Module 10 Flashcards
Intro to Management of Obesity
1
Q
Briefly explain each step of the obesity algorithm.
A
- Data collection: information about the patients/client is collected
- Evaluation and Assessment: Edmonton Staging System classification made for patient
- Management decisions: tailor a particular intervention towards an individual’s needs
- Motivational interviewing
2
Q
Why is the Edmonton Staging system a better measure of obesity than BMI?
A
- It can predict risk of mortality (whereas BMI risk is all the same)
- Higher stages associated with higher hazard ratios for CVD and cancer
3
Q
What are the 5 A’s of obesity management?
A
- Ask - are they ok with discussing their weight?
- Assess - eating behaviours, drivers of excess weight gain, and obesity stage.
- Advise - health risks of obesity, the benefits of modest weight loss, treatment options
- Agree - on realistic goals
- Arrange/Assist - individualized dietary and exercise prescription, Assist in identifying and addressing barriers; provide resources; assist in finding and consulting with appropriate providers; arrange regular follow up
4
Q
After periods of dieting, what tends to happen. Give some reasons for why this happens.
A
- People regain the weight after the dieting ends
- This may be due to physiological adaptations that cause ghrelin levels to increase and levels of satiety factors (leptin, peptide YY, cholecystokinin) to decrease
5
Q
Briefly outline the Minnesota starvation study and what it found.
A
Study design:
- 3 months observation, normal diet (~3492 kcal/d)
- 6 months semi-starvation, calories halved (1570 kcal/d)
- 3 month structures refeeding (4 groups at different caloric intakes)
- Optional 8 weeks of unrestricted feeding
Findings:
- After the study, men ate beyond initial levels (around 3000-5000 kcal/day)
- Weight returned to 109% of initial
- Body fat percentage remained higher than initial weight
6
Q
What was the most notable finding from the “Biggest Loser” study
A
Even though the participants were able to spare fat-free mass, their RMR dropped disproportionately (metabolic adaptation)
7
Q
Define metabolic adaptation.
A
Residual RMR after adjusting for changes in body composition and age
8
Q
List some potential strategies for preventing metabolic adaptations during weight loss.
A
- Focus on higher protein intake
- Perhaps increase fiber intake
- Diet breaks and refeeds
