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Medical Nutrition Therapy > Weight Management > Flashcards

Weight Management Flashcards

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USMLE® Step 1 flashcards
1
Q

_____ US nutritional health problem is obesity

____% of adults are overweight or obese
____% of adults are obese

A

1
74%
42%

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2
Q

lowest rates of obesity?
highest rates?

A

HI

KY and WV

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3
Q

____% of the worlds population is obese
has _____ worldwide since 1975

A

13%
trippled

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4
Q

obesity is recognized as a _________ disease

adipose tissue secretes ___________ which can result in insulin resistance and oxidant stress

A

chronic inflammatory

pro inflammatory cytokines

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5
Q

A state where weight exceeds a standard based on height

A

overweight

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6
Q

Condition of excessive adipose tissue that may impair health

A

obese

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7
Q

overweight BMI
obese BMI

A

25-29.9
≥30

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8
Q

Adult male:
Total body fat

________ of body weight for the average male
____ essential fat
_____ body fat indicates obesity

A

18 -24%
3%
25%

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9
Q

Adult woman:
________ of body weight for the average female
_____ essential fat
_____ body fat indicates obesity

A

25 -31%
12%
≥30%

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10
Q

increase in cell size is ____________
increased number of cells is _________

___________ does not decrease with weight loss

A

hypertrophy
hyperplasia

Number of fat cells

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11
Q

two major types of fat deposition

A

android fat distribution
gyroid fat distribution

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12
Q

android fat distribution is _______
more common is _____

A

excess subcutaneous truncal abdominal fat (apple shape)
men

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13
Q

gynoid fat distribution is ____________
more common in ______

A

excess gluteofemoral fat (pear shape)
women

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14
Q

android fat distribution
- Increased risk for __________ fat
- high correlation with ___________
- associated with a significant risk for medical issues

A

abdominal visceral
insulin resistance

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15
Q

__________ 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
A

Metabolic Syndrome (MetS)
3

Abdominal obesity
45
35

150
40
50

100
135
85

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16
Q

Treatment of metabolic syndrome is to treat underlying conditions/risk factors:

  • _______management
  • physical activity
  • treat ________
  • improve ___________
  • reduce ____ levels
A

weight
dyslipidemia
blood glucose levels
BP

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17
Q

RMR declines with _____ and ______

____ is a major determinant of RMR

A

age
restricted energy intake

LBM

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18
Q

______ have an immediate effect on satiety

A

gut peptides

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19
Q

examples of gut peptides and what they do

A

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

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20
Q

ghrelin is produced by ______ cells and acts on the _________ to __________

levels __________ in people who are eating

__________ levels found after laparoscopic sleeve gastrectomy & gastric bypass

A

gastric
hypothalamus
stimulate hunger

increase
suppressed

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21
Q

leptin is the hormone produced by _________ and is correlated with ________

A

adipose tissue
% body fat

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22
Q

leptin acts on receptors in the ___________ to ___________

________ energy expenditure

with obesity, leptin levels ______ and _____ it’s ability to function

cells become _______ to leptin

A

hypothalamus
inhibit food intake

increases

increase
lose

resistant

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23
Q

examples of brain neurotransmitters

A

serotonin
corticotropin releasing factor (CRF)
Neuropeptide Y

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24
Q

what does serotonin do ?
lower levels associated with _______

A

decrease appetite
lower levels are associated with an increased appetite for CHO

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25
Q

what does corticotropin releasing factor (CRF) do?
released during __________

A

decreases appetite
exercise

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26
Q

what does neuropeptide Y do?
increases in periods of __________-

A

increases appetite
increases in food deprivation

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27
Q

the body has a natural tendency to maintain or return to a specific weight by adjusting internal regulatory systems

A

set point theory

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28
Q

lifestyle factors that LEAD TO OBESITY

A

inadequate PA
sedentary behaviors
lack of sleep

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29
Q

environmental factors that have affect

A

larger food portion sizes
fast food
food marketing
all you can eat buffets

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30
Q

determine degree of overweight or obesity through ____ and ______ and do nutrition focused physical exam to assess for _____________

A

BMI and waist circumference
sarcopenia obesity

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31
Q

reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems

A

BMI

32
Q

limitations of BMI

A

measures excess weight, not body fat
doesn’t distinguish between fat, muscle, or bone mass
does not provide info on distribution of fat

