Weight Management Flashcards
_____ US nutritional health problem is obesity
____% of adults are overweight or obese
____% of adults are obese
1
74%
42%
lowest rates of obesity?
highest rates?
HI
KY and WV
____% of the worlds population is obese
has _____ worldwide since 1975
13%
trippled
obesity is recognized as a _________ disease
adipose tissue secretes ___________ which can result in insulin resistance and oxidant stress
chronic inflammatory
pro inflammatory cytokines
A state where weight exceeds a standard based on height
overweight
Condition of excessive adipose tissue that may impair health
obese
overweight BMI
obese BMI
25-29.9
≥30
Adult male:
Total body fat
________ of body weight for the average male
____ essential fat
_____ body fat indicates obesity
18 -24%
3%
25%
Adult woman:
________ of body weight for the average female
_____ essential fat
_____ body fat indicates obesity
25 -31%
12%
≥30%
increase in cell size is ____________
increased number of cells is _________
___________ does not decrease with weight loss
hypertrophy
hyperplasia
Number of fat cells
two major types of fat deposition
android fat distribution
gyroid fat distribution
android fat distribution is _______
more common is _____
excess subcutaneous truncal abdominal fat (apple shape)
men
gynoid fat distribution is ____________
more common in ______
excess gluteofemoral fat (pear shape)
women
android fat distribution
- Increased risk for __________ fat
- high correlation with ___________
- associated with a significant risk for medical issues
abdominal visceral
insulin resistance
__________ is Clustering of CHD risk factors
Diagnosed by having >____ of the following:
- _____________
- Waist circumference > ___ in. for men & > ___ in. for women
- TG > ___ mg/dL
- HDL <___ mg/dL for men & <___ mg/dL for women
- Glucose intolerance: FBG > ____ mg/dL
- BP: ≥____/ ≥____ mmHg
Metabolic Syndrome (MetS)
3
Abdominal obesity
45
35
150
40
50
100
135
85
Treatment of metabolic syndrome is to treat underlying conditions/risk factors:
- _______management
- physical activity
- treat ________
- improve ___________
- reduce ____ levels
weight
dyslipidemia
blood glucose levels
BP
RMR declines with _____ and ______
____ is a major determinant of RMR
age
restricted energy intake
LBM
______ have an immediate effect on satiety
gut peptides
examples of gut peptides and what they do
cholecystokinin (CCK)
- inhibits food intake
- gallbladder release bile
Bombesin
- reduces food intake
- enhances release of CCK
Incretins (ex: glucagon peptide 1)
- decrease gastric emptying
- promote satiety and decrease food intake
ghrelin is produced by ______ cells and acts on the _________ to __________
levels __________ in people who are eating
__________ levels found after laparoscopic sleeve gastrectomy & gastric bypass
gastric
hypothalamus
stimulate hunger
increase
suppressed
leptin is the hormone produced by _________ and is correlated with ________
adipose tissue
% body fat
leptin acts on receptors in the ___________ to ___________
________ energy expenditure
with obesity, leptin levels ______ and _____ it’s ability to function
cells become _______ to leptin
hypothalamus
inhibit food intake
increases
increase
lose
resistant
examples of brain neurotransmitters
serotonin
corticotropin releasing factor (CRF)
Neuropeptide Y
what does serotonin do ?
lower levels associated with _______
decrease appetite
lower levels are associated with an increased appetite for CHO
what does corticotropin releasing factor (CRF) do?
released during __________
decreases appetite
exercise
what does neuropeptide Y do?
increases in periods of __________-
increases appetite
increases in food deprivation
the body has a natural tendency to maintain or return to a specific weight by adjusting internal regulatory systems
set point theory
lifestyle factors that LEAD TO OBESITY
inadequate PA
sedentary behaviors
lack of sleep
environmental factors that have affect
larger food portion sizes
fast food
food marketing
all you can eat buffets
determine degree of overweight or obesity through ____ and ______ and do nutrition focused physical exam to assess for _____________
BMI and waist circumference
sarcopenia obesity
reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems
BMI
limitations of BMI
measures excess weight, not body fat
doesn’t distinguish between fat, muscle, or bone mass
does not provide info on distribution of fat
underweight BMI
<18.5
normal BMI
18.5-24.9
overweight BMI
25-29.9
obesity class 1 BMI
30-34.9
obesity class 2 BMI
35-39.9
extreme obesity BMI
≥40
how to find BMI range
ht to meters squared and then multiply by BMI values of range
high waist circumference for women vs men
women >35 in
men >40 in
waist circumference is measures ___________
above hips usually above belly button
comprehensive lifestyle intervention includes diet therapy, physical activity, and behavioral modification. aid is recommended to participate for _________ and is on site, high intensity. program provided by trained interventionists. high intensity meaning ____ sessions in _____
≥6 months
≥14 sessions in 6 months
goals for weight loss is ______ of initial body weight in ____ months
5-10% in 6 months
weight loss after age ____ is not reccommended
65
recommended calorie deficit guidelines result in a loss of ________ per week for persons with BMI _______
________ per week for persons with BMI _______
0.5-1
27-35
1-2 lb
>35
de-emphasize IBW because most individuals cannot achieve IBW and cannot maintain losses more than _____
15%
reduced calorie diets should prescribe a kcal deficit of ________
500-1000 kcal/day
for reduced calorie diets, use ________ to estimate RMR, and multiply by AF. Then subtract kcal to promote weight loss
provide _____ of protein to minimize the loss of LBM and preserve bone mineral density
mifflin St. Jeor
1.2 g/kg
all diets must contain ______ to result in weight loss
kcal deficit
should take MVI with minerals if daily intake is less than ________ kcal for women and _______ for men
1200
1800
VLCD are ______ kcal per day and are designed to preserve LBM, so protein of _____ per day. Usually in the form of ______ and last _______.
