Chapter 23: Managing Weight Loss Plateaus And Maintaining Weight

Question 1

Plateau

Answer 1

A period of stalled progress of 1 month or longer.

Question 2

Energy Balance

Answer 2

The amount of calories consumed compared to the amount of calories expended.

Question 3

Dietary Adherence

Answer 3

The degree to which an individual sticks with a diet.

Question 4

Reduced Obese

Answer 4

Obese people who have lost weight.

Question 5

Satiety

Answer 5

A feeling of fullness and satisfaction.

Question 6

Hyperpalatable

Answer 6

Foods that are ultra-processed and made to be highly appealing to our senses.

Question 7

Maintenance Practice

Answer 7

Periods of body weight plateaus where a client practices maintenance of habits and becomes used to the new body weight.

Question 8

Metabolic Adaptation

Answer 8

A greater-than-expected decrease in energy expenditure due to weight loss.

Question 9

Satiety

Answer 9

A feeling of fullness and satisfaction.

Question 10

Energy Density

Answer 10

The amount of calories relative to the volume or weight of a food, often expressed in calories per gram.

Question 11

Buffet Effect

Answer 11

The tendency for people to eat more when offered a wide variety of foods.

Question 12

Optimal Foraging Theory (OFT)

Answer 12

Refers to how human brains assign value to food – OFT is defined by the calories gained from a food relative to how much energy and time is needed to obtain it.

Question 13

Impaired Satiety Signals

Answer 13

A loss of effectiveness of the signals that travel to the brain and tell people they are full.

Question 14

Sedentary Lifestyle

Answer 14

Randomized controlled trials (RCTs) show that weight regain is more likely when physical activity energy expenditure is low (1,000 calories per week) (Tate, Jeffery, Sherwood, & Wing, 2007). Low leisure time is likely to lead to weight regain (Elfhag & Rossner, 2005). Perceived barriers for carrying out physical activity are also associated with weight regain (Elfhag & Rossner, 2005). The use of activity monitors like accelerometers and pedometers can be useful in providing feedback on overall daily physical-activity levels.

Question 15

Disinhibited eating

Answer 15

People that tend to have no restraint regarding their eating habits are more likely to regain weight (Elfhag & Rossner, 2005). While long-term maintenance allows for more flexibility than a weight-loss phase, some restraint is still necessary. Thus, continuing to practice some of the same restrained eating habits during maintenance, as what was practiced during active weight loss, can be helpful.

Question 16

Dichotomous view of foods and a rigid approach to dieting

Answer 16

Rigid approaches are an all-or-nothing approach to dieting and allow for very little flexibility. They tend to label foods as good or bad or allowed or disallowed. Rigid approaches are associated with pre-occupation with food (Westenhoefer et al., 2013). Rigid, all-or-nothing approaches are a risk factor for periods of overeating (Linardon, 2018). Rigid control of eating behavior can increase feelings of deprivation and cravings (Meule, Westenhofer, & Kubler, 2011). Clients should avoid labeling foods in a dichotomous fashion and quality should be viewed on a continuum with some foods higher in quality (like fruits and vegetables) and some foods lower in quality (like energy-dense desserts).

Question 17

Binge Eating

Answer 17

Binge eating includes the consumption of large quantities of food while feeling a lack of control over eating. It is associated with increased risk of weight regain and people who binge eat experience distress about their episodes (Elfhag & Rossner, 2005). If a client has issues with binge eating, seeking out professional counseling from someone with expertise in binge eating can be helpful.

Question 18

Emotional eating, psychosocial stress, and low coping capacity

Answer 18

People who regain weight often have poor coping strategies and tend to eat in response to stressful events and emotions (Elfhag & Rossner, 2005). They may use escape-avoidance ways to cope that include eating and passively wish the problems would vanish (Elfhag & Rossner, 2005). Clients should be encouraged to find alternatives to eating for coping with stress. Clients should also be encouraged to actively problem solve when faced with challenging situations.

Question 19

Lack of social support

Answer 19

Lack of social support or negative involvement from family, spouses, or friends are associated with regain (Elfhag & Rossner, 2005). Clients should be encouraged to seek out support wherever they can. If support from family or friends is lacking, then support groups or Internet groups may be useful alternatives.

Question 20

Psychopathology

Answer 20

Depression or other psychiatric diagnoses may be associated with regain risk, although the research findings have not been consistent (Elfhag & Rossner, 2005). Clients should seek professional help in cases where psychopathology may be a risk factor.