33
Q

underweight BMI

A

<18.5

34
Q

normal BMI

A

18.5-24.9

35
Q

overweight BMI

A

25-29.9

36
Q

obesity class 1 BMI

A

30-34.9

37
Q

obesity class 2 BMI

A

35-39.9

38
Q

extreme obesity BMI

A

≥40

39
Q

how to find BMI range

A

ht to meters squared and then multiply by BMI values of range

40
Q

high waist circumference for women vs men

A

women >35 in
men >40 in

41
Q

waist circumference is measures ___________

A

above hips usually above belly button

42
Q

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 _____

A

≥6 months

≥14 sessions in 6 months

43
Q

goals for weight loss is ______ of initial body weight in ____ months

A

5-10% in 6 months

44
Q

weight loss after age ____ is not reccommended

A

65

45
Q

recommended calorie deficit guidelines result in a loss of ________ per week for persons with BMI _______
________ per week for persons with BMI _______

A

0.5-1
27-35

1-2 lb
>35

46
Q

de-emphasize IBW because most individuals cannot achieve IBW and cannot maintain losses more than _____

A

15%

47
Q

reduced calorie diets should prescribe a kcal deficit of ________

A

500-1000 kcal/day

48
Q

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

A

mifflin St. Jeor

1.2 g/kg

49
Q

all diets must contain ______ to result in weight loss

A

kcal deficit

50
Q

should take MVI with minerals if daily intake is less than ________ kcal for women and _______ for men

A

1200
1800

51
Q

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 ________

A

≤800 kcal/day
0.8-1.5 g/kg
shakes
≥30
supplementation and medical supervision

52
Q

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 ________

A

initial weight loss
One

fatigue, weakness, lightheadedness
increased risk for gallstones
increased risk of gout flare up

53
Q

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

A

behavior modification strategies

54
Q

behavior modification strategies

A

stimulus control
cognitive restructuring
motivational interviewing
problem solving
social support
self monitoring

55
Q

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.

A

stimuli
undesirable behaviors

56
Q

PA contributes to energy deficit. Does it produce more or less weight loss than decreasing energy intake?

combination produces the most weight loss

A

less

57
Q

physical activity can minimize ______ during weight loss and improve insulin sensitivity. may contribute to ____________

A

LBM
abdominal fat mobilization

58
Q

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

A

150-420 min/week

200-300 minutes

59
Q

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

A

30
27
6 months

60
Q

main type of medication for weight loss

A

appetite suppressents

61
Q

appetite suppressants stimulate the release or block the reuptake of _______

promote weight loss by __________ and _________

A

norepinephrine, dopamine, and serotonin

decreasing appetite
increasing satiety

62
Q

examples of FDA Approved appetite suppressants

approved for short term use of _______

A

Phentermine (Apidex)
Benzphetamine (Didrex)
Diethylpropion (Tenuate)
Phendimetrazine (Control PDM)

≤12 weeks

63
Q

side effects of appetite suppressants

A

increase BP and HR
nervousness
insomnia
dry mouth
constipation
dizziness
headache

64
Q

FDA-Approved Drugs for LONG term use

A

Phentermine-Topiramate (Qsymia)
Naltrexone-Bupropion (Contrave)
Glucagon-like Peptide-1 (GLP-1) Receptor Agonists
Orlistat (Xenical)

65
Q

Phentermine-Topiramate (Qsymia) is used to _______, ________, and _______

A

decrease appetite
increase satiety
may make food taste less appealing

66
Q

side effects of Phentermine-Topiramate (Qsymia)

A

paresthesia
dizziness
trouble sleeping
constipation
dry mouth
increased HR

May cause birth defects DO NOT take if planning to get pregnant

67
Q

Naltrexone-Bupropion (Contrave) will __________ and _________

A

decrease appetite
increase satiety

68
Q

side effects of Naltrexone-Bupropion (Contrave)

A

N/V/C/D
dizziness
increased BP and HR
insomnia
liver damage
suicidal thoughts

69
Q

Glucagon-like Peptide-1 (GLP-1) Receptor Agonists will ______________ and _______________

A

Delay gastric emptying and increase satiety

70
Q

side effects of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists ?

A

N/D/C
abdominal pain
HA
may increase risk of pancreatitis

71
Q

examples of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists ?

A

Liraglutide (Saxenda) - daily injection
Semaglutide (Wegovy) - weekly injection

72
Q

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

A

ozempic

73
Q

Orlistat (Xenical) will _______________ which _____________

approved for long term use for adults and children ≥______

A

inhibit gastric and pancreatic lipase
reduces absorption of dietary fat by about 30%

12 yrs

74
Q

OTC version of Orlistat (Xenical)

A

Alli (reduced strength)

75
Q

side effects of Orlistat (Xenical)

A

diarrhea
abdominal cramps
oily stools
flatulence
fecal incontinuence

76
Q

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

A

1 hour
30%
2 hours

Medical Nutrition Therapy (12 decks)

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