Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Nutrition > Obesity 1 > Flashcards

Obesity 1 Flashcards

1
Q

Obesity

A
  • complex, chronic disease
  • excessive accumulation of fat in the body and is associated with numerous health problems (coronary heart disease, insulin resistance, T2D, hypertension, NAFLD, and certain cancers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

guidlines for body mass

A

BMI = 25-29.9 is overweight
BMI >30 is obese for adults 19-65

abdominal / waste circumference
women >88 cm
men >102 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

etiology

A

multifacotrial

  • genetics
  • environmental
  • metabolic/physiological
  • biochemical
  • psychological
  • cultural (drive to eat is strong bc it represents survival)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

genetics

A
  • obesity gene map
  • leptin ~ obesity gene
  • genes involved in body composition, RMR, appetitie, neuroedocrine signals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

environment

A
  • factors influencing overeating - variety, palatabilty, convenience, cost
  • factors influencing under-activity - technology, urbanization, safety, convenience
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

metabolic/physiological

A
  • low metabolism?
  • low lean body mass?
  • less regulation of appetite? (pressure for kids to eat big meals when they want to “graze”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

biochemical

A
  • thyroid metabolism
  • CNS impairment
  • huge bolus overpower signals back from the gut to brain
  • biochemical signals get distorted by the quality, frequency, and volume of what we eat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

psychological

A
  • behavioural factors
  • peer pressure
  • societal pressure
  • depression, anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cultural

A
  • cultures that value high body fat, high food intake and low activity levels
  • starting to change due to awareness
  • acculturation of food intake
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

struggle of definition

A
  • imbalance between energy intake and energy output – overtime will lead to weight gain
  • specific periods of growth and development
  • increase in general population - decline in energy expenditure not matched by energy intake
  • can’t place all responsibility on pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment controversies

A
  • needing to weigh
  • outcome depends on client attitudes, motivation and behaviours ~ work with pt to set goals , approach nutrition quality not weight outcomes
  • focus endpoint should be eating patterns, activities, normalizing eating, motivation not weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

successful treatment is usually lifelong

A
  • health practices
  • food choices
  • exercise programs ~ doesn’t have to be working out
  • support systems
  • behavioral modification (not just education)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

cost of obesity

A
  • financial
  • person ~ peer problems, social isolation
  • improve existing health problems
  • decrease future health risks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Rationale Against weight loss

A
  • no effective, long-term safe treatment for obesity
  • pressure to be thin
  • weight cycling ~ it is better to stay the same weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

nutrition assessment

A
  • general guidelines eg BMI
  • lifestyle practices
  • PA hx
  • unhealthy eating patterns
  • resources and abilities
  • motivation
  • long term weight hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

risk factors (Nutrition assessment)

A
  • associated with mortality ~ CAD, atherosclerotic diease, type 2 diabetes, sleep apnea
  • other risks ~ gallstones, high TAG, infertility, osteoarthritis, stress incontinence (urinary)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

obesity treatment

A
  • surgery
  • medication
  • lifestyle management ~ nutrition therapy, PA, behavioural modification
18
Q

Bariatric Surgery

A
  • not for ppl at risk of gaining weight back
  • BMI > 40 or >35 with comobidities
  • impaired Q of L
  • only when all non-surgical treatments have failed
  • includes: gastroplasty (stapling), gastric banding, gastric bypass
19
Q

Bariatric Surgery cont

A
  • benefits outweigh potential hazards
  • reduction of weight
  • resolution of hypertension, T2D, back pain, dyslipidemia, osteoarthritis, sleep apnea, non-alcoholic steatohepatitis
  • vitamin deficiency, electrolyte problems, intestine failure
  • gradual weight regain and return of comorbidities may occur
20
Q

After Bariatric Surgery

A
  • diet progresses from NPO to clear fluids to DAT
  • long term vit and mineral supplementation (iron, calcium, D, B12, folic acid, and C)
  • bleeds may be common
21
Q

Obesity Treatment - Pharmacotherapy

A
  • suprpess appetite
  • causes malabsorption
  • questionable long term effects
  • only for BMI >30 or BMI >27 with comorbidities
  • used with low energy diet, low fat diet, PA and behavioural therapy
22
Q

Pharmacotherapy - Sibutramine (meridia)

A
  • selective serotonin and noradrenaline re-uptake inhibitor *
  • 5-10% weight loss maintained for up to 12 months
  • side effect: cardiovascular symptomologies (increase heart rate and blood pressure)
  • not for pt with CAD, HTN, stroke, CHF, or pt taking anorexiant drugs
23
Q

Pharmacotherapy - Olistate (Xenical) * main drug

A
  • lipase inhibitor, causes fat malabsorption
  • prevents <30%
  • monitor level of fat soluble vitamins
  • side effects which resolve in 1-5 weeks: oily diarrhea, fecal urgency, gastric cramping, large stools, steatorrhea
24
Q

