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Applied Physiology > Obesity > Flashcards

Obesity Flashcards

1
Q

Obesity - Definition

A

Def: Excess body fat
Functional Def: % BF at which increase disease risk
Consuming more than expending

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2
Q

Obesity - BMI

A

> or = 30 kg/m^2

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3
Q

Average Americans will gain __ after age 25

A

1 lb/yr

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4
Q

Overweight and Obesity by BMI (kg/m^2)

A

Underweight: less than 18.5
Normal: 18.5-24.9
Overweight: 25.0-29.9
Obesity Stage 1: 30.0-34.9
Obesity Stage 2: 35.0-39.9
Extreme Obesity Stage 3: 40.0 and higher

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5
Q

Disease risk relative to normal weight and waist circumference

A

Increased disease risk with more central adiposity

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6
Q

BMI & Children Categories and Ranges

A

Underweight: Less than 5th percentile
Healthy weight: 5th percentile to less than 85th percentile
Overweight: 85th to less than the 95th percentile
Obese: Equal to or greater than the 95th percentile

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7
Q

Identify the percentiles

A

Red to Yellow: 95th
Yellow to green: 85th
Tan to green: 5th

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8
Q

BMI & Risk Disease

A

As BMI does up, risk of developing disease increases

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9
Q

BMI & CV Disease Mortality

A

BMI and CV Disease Mortality increases as we gain weight.

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10
Q

Is BMI and Mortality associated?

A

Yes, as BMI increases Mortality increase.

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11
Q

Fitness vs Fatness and All-Cause Mortality

A

Someone who is unfit is 2x more likely to die from all-cause mortality than any BMI

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12
Q

Normal wt & >40/>35” waist has a higher mortality than >30 BMI, what does this mean?

A

Central adiposity is worse than having a higher BMI

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13
Q

Explain the relationship between visceral fat & risk factors

A

Visceral fat is very complex

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14
Q

What is important about the obesity and CV disease?

A

Postitive Relationship

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15
Q

Why is weight gain/weight loss difficult?

A

No simple solution. One of many different factors.

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16
Q

Obesity and Cardiomyopathy

A

Strong relationship

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17
Q

US Women - kcal/wk

A

Physical activity burned in kcals by week has reduced decade to decade

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18
Q

Morbid Obesity

A

When obesity interferes with vital functions
Ex: Breathing

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19
Q

Malignant Obesity

A
  • 60% above desirable weight OR
  • An absolute excess of > or equal 100 lbs
  • Both of these double of all causes of morbidity and mortality
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20
Q

Obesity and Social Stigma

A
  • Ridiculed
  • Discriminated
  • Rejections may cause emotional problems
  • Compounded unrealistic expectations and pressure to look lean

^People who are morbidly obese likely faced these things

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21
Q

Habitual Dieters

A
  • Usually emphasize weight loss rather than fat loss
  • Concentrate on losing weight quickly rather than changing habits (How are society approaches this)
  • Goal: Balance energy intake & energy expenditure
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22
Q

Fat Distribution

A

Upper-body (android) obesity
- Greater fat storage in the upper body and abdominal area (apple shaped)
- Occurs more frequently in men
- Carries and increased risk for CAD, HTN, Stoke and diabetes

Lower-body (gynoid) obesity
- Greater fat storage in the lower body around the hips, buttocks, and thighs (pear shaped)
- Occurs more frequently in women

23
Q

Who is more likely to have an apple body fat distribution?

24
Q

What can body composition be split into?

A

Fat-free mass (FFM) & Body Fat (BF)

