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HEALTH > obesity > Flashcards

obesity Flashcards

1
Q

what is obesity

A

undesired weight gain due to greater energy cosnumption than is expended
chronic and life threatening
assoc with range of diseases

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2
Q

why is fat life threatening

A

active agent in the body

accumulates and causes ill health

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3
Q

symptoms of obesity

A

sleep apnea
hypertension
chd/diabetes
joint trauma etc

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4
Q

how is obesity defined

A

pop means
bmi
waist circumference
% body fat

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5
Q

obesity in gender

A

66% men
58% women
(men bmi fat vs muscle)

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6
Q

ross 1994 obesity survey

A

phone survey 18-90y/o
is obesity distressing?
bmi, self-reports of depresssion, physical activity and diet behaviours

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7
Q

ross 1994 results - overweight

A

overweight less physically active, worse physical health, more likely to diet, older, married, higher SES

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8
Q

ross 1994 results dieting

A

more women than men
under 42 y/o
more educated

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9
Q

ross 1994 results mental health

A

only assoc with depression in those trying to lose weight

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10
Q

behavioural cause of obesity

A

physical activity

eating behaviour

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11
Q

physiological cause of obesity

A

genetis
metabolic rate theory
appetite reg

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12
Q

environmental cause of obesity

A

socioeconomic status
ads/marketing
parenting

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13
Q

genetics on obesity

garn et al 1981

A

60-70% variance of obesity can be explained by genetics
1 obese parent = 40% chance
2 obese parents 80% chance
thin = 7% chance

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14
Q

stunkard 1990
twi/adopt studies
genetics and obesit

A

mono or dizygotic twins
study bmi of 93 identical - genetics explain 66-70% variance
adoptive/bio parents
weight strong assoc bio not adoptive

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15
Q

if obesity is genetic, how is it manifested as a predisposition?

A

body weight distribution inherited (bouchard t al 1990)

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16
Q

problem with genetic twin and adoptee studies

A

identical treated similar in diff environ
adoptive similar to biological
need to confirm zygosticity
small samples

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17
Q

metabolic rate theory on obesity

A

theorised that people who are obest may have a slower metabolic rate
burn less calories and therefore need less caloric intake

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18
Q

what is metabolic rate

A

rate of energy used to carry out biological and chemical processes in the body that are vital to staying alive

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19
Q

ravvussin et al 1988
pima indians
met rate theory

A

pima indians abnormally high % pop obest (80-85%)
MBR baeline and 4y follow up
lowest MBR = highest wait gain

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20
Q

tantarinni et al 2003
arizona pina indians
met rate

A

in naturalistic setting
energy intake and expenditure measured t BL - predicted weight
baseline MBR ke determinent of body weight change

MBR RISK FACTOR

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21
Q

how might MBR charactersie heightened obesity

A

risk factor
obese have higher MBR because of weight and necessary energy needded to survive at rest compared to thin
likely that low MBR at risk of onset, BUT MBR increase with weight change

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22
Q

montague et al 1997

appetite reg

A

OB gene responsible for leptin production - tells brain when full and when to stop eating
obese may not produce enough leptin and therefore overeat

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23
Q

ferooqi et al 1999

appetite reg

A

x2 leptin injections p/day in overweight children decreases food intake and lose 1-2kg per month

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24
Q

beh: physical activity on obessity

A

modern day: linear increase in weight may be correlted with industrialisation, transport and reduction in agric
less energy exerted in daily activities
heightened emphasis on knowledge

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25
Q

stern 1984 physical activity

A

phone extension upstairs saves approx 10,500 kcal per year for not having to walk downstairs

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26
Q

prob with physical activity studies

A

correlational - dont know if cause or consequence or if a third factor might mediate the assoc
dependent on opportunity etc

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27
Q

waller et al 2008

physical activity twins

A

150 twin pairs
genetics vs activity
physical activity assoc with smaller waist, less weight gain in active twin

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28
Q

do the obese exercise less?

A

walk less on daily basis
escalators>stairs
sedentary throughout the week

29
Q

brusch et al 1974 emotionality theory

eating beh

A

psychosomatic theory of eating disorders
misinterpret ffeeling of emptiness/apathy for hunger
comfort eating fills the void

30
Q

van strein et al 2009 eating beh

A

cross sectional study
Q - dietary restraint, emotional eating, external eating (Sight/smell)
restraint and emotional eating mediate overweight
restraint prevent obesity

31
Q

do the obese eat more?

A

early research relies on self report andlikely to be influenced by social desireability and demand characteristics
BUT must eat more if maintined weight
-more calories - may be due to range of diff factors ie more unhealthy or bigger portions or more snacking over day

32
Q

leasle et al 2007

do obese have diff eating beh

A

eat at fasterrate
larger spoonfuls
more intake

33
Q

berg et al 20009

do obese have diff eating patterns

A

skip breakfast/lunch
more likely to eat late at night
larger portion sizes

34
Q

prentice and jebb 1995

do obese eat diff food?

