Module 9

Question 1

What are the three somatotype’s

Answer 1

1. Endomorph
2. Mesomorph
3. Ectomorph

Question 2

Describe the different ways that we can estimate body composition

Answer 2

1. Hydro densitometry
2. Air displacement
3. DXA
4. Bioelectrical impedance
5. Skinfolds

Question 3

What is the equation for BMI, and what are the different classes

Answer 3

Underweight = <18.5
Normal = 18.5-24.9
Overweight = 25–29.9
Obese class 1 = 30–34.9
 Obese class 2 = 35–39.9
Obesity class 3 = >40

Question 4

What are the advantages and disadvantages to calculating body composition with BMI

Answer 4

Advantages: cheap, quick, easy and non-invasive
Disadvantages: does not differentiate muscle and fat

Question 5

What composition of body fat is necessary for the health of men and women

Answer 5

Essential fat: men = 3%, women = 12%
Total fat: men = 12–15%, women = 25–28%

Question 6

Define hyperplasia

Answer 6

Hyperplasia: an increase in the reproduction rate of new body fat cells

Question 7

Define hypertrophy

Answer 7

Hypertrophy: an increase in the size of existing fat cells

Question 8

What are the two categories for distribution of body fat

Answer 8

Android and gyNoid

Question 9

What waist to hip ratio is considered healthy

Answer 9

Women = less than 0.8
Men = less than 0.9

Question 10

What occurs with excess or dysfunctional adiposity

Answer 10

Inflammation, increased risk of metabolic, mechanical and mental health complications. Potential complications include type two diabetes, hypertension, sleep apnea, osteoarthritis, cancers. Obesity reduces healthy life years and can reduce expectancy by 6–14 years

Question 11

What are the main causes of obesity

Answer 11

1. Drugs (Some anti-depressants and steroids can cause significant weight gain)
2. Endocrine disrupting chemicals (Can interfere with hormones and endocrine functions)
3. Epigenetics (Heritability of obesity is 40–70%)
4. Ethnicity
5. Excessive caloric intake
6. Gastrointestinal microbiome (to fila are predominantly seen to inhabit people with obesity: firmicutes and bacterioides)
7. Gestational weight gain and diabetes (contributes to obesity in children)
8. Medical conditions (Metabolic syndrome)
9. Physical inactivity (More than 28% of the world and 81% of adolescence are in active)
10. Psychosocial stress (Stress increases exposure to glucocorticoid which promote obesity)
11. Sleep (Lack of sleep produces glucose intolerance, insulin sensitivity and increases cortisol)
12. Socio economic status

Question 12

Table of hormones, produced, stimulus, action

Question 13

How many people are currently obese?

Answer 13

800 million people are currently obese
39 million are children under five, 340 million are aged 5–19
 51% of the world will be overweight or obese within 12 years

Question 14

How many healthcare professionals hold weight bias

Answer 14

50%

Question 15

Describe wait bias, how it is experienced by obese people, and how many experience it

Answer 15

Weight bias affects impact of care (obese patients less likely to receive care services], mental health [weight bias contributes to higher anxiety and depression], misconceptions [healthcare professionals may believe that patients with obesity are less compliant with treatment]. 65% of individuals with obesity report weight stigma.

Question 16

What results from a 5–10% body mass loss?

Answer 16

Increased HDL [5 mg/dL], insulin sensitivity
decreased LDL [10 mg/DL], triglycerides [40 mg/dL], Blood pressure [5 mmHg], haemoglobin A1c [0.5%], insulin levels, inflammatory markers

Question 17

What are some weight management strategies

Answer 17

1. Medical nutrition therapy – nutrition based treatment provided by registered dietician nutritionist
2. Exercise – 30–60 minutes most days
3. Psychological – behaviour change, time management and stress
4. Bariatric surgery - only for those in class three obesity with at least one comorbidity [heart disease, high blood pressure, sleep apnea, diabetes, osteoarthritis, Gerd reflux, dyslipidaemia)
5. Medications – [BMI over 27] appetite suppressants, drugs that reduce fat absorption.

