Obesity and weight management

Question 1

Risk factors of overweight?

Answer 1

• environmental factors
• Epigenome
• genetic background
• syndemics

Question 2

Physical activity benefits

Answer 2

Men and women who are aged 65 years and above are more active have lower rates of:
• All-cause mortality
• Coronary heart disease, high blood pressure, stroke
• Type 2 diabetes
• Colon cancer, breast cancer
• Higher level of cardiorespiratory and muscular fitness
• Increase bone health
• Reduces risk of falls
• Reduces risk of depression

Question 3

Principles of weight management 5As

Answer 3

Ask and assess = current lifestyle behaviours and body mass index, comorbidities and other factors related to health risk

Advise = promote the benefits of a healthy lifestyle and explain the benefits of weight management

Assist = develop a weight management program that includes lifestyle interventions tailored to the individual and plan for review and monitoring

Arrange = regular follow-up visits, referral as required and support for long term weight management

Question 4

Challenges of weight loss - barriers?

Answer 4

• psychological adaption to energy deficit
• waning motivation to sustain lifestyle change
• resumption of old habits
• depressive symptoms
• negative peer and family influence

Question 5

successful Weight management in older people

Answer 5

• Maintaining high levels of physical activity and limiting sedentary activities
• Eating a diet low in kilojoules
• Regularly eating breakfast
• Maintaining consistent eating pattern throughout the week and year
• Identifying triggers of emotional eating and developing alternative strategies for regulating mood

Question 6

Weight management in older people - High quality diet

Answer 6

• Older adults need fewer kilojoules than younger adults
• Reduced lean body mass
• Reduced physical activity
• Older adults need more nutrients than younger adults
• Reduced absorption and assimilation of nutrients from the gut
  o Natural changes with ageing (reduced ability to chew, decline in gut function)
  o illness
  o Medications (laxatives, antibiotics)

Question 7

Nutritional deficiencies in elderly people

Answer 7

• Most elderly people do not meet their nutritional needs
• Not acting the minimum amount of protein
• Common deficiencies: protein, dietary fibre, water, vitamin, B6, vitamin B12, vitamin B9

Question 8

Models by which older people can lose weight when medically necessary

Answer 8

• Lifestyle intervention
  o Reduced kilojoule intake
  o Increased physical activity, particularly strength training
• Weight loss medications
  o Not extensively tested in older people, all have significant side effects
  o Polypharmacy
• Weight loss surgery
  o Not extensively studied, but appears safe and reasonably effective in elderly people