Chapter 4: Weight Management And Childhood Obesity Flashcards
1
Q
People First language with Obesity
A
“The boy with obesity” rather than “obese boy”
2
Q
What percent of adults are overweight?
A
54%
3
Q
What percentage of people live with obesity?
A
18% or 1 in 5
4
Q
What is Obesity?
A
Abnormal or excess body fat that impairs health
Lifelong chronic disease
Our bodies effectively defend our body fat
5
Q
What health problems is obesity the leading cause of?
A
Type 2 Diabetes
High Blood Pressure
Heart Disease
Stroke
6
Q
What does weight bias increase?
A
Morbidity and mortality
Inequities in employment, health care, and eduction
7
Q
What is a key Clinical Practice Guideline?
A
Shift to focus on patient health over weight loss
8
Q
Does excess fat affect health?
A
Yes if obesity
Also No as normal bodies have fat on them
9
Q
Who is Doctor Ian Patton?
A
Guest Lecturer
Director of Advocacy and Public Engagement at Obesity Canada
10
Q
What is Obesity Canada?
A
National Health Charity Organization
Improves lives through research, education & advocacy
Medical education and public education
11
Q
What did obesity used to be based on?
A
BMI (Body mass Index)
12
Q
What is obesity based on now?
A
Chronic disease, reduces lifespan, and impairs health
Beyond size and weight
13
Q
What body part regulates weight?
A
The brain !!!!
14
Q
What 3 factors contribute to obesity pathogenesis?
A
Complex biological, psychosocial and environmental factors
15
Q
T or F: Weight loss is eating less and moving more
A
False!!
16
Q
What are the three pillars of obesity management?
A
Psychological intervention
Pharmacological therapy
Bariatric Surgery
17
Q
What do the three pillars hold up?
A
Medical Nutrition Therapy
Physical activity
18
Q
International Foundations of Obesity Management (5)
A
- Complex, Chronic disease
- Driven by powerful underlying biology (not by choice)
- Many health effects of excess weight start early
- Treatable
- Bias, stigma, and discrimination are harmful
19
Q
What is the difference between bias, stigma, and discrimination?
A
Bias is a personal negative attitude and view held
Stigma is a social stereotype rooted from society
Discrimination is a verbal, physical, and relational action
20
Q
What percent of overweight adults are stigmatized by coworkers?
A
54%
21
Q
What percent of adults report a weight bias from a healthcare professional?
A
64%
22
Q
What percent of overweight kids have a higher change of getting bullied?
A
63%
23
Q
What percentage of photos and videos online stigmatize people with obesity?
A
Images: 72%
Videos: 77%
24
Q
What are overweight people subjected to in health care?
A
Less time spent on patients
Less patient discussion
Blaming issues on weight
Reduced preventative screening
Less intervention
25
Is shaming ineffective?
Yes!
It causes less weight loss as it increases bad eating behaviours
26
key themes of obesity from the Canadian Community
Demoralizing
Debilitating
Lonely
Exhausting
Shameful
Limiting
27
Obesity Media vs Obesity Canada Images
“No necks” vs show positive and everyday things (working out, going to the doctor, playing with children)
28
What do we need to stop discrimination?
Need Policy interventions
29
How much more likely are you to be discriminated if you are overweight, obese, or extremely obese?
Overweight: 12x
Obese: 30x
Extremely Obese: 100x
30
How much less do obese men and women make?
Men make 3% less
Women make 6% less
31
How many kids are overweight?
1/3 of kids
32
What percent of kids are obese?
11.7%
33
How many kids were overweight in 1978?
1/4
34
Socio Ecological Model of Childhood Obesity?
Child
Parent
family and peers
Neighborhood
School
Community
National Policies
35
What is the singular cause of paediatric obesity?
Is not
Complex interactions between child and environment
36
how much money is spent on food marketing each year?
1/2 billion
37
What does CHAMP stand for?
the Children’s Health and Activity Modification program
38
What was CHAMP based for?
Community and family based program
39
Who funded the CHAMP project?
Lawson Foundation
40
What is Jospehs Story?
11 year old Joseph was sent to a weight loss camp
After returning home he regained all the weight he had lost
41
What kind of project was CHAMP
Pilot project!!
42
What was the general purpose of CHAMP?
