obesity

Question 1

what are the 2 perspectives of body weight

Answer 1

bmi and %body fat

Question 2

ideal body weight range in bmi

Answer 2

18.5-25 kg/m2

Question 3

define obesity/OW

Answer 3

body weight above a standard relative to height

Question 4

explain the relationship between all cuase mortality and bmi

Answer 4

j shape relationship
low bmi = increased risk mort.
high bmi = increased risk mort

Question 5

why does high bmi = higher mortality risk?

Answer 5

increased risk for developing diseases
major risk is heart disease
biggest player is hypertension and dyslipidemia
= cvd risk = death risk

but there are diff types of disorders and risk of morbifities depending on disease

Question 6

examples of conditions that you are greatly increased risk for morbidity when obese

Answer 6

-sleep apnea
breathing issues
t2d, ir
dyslipidemia
galbladder disease

Question 7

bmi classifications

Answer 7

uw 18.5
normal 18.5 - 24.9
ow 25-29.9
ob1 30-34.9
ob2 35- 39.9
ob3 > 40

Question 8

which anthro measures DO NOT correlate with fatness?

Answer 8

height
waist: hip ratio

Question 9

measures for assessment of fatness

Answer 9

wHtR
weight
hip
waist
bai
bmi
weight: height

Question 10

explain why its important to look at other indictators ALONG with bmi when analyzing fatness

Answer 10

whtr sensitive to risk of cvd
bmi considered some people at no risk but same ppl considered at risk with whtr

you can have a normal bmi but still be at risk with whtr value

Question 11

value of whtr = increased risk of what?

Answer 11

> 0.5 = risk for obesity related cvd

Question 12

what is BAI

Answer 12

body adiposity index
=hip circ and height

Question 13

what to remember about BAI?

Answer 13

not a better measure of adiposity compared to bmi, waist or hip circ

Question 14

genes that are associated with obesity related traits

Answer 14

BDNF
brain develipment neurotropic factor

Question 15

BDNF and obesity

Answer 15

bdnf = Appetite regulation via supression
also acts on brain for neuro development

obesity = less bdnf levels and responsivness

Question 16

why does bdnf have low bioavailablity

Answer 16

short half life
low brain penetration

=via injection solution

Question 17

define epigenetics

Answer 17

variations in gene expression that are not caused by changes in dna sequences

Question 18

bi directional relationship bet?

Answer 18

epigenetics and obesity

Question 19

4 developmental contributors to increasing the risk of obesity + pathways

Answer 19

1. maternal preconception body composition = mismatch
2. maternal undernutrition = mismatch
3. maternal obesity/gd = fetal hyperinsulinimia , more fat cells
4. low birth weight = mismatch
5. post natal nutrition = apetite control/ preferences

Question 20

theories of overnutrition

Answer 20

1. genetic
2. lipostatic
3. thermogenetic
4. diabetes associated
5. psychlogical causation
6. thermostatic
7. sleep deprivation

Question 21

thermostatic vs thermogenetic theory

Answer 21

static = dipping below body temp set point = apetite change = h response

genetic = obese = low brown fat cells = less excess energy burning

Question 22

lipostatic theory

Answer 22

theory of overnutrition
= obese indiv have higher hypothalmic set point
=body fights to bring u back to this range when you step outside of it
=harder to lose weight

Question 23

pns vs sns in food intake

Answer 23

pns = increase intake
sns = decrease intake

Question 24

role of hypothalamus

Answer 24

1. feeding behaviours
2. energy expenditure
3. food intake

Question 25

explain the concept of yoyo diet and body weight set point

Answer 25

see ipad diagram

Question 26

where is PYY secreted

Answer 26

L cells of ileum, rectum and colon

Question 27

where is CCK secrted

Answer 27

i cells of small int

Question 28

where is glp1 secreted

Answer 28

L cells small intes

Question 29

long term regulators of apetite

Answer 29

insulin leptin

Question 30

explain exclusive Breastmilk feeding effects on apetite regulating hormones

Answer 30

BF = apetite supressing nature less ghrelin, leptin , insulin and pyy lactose, protein and fat combo = apetite suppressed good insulin sensitivity

Question 31

short term regulators of apetite

Answer 31

cck ghrelin pyy

Question 32

how do weight loss surgeries impact apetite regulating hormones?

