Obesity

Question 1

Obj: Describe the major factors that contribute to obesity

Answer 1

1. Environmental Factors
2. Stress
3. Genetics
4. Hormones
5. sleep
6. Energy balance
   ……………………………………………
7. include availability, quantity an energy density of foods consumed, labor saving devices, more times spent sitting and less aviabliibyt of facilities to be active, gretater stress ad use of medicines that cause weight gain
8. chronic psychological stress stimluates hunger (especially craving for high calorie palatable food)
9. less than 5% of genes associated with BMI and body fat; genetci predopistion to obesity can be reduced by 40% by being active; genes can influcen how much weight is lost/gained; though soeme rare genetic disorders that affect metabolism, energy balance and fat distribution , lifteyle is more curcial
10. key hormones= leptin, adiponectin, immune hormones (cytokines), Ghrelin, peptide YY
11. sleep affects appetite, immune system, stress, inflammatory mediators and fatigue= redicded physical activity; Obstructive sleep apnea can disrupt sleep and obesity and OSA can cycle
12. Energy intake greater than energy expenditure

Question 2

Obj: list the diagnostic criteria for both overweight and obesity (according to BMI)

Answer 2

Weight class BMI Obesity class

Underweight <18.5 –
Normal 18.5 -24.9 —
Overweight 25.0- 29.9 —-
Obesity 30.0- 34.9 1
35.0-39.9 2
Extreme obesity 40.0 + 3

Question 3

Obj: Explain the 3 chief components of a behavioral weight-loss plan

Answer 3

1. Calorie reduction
2. Physical activity
3. Behavioral strategies

…………………………..
1. produce a 500- 1000 Kcal deficit from baseline through reduced intake and increased physical activity: portion control; reduce calorie dense foods; increase fruits and veggies

2. Increase moderate-intensity activities: begin with 50 min/wk and gradual increase to 150 min/wk with goal of 200-300min/wk for greater weight loss; strength train 2 times /wk
3. Behavioral strategies to increase adherence to increase adherence to the diet and activity goals; self monitoring, avoid tempting situations through stimulus control (remove high calorie foods from home); spend time around active people; behavioral substitutions ( walk instead of unhealthy snack munching); SMART goals

Question 4

Obj: outline key Dietary strategies for weight loss and weight maintenance

Answer 4

1. Reduce fat/carbs to attain a calorie deficit of 500- 1000 Kcal/day to produce 102 lbs weight loss/wk
2. Portion control
3. Eating frequently throughout day (rather than one big dinner)
4. Consume foods high in Nutrient density and low in energy density( fruits, veggies, whole grains, legumes)
5. Eat RDA for protein 46-56 g/day (10-35% total caloric intake) to keep lean mass while losing the weight

Question 5

Obj: Discuss the role of physical activity and exercise in the prevention and treatment of overweight and obesity

Answer 5

1. acute exercise especially when performed at greater than 60% of maximal oxygen uptake (v)2 max) suppresses appetite by altering gut-apetite regulating hormones for 2-10 hours after exercise
2. total distance rather than intensity= greater impact on EE
3. total distance can be walked at separate times= same effect on EE
4. non-exercise activity thermogenesis (redisgn everyday things to encourage more energy expenditure)

Question 6

Obj: Discuss the role of aerobic training in the prevention and treatment of overweight and obesity. Using FITT principle.

Answer 6

Aerobic exercise is beneficial in burning those calories efficiently!

Frequency: 3-5 times/wk

Intensity: Moderate ( and at the highest level that you can sustain the longest)

Time: 30-60 mins total/day

Type: low-impact, rythemic using large muscle groups; can be weight breaking (risk walk) or non-weight bearing (swimming/cycling)

Question 7

Obj: Discuss the role of resistance training in the prevention and treatment of overweight and obesity. Using FITT principle.

Answer 7

Resistance training doesn’t produce the biigesst change in scale weight but is crucial in improved body composition (specifically fat: lean mass ratio); improves muscular strength and muscular endurance= improve functional tasks for clients

Frequency:at least 2 times/wk with a day of rest between sessions

Intensity: mod level (usually when they can lift a weight only 8-15 times per set)

Time: full body resistance training program only needs 20-30 mins to complete

Type: exercise all major muscle groups using free weights, machines, or body-weight exercises. Form depends on client.

Question 8

Q: what percentage of children and adolescents have obesity?

Answer 8

18%

Question 9

Q: When working with a client who has overweight or obesity, about what topic is MOST important to ask?

a. preferred baseline measurments
b. permissions to talk about weight
c. social support
d. eating and physical-activity hevaiors

Answer 9

B. permissions to talk about wieght

Question 10

Q: What was the main contributor to increase in daily caloric intake in both men and women between 1971 and 2000?

a. increase in carb intake
b. increase in protein intake
c. increase in alcohol intake
d. increase in total dietary fat intake

Answer 10

A. increase in carb inatake

Question 11

Q: What is an example of change talk by a client?

A. since I saw my physician and he diagnosed me as overweight, I want to change

b eating donuts and drinking coffee during the day makes me tired
C. I tried drinking more water but it didn’t make me feel any different
d. Those stretches I do for my back make me sleep better and I don’t snack at night

Answer 11

d. Those stretches I do for my back make me sleep better and I don’t snack at night

Question 12

Q: Which of the following is among the possible causes of obesity epidemic?

