General

Question 1

hypertrophic obersity

Answer 1

obersity characteriszed by increase in fat cell size

fat cell weight in avg-weight ppl = .5 micrograms

with weight gain, increase to 1.0 micrograms

Question 2

what happens after the cell reaches 1.0 micrograms

Answer 2

hyperplastic obesity is more likely, i.e. increase in the NUMBER of fat cells rather than only inceeases in size

Question 3

avg weight person number of fat cells?

Answer 3

25-35 billion.

a person with BMI over or at 40, can have as many as 100-150 billion cells

Question 4

BEST Treatment

Answer 4

B = biological, e = enivron, s = social/psych, t = timing present weight loss effort, and together with patient in considering all four factors will choos ehte best Treatment

Question 5

given what you know about hypertrophic vs. hyperplastic, why do some patients fail to reach sttsitically average weight even with bariatric surgery?

Answer 5

patients with severe hyperplastic obesity can have as many as two to three times as many fat cells as the average person. thus even when nomral fat cell weight (0.5 micrograsm) is aheived the patient still possess an increased fat mass

Question 6

can i assess for fat cell size and number directly

Answer 6

no, obviously not, but i can estimate based of a chart in the Wadden and Phelan chapter

plots the relationship between cell number (billions) and percetnage of ideal body weight

Question 7

how much variation to our genes account for when it comes to our weight

Answer 7

20-40%, twin and family studies (some estimates as high as 70%); polygenic

Question 8

in addition to body weight, _______ seems to be heritable too

Answer 8

fat distribution

Question 9

since there’s no good way yet to test someones genetic predispostion to obesity, how can i estimate how much biology is playing a role?

Answer 9

asses age of onsent, family history, and weight loss history

Question 10

what is the strongest predictor of adult obseity?

Answer 10

the combination of, childhood onset of obseity + family history of obseity

70-75% of kids with these risk factor go on to be obse as adults

Question 11

childhood and adolescent onset ____) your risk of adlt obseity

Answer 11

doubles

Question 12

having one obese parent ______ your risk of adult obseity

Answer 12

doubles

Question 13

which is stronger predciotr? mom or dad?

Answer 13

maternal obserity seems to be a stronger predicotr

Question 14

when getting a family weight history dont forget to assess:

Answer 14

parents, sibiliing, maternal and paternal grandparents

Question 15

what does rapid weight gain after treatment suggest?

Answer 15

higher likelyhood of hyperplastic obesity, greater biologiocal influence, patient may not regain statitically average weight

Question 16

if you suspect a marked biological predisposition what are three things you want to talk with the pateint about?

Answer 16

1) the fact that even though theres iekly a strong bio influence on teir weight and body shape, the environement still plays a big role
2) changes they make to their environemnt, treatment, can result in weight looss (even if they never achievne stat average weight)
3) ack bio influence can relive the guilt some atients feel

Question 17

when assessing the “E” in BEST, what are the major areas you want to cover?

Answer 17

eating patterns, daily caloric intake, probelm eating, and physical activity