To develop, implement, and assess effectiveness of a 4 week lifestyle intervention for children with obesity and there families
43
What were the objectives of CHAMP?
Increase physical actitivity
Improve physiological and psychological outcomes
Improve dietary patterns and self efficacy
44
How many kids, and of what gender were participants in year 1?
15 kids, (8 female, 7 male)
Ages 8-14
45
How long was the intervention?
4 week long
August 2008 & 2009
Monday to Friday 9am-4pm
46
What was the BMI of the children?
95th percentile for age and sex
47
What was the group based education?
Nutrition education
Behaviour modification
Psychological education
Parent and booster sessions
48
Week 1 Program Details
Sports week
49
Week 2 Program Details
Healthy eating around the clock
50
Week 3 program details
Olympic Week
51
Week 4 Program details?
Adventure week
52
Research Components initial meeting criteria?
Letter of info, consent (child and parent)
Demographic questionnaire
Quality of Life (PedsQL4.0)
Acticals
DXA Scan
53
What is an Actical?
Measures children’s activity
Used 7 days before, after and 12 months later
54
What was the second research component?
Blood work and physical assessment with CHAMP paediatrician
55
What was the third research component?
Phone calls with parents and CHAMP dietician
Child self-efficacy towards healthy living questionnaire
56
What was the fourth research component?
First Day of CHAMP
Physical Activity Questionnaire
Fitness Testing (Cooper 12 minute walk test)
57
What was the fifth research component?
Mid- CHAMP assessments
Weekly fidelity checks (parents and kids)
Cohesion/ perceptions of belongingness
58
What was the 6th and final research component?
Focus group Interviews
After 4 weeks
Separate for kids and parents
59
What was the child verses the parent attendance?
Child: 91%
Parent: 69%
60
What was CHAMP families?
Parent focused lifestyle intervention for children with obesity
61
Why focus on parents?
More cost effective
Primary decision makers in meals
Can be more effective
62
What were the 3 components of CHAMP families?
Group Based
Home Based
Follow Up
63
What is the Group based component?
parent only
8, 90 minute health education session at local YMCA
Content delivered by researchers, health professionals and organizations
64
What is the group based curriculum?
Healthy eating
Screen time
Sedentary behaviours
Food marketing
Family communication
65
What is the Home based component?
Family component
Weekly worksheets completed at home
Family discussions and goal setting
66
What is the Follow- up component?
Family component
3 & 6 months post
Reiteration of information
67
What did the focus groups allow parents to feel more confident in?
In there role as “primary agent of change”
68
What was there a desire for after CHAMP Families?
Child and parent involvement together
69
What percentage of Canadians unintentionally gained weight in COVID
42%
70
What is the self reported percentage of overweight and obese adults?
36% are overweight
28% are obese
71
What 4 things are essential for weight management?
Long term coordination
Proper nutrition
Adequate physical activity
Stress management
72
What is Fat free mass?
Non-fat tissues, bones, water, muscle, connective tissues, organ tissue, and teeth
73
What is body fat?
Nerves, brain, heart, lungs, liver, mammary glands, and organs
Main source of stored energy
74
What are the three types of fat?
Subcutaneous fat
Visceral fat
Ectopic fat
75
What is Subcutaneous fat?
Protective layer of fat, buffer for excess energy, intake 80% of all fat.
76
What is visceral fat?
Fat embedded in the mesentary (connects intestines to abdominal wall).
Excess is linked to heart disease
77
How much visceral fat is in men verses women?
Men: 10-20%
Women: 5-8%
78
What is ectopic fat?
Located on or within organs (liver, heart, brain) increases risk for metabolic syndrome, heart disease, and stroke
79
How many calories is in 1kg of fat?
7000 calories
80
How many premature deaths between the age of 20-64 are attributable to obesity?
1 in 10
81
What is a positive energy balance?
More cals in than out (gain weight)
82
What is a negative energy balance?
Less cals in than out (lose weight)
83
What is the critique of height weight charts?
Inaccurate as it assumes all weight is fat
84
What is BMI?
Body Mass Index
Based on concept weight should be proportional to height
Doesn’t distinguish between fat weight and fat free weight
85
Who is BMI inaccurate for?
Short people, athletes, older adults, women
86
How do you calculate body weight?
Kg/h^2
87
What is a normal BMI?
