ch 9 weight management: overweight, obesity, and underweight

what % of people in the US is overweight or obese
68%
is overweight or obesity in women, poor people, blacks and hispanics?
yes
what % is obesity in children
34
when your BMI is over 25 you are
overweight and/or obese
when energy in is greater then energy out that cause
weight gain
where is fat stored?
in fat cells of adipose tissue
what does body fat depend on
number and size of fat cells
what are periods in life where fat cell numbers increase
late childhood and early puberty
what is cell proliferation
when you have high triglycerides that causes an increase in fat cell size
what do high triglycerides cause?
and increase in fat cell size
when energy out is greater than energy in that causes you to
lose weight
when fat cell size decreases but there is no change in number that is because
energy out is greater than energy in
what removes triglycerides from blood storage
lipoprotein lipase
LPL
lipoprotein lipase
what do obese people have more of
lipoprotein lipase
what causes varying activity of LPL
gender
where is the most female activity of LPL
breast, hips and thighs
where is the most male activity of LPL
abdominal
fat oxidation is not efficient in
obese people
when the body tends to maintain a certain weight by means of its own internal controls
set point theory
what is a genetic disorder that has excessive appetite, massive obesity, short stature, and often mental retardation
prader-willi
what may determine predispositions to obesity
genetics
what are the two things genes interact with
1) diet and physical activity
2)satiety and energy balance
human genome
you cannot change your genome but you can influence the epigenome
what can influence the epigenome
physical activity
what is the obesity genome called?
ob
what is expressed by the codes for the protein leptin
ob
what is a protein produced by adipose tissue that is directly linked to a decrease in appetite and an increase in energy expenditure
leptin
what acts as a hormone in the hypothalamus
leptin
what happens with an increase in body fat to the hormone protein leptin?
an increase in body fat causes an increase in leptin which surpresses appetite
what promotes negative energy balance
leptin
what is the obesity gene
a genetic deficiency of leptin or genetic mutation
is the obesity gene rare?
yes
what is leptin resistance
when people have leptin it just fails to supress appetite
what is caused by fructose consumption
leptin resistance
what triggers your desire to eat
ghrelin
what promotes positive energy balance and weight gain
ghrelin
what is decreased by physical activity, gastric bypass surgery and weight gain?
ghrelin
ghrelin increases with the lack of
sleep
uncoupling proteins
influences the storing of fat
what are two types of body fat
1)brown adipose tissue
2) white adipose tissue
what releases stored energy as heat
brown adipose tissue
what is uncoupled from ATP formation that expends energy
brown adipose tissue
brown adipose tissue is found in
newborns
what is less than 1% of adult fat
brown adipose tissue
brown adipose tissue is found less in
obese
what stores fat for other cells to use
white adipose tissue
all of the circumstances that we encounter daily that push us towards fattness
obesogenic environment
is there an interaction between environment and genetics?
yes
present and past eating and activity patterns influence current body weight
yes
availabilty of food can cause
overeating
the serving size of food can cause
overeating
for an extra $.67 to upsize a meal, you consume and extra
400kcal, 36gm of fat, and $1-$7 of healthcare costs
exercise uses about
150 calories a day or about 1000 calories a week
life requires little exertion because of
modern technology
inactivity contributes to
weight gain and poor health
what is the DRI prevention of weight gain
60 mins of moderate activity everyday
NEAT
nonexcercise activity thermogensis
what causes 350 extra kcal burned per day
NEAT
what are 3 indicators that show overweight or obesity
1)BMI
2)waist circumference
3) disease risk profile
disease risk profile takes into account
family history, life threatening diseases, and common risk factors for chronic disease
what do you need for beneficial weight loss
1)you need to consider health status
2)you have to have motivation
what is the key component to weight loss
motivation
when health is not the motivation for weight loss that is usually in people that are
overweight but in good health
when a person has 2 or more risk factors and it is recommended that u lose weight that is usually seen in people who are
overweight or obese with risk factors
people who are obese and overweight with a life-threatening condition are always
recommended to lose weight
most people are not
successful in losing weight and maintaining it
being obese and overweight has social consequences like
being judged at school, jobs, and in other social situations
what are the psychological problems of being overweight or obese
embarrassment which leads to anxiety and depression
what has little success with weight loss maintenance
diet books and weight-loss programs
what are popular diets that promote quick weight loss
fad diets
what limits food choices which reduces energy intake
fad diets
what is an herbal weight-loss product that uses the illegal ephedrine
St. John’s Wort
what does ephedrine do?
stimulates modest weight loss with high risk factors
did laws ban ephedrine?