Question 18

What are the two most popular medication’s for obesity

Answer 18

1. Ozempic
   - Active ingredient: semaglutide. Approved by health Canada. Weight loss 10–12%
2.  wegovy
   - Active ingredients: semaglutide. Approved by health Canada. Weight loss 16–18%

Question 19

Describe the semaglutide mechanism

Answer 19

Mimics glucagon-like peptide (GLP-1) which regulates appetite, meaning you eat less when taking it
Slows down gastric emptying to make people feel fuller when they eat

Question 20

Explain the health at every size approach

Answer 20

Focused on three principles
1. Intuitive eating
2. Body acceptance regardless of size or shape
3. Physical activity for movement and health rather than for elite performance or to shape the body

Question 21

What are some long-term nutrition strategies for body weight change

Answer 21

1. She’s whole grains, beans, legumes and minimize intake of foods with added sugar [less than 10% total kcals]
2. Meet protein requirements at a minimum and consider increasing proteins help with satiation
3. added fats are calorie dense and should be considered on an individual basis
4. Choose 5–7 portions of fruit and vegetables a day
5. Choose healthful snacks [nuts, yogurt, fruit, vegetables, hummus, tuna, eggs, milk)
6. Consider portion sizes in relation to needs and activity
7. Choose a sustainable approach for long-term health
   

Question 22

Describe what happens when we starve ourselves

Answer 22

Cognitive - we become preoccupied with food, have difficulty concentrating, and food becomes the main topic of conversation
 Behavioural – we become possessive of food, increase tea / coffee / gum / hot sauce / salt consumption, develop OCD like rituals with eating
Emotional – increased anxiety, depressive symptoms, sensitivity, irritability
Physical – weight loss, gastrointestinal issues, decreased need for sleep, hair loss, reduction of metabolism

Question 23

 On the spectrum of eating habits and behaviors, what are some characteristics of [left to right] healthy eating, disordered eating and eating disorders

Answer 23

Healthy eating - flexible, healthy, physical activity, confidence
 Disordered eating – attempt to change body size and shape, some distress about body size and shape
Eating disorder – disturbed body image, medical complications begin


Question 24

What are the health implications of being underweight

Answer 24

1. Physiological: increased serum lipids, decreased blood pressure and RMR, hormonal disruption of thyroid hormones, cortisol, insulin, grehlin and leptin)
2. Cognitive effects: declines in cognitive performance, increased risk of mood disorders and anxiety
3. Bone Health: low bone mineral density, increased risk of fractures and osteoporosis
4. Gastrointestinal Health: gastrointestinal upset and digestive issues
5. Immune response: impaired immune response, leading to increased infection risk
6. Reproductive health: impaired reproductive function especially in females
7. Additional health implications: nutritional deficiencies, fatigue, delayed wound healing, cardiovascular risk, hypothermia, increased risk of Sarcopenia, or the loss of muscle mass.

Question 25

How many eating disorder patients are women

Answer 25

80%

Question 26

How common is anorexia and boulimia in the population

Answer 26

Anorexia: 0.5%
Bulimia: 1%

Question 27

What is the mortality rate of boulimia

Answer 27

5%

Question 28

How many eating disorder patients have a dual diagnosis with __________

Answer 28

50%, dual diagnosis with substance abuse or another addiction

Question 29

What are the three criteria to diagnose anorexia nervosa

Answer 29

1. Restriction of energy intake – must be below that required to maintain weight leading to significantly low body weight in the context of age, sex, developmental trajectory and physical health
2. Fear of weight gain
3. Body image disturbance – Persistent lack of recognition of the seriousness of one’s current low body weight or disturbance in the way in which one’s body shape or weight is experienced

Question 30

What are the 3 criteria for boulimia nervosa

Answer 30

1. Recurrent episodes - binge eating in a discrete period of less than two hours at least one time per week over three or more months
2. Recurrent inappropriate compensatory behaviour to prevent weight gain
3. Self-evaluation unduly influenced by body shape and wait

Question 31

What are the criteria for binge eating disorder

Answer 31

1. Episodes of binge eating at least once a week for three months
2. Three of the following: eating much faster than normal, eating until uncomfortably full, eating large amounts regardless of hunger cues, eating alone due to embarrassment, feelings of self disgust or guilt

Question 32

Define atypical anorexia nervosa, purging disorder, nighttime eating disorder

Answer 32

Atypical anorexia nervosa: all the symptoms of anorexia except being underweight
Purging disorder: no compulsion to binge eat but there is a compulsion to purge
 Night time eating disorder: compulsion to eat, waking some one multiple times per night

Question 33

The ___________ Is a five stage system of obesity classification that considers the metabolic, physical, and psychological parameters in order to determine the optimal obesity treatment

Answer 33

EOSS