Reserved for individuals with BMI of ________
need _______ and ________
≤800 kcal/day
0.8-1.5 g/kg
shakes
≥30
supplementation and medical supervision
VLCD produce greater _______ than reduced calorie diets, however when more than ____ year, weight loss is no different than LCD.
weight gain is a problem and side effects include ________
initial weight loss
One
fatigue, weakness, lightheadedness
increased risk for gallstones
increased risk of gout flare up
provides client with a set of techniques to identify and overcome barriers to positive dietary, exercise, and lifestyle habits. Uses goal setting, stimulus control, and cognitive restructuring
behavior modification strategies
behavior modification strategies
stimulus control
cognitive restructuring
motivational interviewing
problem solving
social support
self monitoring
self monitoring consists of monitoring and recording of food intake, exercise, and weight that helps the individual identify _______ that lead to ____________. Then steps can be taken to prevent them from occurring or change the individuals reaction to them.
stimuli
undesirable behaviors
PA contributes to energy deficit. Does it produce more or less weight loss than decreasing energy intake?
combination produces the most weight loss
less
physical activity can minimize ______ during weight loss and improve insulin sensitivity. may contribute to ____________
LBM
abdominal fat mobilization
Gradually accumulate _______ min / week or more, depending on intensity, unless medically contraindicated.
________ minutes or more a week is recommended fr weight maintenance to prevent weight regain
150-420 min/week
200-300 minutes
criteria for use of pharmacotherapy is BMI ≥ ______ or BMI ≥_______ with significant obesity related comorbidities
lifestyle interventions should be attempted for at least _____ before considering drug therapy
30
27
6 months
main type of medication for weight loss
appetite suppressents
appetite suppressants stimulate the release or block the reuptake of _______
promote weight loss by __________ and _________
norepinephrine, dopamine, and serotonin
decreasing appetite
increasing satiety
examples of FDA Approved appetite suppressants
approved for short term use of _______
Phentermine (Apidex)
Benzphetamine (Didrex)
Diethylpropion (Tenuate)
Phendimetrazine (Control PDM)
≤12 weeks
side effects of appetite suppressants
increase BP and HR
nervousness
insomnia
dry mouth
constipation
dizziness
headache
FDA-Approved Drugs for LONG term use
Phentermine-Topiramate (Qsymia)
Naltrexone-Bupropion (Contrave)
Glucagon-like Peptide-1 (GLP-1) Receptor Agonists
Orlistat (Xenical)
Phentermine-Topiramate (Qsymia) is used to _______, ________, and _______
decrease appetite
increase satiety
may make food taste less appealing
side effects of Phentermine-Topiramate (Qsymia)
paresthesia
dizziness
trouble sleeping
constipation
dry mouth
increased HR
May cause birth defects DO NOT take if planning to get pregnant
Naltrexone-Bupropion (Contrave) will __________ and _________
decrease appetite
increase satiety
side effects of Naltrexone-Bupropion (Contrave)
N/V/C/D
dizziness
increased BP and HR
insomnia
liver damage
suicidal thoughts
Glucagon-like Peptide-1 (GLP-1) Receptor Agonists will ______________ and _______________
Delay gastric emptying and increase satiety
side effects of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists ?
N/D/C
abdominal pain
HA
may increase risk of pancreatitis
examples of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists ?
Liraglutide (Saxenda) - daily injection
Semaglutide (Wegovy) - weekly injection
Glucagon-like Peptide-1 (GLP-1) Receptor Agonists being used for weight loss that is not approved by FDA for weight loss, just Type 2 Diabetes
ozempic
Orlistat (Xenical) will _______________ which _____________
approved for long term use for adults and children ≥______
inhibit gastric and pancreatic lipase
reduces absorption of dietary fat by about 30%
12 yrs
OTC version of Orlistat (Xenical)
Alli (reduced strength)
side effects of Orlistat (Xenical)
diarrhea
abdominal cramps
oily stools
flatulence
fecal incontinuence
orlistat should be taken with or within _____ of meals containing fat
patients should be on a nutritionally balanced, reduced calorie diet with about _____ of calories from fat
Take MVI with minerals once a day more than _____ apart from medication
1 hour
30%
2 hours