A

“not all calories are equal”
may be related to proportion of fat>carb
diff between complex carbs and fat on body

35
Q

complex carb on weight

A

more energy to burn
acticates oxidatio in body
more fibre - fuller for longer - stop snakcing

36
Q

fat on weight

blundell and macdiarmid

A

not oxidised
stored
doesnt fill stomach or switch off desire to eat
higher cal in smaller quanities

37
Q

batton-smith and woodward 1994

fat proprotion consumed

A

scottish men with low carb intake 4x more likely to be obese, and 2-3x more likely inwomen than high carb diet

38
Q

wang and lim 2012

chidhood obesity and SES

A

review of research and government stats
increased obesity in industrialised countries
lower ses – high fat and sugar cheaper
in deeloping - high ses as more access to high fat and sugar

39
Q

problem with SES research on obesity

A

correlational
large variance
other mediators

40
Q

lesser zimmerman and cohen 2012 phone survey

ads on obesity

A

direct relationship between soda consumption and outdoor ads where live

41
Q

andrevera et al 2011 ads on obesity

A

fizzy drink freq on tv 2002-2004 and consumption in children
increase tv ad exposure increases consumption, especially low ses
- now banned on child tv

42
Q

problem with ad research on obesity

A

in children - parental influence and exposure

majority self report

43
Q

parent influence on obesity in children

A

determine what is in the house and what exosed to from young age when still developing preferences

44
Q

wake et al 2007 parental influence on obesity

A

self reported parenting styles nd child bmi
mothers not sig influence
fathers disengaged/permissive increase bmi

45
Q

problem with wake et al

A

self report - mother bias
white middle class - where obesity assoc with ses
mothers do play a role - may be dependent on age? - mothers more in adolescence?

46
Q

problems with research specific factors assoc with obesity

A

although allows us to get estimate of how influential might be and identify the factors, it ignores the complexity and interactions between them that lead to weight gain

47
Q

stunkaard - problem with traditional obesity treatment

A

tendency to fail
most dont persist
those who do fail to sig lose weight
those who do likely to regain it

48
Q

different behavioural techniques to weight loss and control

A

restraint/dieting

nudging

49
Q

waden 1993 eating restraint - beh techniques

A

short and long term impact of mod and severe caloric restriction
80% maintain programme for 20 weeks
50% lose 20lb+
only efffctive short term

50
Q

multidimensional beh weight loss programmes

A

improved from traditional

compine traditional with exercise, cog therapy/restructure, att change and relapse prevention models

51
Q

fabricature and wadden 2006

beh technqiues

A

despite advances, programmes relatively unchanged in their success rates over the last 20 years

52
Q

woodey and woodey 1984 the reality of retraint technqiues

A

even if weight loss is successful, it is likely to be condemned to a life of weight obsesssion, semi starvation and chronic hunger

53
Q

what is nudging beh technique

A

small and subtle changes in eating behaviour that can have a gradua cumulative impact on health
ie portion sizes

54
Q

wasinck and van kleep 2014 nudging change4life

A

making dinner with children, eating around the table
combat mindless eating
make aware of what eating and how eating/how much

55
Q

ogden and hills 2008 - identity and beh chnge

A

**prev
assoc with change in identity- reinvention of self following sig life events
- unhealthy beh no longer necessary/functional
- change beliefs on causes and solutions

56
Q

problem with diet/restraint

wadden 1986

A

diet linked to depression, anxiety and binge eating
restraint theory
promote weight cycling
linked to physological problems

57
Q

brownell 1986

weight cycling in restraint health problems

A

rats change propensity to lose weight

decrease MBR and increase body fat %

58
Q

the obesity dieting paradox

A

obesity health risk
dieting promoted weight cycling also detrimental to health
reduced food intake promoted overeating
success promotes consistent mental health and obsession
CAUSE=CURE

59
Q

IMPORTANCE OF WEIGHT LOSS

A

sig reduced risk to health problems
improve confidence, SE and wellbeing
high psychological reward

60
Q

medical treatments of obesity

A

medication

surgery

61
Q

medical management pathway

A

more extreme methods as each teir fails to work
only implement medican when BMI 30+ and diet/exercise failed to work
only continue meds until lose 10% weight -3m maximum

62
Q

two types of weight meds

A

appetite supressors ie phentamine

gastrointestinal meds - ie orlistat

63
Q

ogden and sidhu 2006

A

meds may only be influential to the extent that they promote beh change
- imporve diet and activity levels
change how percieve eating - cognitive

appetite supressors - more placeabo

64
Q

probs with meds

A

placaebo
more behavioural than medical?
neg side effects - dangerous to health
dependent upon adherence - many use as lifestyle dru

65
Q

types of surgical procedures for weight loss

A

bariatric (gastric band), bypass (remove part of intestine, smaller SA), sleeve (gastrectomy - stomach stapling)

66
Q

how do surgical procedures impact diet

A

restrict amount can consume and absorb
fuller faster
aversive - more uncomfortabl when eat
resuires rapid beh adaptation

67
Q

togerson and sjostrom 2001 surgical procedures

A

matched pairs surgery or traditional
28kg after 2 years in surgert, 0.5k traditional
traditional GAIN 0.7kg after 8 years
surgery reduce hypertension, diabetes, improve quality of life, mental health and social wellbeing

68
Q

the bypass paradox

ogden et al 2006

A

15 surgical patients
experiences pre and post
resonse
- 14 sig loss of weight (x2 probs)
prior- felt lack of control
decisional - felt shift in responsibitily, recog life threat
post - shift in relationship with food, no longer ‘internal battle’
either felt shift in control to experts - relief
or shift towards self - more control over own life

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