Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1051 PBL > Weight Management Lecture 1 > Flashcards

Weight Management Lecture 1 Flashcards

1
Q

t/f obese children have a higher risk of adult obesity

A

treu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 5 A’s of helping with obesity?

A
  1. ask permission to talk about weight
  2. assess their story
  3. advise on management
  4. agree on goals
  5. assist with their drivers and barriers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list 3 reasons people want to lose weight

A
  1. image
  2. health (physical and psychological)
  3. performance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

list 5 ways people try to lose weight

A
  1. diet
  2. exercise
  3. medication
  4. surgery
  5. controlling other factors such as stress, energy etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the cause of obesity is NOT simply ___, but rather the complex interplay of _____

A

inbalance of calories in vs out; multiple genetic factors, metabolic and behavioural and environamnetal factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how are humans hard-wired against weight loss?

A

decreased food intake and increased physical activity lead to a negative energy balance and trigger cascade of metabolic and neurohormonal adaptive mechanisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the ABC’s of weight couseling?

A

ask permission
build a relationship
critically look for weight bias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is weight bias?

A

negative attitudes towards others bc of their weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is weight stigma?

A

stereotypes and labels we assign to people who have obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is weight stigma?

A

actions against people with obesity that can casue social exclusion and inequities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

BMI should serve only as a ___

A

screening measurement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

t/f BMI should be used with other information to identify who may benefit from obesity management

A

treu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

BMI is the most commonly used objective surrogate marker for

A

body fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how is BMI calculated ?

A

weight (kg) / height (m2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

1 lb is ____kg

A

2.2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

integration of BMI and ____ in clinical assessment may identify the higher risk phenotype of obesity better than either alone, particularly is those with low BMI

A

waist circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the Edmonton obesity staging system measuring?

A

assessment of risk factors & physical symptoms (risk factors and established co-morbidities) psychological symptoms and physical limitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

does BMI provide information on the distribution of fat?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

body fat in what region is associated with higher prevalence of comorbidities

A

central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

wasit circumference should be measured at what stage of breathing?

A

end of normal exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

cut-off values for waist circumference vary with ___, ___ and ___

A

gender, age, ethnicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

can you have a high BMI and be healthy?

A

yes!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

in healthy individuals with a high BMI, is there any evidence to suggest long-term benefits of intentional weight loss? What should the focus be for these individuals?

A

no; focus on healthy lifestyle and not gaining weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

BMI measurements are most useful for what age category?

A

20-65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what 2 adult groups may not be accurately represented by their BMI?

A

those who do a lot of muscle resistance training and those with extreme short/tall stature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

is BMI appropriate for infants, children, adolescents, pregnant and breastfeeding women?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

why is BMI not appropriate for adults over 65?

A
  1. not associated with increased mortality in this group

2. being underweight is the greater concern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

t/f health canada recommends that diagnosis of obesity not be based off BMI alone

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the 3 regions of the brain that regulate weight?

A
  1. hypothalamus
  2. mesolimbic
  3. cognitive lobe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the main role of the hypothalamus in weight regulation?

A

energy homeostasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the main role of the mesolimbic in weight regulation?

A

pleasure center, involved in the rewarding aspect of eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the main role of the cognitive lobe in weight regulation?

A

executive functioning (voice of reason) that can override the mesolimbic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when does the cognitive lobe work best in weight regulation and supressing the mesolimbic?

A

under smooth conditions of rest, low stress and support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the important goal of therapy for weight management?

A

focus on improved health and wellbeing, not the amount of weight lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

t/f even modest and sustained weight loss is associated with improvements in co-morbidities associated with obesity

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

the pathophysiology of obesity is a complex interaction of ___ and ___

A

individual factors and societal factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

list 3 medical conditions that are “organic” causes of weight gain

A
  1. cushings disease
  2. hypothyroidism
  3. endocrinopathies
38
Q

what sort of risk factors are associated with stage 1 obesity? Examples?

A

obesity-related subclinical risk factors ; borderline hypertension, impaired fasting glucose; elevated liver enzymes

39
Q

what type and severity of physical symptoms might be seen in stage 1 obesity?

A

mild (currently not requiring medication for comorbidities); trouble breathing on moderate exertion; occaisional aches and pains

40
Q

what type and severity of psychological symptoms might be seen in stage 1 obesity? How is the quality of life impacted?

A

mild obesity-related physchological symptoms and or mild impairment of well-being. QOL not impacted

41
Q

stage 3 obesity is associated with a sugnificant level of at least 1 of what 4 factors? is quality of life impacted?

A
  1. end-organ damage (heart attack, diabetes complications
  2. obesity-related psychological symptoms
  3. functional limitations
  4. impairment of well-being
    no
42
Q

what is the effect of obesity on leptin?

A

brain gets feeling of chronic low leptin levels

43
Q

what structures in the hypothalamus that increase appetite

A

agouti related peptide and the neuropeptide y

44
Q

what structures in the hyptholamus suppress appetite?

A

pro opimelanocortin (POMP C) and cocaine and amphetamine regulating transcript (CART)

45
Q

ghrelin ____ (raises / lowers) metabolism

A

lowers

46
Q

ghrelin stmilulates what parts of the hypothalamus?

A

the AgPR / NPY (stimulates hunger)

47
Q

release of insulin stimulates what hypothalamus structures? what does it supress?

