lbs/week weight gain
500-1000 kcal
underweight - dietary mgmt
calculate TER based on: desirable body weight and level of activity
-
underweight - dietary mgmt
calculate TER based on: desirable body weight (kg) with _____
45-50 kcal/day
underweight - mgmt
may promote gaining of lean mass
exercise
underweight - mgmt
small frequent feeding, healthier eating habits, less strenuous activities
behavior modifications
underweight - mgmt
appetite enhancers
drugs
eating disorders
refers to an eating disorder characterized by a refusal to maintain a minimally normal body weight and a distortion of body shape and weight
anorexia nervosa
eating disorders
etiological factors: distorted body image brought about by familial or environment influences
anorexia nervosa
eating disorders
characteristics:
-refusal to gain weight
-intense fear of gaining weight tho underweight
-disturbance in the way body shape is experience
-amenorrhea
anorexia nervosa
absence of menstrual periods
amenorrhea
eating disorders
types of anorexia nervosa (2)
restricting types and binging type
eating disorders - complications
hypothermia/dehydration
metabolic
eating disorders - complications
bradycardia, arrhythmia
cardiovascular
eating disorders - complications
electrolyte imbalance, anemia
nutritional
eating disorders - complications
leukopenia
hematologic
eating disorders - complications
azotemia
renal
eating disorders - complications
muscle weakness, stress fractures
musculoskeletal
eating disorders - complications
diarrhea, constipation, swollen glands, damaged lining, atrophy
gastrointestinal
eating disorders - complications
infection
immunologic
a condition that happens when waste product levels in your blood are too high
azotemia
dietary mgmt
use food items that do not promote early satiety; increase frequency; supplementations; cold or room temp foods; less caffeine
behavior modification, psychologic mgmt
anorexia nervosa
pertains to an eating disorder characterized by repeated episodes of binge eating usually followed by self-induced vomiting, misuse of laxatives or diuretics, fasting or excessive exercise
bulimia nervosa
eating disorders
characteristics:
-binge eating
-self-induced vomiting
-misuse of laxatives
-diuretics or enemas
-negative self-perceptions
bulimia nervosa
types of bulimia nervosa (2)
purging and non-purging types
eating disorders
complications:
metabolic acidosis, pharyngitis, esophagitis, parotitis, dental problems, colon injury, myocarditis
bulimia nervosa
eating disorders - mgmt
use of food items that promote early satiety; warm foods; include foods that require effort to eat in portions
bulimia nervosa
eating disorders - mgmt
eat slowly and seating down
bulimia nervosa
eating disorders - mgmt
use of antidepressants and opiate antagonists (restrict consumption of sweets and high fatty foods)
bulimia nervosa
