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Kine 1020 > Weight Loss - Lecture 20 > Flashcards

Weight Loss - Lecture 20 Flashcards

1
Q

How do you know when you’re full?

A

Energy surplus (15 kcal difference that causes weight gain) is matched with appetite and energy expenditure

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2
Q

How does the body manage energy expenditure with energy intake

A

Controlling appetite

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3
Q

Grehlin

A

Hunger signals from the stomach that go to the brain and tell you you’re hungry

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4
Q

Why do people say to eat slowly?

A

It takes about 20 minutes for your brain to register that the grehlin signal is turned off making you full.

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5
Q

Leptin

A

Sends signal from adipose tissue to brain to say you’re full.

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6
Q

Prader-Willi Syndrome (Improper Signal Regulation)

A

Excessive grehlin; that causes excessive hunger and food consumption

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7
Q

Are there medications to control appetite

A

No effective medications so far

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8
Q

Key Role of Leptin

A

Decrease appetite and increase metabolism

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9
Q

Leptin Deficiency

A

Unable to produce leptin signals that tell you you are full

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10
Q

Hyperphagia

A

Constantly hungry caused by a deficiency of leptin

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11
Q

Prevalence in Leptin Deficiency

A

Only a few dozen cases; not a cause for obesity

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12
Q

Leptin Resistance

A

Too much leptin; signal does not get sent to brain

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13
Q

Who is affected by leptin resistance more?

A

Obese people

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14
Q

When there is leptin resistance what happens to food intake?

A

Since the signal is not being processed by the brain, food intake will increase because we are not getting the signal that we are full.

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15
Q

Do lean people have leptin resistance

A

No because leptin is released from adipose tissue also known as your fat cells so lean people don’t have high amounts of leptin circulating

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16
Q

Gut Satiety Hormones (Where are they usually released)?

A

Released in the intestine in response to food to decrease urge to eat

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17
Q

What nutrient increases gut hormone production

A

High fibre diet

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18
Q

Do individuals with obesity secrete more or less appetite reducing gut hormones than lean people

A

Secrete less appetite gut hormones due to lack of signal

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19
Q

Volumetrics - Energy Density

A

Uses hormones produced in the intestine to help with satiety

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20
Q

Purpose of Volumetrics

A

Choose lower energy dense foods per volume of food that will help you feel full (satiated) and less hungry

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21
Q

What would a low and high calorie/energy dense food be?

A

Choosing more fruits and vegetables over meat and cheese

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22
Q

Purpose of Fibre Pills (PGX)

A

Thought that increasing the fibre would decrease Glycemic Index and therefore increase satiety

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23
Q

Meta Analysis Results of PGX

A
  • No significant effects on body weight
  • Big reductions of LDL due to fibre preventing it from being reabsorbed into bloodstream
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24
Q

How does the environment play a role in weight gain? (Bottomless soup bowl experiment)

A

Thinking about how much you want to eat tricks you into eating more

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25
Q

What was determined from free popcorn experiment

A

1) We’ll take the food that’s presented to us
2) If there is a lot we’ll try to each as much as you can

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26
Q

Advertisements and their relationship to Food Consumption

A

Seeing an ad on tv makes us eat unhealthy food.

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27
Q

How does Variety affect food consumption

A

The more variety of foods there are the more you want to try.

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28
Q

Plate size and food consumption

A

Size of plate tells you how much to eat. (Smaller plates mean small servings)

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29
Q

All the social factors that influence food intake

A

Portion size, Taste, Advertisement, Variety, Plate Size, Availability

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30
Q

How Dieting helps with obesity?

A

Cutting down amount of carbs you intake can help for a short period of time (weeks or months)

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31
Q

Why is diet not a cure for obesity

A

Diet will tend to rebound at a point in time and then weight gain occurs and we start back at where we were initially

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32
Q

Why do we tend to rebound even after dieting

A

Physiology; you can’t diet forever because your body likes to store energy and hold onto fat for times where food may be scarce

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33
Q

Does this mean dieting doesn’t work?

A

Not true as there is about a 3-5% long term effect that comes with health benefits.

