Obesity and Weight Loss (Extras)

Question 1

The Very Low Diets (Cals, Requirements, AE)

Answer 1

Very Low Calorie Diet (VLCD)
• < 800 kcal/day, at least 1g/kg protein

• Requires supervision/monitoring

Multivitamin for diets < 1,200 kcal/day

Starvation
• Depletes body of lean tissue (protein), electrolytes, and fat

Adverse Effects 
• Fatigue 
• Hair loss 
• Dizziness 
• Diarrhea 
• Constipation
• Dry skin 
• Irregular menses 
• Gallstones

Question 2

Vegetarianism (Pros and Cons)

Answer 2

Pros
• Reduce fat intake

• Increased fiber
• Can help reduce coronary artery disease

Cons
• Miss essential fatty acids
• Vegans: miss Vitamin B12

Question 3

High Protein, High Fat, Low Carb (CONS)

Answer 3

Ketogenic Diets
• Decrease insulin release

• Simplified food choices
• Promote body fat storage

Fad Diets
• Atkin’s Diet: 5-15% of calories from carbs
• Zone Diet: 35-50% of calories from carbs

Cons
• High protein -> Ketone bodies -> Ketoacidosis
• ↑Cholesterol -> Cardiovascular Disease
• Electrolyte imbalance and vitamin insufficiencies

Question 4

Paleolithic Diet (Pros and Cons)

Answer 4

Eat hunter-gatherer style (as if no agriculture)
• No grains, legumes, dairy, refined salt/sugar/oils

Pros
• Relatively nutritious/healthy (choose lean meats)
• Carbs consumed with lower glycemic index

Cons
• Calcium/Vitamin D deficiency
• $$$

Question 5

Intermittent Fasting

Answer 5

• No limitations on foods or food groups
• The 16/8 method: aka the Leangains protocol
• skip breakfast and restrict daily eating period to 8 hours
• fast for 16 hours in between

• Eat-Stop-Eat:
- fast for 24 hours, once or twice a week

• The 5:2 diet:

• consume only 500–600 calories on two non-consecutive days of the week
• eat normally the other 5 days

Question 6

Commercial Weight Loss Programs (Pros and Cons)

Answer 6

• Weight Watchers, Jenny Craig, etc.
• Pros
• Social support
• Diabetes Prevention

• Cons
- $$$

Question 7

Meal Replacement Therapy

Answer 7

• Slim Fast, Shakeology, etc.
• Swap 1-2 meals/day for shake, bar, measured meal

Pros
• Portion control
• Low-fat, Low-carb
• Early weight loss (psychological boost to adherence)

Cons
• Short-termefficacy
• Weight maintenance
• $$$

Question 8

Supplements – Increased Metabolism

Answer 8

Caffeine, bitter orange
• Stimulants, energy boosters, thermogenic aids
• Caution: hypertension, tachycardia

Green tea, chromium, garcinia
• Modulate fat/carbohydrate metabolism
• ↓ body fat, ↑ lean muscle mass
• Caution: mood/sleep changes, headaches

Question 9

Supplements – Appetite Suppressants

Answer 9

Guar gum, glucomannin
• Promote satiety, decrease caloric intake
• Caution: GI distress, flatulence, N/V

5-Hydroxytryptophan, Hoodia, St. John’s Wort
• Decreases appetite
• SE: GI discomfort, mood disturbances
• Drug-drug interactions with antidepressants

Question 10

Supplements – Block Absorption

Answer 10

Chitosan
• Block intestinal fat absorption
• Caution: GI upset, gas, nausea, constipation

Bean pod
• Block intestinal carbohydrate absorption
• Dietary fiber
• Caution: heartburn, gas, diarrhea, stomach pain

Question 11

Supplements – Loosen Up

Answer 11

• Cascara sagrada, psyllium
- Laxative – limit use to 1-2 weeks at a time

• Dandelion, caffeine
- Diuretic

• CAUTION: Agents subject to abuse