Pharmacotherapy - Lorcaserin (Belviq)

A
  • approved by FDA in 2012
  • selective serotonin receptor agonist
  • enhanced satiety after a meal and reduce pre-meal appetite and food intake
  • side effects: anything regarding the CNS, heart disease, depression, hypoglycemia if diabetic, headache, fatigue, dizziness, dry mouth, constipation
25
Q

treatment - diet therapy

A
  • don’t know how to apply Canada’s Food Guide; feel as though the issue is beyond this
  • emphasize cereals, breads, grain products, vegetables and fruits
  • choose low fat dairy products , lean meats
  • PA
  • limit salt, alcohol, and caffeine
  • variety of foods
  • Food Guide should be incorporated in combination with weight loss, lifestyle mod
26
Q

Composition of Diet for Diet therapy

A

50-60% CHO
<10% saturated fat)
10-20% protein

27
Q

Diet Therapy - Calorie Reduced Diets

A
  • not able to prove this helps long term
  • prescribed when weight loss is desired
  • calorie deficit of 500-1000 kcal/d –> lose 1-2 lbs per week
  • min intake of 1200 kcal/d for wt loss; may decrease RMR (weight gain again after normalization)
  • food choices high in fibre ** longer to eat, slow gastric emptying, promote satiety
28
Q

Diet therapy - Prepackaged Meal Programs

A
  • effective for short term weight loss
  • should have counseling component ~ take responsibility off the client
  • include PA
  • support and education required for long term maintenance
29
Q

Diet Therapy - Fad Diets

A
  • may not be medically sound (very low CHO diet may lead to ketosis)
  • initial weight loss attracts people but is hard to maintain
  • plan for fat stores to be used
30
Q

Protein Sparing Modified Fast

A
  • protect lean body mass stores
  • high protein diet (2-3 g/kg) with low CHO (102% w/v)
  • no dairy, fruits, veg, or grains
  • increases ketosis (not ketoacidosis), rapid weight loss, appetite suppression (caused by ketosis)
  • more vit and mineral deficiency, low K levels
  • if diet is liquid protein ~ provide electrolytes
31
Q

More on the PSMD

A
  • goal is to protect the lean body mass stores and promote fat mass loss
  • nutritionally incomplete ~ close monitor of electrolytes and fluid status
  • deficient in K and other nutrients
  • rarely used bc of dangers of electrolyte disturbances ~ risk for cardiac arrythmias
32
Q

Atkins Diet

A
  • involves 4 phases, staring with lowest amount of CHO intake
  • controlled, individualized CHO intake
  • high protein
33
Q

CHO addicts Diet

A
  • begins with restricted 2 week phase

- has a list of foods that cannot be eaten

34
Q

Zone Diet

A
  • suggests a CHO/Protein/Fat ratio ~ 40/30/30
  • sorts CHOs into favourable and nonfavourable
  • considers portion size and GI
35
Q

South Beach Diet

A
  • includes GI, types of CHO, allows “good fats”
  • involves 3 phases, neither “low CHO” or “low fat”
  • consume the “right carbs” and “right fats”
36
Q

Weight Watchers Diet

A
  • involves a point system
  • healthy eating and PA
  • does not prohibit any food types
37
Q

Treatment - Size Acceptance Approach

A
  • approach for lifestyle not weight
  • health beyond weight losss
  • positive body image
  • avoid client feeling blamed
  • knowledge vs coping skills
  • before 12 yrs old assist changing lifestyle and behaviours
38
Q

Treatment - PA, Exercise

A
  • PA ~ any modify movement produced by skeletal muscle that results in energy expenditure = more promotion for * (overall goal for 60 min a day in periods of 10 min each)
  • exercise ~ specific, planned, structured activity
  • both behaviors are directly related to energy expenditure
39
Q

Regular PA considered predictor of Weight Loss Success

Why?

A
  • contributes to overall weight loss
  • may decrease abdominal fat
  • increase cardio-respiratory fitness
  • maintain weight loss
  • increase metabolic rate
  • changes in WC
40
Q

success of PA

A
  • include family
  • tailored to each person (1 30 minute bout vs 3 10 minutes)
  • usually require guidance
  • more successful when simple (walking vs going to the gym)
  • positive social interaction
  • be achievable within resources
41
Q

Treatment - Behavioral Modification

A
  • permanent change of lifestyle habits over generations
  • decrease, change, or eliminate these habits that contribute to weight loss
  • self-understanding, monitoring
  • translate self-awareness to behavioral change
  • ID and change env factors that may lead to unhealthy behaviors
  • develop coping mechanisms *
42
Q

Alternative Weight Loss Products

A
  • consider drug-drug interactions, drug-nutrient interactions
  • amount of active ingredient, contamination and mis-identification

Clinical Nutrition (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions