Obesity - Management Strategies

Question 1

Behavioual

Answer 1

Self-monitoring
Stimulus control
Cognitive restructuring
Social support

Question 2

Behavioural:

Self monitoring

Answer 2

Technology
Immediate feedback
Understand lifestyle choices helpful or harmful
Observe + record - eating, exercise, emotions

Question 3

Behavioural:

Stimulus control

Answer 3

Eat at table
Smaller plates
Eat same time + place
Healthy snacks available
Shoes in place to remind
Don’t buy tempting foods

Question 4

Behavioural:

Cognitive restruction

Answer 4

Cognitive behavioural therapy
Helps stop negative cycles
Replace all or nothing with realistic ideas
Self-efficacy
Mindful eating

Question 5

Behavioural:

Social support

Answer 5

Family, friends

Commercial slimming groups - peer to peer, dynamic, regular contact, learn from others

Question 6

Dietary

Answer 6

Recommendations
Moderate deficit diet
Meal replacements
Very low calorie diet
Considerations
2-day diet
Monitoring
Menu planning

Question 7

Dietary:

Recommendations

Answer 7

2000kcal/day
Protein = 15%
Fat = 35%
CHO = 50%

Question 8

Moderate deficit diet

Answer 8

Intake restricted
Usually 600kcal -> -0.5kg/wk
Weight loss continuing up to 3yr period

Question 9

Meal replacements

Answer 9

Calorie controlled
Higher weight-loss at 3 months + 1yr (compared to trad diets)

Disadvantages

• not sustainable
• limited flavours/lack variety
• lower satiety
• no behaviour change

Question 10

Very low calorie diet

Answer 10

Liquid based
Reduce fat + CHO
<800kcal/d
Loss 1.5-2.5kg/wk
Max 12 weeks
BMI >30
High drop out rate + regain weight

Question 11

Dietary considerations

Answer 11

Tailor to individual
Fad diets
Change not diet

Question 12

2-day diet

Answer 12

Low CHO x2days
Healthy eating x5days
Greater fat loss
Intermitted energy restriction
Decreased insulin + inflammatory markers (linked to CVD + diabetes)

Question 13

Dietary

Monitoring

Answer 13

Phases

Regular

Question 14

Dietary

menu planning

Answer 14

Preferences
Variety
Organised shopping

Question 15

Physical activity

Answer 15

Benefits
Barriers
Early years
Adults
Older
Obesity prevention
Health at every size

Question 16

Physical activity

Barriers

Answer 16

Low energy level

Motivation

Question 17

Physical activity

Benefits

Answer 17

Social
Strengthen body
Prevent major diseases

Question 18

Physical activity

Early years

Answer 18

Encouraged from birth
Pre-school = 3hrs/day
<5yrs = minimise sedentary for long periods

Question 19

Physical activity

Adults

Answer 19

2 1/2 hours / week
75mins high intensity
Strength 2x week

Question 20

Physical activity

Older adults

Answer 20

Any P.A is of benefit
Active daily
Activity that improves balance + coordination

Question 21

Physical activity

Obesity prevention

Answer 21

45-60 mins/day

Previously obese = 60-90 min/day

Question 22

Physical activity

Health at every size

Answer 22

Acceptance + healthy lifestyle without dieting
Promotes + attitudes

May never result in weight loss so no decrease disease risk
Promotes ‘not my fault’ thinking

Question 23

Pharmacological

Answer 23

Human drug trials
Suppress appetite
Affecting EE
Nutrient partitioning
Obesity drugs

Question 24

Pharmacological:

Human drug trials

Answer 24

Phase 1 - tolerability
Phase 2 - proof concept
Phase 3 - large scale multi-centre trials
Phase 4 - long term monitoring

Question 25

Pharmacological:

Drugs suppress appetite

Answer 25

Sympathomimetics - mimic effect of neurotransmitters of PNS

Noradrenergic - phenteramine (release + block norE uptake)

Serotonergic - fluoxetine (serotonin release)

Combo of N + S

Subitramine - antidepressant re-marketed

Phytocannabinoid antagonists

Question 26

Pharmacological:

Affecting EE

Answer 26

B-3 adrenergic agonists

Ephedrine - stimulates norA secretion

Question 27

Pharmacological:

Drugs affecting nutrient partitioning

Answer 27

Glucagon-like peptide-1

Orlistat - behaviour change (side effects), reduces fat absorption, BMI >28 with risk factors or BMI >30

Alli - OTC orlistat

Question 28

Pharmacological:

Obesity drugs

Answer 28

XLS medical - fibre binds with fat preventing absorption, otc

Ideal - orally active, few side effects, visceral fat decrease, non-toxic, long acting

Others available - fibre pills, diuretics, laxatives, tapeworm pills

Some consider drugs ‘medicalise unhealthy lifestyle’