25
Mean Percentage Body Fat: Men vs Women
Women have more essential fat
26
Ideal Body Composition
- Health, aestetics, performance - Women: 16 - 25% -> up to 32% BF - Men <20% -> up to 22% BF - On average men and women fall above the recommended fat % in almost all age categories - Essential Fat: Males 2-5%, Females 10-13%
27
Measuring Body Composition
- Body composition based on **assumptions** from dissections - Indirect Methods 1. Hydrostatic weighing 2. Dual X-ray Absorptiometry (DXA) - Indirect (indirect) Methods 1. Anthropometric 2. skinfold techniques 3. Electrical Impedance 4. Air Plethysmography The more indirect we get the more source of error!
28
Hydrostatic weighing
- Measures body density; we measure BF % but using the body density to calculate it) - Body Composition Technique - Errors (Residual Volume - lungs, intestinal gas, density of water - temp)
29
Body Density
= Body mass/Body volume - Mass measure on a normal scale (kg) - Volume via hydrostatic weighing
30
Body Fat %
= (495/body density) - 450
31
Somatotype
- Very subjective, assessment requires extensive training - 3 Types: - Endomorph: corpulence & roundness - Mesomorph: muscularity - Ectomorph: Linearity and Fragile
32
Types of Anthropometrics (study of measurments and proportions of body)
- Skinfolds - Experienced tester - Equation derived from similar population (Ex: College age, use college age equations) - Dehydration (can affect skinfold measurments) - Body Mass Index (BMI)
33
BMI equation and r
- Weight/height^2 - Used in large epidemiological studies - Correlated with body fat (r=0.8)
34
Waist to Hip Ratio
- Abdominal fat is a predictor for risk factors - Increased risk of MI, Angina, Diabetes, Gall bladder disease and stroke - Men >0.95 (Heart Disease) - Women >0.86 (Insulin resistance)
35
Waist Circumference
Positively correlated with abdominal fat Men > 40 inches Women > 35 inches
36
Dual Energy X ray Absoptiometry (DXA)
- Osteoporosis risk - Soft tissue assessment - New gold standard - Accuracy differs in parts of body - Weight limitation (typically 350 lbs)
37
Bioelectrical Impedance
- Impedance to electrical flow is measured - Impedance is greater in people with more fat - Affected by hydration status - About as accurate as skinfolds - Less accurate in very thin and very obese
38
Air Plethysmography (Bod Pod)
Measures air pressure and body volume to estimate density Density = body mass/body volume
39
Control of Food Intake
Hypothalamus is the control center - Ventral = hunger center - Ventromedial = satiety center - Satiety center usually dominates (except when nutrient status is low) - **Satiety can be repressed over time. Important to focus on what you are eating** - Physiological and Physiological Factors regulate hunger/satiety
40
What are the 3 energy expenditure components?
- Resting Metabolic Rate (RMR) - Thermogenesis - Physical Activity
41
RMR
- 70% of Daily Energy Expenditure - Declines with age (% BF increases, lean body mass decreases) - Higher in men
42
Thermogenesis
Stimulating Factors: - Food intake (5-10% of Total Energy Expenditure) - Cold Exposure - Psychological Stress - **Accounts for 15% of daily expenditure**
43
Physical Activity and Obesity
Physical activity in combination w/ dietary restriction improves early and long term outcomes - Helps preserve lean body mass - Increases total energy output - Affects substrate utilization
44
Evidence categories
A - Many Randomized control studies (RCT) B - Fewer RCT; meta-analysis of RCT; pop. dif from target pop. C - Non-RCT; Observational studies D - Panel consensus judgement (people talking)
45
Dietary Therapy
- Low Cal Diet (A) - **Reducing dietary fats alone without a reduction in calories is not sufficent for weight loss (A)** - Goal deficit 500-1000 kcal/day, 1-2 lbs per week (A)
46
Physical Activity and Obesity - Long Term
At least 30 min or more of moderate int PA on most days of week (B)
47
Physical Activity and Diet
Combination of reduced cals and increased PA (A) - May produce weight loss and less abdominal fat - Increase cardiorespiratory fitness
48
Behavior Therapy
- Useful add-on when used to reinforce changes in diet and PA
49
Weight loss and weight management should be a comdbination of: ....
Dietary Therapy (Low cal diet) Physical Activity Behavior Therapy
50
Pills and Obesity
Weight loss pills can be used as part of weight loss program (B)
51
Current Meds for Obesity
Orlistat (inhibitor of gastric and pancreatic lipase prevents intestinal fat metabolism and absoprtion) Phentermine-ER topiramate (enhances satiety) Lorcaserin (selective agonist of serotonin decreases food intake and enhances satiety
52
When is it okay to get weight loss surgery?
BMI > 40 BMI > 35 with comorbid conditions Less invasive strategies don't work and at risk for mortality (B)
53
Weight loss and Management
*For a person with a BMI 27-35 * Initial goal is to reduce BW by 10% in 6 months -- Ex: 150 lbs -> lose 15 lbs in 6 months * Reduce 300-500 kcal/day * 1/2 to 1 lb per week ## Footnote Greanys Friend: Loss of lymphatics can cause edema in the lower body
54
Biggest Losers Show - Why did they gain weight back?
- Dramatic weight loss may not be the awnser to long term weight loss

Applied Physiology (11 decks)

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