Exam 3 Obesity

Question 1

Reported vs. actual studies

Answer 1

Often caloric intake way under-reported

Output often over-reported

Question 2

Energy expenditure _______ with weight gain

Answer 2

Increases

Question 3

Weight loss keys

Answer 3

Create negative energy balance
Most practicle: reduce food intake
1-2 lbs per week (500 to 1000 kcal/day)

Question 4

Weight bias

Answer 4

See as less compliant

Want to treat less, less job satisfaction

Question 5

Ways to accomidate weight bias

Answer 5

Most have had bad interaction with provider
Most have tried to loose weight
Can we talk about “weight” not obesity

Question 6

Tools for weight loss

Answer 6

Food diaries and record keeping
Fat gram budget - limit intake but have diet approach (not just eat less)
Decrease portions
Decrease energy density

Question 7

DG Nutrient content

Answer 7

55% carbohydrate
15% protein
30% fat

Question 8

Meal replacement

Answer 8

Not just bar

Need to have carbs/fat/protein and vitamins

Question 9

Self help diets

Answer 9

Balanced macronutrients diets have better retention
All had similar weight loss at 1 yr
Best diet is one patient can stay on

Question 10

High intensity programs

Answer 10

On-site, 14 sessions in 6 months

Trained interventionist with personal feedback

Question 11

Creating better energy balance

Answer 11

Limit screen/TV time
Longer sleep duration
(sleep deprivation leads to muscle breakdown leads to decreased EE)
Social environment/neighborhood

Question 12

Weight loss maintenance

Answer 12

Energy balance

Physical activity

Question 13

Physical activity

Answer 13

Doesn’t help short term loss
Does change body composition (helps with maintenance)
Helps preserve fat free mass

Question 14

Type of physical activity

Answer 14

Combined aerobic and resistance
30 min a day help decrease weight effects
60 min a day prevent weight regain
Have specific goal - FITT
Can be lifestyle or programmed activity

Question 15

Pedometer activity program

Answer 15

Increase by 500 steps/day

10,000-15,000 should be goal

Question 16

Problems keeping weight off

Answer 16

Higher ghrelin levels even 1 year after loss

Less fullness feelings

Question 17

Adaptations to overfeeding

Answer 17

Chronic overfeeding leads to less than expected weight gain (based on amount of calories ingested)
Significant individual differences

Question 18

Adaptations to environment

Answer 18

Genetics
Increased EE (REE, TEF, Activity - fidgeting)
Substrate metabolism (fat ox)
Reduced intake/appetite (behavioral changes)

Question 19

Neuronal control of hunger

Answer 19

Lateral nucleus of the hypothalamus = hunger
Ablation -> mice refusing to eat
Ventromedial nucleus of the hypothalamus = satiety
Ablation -> fatty mice

Question 20

Leptin

Answer 20

Released by adipose tissue

Stimulates catabolic, inhibits anabolic

Question 21

Satiety hormones released by distal ileum

Answer 21

PYY

GLP-1

Question 22

Problems of homeostatic set point

Answer 22

Biology is set for undernutrition

Resistance to leptin and other hormones?

Question 23

Obesity prone non-homeostatic mechs

Answer 23

More persistent:
Attention
Reward
Motivation
Memory
Activation of insula and pfc in fed state