Obesity tx-Diet + Ex

Question 1

What is the indication for patients to be on pharmacotherapy for weight loss?

Answer 1

If they are overweight (27-29.9)
AND
have co morbidty

Question 2

What is the indication for patients to be on pharmacotherapy AND surgery for weight loss?

Answer 2

If they are Obese II (35-39.9)
- and have comorbidity

Or they have BMI >40

Question 3

Medically supervised/combo of diet + drug results in how much weight loss? Surgery?

Answer 3

10-15%

15-30%

Question 4

Most practical way to achieve weight loss?

Answer 4

Reducing food intake

1 lb of adipose tissue takes 500 calories to burn

Question 5

Tools + strategies for decreasing caloric intake

Answer 5

1. Food diaries, record keeping
2. Fat gram budget
3. Meal replacements
   - portion and fat control
   - convenient
4. Decrease portions by 25-33%
5. Reduce energy density
6. Diet books/Commercial programs

Question 6

What is the recommended nutrient content of a weight reducing diet?
- % based on calorie intake

Answer 6

55% carbohydrates

• WHOLE grain
• little added sugar

Question 7

Weight loss studies on macronutrient content show what?

Answer 7

Macronutrient content (over long term) of diet did NOT affect weight loss at 2 years

• Difference btwn low fat diet or low carb diet
• same same

Behavior is the most imp

Question 8

Diet Energy density influences weight how?

Answer 8

Diet E density is independent of Fat content
- ie: bacon vs turkey same weight, but different calories

Bacon has way more E density

• consuming more calories
• probably why patients think they arent eating much

Question 9

How can meal replacements help with diet?

Answer 9

What ever weight you loss, it helps you maintain it.

Question 10

Atkins

Answer 10

Low carb diet

Question 11

Ornish diet

Answer 11

Low fat diet

Question 12

Best diet is????

Answer 12

Low fat almost identical to low carb

• there is no clear single best diet in terms of macronutrient content
• Macronutrient content did not affect weight loss at 6 mo

Question 13

high intensity programs guideline?

Answer 13

1. participate for >6 mo
2. on site (>14 sessions in 6 mo)
3. electronically or telephonic programs that include PERSONAL feedback
4. some commercial based programs that provide a comprehensive lifestyle intervention

Question 14

Maintenance after weight loss

Answer 14

1. Participate long term >1 year in a comprehensive weight loss maintenance program
2. Prescribe face to face or telephone delivered weight loss maintenance programs
   - regular content with trained interventionist

Weight loss maintenance

• physical activity is essential for weight loss maintenance sucess
• create E balance at a reduced body weight

Question 15

Short sleep duration effect on dietary efforts

Answer 15

reduced sleep time –> drive to eat high carb, high fat, E dense foods

Question 16

People with low income put in a higher income area influences health behaviors how?

Answer 16

These people have lower prevalence of BMI >35/>40

Question 17

Physical activity helps preserve what during weight loss?

Answer 17

Fat free mass

• Physical activity is critical for weight loss loss maintenance NOT inducing weight loss

Question 18

Combination of Aerobic and resistance activity results in what?

Answer 18

lowers Hb A1c

- better at regulating sugar

Question 19

Current PA recommendations to improve health related outcomes

• how much time is required to prevent weight regain?

Answer 19

Min:
- 30 min moderate activity most days of the week (150 min min/week)

Prev weight gain:

• 60 min/day
• 60-90 min/day (300 min/week)

Question 20

Behaviors of successfull long term weight management

Answer 20

1. self-monitoring
2. low calorie, low fat diet
3. Eat breakfast daily
4. Regular physical activity
5. Limit TV viewing

Question 21

Ghrelin

Answer 21

correlates with how hungry you feel

• this is why people can lose weight, but not keep it off
• after you lose weight, you feel MORE hungry than people who never lost weight
• these Ghrelin levels never go back to baseline even after gaining back all of their weight
• PHYSIOLOGIC RESPONSE TO WEIGHT LOSS