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34
Q

What does the body do with calories or excess energy? (how diets basically work)

A

Body willingly stores energy and convert calories into usable energy (fat)

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35
Q

Why do meal replacements work so well with people losing weight?

A

No need to think about what to make to eat.

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36
Q

How pricey is dieting compared to normal eating?

A

Average cost of food in Toronto is just a bit less than a meal plan.

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37
Q

How is Atkins dieting not necessarily a health benefit

A

Although it’s high in fat and protein making you full but fibre intake is low, cholesterol becomes very high and other long term health related issues.

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38
Q

Effects of Fat mass on surviving during starvation

A

Obese person lasted a year and lost 126kg but the lean man lasted 60 days.

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39
Q

What did the fat mass starvation prove?

A

The obese man was still heavier, so if you want to diet while obese it will take quite some time to lose that weight.

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40
Q

Why does it take so long for one to lose high amounts of weight.

A

Once again it’s physiology as the body wants to store energy not lose what may be useful.

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41
Q

*Physical activity and obesity reduction: dose response?

A

The more calories you burn the more weight you lose

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42
Q

Following the guidelines how many weeks of exercise does it take to burn 1kg

A

10 weeks of constant 2000-4000 kcal/week

43
Q

Why does weight loss in Diet+Exercise equal the same in just Diet?

A

It’s takes a lot of effort to burn a significant amount of calories and lose minimal amounts of weight

44
Q

Does exercise necessarily help lose weight?

A

It’s more of a health benefit rather than a weight loss solution.

45
Q

The Fat Burning Zone

A

The idea that low intensity fat burning exercises loses weight is untrue

46
Q

*Why is the fat burning zone untrue

A

If we look at the amount of calories you burn being equal to weight loss, high intensity exercise burns more calories and therefore more fat.

47
Q

Over 95% of people will not maintain a reduced weight.

A

Weight loss patients who have a goal of 50kg rebound.

Whose fault is that?

48
Q

Gliosis and how it makes you potentially gain weight/keep weight as is

A

Prevents you from starving to death by resetting weight at higher and higher set points

49
Q

Gliosis

A

Scar tissue in the hypothalamus

50
Q

Who are the people who don’t have this

A

Those who do not have this permanent reset in their brain

51
Q

How do your bones contribute in regulating weight?

A

Bones have feedback signals

52
Q

What do the feedback signals indicate?

A

You’re starving because of stress on bone.

53
Q

*How does the body adapt to body weight changes when it comes to Resting Energy Expenditure?

A

The body makes sure we don’t eat too much calories so energy expenditure goes up

54
Q

Does everyone have this increase in energy expenditure from overeating?

A

Those who are able to control the amount of calories they gain and burn are likely to have this increased energy expenditure.

55
Q

What does the body do during undereating?

A

The muscles will burn less calories (decreased energy expenditure) when under eating because the body is trying not to make the weight disappear.

56
Q

What does it mean when someone is energy efficient?

A

Those who keeps their calories; typically harder to lose weight.

57
Q

Why does under eating sometimes cause weight gain?

A

Body’s physiology refusing to lose weight.

58
Q

Weight loss associations with increases in Skeletal muscle efficiency

A

The longer you exercise and the more you do it, the more weight you lose.

59
Q

Why is physiology making it hard for people to want to lose weight?

A

People do a lot more exercise and expect to lose a lot more weight overtime, but body’s physiology does not allow that.

60
Q

How does appetite affect those exercising in an attempt to lose weight

A

Longer bouts of exercise is related to having a greater appetite, so losing weight seems unrealistic when you need to eat a lot.

61
Q

Body weights of those who are no longer sedentary are all the same

A

How sedentary workers lose weight from increased energy expenditure

62
Q

*What does an increase in energy expenditure prove?

A

When the energy expenditure increases, there is the possibility to lose weight but the body’s physiology tries to reset because it sees this loss as negative.

63
Q

How do people manage to keep their weight down for several years?

A

Eating far less than they need to and sometimes even less due to energy requirements changing.

64
Q

Problems with constant weight gain and weight loss (Weight Cycling)

A
  • decrease metabolic rate
  • CHD risk factors
  • Cancer risk factors
65
Q

Three Pillars of Obesity Management

A

Psychological Intervention, Pharmacological Therapy, Bariatric Surgery

66
Q

What do weight loss drugs try to target?