Question 21

Medication-induced appetite elevation

Answer 21

Some medications may increase appetite and lead to weight regain. For example, glucocorticoid medications can increase appetite and food reward, leading to abdominal weight gain (Serfling, Buades-Rotger, Harbeck, Kramer, & Brabant, 2018). Clients should discuss their medications and potential alternatives with their physicians.

Question 22

Excessive Loss of Fat-Free Mass

Answer 22

The percentage of weight loss from fat-free mass during a diet is a predictor of subsequent weight regain (Vink, Roumans, Arkenbosch, Mariman, & van Baak, 2016). Exercise can be an important tool to help prevent the loss of fat-free mass.

Question 23

Diet Burnout

Answer 23

Long-term weight maintenance takes increased effort (Kruseman, Schmutz, & Carrard, 2017). The constant required effort may lead to psychological burnout, particularly if the diet is disliked, there is a lack of flexibility, and/or there is no break from the diet. Thus, it is important to ensure a diet fits a client’s preferences and has adequate flexibility to help prevent burnout. Prescription of maintenance breaks can also be useful.

Question 24

Weight Cycling

Answer 24

Repetitive cycles of weight loss followed by weight regain where most or all of the weight is gained back.

Question 25

Intermittent Dietary Strategies

Answer 25

Alternating periods of energy restriction with periods of maintenance or diet breaks.

Question 26

What period of stalled progress best represents a weight loss plateau?

Answer 26

One month or longer

Question 27

What is the main reason for a weight loss plateau?

Answer 27

An increase in energy intake so energy intake matches energy expenditure.

Question 28

True or False? It’s not a matter of if a plateau will occur, but when.

Answer 28

True

Question 29

Which item represents a reason for poor long-term weight maintenance statistics?

Answer 29

Impaired satiety signals

Question 30

Setting a “red-light number” in terms of weight regain as a trigger for action can be useful for maintaining long-term weight loss. This is best categorised under which maintenance-associated factor?

Answer 30

Self-monitoring

Question 31

A client tells their Nutrition Coach that co-workers bring doughnuts to work every morning. Which psychological barrier to adherence does this represent?

Answer 31

Situational barrier

Question 32

A client tells their Nutrition Coach, “First the experts told us to decrease our fat intake, now they tell us to decrease our carb intake! I don’t know what to do.” Which psychological barrier to adherence does this represent?

Answer 32

Confusion

Question 33

Which item represents a method for cognitively reframing a weight-loss plateau?

Answer 33

Consider plateaus as maintenance practice or opportunities to test the programme sustainability.

Question 34

Setting a red-light number in terms of weight regain as a trigger for action can be useful for maintaining long-term weight loss. This is best categorised under which maintenance-associated factor?

Answer 34

Self-monitoring

Question 35

A client has just started a weight-loss programme and is trying a low-carb diet. There has not been any weight-loss for the first 3 weeks of the diet. Which item represents the best approach to managing this situation?

Answer 35

Change the dietary strategy, as early adherence predicts long-term adherence.

Question 36

A client’s previous diet involved a list of “good” or “bad” foods. Which characteristic of successful long-term weight maintenance would be useful for this client?

Answer 36

Flexible dietary control

Question 37

Which item represents the likely outcome of a lapse in dietary adherence?

Answer 37

Increase in energy intake

Question 38

Which item refers to the amount of calories provided from a food, in relation to how much energy and time it took to get it?

Answer 38

Optimal Foraging Theory

Question 39

A client has been under a lot of stress which has been leading to incidents of overeating. On which characteristic of successful long-term weight maintenance should this client work?

Answer 39

Coping capacity

Question 40

A person has not experienced any weight loss for 8 weeks. Which of the following best represents what needs to happen for this person to start to experience weight loss again?

Answer 40

Increase energy expenditure

Question 41

Which of the following can help a client adhere to a diet without negatively effecting long-term success?

Answer 41

Intermittent dietary strategies

Question 42

A client is looking to change nutritional habits and start a diet consisting of high protein and plenty of fruits and vegetables. Which item represents the best way to initially go about this?

Answer 42

Establish a specific plan for the diet and how to follow through with it.

Question 43

What types of foods are the best example of staples of a low energy density diet?

Answer 43

Whole fruits and vegetables