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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
stern 1984 physical activity
phone extension upstairs saves approx 10,500 kcal per year for not having to walk downstairs
26
prob with physical activity studies
correlational - dont know if cause or consequence or if a third factor might mediate the assoc dependent on opportunity etc
27
waller et al 2008 | physical activity twins
150 twin pairs genetics vs activity physical activity assoc with smaller waist, less weight gain in active twin
28
do the obese exercise less?
walk less on daily basis escalators>stairs sedentary throughout the week
29
brusch et al 1974 emotionality theory | eating beh
psychosomatic theory of eating disorders misinterpret ffeeling of emptiness/apathy for hunger comfort eating fills the void
30
van strein et al 2009 eating beh
cross sectional study Q - dietary restraint, emotional eating, external eating (Sight/smell) restraint and emotional eating mediate overweight restraint prevent obesity
31
do the obese eat more?
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
leasle et al 2007 | do obese have diff eating beh
eat at fasterrate larger spoonfuls more intake
33
berg et al 20009 | do obese have diff eating patterns
skip breakfast/lunch more likely to eat late at night larger portion sizes
34
prentice and jebb 1995 | do obese eat diff food?
"not all calories are equal" may be related to proportion of fat>carb diff between complex carbs and fat on body
35
complex carb on weight
more energy to burn acticates oxidatio in body more fibre - fuller for longer - stop snakcing
36
fat on weight | blundell and macdiarmid
not oxidised stored doesnt fill stomach or switch off desire to eat higher cal in smaller quanities
37
batton-smith and woodward 1994 | fat proprotion consumed
scottish men with low carb intake 4x more likely to be obese, and 2-3x more likely inwomen than high carb diet
38
wang and lim 2012 | chidhood obesity and SES
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
problem with SES research on obesity
correlational large variance other mediators
40
lesser zimmerman and cohen 2012 phone survey | ads on obesity
direct relationship between soda consumption and outdoor ads where live
41
andrevera et al 2011 ads on obesity
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
problem with ad research on obesity
in children - parental influence and exposure | majority self report
43
parent influence on obesity in children
determine what is in the house and what exosed to from young age when still developing preferences
44
wake et al 2007 parental influence on obesity
self reported parenting styles nd child bmi mothers not sig influence fathers disengaged/permissive increase bmi
45
problem with wake et al
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
problems with research specific factors assoc with obesity
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
stunkaard - problem with traditional obesity treatment
tendency to fail most dont persist those who do fail to sig lose weight those who do likely to regain it
48
different behavioural techniques to weight loss and control
restraint/dieting | nudging
49
waden 1993 eating restraint - beh techniques
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
multidimensional beh weight loss programmes
improved from traditional | compine traditional with exercise, cog therapy/restructure, att change and relapse prevention models
51
fabricature and wadden 2006 | beh technqiues
despite advances, programmes relatively unchanged in their success rates over the last 20 years
52
woodey and woodey 1984 the reality of retraint technqiues
even if weight loss is successful, it is likely to be condemned to a life of weight obsesssion, semi starvation and chronic hunger
53
what is nudging beh technique
small and subtle changes in eating behaviour that can have a gradua cumulative impact on health ie portion sizes
54
wasinck and van kleep 2014 nudging change4life
making dinner with children, eating around the table combat mindless eating make aware of what eating and how eating/how much
55
ogden and hills 2008 - identity and beh chnge
**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
problem with diet/restraint | wadden 1986
diet linked to depression, anxiety and binge eating restraint theory promote weight cycling linked to physological problems
57
brownell 1986 | weight cycling in restraint health problems
rats change propensity to lose weight | decrease MBR and increase body fat %
58
the obesity dieting paradox
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
IMPORTANCE OF WEIGHT LOSS
sig reduced risk to health problems improve confidence, SE and wellbeing high psychological reward
60
medical treatments of obesity
medication | surgery
61
medical management pathway
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
two types of weight meds
appetite supressors ie phentamine | gastrointestinal meds - ie orlistat
63
ogden and sidhu 2006
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
probs with meds
placaebo more behavioural than medical? neg side effects - dangerous to health dependent upon adherence - many use as lifestyle dru
65
types of surgical procedures for weight loss
bariatric (gastric band), bypass (remove part of intestine, smaller SA), sleeve (gastrectomy - stomach stapling)
66
how do surgical procedures impact diet
restrict amount can consume and absorb fuller faster aversive - more uncomfortabl when eat resuires rapid beh adaptation
67
togerson and sjostrom 2001 surgical procedures
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
the bypass paradox | ogden et al 2006
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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