A

Intake or Expenditure

67
Q

How do the drugs target intake

A

Affecting appetite and how much you eat as well as Absorption of food

68
Q

How do the drugs target expenditure?

A

Affects Stimulants

69
Q

How many weight loss medications are approved in Canada?

A

4 (Orlistat, Wegovy, Saxenda, and Contrave)

70
Q

Orlistat

A

Prevents lipase from cutting triglycerides and letting them be absorbed by the intestine.

71
Q

What is the weight loss expected with Orlistat?

A

3% above lifestyle

72
Q

Side effects of Orlistat?

A

Loose bowel movements
- Fat turns to liquid in body temperature and comes out liquid

73
Q

Why should patients on Orlistat be on a low fat diet?

A

Because the fat that doesn’t get absorbed ends up causing a mess in your bowels so keeping a low fat diet would decrease loose bowel.

74
Q

Cost of Orlistat?

A

$180/ month (Not covered by OHIP)

75
Q

What is Saxenda

A

An injectable medication that suppresses appetite

76
Q

How is Saxenda helpful for those with obesity

A

Because obese people have less gut hormones, taking this will help with their satiety.

77
Q

What’s the weight loss expected with Saxenda?

A

8% above lifestyle

78
Q

Why do insurance companies want to see proof of weight loss to cover medication?

A

Because of stigmatization that the person has no will power and instead relies on medication.

79
Q

Side effects of Saxenda

A
  • Nausea
  • Gallstone and acute pancreatitis rare
80
Q

Cost of Saxenda

A

400$/month

81
Q

Contrave and how it was made?

A

Two medications that had a side effect of weight loss were put together.

82
Q

What does contrave do?

A

Suppresses Appetite

83
Q

Expected weight loss

A

8.1%; 5% due to lifestyle

84
Q

Semaglutide (Wegovy)

A

Imitates GLP-1 Hormone that regulates appetite and lower calories consumed.

85
Q

Expected weight loss

A

15%

86
Q

Cost of Wegovy?

A

$1627/month

87
Q

Surgery and its effects on weight loss?

A

Surgery is the only thing keeping people at a sustained weight loss.

88
Q

How does gastric surgery work?

A

Targets stomach size or time to absorb (shorten intestine)

89
Q

Benefits of Bariatric Surgery on Cardiovascular Risk

A

Decreases Hypertension, Dyslipidemia, Diabetes, Sleepapnea

90
Q

Is it a cure for these diseases like diabetes?

A

No; they just don’t need to take their medication associated with disease.

91
Q

What is the reduction of risk with surgical weight loss?

A

89% risk reduction

92
Q

Wait time for bariatric surgery in Ontario?

A

2-3 years

93
Q

Overall difference in weight loss with diet vs. surgery

A

Far greater weight loss with surgery that is sustained compared to diet

94
Q

Why do people not want Bariatric Surgery?

A

They believe in their willpower and think it’s unnecessary

95
Q

Firmly held belief by society and obese people

A

Problem of not losing weight is because of their lack of willpower

96
Q

How does bariatric surgery affect hormones causing weight loss?

A

Resets that gut-brain signal to a lower number rather than a higher number.

97
Q

What does resetting to a lower number entail?

A

Appetite decreases and weight will be lost.

98
Q

Percentage of people that don’t need bariatric surgery?

A

42%

99
Q

Downside of waiting too long to get bariatric surgery?

A

Excess skin form after surgery and will be an impairment on QOL due to immense weight.

100
Q

Health professionals tend to attribute patients health issues to excess weight

A

Health professionals not listening to the problem.

101
Q

Obese patients get worse health outcomes because of late diagnosis

A

Health professionals ignoring the real issue and focusing on something irrelevant

102
Q

Weight Loss products are the #1 scam because?

A

They tell patients a lie to make them desperate to buy it.

103
Q

Main message about obesity and weight control?

A

Understand that there may be nothing we can do to cure it, but we need to get our biases in check before judging someone.

Kine 1020 (43 decks)

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