Answer 32

impacted in how the hormones respond decreased satiety bc trying to compensate for weight loss =more ghrelin = less satiety

Question 33

ghrelin levels post RYGB?

Answer 33

less ghrelin bc loss of parietal cells from stomach

Question 34

what are some predictors of weight loss?

Answer 34

high: -bmi -adipocyte hyperplasia / fat levels -male RMR/expernditure levels early weight loss, counselling, support, goal setting ## Footnote adipocyte hyperplasia = # fat cells

Question 35

mechanisms of weight regain

Answer 35

1. changes in energy expenditure 2. neuroendocrone pathways 3. gut physiology 4. sibjective apetite 5. nutrient metabolism

Question 36

to maintain weight loss

Answer 36

need behavioral interventions = diet = PA

Question 37

best type of diet to maintain weight loss?

Answer 37

high protein more low gi foods

Question 38

3 main counselling approaches to managing obesity

Answer 38

1. diet/kcal focus 2. food, exercise, beh mods 3. hea;thy lifesty;e approach/health @ every size

Question 39

when assessing an obese indiv, what are some things to remember

Answer 39

-ABCDE -Assess 4 Ms assess knowledge = unrealistic goals. = pa importance =diet role and options

Question 40

how much kcal defecit?

Answer 40

100-200 per day

Question 41

how many kcal def do u need to burn 1 kg

Answer 41

5000-7000

Question 42

strategies to reduce kcals in foods

Answer 42

1. high intensity non nutritive sweetners 2. sugar subs, bulking agents 3. more fibre 4. fat replacers/reducing energy from fats

Question 43

example of a fat replacer

Answer 43

olestra =0 kcal =replaces function and flavoour of fat causes gi issues and loose stool tho

Question 44

example of sugar sub

Answer 44

inulin polyols polydextrose dont really taste like anything so mixed with sweetners, more for sensory properties

Question 45

weight loss drugs

Answer 45

1. pancreatic lipase inhibitors (orlistat) 2. saxenda (glp1 agonist) 3. metformin

Question 46

ozempic vs saxenda

Answer 46

ozempic = 1x / wek saxenda =1 x / day

Question 47

why dont nasal PYY sprays work for WEIGHT LOSS DRUGS

Answer 47

immune cells block pyy into bloodstream

Question 48

types of bariatric surgeries?

Answer 48

1. adjustable gastric band 2. sleeve gastromy 3. rygb 4. bpd/ds

Question 49

3 main mechanisms of bariatric surgery

Answer 49

restriction malabsorption both

Question 50

which bariatric surgeries are both restrictive and malabsorptive

Answer 50

rygb bpd/ds

Question 51

pre surgical care

Answer 51

assessment assess defeciences education - expect, complications, reinforce pa and diet

Question 52

post surgical care

Answer 52

diet care long term nutri complications

Question 53

example of a post surgery nutrition plan

Answer 53

supplements diet progression

Question 54

post op diet consists of

Answer 54

slow progression 1. clear fluids 2. full fluids 3. pureed 4. soft 5. solid proteins = immunity and healing supplements =malabsorption

Question 55

long term issues post op

Answer 55

context of rygb and bpd 1. dumping syndrome 2. gallstones 3. nutr defiences

Question 56

what things slow gastric emptying

Answer 56

slow kcal needs small meals more protein and fat

Question 57

what increases gastric emptying

Answer 57

more cho solids and liquids

Question 58

what condition also happens with dumping syndrome

Answer 58

hypoglycemia