Obesity Flashcards
Obesity
-Accumulation of fat to the extent that it compromises health
BMI
Limitations:
1) Does not consider location of fats
2) Does not differentiate between muscle and fats
3) Inaccurate in different ethnic groups
4) Less accurate for elderly
Waist circumference
Strengths:
1) Consider location of fat (central obesity most dangerous)
Limitations:
1) Does not take into account skeletal size
Waist : Hip ratio
Waist : Height ratio
Strengths:
1) Better predictors of morbidty than waist circumference
Limitations:
1) Difficult to assess
2) Lack reference data, standard measurement protocols and accuracy in severe obese
Physical consequences
1) Diabetes (high morbidity/mortality)
2) Cardiovascular problems (High BMI correlates with increase risk for CVDs)
3) Cancer
- Overweight and obesity increase risk of ovarian, breast, kidney, colorectal cancers in females
- Obesity is associated with increase risk of oesophageal cancer in males
Pathways linking obesity and ill-health
Direct pathway: 1) Abdominal fat release adpokines into circulation Adpokines are associated with: -Inflammation -Dyslipidaemia -Insulin resistance
Indirect pathway:
1) Unhealthy behaviours (e.g. smoking, eating habits, alcohol)
Psychological consequences
1) Depression
2) Lower self-esteem
3) Body dissatisfaction
Social Consequences
1) Education
- Lower attendance
- Lower teacher ratings
- Bullying and teasing
2) Marriage and social position
- Less likely to get married
- Downward socio-economic trajectory for obese women
3) Less likely to get employed or get promoted
4) Social stereotypes
- Weak-willed
- Unattractive
Causes of obesity – Biology
- Predicted by parental obesity
- Includes:
1) Fat cell theory
2) Metabolic theory
3) Inherited less leptin
Causes of obesity – Activity environment
-Influence that the environment has on an individual’s activity behaviour
E.g. if it is raining today, I will not go for a run
Causes of obesity – Physical activity
- Frequency
- Intensity
- Type
Causes of obesity – Societal influences
- Media
- Peer pressure
- Culture
Causes of obesity – Individual psychology
-Individual’s psychology drive for particular food and consumption patterns or physical activity patterns/preferences
Causes of obesity – Food consumption
- Frequency
- Quantity
- Quality
Causes of obesity – Food environment
- Food advertisement (more money spent on advertising unhealthy food options)
- Availability
- Cost (healthy food options are more expensive)
- High fat
- Portion size
- Variety
- Nutrition labelling (time-consuming and difficult to understand)
Developmental model
- Emphasis on learning
- Includes:
1) Exposure
2) Social Learning (via modelling and observation)
3) Association
Cognitive model
- Emphasis on beliefs and attitudes
- Attitude includes:
1) Perceived behavioural control
2) Social norms
3) Attitude (self)
Limitations:
-Intention-behaviour gap
Weight concern and body dissatisfaction
-Emphasis on the meaning of food and weight
Body dissatisfaction:
1) Research on size estimation
2) Perception of ideal vs reality
3) Can lead to dieting (restraint theory)
4) Can lead to overeating by:
- ‘What the hell’ effect
- Motivational collapse
- Mood modification
UK Public Health Initiatives
1) Public Health Responsibility (2011) – Private sectors pledge to attempt to improve public health
2) Change 4 life campaign
3) ‘Eatwell guide’ (2016)
4) ‘Tackling obesity’ strategy (2020) includes:
- Improve access to weight loss programmes through primary care (incentives + increase services)
- Change to food environment by:
1) Ban food adverts on high fat, salt and sugar on TV and online after 9pm
2) Calorie labelling in restaurants, cafes and takeaways
3) End promotion of high fat, sugar and salt products in stores and online
4) Consultation on ‘traffic light’ nutritional info and calorie labelling on alcohol
Treatments
1) Pharmacology
2) Surgery (e.g. gastric bypass, gastric banding, etc.)
3) Behavioural intentions
Behavioural intention – Lifestyle intervention
1) Promote healthy lifestyle habits
2) Dietary counselling
3) Physical exercise training
4) Behavioural change targets
Participants lost about 3.5kg on average, which is maintained for 3 years
Behavioural intention – Behavioural therapy
1) Advice on modifying energy balance
2) Increase control over energy balance behaviours:
- Functional analysis of behaviour – classical conditioning (e.g. eating a snack whilst watching TV)
- Goal setting in terms of behaviour change
- Self-monitoring of eating and activity
- Stimulus control over food and activity choices (Avoidance, Distraction, Resistance)
-Self-reinforcement of behaviour change
-Reward for good behaviours
-Evaluation of positive and negative cognitions (stop ‘what the hell’ effect)
-Relapse prevention
3) Cognitive restructuring
-aims to modify thoughts that undermine weight loss
-can be classified into 3 categories:
>Impossible to lose weight – previous failed attempts
>Unrealistic goals
> Self-criticism regarding eating and weight gain
Participants lose about 10.7kg in 30 weeks of treatment
80% of participants complete treatment
