Obesity

Question 1

In a physically active and inactive individual what makes up the daily energy expenditure?

Answer 1

Active - dietary thermogenesis (8), physical activity (32), resting metabolic rate (60)
Inactive - 8, 17, 75

Question 2

What are the BMI thresholds?

Answer 2

Underweight < 18.5
Normal 18.5-24.9
Overweight 25-29.9
Obese 30-34.9 / 34-39.9 / >40

Question 3

What are the body fat percentages for the weight categories?

Answer 3

Under <20
Normal 20-25
Over 26-31
Obese 32-37 / 38-45 / >45

Question 4

List some medical complications of obesity

Answer 4

Pulmonary disease, non alcoholic fatty liver disease, gall stones, gout, arthritis, cancer, pancreatitis, HTN, CHD, diabetes

Question 5

Why do respiratory problems develop?

Answer 5

Excess fat on thorax makes breathing difficult leading to hypoxia and hypercapnia and therefore sleep apnoea

Question 6

What is the effect of a 5kg increase in weight on knee arthritis?

Answer 6

35% increase

Question 7

How much does avoiding inactivity reduce mortality by? Avoiding obesity?

Answer 7

7%

3.6%

Question 8

How many people are metabolically healthy but obese and what is the consequence of this?

Answer 8

15-30% of obese people

No higher risk of CVD

Question 9

What are the 4 main causes of obesity?

Answer 9

Genetic/metabolic/over eating/decrease PA

Question 10

How likely is a child to be obese if both parents are obese? If neither is? Which parent is more important?

Answer 10

70%
7-14%
Mother

Question 11

What are some metabolic causes of obesity?

Answer 11

Hypothyroidism, cushings, metabolic appetite control dysregulation
Difference in diet induced thermogenesis, energy storage, set point theory

Question 12

Explain the set point theory

Answer 12

When people lost weight they went back to the same weight afterwards

Question 13

What is passive overconsumption?

Answer 13

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

Question 14

What is the trend for inactivity?

Answer 14

Increasing as people are walking less, more people have cars, more Tv watched. Total EE decrease by 250-500 calories a day

Question 15

What are the 5 main ways to treat obesity?

Answer 15

Diet, exercise, surgical, pharmacological, behavioural

Question 16

What are the benefits of a 10% reduction in weight

Answer 16

Decrease mortality by 20%, BP by 10/20, fasting glucose and cholesterol

Question 17

What are the 3 main goals with weight treatment?

Answer 17

Prevent gain
Reduce weight - don’t set a landmark, just reach a healthier weight
Maintain weight loss

Question 18

How much should the weekly target weight loss be? How should the sessions be set out?

Answer 18

.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

Question 19

What background info should the prescriber take?

Answer 19

Background, motivation, expectations, confidence, knowledge, weight target, history of weight loss, exercise likes/dislikes

Question 20

What evidence is there for PA and weight?

Answer 20

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

Question 21

How much weight can be lost with exercise, diet and combined?

Answer 21

2-3
1-12
3-15

Question 22

What considerations should there be before commencing exercise?

Answer 22

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

Question 23

What is the prevalence (%) of overweight and obesity? Is this increasing?

Answer 23

Obesity - 23%
Overweight- 44% men and 34% women
Obesity is increasing but overweight is plateauing