18.5-24.9
88
What is an overweight BMI?
25-29.9
89
What is Obese Class 1 BMI?
30-34.9
90
What is Obese class 2 BMI?
35-39.9
91
What is Obese Class 3 BMI?
40+
92
What BMI is the diagnostic criteria for anorexia?
Below 17.5
93
What are Calipers used for?
Skinfold measurements, determines body fat levels
94
What percentage of body fat is considered very lean for men and women (not recommended)?
Women: 10-13%
Male: 3%
95
What is circumference measurement?
From top of hip bone & lowest rib
96
What does bod pod use to measure weight?
uses air instead of water
97
What is hydrostatic (underwater) weighing?
Most accurate for analyzing body composition
Body % fat is calculated from body density
Muscle has more density than fat in water
FAT FLOATS
98
Excess body fat reduces life expectancy by how much?
20 years
99
how much is the average north american life expectancy expected to drop?
Drop by 5 years
100
What % of total body weight loss can improve health?
5-10%
101
What is the fifth cause of death in Canada?
Diabetes
102
What % of Canadians live with or have pre diabetes?
29%
103
What are the early symptoms of diabetes?
No symptoms in the early stages
104
What is type 1 diabetes?
Viral infection
Body’s immune system destroys insulin producing cells in the pancreas
105
What percentage is Diabetes increasing by? When does it usually strike?
3-5% yearly in Canada
Strikes before 30
Common onset 10-14 years
106
What is type 2 diabetes?
Pancreas doesn’t produce enough insulin, or/and cells are resistant to insulin
107
What is something new about Type 2 diabetes?
It is occurring in children
Used to only occur in people 40+
108
What percent of people with Type 2 diabetes are unaware?
33%
109
How common is gestational diabetes?
1 in 10
110
When does gestational diabetes occur?
With babies bigger than 9 pounds
Disappears after pregnancy
111
What percent of women with gestational diabetes eventually develop type 2 diabetes?
30%
112
What percent of people with pre diabetes will develop type 2 diabetes?
1/2
113
What percentage of people of Canadians are estimated to have diabetes by 2031? What percentage in each age group?
33%
18.1% 65+
1.1% 18-34
3.7% 35-49
9.9% 50-64
114
What percentage of strokes, heart attacks, and non-trauma leg/foot amputations are caused by diabetes?
Strokes: 30%
Heart Attacks: 40%
Foot Amp: 70%
115
If you are depressed what increase of developing type 2 diabetes do you have?
40-60%
116
What percent of type 2 diabetes could be prevented?
90%
5-7% weight loss reduces risk up to 69%
117
Which ethnicities have an increased risk of Type 2 diabetes?
Indigenous, African, Arab, Asian Hispanic and south Asian
118
Women who are mildly or moderately overweight have what increased chance of developing coronary heart disease?
80%
119
5A’s of Obesity Management: From practioner to patient
Ask- permission to discuss weight
Asses- obesity related risks and root causes
Advise- health risk and treatment
Agree- outcomes and goals
Assist- accessing appropriate resource
120
Where do men and post menopausal women store fat?
In upper regions of there bodies (abdominal)
121
Where do Premenopausal women store fat?
Hips, butt and thighs
122
At what circumference in men and women is there an increase of chronic disease?
Men- 40in
Women- 35in
123
What is extreme leanness linked to?
Linked to reproductive, circulatory, and immune system disorders
Ex. Muscle wasting, fatigue, eating disorders
124
What is the female athlete triad?
Abnormal eating and excess exercise
Leads to amenorrhea (loss of period)
Decreased bone density (premature osteoporosis)
Leads to decreased performance, heart disturbances and death
125
What is Nutrigenomics?
Study of how nutrients and genes interact
126
How many genes are associated with body size, shape, fat and metabolic rate?
50 genes
127
What is the % chance of a child being obese if there parent is?
40% chance
80% if both parents
128
Which is inherited the tendency or the expression of obesity?
Tendency: inherited
Expression: affected by environmental and behavioural factors
129
What is Metabolism?
Sum of all vital processes food, energy and nutrients are made available and used by body
130
How much is the Resting metabolic rate used for daily life?
65-70% of daily energy
10% digestion
20-30% physical activity
131
What does a higher RMR mean?