A

POMC / CART (suppresses appetite); inhibits the AgPR and NPY

48
Q

leptin is released from ___ and stimulates ___ and supresses ___

A

adipose tissue; POMPC and CART ; AgPR and NPY

49
Q

soluble and insoluble fiber promote satiety by ___

A

delaying gastric emptying and causing feeling of fullness

50
Q

glycemic index compares _____ to ingestion of ___g of available carbohydrates from a test food with that of a reference food (glucose or white bread)

A

blood glucose ; 50

51
Q

t/f a higher glycemic index produces more of an insulin spike than lower gylcemic index foods

A

true

52
Q

t/f high-fiber low glycemic index diet results in fewer glycemic spikes

A

treu

53
Q

what is the focus of medical nutrition therapy?

A

individualized eating patterns, food quality and healthy relationship with food

54
Q

t/f medical nutrition therapy includes mindfulness-based eating practices that may help reduce cravings, reduce reward-driven eating, improve body satisfaction and improve awareness of hunger and satiety

A

true

55
Q

t/f medical nutrition therapy assesses for micronutrient deficiencies

A

true

56
Q

what is a negative physiologic impact of very-low calorie diets?

A

may effect neurobiological pathways that control appetite, hunger and cravings. Body weight regulation may result in increased food intake and weight gain

57
Q

what are the risks of a low carb LCD +/- protein diet (keto_

A

increased bone calcium loss, dehydration, gout, kidney and liver disease

58
Q

low fat diets can produce significant weightloss up to ___ years

A

3

59
Q

t/f low fat diets are comparable to reduced energy diets in comparison of weight loss

A

true

60
Q

what is the mediterranean diet?

A

high intake of natural fats, plant foods, moderate intake of fish, poultry, dairy and red wine (low inatke of red meat , eggs and sweets)

61
Q

what is the DASH diet?

A

dietary approach to stop hypertension; emphasizes high intake of fruit, low-fat dairy, veggies, grains, nuts and low intake of red/processed meat and sweets

62
Q

who is considered for weight loss surgury?

A

BMI > 40 or BMI 35-40 with combined high-risk comorbidities

63
Q

what are the 2 main types of weight loss surgury?

A
  1. gastric bypass

2. banded gastroplasty

64
Q

what is gastric bypass?

A

creating a short bowel to produce malabsorption of ingested calories

65
Q

what is banded gastroplasty?

A

a small stomach is created to prevent large caloric intake at any one time

66
Q

which weight loss surgery is associated with greater improvement of weight loss outcomes and better long term outcomes?

A

banded gastroplasty

67
Q

what are some of the complications of weight loss surgery?

A

wound healing, metabolic distrubances, severe diarrhea, bloating, anorectal pain, disruption of drug absorption

68
Q

what is an example of a drug used for weight loss?

A

Bupropion 90mg / Naltrexone 8 mg (Contrave)

69
Q

what BMI may be eligible for Bupropion naltrexone treatment?

A

> 30, 27 with comorbidities

70
Q

what is the usual function of bupropion?

A

inhibits reuptake of DA and NE and causes mild appetite suppression

71
Q

what is naltrexne used for usually?

A

opioid antagonist

72
Q

how is buproprion naltrexone suspected to suppress appetite?

A

by increasing firing of the POMC

73
Q

t/f combination of weight loss mediaction and lifestyle is more successful than lifestyle alone

A

true

74
Q

medications used for weight loss have at least one of the following effects

A
  1. reduce food intake (suppress appetite)
  2. reduce. nutrition absorption
  3. increase enerfy expenditure
75
Q

a ____% reduction in weight is realistic for weight loss medications

A

5-10

76
Q

t/f weight loss requires reduced calories

A

true

77
Q

what is the effect of orlisat of weight loss?

A

inhibits fat absorption by blocking pancreatic lipase, makes oily stools that might make patients want to eat less fat to avoid this

78
Q

what are some notable drug interactions with orlisat?

A
  1. reduction of fat-soluble vitamin absorption
  2. can reduce absorption of synthroid
  3. may affect absorption of oral contraceptives
79
Q

what are some innapropriate mediactions for weight loss?

A

laxatives, syrup of ipecac, diuretics, thermogenic agents

80
Q

who should NOT take bupropion naltrexone?

A

those with uncontrolled high BP, seizures, bulimia, anorexia, opioid use, MAOIs, severe kidney / liver damage

81
Q

is there risk of suicidal thoughts with use of bupropion naltrexone?

A

yes

82
Q

what is a risk of bupropion naltrexone for those with type 2 diabetes?

A

hypogylcemia if pt on glucose lowering treatment

83
Q

what are some adverse effects of bupropion naltrexone?

A

nausea, constipation, dizziness, dry mouth acute glaucoma and headache

84
Q

should bunaltrexone be taken with a high fat meal?

A

no

85
Q

can bunaltrexone be crushed or broken? why /why not?

A

no, risk of seizures

86
Q

what is liraglutide?

A

long-acting analog of human glucagon-like peptide (incretin)

87
Q

what is the function of the liraglutide?

A

stmulates insulin secretion, reduces postprandial glucagon levels, slows gastric emptying and acts on sateiety pathwasy to reduce food inatke

88
Q

who should NOT take liraglutide?

A

if family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2

89
Q

what are some of the adverse effects of liraglutide?

A

nausea, vommiting, upset stomach, gall stones, pancreatitis, increased heart rate, low blood sugar and difficulty sleeping

90
Q

how is liraglutide dosed?

A

SC injection

1051 PBL (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions