Obesity Flashcards
In a physically active and inactive individual what makes up the daily energy expenditure?
Active - dietary thermogenesis (8), physical activity (32), resting metabolic rate (60)
Inactive - 8, 17, 75
What are the BMI thresholds?
Underweight < 18.5
Normal 18.5-24.9
Overweight 25-29.9
Obese 30-34.9 / 34-39.9 / >40
What are the body fat percentages for the weight categories?
Under <20
Normal 20-25
Over 26-31
Obese 32-37 / 38-45 / >45
List some medical complications of obesity
Pulmonary disease, non alcoholic fatty liver disease, gall stones, gout, arthritis, cancer, pancreatitis, HTN, CHD, diabetes
Why do respiratory problems develop?
Excess fat on thorax makes breathing difficult leading to hypoxia and hypercapnia and therefore sleep apnoea
What is the effect of a 5kg increase in weight on knee arthritis?
35% increase
How much does avoiding inactivity reduce mortality by? Avoiding obesity?
7%
3.6%
How many people are metabolically healthy but obese and what is the consequence of this?
15-30% of obese people
No higher risk of CVD
What are the 4 main causes of obesity?
Genetic/metabolic/over eating/decrease PA
How likely is a child to be obese if both parents are obese? If neither is? Which parent is more important?
70%
7-14%
Mother
What are some metabolic causes of obesity?
Hypothyroidism, cushings, metabolic appetite control dysregulation
Difference in diet induced thermogenesis, energy storage, set point theory
Explain the set point theory
When people lost weight they went back to the same weight afterwards
What is passive overconsumption?
People eat the same volume of food so if they eat a high volume of fat food more weight will be gained than a high volume of carbohydrate heavy food
What is the trend for inactivity?
Increasing as people are walking less, more people have cars, more Tv watched. Total EE decrease by 250-500 calories a day
What are the 5 main ways to treat obesity?
Diet, exercise, surgical, pharmacological, behavioural
What are the benefits of a 10% reduction in weight
Decrease mortality by 20%, BP by 10/20, fasting glucose and cholesterol
What are the 3 main goals with weight treatment?
Prevent gain
Reduce weight - don’t set a landmark, just reach a healthier weight
Maintain weight loss
How much should the weekly target weight loss be? How should the sessions be set out?
.5kg a week
Minimum 3, ideally 5-7 days a week
20-60 minute sessions broken up into 3-10 minute sections
40-70% VO2/55-65HRmax
Any aerobic activity and 1-2 sets of 8-15 reps resistance twice a week
What background info should the prescriber take?
Background, motivation, expectations, confidence, knowledge, weight target, history of weight loss, exercise likes/dislikes
What evidence is there for PA and weight?
Strong evidence it contributes to weight loss and increases cardiovascular fitness
Good evidence it decreases abdominal fat
Lose less FFM, improves maintenance, improve health independently of weight
How much weight can be lost with exercise, diet and combined?
2-3
1-12
3-15
What considerations should there be before commencing exercise?
Aggravated HTN/arthritis Avoid high intensity/impact/agility Don't have reward food Sensitive to bit image Don't weight too often Multiple short bouts is better than one long one
What is the prevalence (%) of overweight and obesity? Is this increasing?
Obesity - 23%
Overweight- 44% men and 34% women
Obesity is increasing but overweight is plateauing