Increased muscle mass
Can burn more cals at rest and can take in more cals and not gain weight
132
What type of training can protect against age related RMR decline?
Resistance training
133
What is hormones role?
In accumulation of body fat (especially in women)
Puberty, pregnancy, and menopause contribute to amount and location of fat
134
What does Leptin Hormone do?
Let’s brain know how big or small fat stores are
135
What does the Gherlin Hormone do?
Goes up before eating and down 3 hours after a meal
Regulates weight, sleep, whole grains lower it
136
What are adipose cells?
Fat is stored in the adipose tissue and the adipose cells inflate to hold body fat
137
What is the difference between visceral fat and subcutaneous fat?
Visceral fat is bio active and metabolically active (holds inflammatory chemicals, and growth factors)
Subcutaneous fat carries little to no health risk (soft and flabby) not metabolically active
138
What is gynoid obesity?
Lower body fat (pear shaped)
139
What is Android Obesity?
Upper body fat (apple shape)
140
Where are the highest obesity rates found in Canada (geographically)?
Rural areas and Atlantic Canada
141
In Asian people which is a better predictor of obesity: waist circumference or BMI
Waist circumference
142
How much do people underestimate there caloric intake by?
30%
143
What percent of kids 5-17 met movement guidelines before COVID
15%
144
What percent of overweight people watch excessive TV?
60%
145
Sleep debt and short sleep duration is associated with what?
Increased BMI and abdominal obesity
146
What percent of food ads are unhealthy?
90%
147
Name 4 obesogens:
DES, BPA, phthalates, organotins
148
What obesogen is banned?
Partially hydrogenated oils (PHO) in 2018
149
What 2 things disrupt the body’s control over fat production and energy?
Endocrine disrupting chemicals and ones relationships to weight gain
150
What happens when food becomes the primary means of regulating emotions?
Binge eating/ eating disorders
151
Are men or women more obese at a higher income?
Men are more obese at a higher income and women are at lower income
152
T or F: Slow weight gain over time is a major cause of obesity
True
153
What is the health halo effect?
Overestimate how something is based off a single claim
154
T or F: Foods low in energy density have more volume and Bulk
True
155
How many meals should you eat for weight management?
4-5 small meals per day
156
Skipping meals leads to what:
Excessive hunger, deprivation and increased vulnerability to binge eating
157
Is the freshman 15 real?
No
Freshman 7.5 and only effects 60%
158
T of F people who eat breakfast consume more calories in a day
False they consume less
159
What happens to low cal dieters?
Rapid loss of body water, and then weight loss slows
160
What do formulas and food bars result in?
Rapid weight loss that is then gained back
161
How many grams of fibre do you need in a day?
25 to 38 grams
162
What does caffeine cause?
Nervousness, jitteriness, vomiting and tachycardia
163
What does TOPS stand for and OA?
Take off pounds sensibly
Overeaters anonymous
164
How many weight watchers users maintain weight loss?
10-15%
165
What percent of noom users report weight loss?
80%
166
Which weight loss drug is approved for long term use? How does it function?
Xenical
Lowers calorie consumption by blocking fat absorption in the intestines, prevents 30% of fat from being digested
167
When does weight loss level off (from drugs)
4-6 months
168
When is prescription weight loss recommended?
BMI 30+
Or 27+ with 2 other risk factors
169
Class 2 and 3 obesity has increased how much since 1985?
455%
170
When is surgery recommended?
BMI 40+
Or BMI 35+ with 2 or more risk factors
171
What is the re-operation rate and mortality rate of surgery
Re-op: 7%
Mortality: 1%
172
How many people are affected by body dysmorphia?
350 000
Usually begins before 18
173
What are the different types of weight loss surgery?
Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable banding procedure
174
Which weight loss procedure is the safest?
banding as it is the least invasive
Total weight loss is 40-70% of fat
175
What is muscle dysmorphia?
Body builders thinking they are skinny and out of shape
176
What % of grade 8 girls verses boys are happy with there bodies
Girls: 30%
Boys: 70%
177
What percent of normal women think they are overweight? What percent overestimate body size?
75% overweight
90% overestimate
178
Which race of women are considered more confident?
Black girls have the “right attitude”
179
How much skinnier are fashion models than North American women?
98%
180
What’s does OFSED stand for?
Other specified feeding or eating disorder