A. Having type 2 Diabetes, hypertension or heart disease
B living in a high-income country
C. Suffering from Obstructive Sleep Apnea
D. The transition from a rural existence to a highly technological existence

Answer 12

D. The transition from a rural existence to a highly technological existence

Question 13

Formula to calculate BMI

Answer 13

Height ^2 (m)

or

weight (lb)
—————- X 703
height^2 (in)

to convert lbs to kg: lbs/ 2.2=kg
to convert height from in to cm then to m
In X 2.54 = cm; cm/ 100= m

Question 14

Waist circumference associated with obesity related metabolic diseases

Answer 14

waist circumference >/= 35 inches (89cm) women
waist circumfunrence >/= 40 inches (102 cm) Men

Question 15

What are the functions of the appetite regulating hormones?

1. Leptin
2. Adiponectin
3. Ghelin
   4.Peptide YY

Answer 15

1. act as a negative feedback loop between the hypothalamus and fat cells (when fat cells decrease, leptin decreases–> hypothalamus gets message to direct body to eat more but when fat cells increases, leptin increases–> hypothalmus gives body directing message to eat less)
2. facilitates the action of insulin by sending blood glucose into the body’s cells for storage or use as fuel, thus increasing the cells’ insulin sensitivity or glucose metabolism
3. “hunger hormone” released by stomach
4. when released by intestine provides feeling of satiety - “stop eating”
   3.

Question 16

Calculating target body fat:
Given client current weight, percent body fat and target body fat %

Answer 16

1. set up problem by having calculated current percent fat free mass and target fat free mass percent
   (100%- %BF)= current % fat free mass
   (100%- Target % BF) = Target % Fat Free mass
2. Calculate client’s Fat Free mass (FFM) in lbs:
   (FFM= client weight lbs X Current % FFM (calculated in step 1)= FFM lbs)
3. Calculate the target body weight:
   Current FFM lbs/ Target % Fat free mass (remember to convert to decimal so 75% is .75 when doing math)
4. Calculate weight loss goal:
   Target body weight- present body weight= amount of lbs needed to lose to reach goal

keep in mind 500kcal/day defiecnt for 7 days/week needed to lose 3,5000 Kcal/week (or 1 lb/week)
so 11 pounds with a 500kcal deficiet= 11 wks to lose

Question 17

What is the associated disease risk for overweight, obese class 1,2 and extreme obesity class 3 when the waist circumference is within ( <=102 cm or 40 in for men/ <=88cm or 35 in for women) and out of ( > 102 cm or 40 in for men/ > 88cm or 35 in for women) recommended waist circumference?

Answer 17

w/I O
Overweight 25.00- 29.9 incr high
Obesity 1 30.0- 34.9 high v Hi
obesity 2 35.0- 39.9 V hi V Hi
Ext obesity 3 40+ ex hi ex hi

Question 18

Q: Visceral fat

A. helps maintain free fatty acid levels in the body
B. is associated with high LDL cholestrol
C. Helps trigger insulin sensitivity of the cells
D. helps facilitate the regulation of blood glucose

Answer 18

A. helps maintain free fatty acid levels in the body

Question 19

Q: given that total energy expenditure is more important to a client who is trying to lose/ maintain weight, an emphasis should be placed on ———–

A. the total distance or time of walking or running
B. the intensity of the aerobic acitvity
C. the Resting Energy Expedntire of the client
D. Redcalualting the energy expenditure when the client loses weight

Answer 19

A. the total distance or time of walking or running

………………………….
total distance or time can also be split up into blocks for convienence

Question 20

What strategies do the participants of the National Weight control Registry do to maintain their weight loss?

Answer 20

1. Modify food intake
2. increase physical actvity and exercise average an 1 hr daily
3. eat breakfast daily
4. weigh themselves weekly
5. watch less than 10 hrs tv week
6. worked with weight loos program

…………………………………
other good options
1. food/exercise/ weight monitoring with fitness diary
2. community programs
3. dietary plans for RDs

Question 21

Define Resting Energy Expenditure?

Equation for males/ females?

Answer 21

REE accounts for 60-75% of the body’s total energy expenditure and is the amount of energy expended at rest

Males: REE(Kcal/day)= (10 X weight [kg]) + (6.25 X height [cm]) - (5 X age [yrs]) + 5

Females: REE (Kcal/day)= (10 X weight [kg]) + (6.25 X height [cm])- (5 X age [yrs]) -161

Conversions keep in mind
To go from Lbs–> Kg Lbs/2.2= kg
to go from In–>cm in X 2.54= cm

Question 22

When helping a client critically evaluate whether a particular diet is a good choice, a question to consider is———–?

Answer 22

1.Does the Diet advocate exercise?
(exercise keeps the weight off)

……………….
2. How does the Diet cut calories? (deficient created or no)

3. What is the Nutrient density of the diet?
   ( will the foods involved be able to meet body’s needed vitamins, minerals and phystochemicsl; if supplements require= NO!)
4. Does it make sense?
   (no extreme promises of weight loss)
5. Where is the evidence?
6. Does it meet individual needs?
   (chronic disease affected should see a doctor before starting a diet)
7. How much?
   (sustainable costs?)
8. What kind of social support does the client have?
   (client will struggle without the support)
9. How easy is it to stick to?
   (is is a lifelong lifestyle change or just a temporary fad= weight gained back when you get off)

Question 23

What are the waist to hip ratio norms?

Answer 23

Excellent Good Average at risk
M <0.85 .85-.89 .9-.95 >.95
F <0.75 .75-.79 .80-.86 >. 86

Question 24

Fact: Individuals with overweight or obesity will use more energy when moving at the same speed as individuals of normal body weight

Question 25

Fact: As for the quantity of exercise needed for inactive clients to gain health benefits, gradual increases in frequency, duration, and/or intensity over a longer period are needed for inactive clients to see health benefits