yes
strategies for weight loss depend on
1) the degree of obesity
2) risk of disease
you can use drugs as a
long-term comprehensive weight-loss programs
can drugs have medical risks but can also assist with modest weight loss
yes
what two drugs do the FDA approve
1)orlistat
2)phentermine
weight loss drug that inhibits pancreatic lipase activity in the GI tract, thus blocking digestion and absorption of dietary fat and limiting energy intake
orlistat
drug that enhances the release of neurotransmitter norepinephrine, which suppresses appetite
phentermine
what is the BMI of clinically severe obesity?
greater than 40
there are more then ___ surgeries performed each year which causes a loss ____% of body weight initially
200,000
20-32%
gastic lipase is a surgery that
reduces food capacity in the stomach which effectively limits food intake
what reduces the production of ghrelin
surgeries like gastric lipase
surgies have
health related benefits
surgies cause
long-term safety and effectiveness
what is the cosmetic procedure that removes fat
liposuction
liposuction has
little weight loss and no health benefits
what are successful weight loss strategies
1)small changes
2)moderate losses
3)reasonable goals
what are reasonable weight loss goals
a reasonable rate of weight loss which would be 1/2 to 2lbs/week or 10% over 6 months
are there benefits to moderate weight loss
yes
do you need to incorporate healthy eating and physical activity to lose weight
yes
do you have to be realistic about energy intake?
yes
providing less energy than needed causes you to
lose weight
to lose weight you should avoid
restricting eating and rapid weight loss
what is a major goal to lose weight
to have nutritional adequacy without excess
to lose weight u should try to stop eating how many calories per day?
500-1000
you should eat breakfast
every day
eating breakfast frequently is
inversely related to obesity
what is the minimum amount of calories you should have per day?
1200
should you have multivitamins or MVI?
yes
you should eat ___ portion
small
you should eat ___ food at each meal
less
you want to feel satisfied not
stuffed
to lose weight u should have structured
meal replacement plans
having lower energy density foods causes
weight loss
for weight loss always remember
water
water helps with
weight management
focusing on fiber can help you
lose weight
fiber is
low in energy density and high in nutrients
what requires energy to eat?
fiber
what speeds up food consumption
fiber
some fats are
energy density and cause satiation
you should select carbs carefully to
lose weight
should u watch out for empty calories?
yes
what do not provide vitamins or minerals?
empty calories
what are examples of empty calories?
fat, sugar, and alc
what is the best approach to weight management
moderate physical activity plus activities of daily life-200-300 min/week
a combination of diet and physical activity causes you to
lose more fat, retain more muscle, and regain less weight
what causes a reduction of abdominal fat
physical activity
kcal expenditure depends on
body weight, intensity, and duration
the greater the energy deficit created by exercise the greater
the fat loss
discretionary kcals are ___ with physical activity
higher
metabolism
speeds up with activity
what has immediate and long-term effects?
metabolism
physical activity ___ fat and ___ lean body mass
decreases, increases
strength training exercise decreases
abdominal fat
do you have a delayed appetite after physical activity
yes
what does physical activity help curb?
inappropriate appetite
what promotes self esteem
physical activity
choose activities like
walking
should you choose physical activity that you enjoy and are willing to do regularly
yes
should you have low to moderate intensity work out
yes
energy-expending daily activities like steps cause
weight loss
what is usually the first to go with spot reducing exercise
abdominal fat
how does the atmosphere influence weight loss
pleasant and comfy makes you eat more food
how does accessibility influence weight loss
less effort needed to obtain food makes you eat more
how does socializing influence weight loss
the longer the meal is the more you are going to eat if its past just eating slow to get hungry, visual cues, and distractions
why do u need to control your portion size when you are eating
because you will gain more weight the bigger it is
what distractions should u look out for while eating
1) initiating eating
2)interfering with internal controls
3)extending duration of eating
when there is a large assortment of food that
increases food consumption
packaging and portion size can influence your
weight loss
the “clean plate club” is ___ good
not
the serving containers only work when you dont
go for multiple servings
changing behavior by manipulating cues or environmental factors that trigger behavior
behavior modifications
what type of attitude helps u lose weight
positive, matter-of-fact
becoming aware of behaviors and keeping records of what you eat can help
weight loss
changing your behaviors include
1)setting small, specific goals
2)practice
3)reward (not food reward)
cognitive skills are based on 2 things
1)problem solving which gets you to the solution and 2) cognitive reconstructing
what is cognitive reconstructing
when you learn to replace negative thoughts
personal attitude helps u understand
the personal relationship someone has with food and the sound emotional health of a person
what are some support groups
WW, TOPS, OA
WW
weight watcher
TOPS
taking off pounds sensibly
OA
overeaters annoynomus
what is weight loss maintenance
achieving a weight loss of at least 10% of initial body weight and maintaining the loss for at least a year
what is successful weight loss?
reaching a goal within a half of year and then plateauing
what should u do when you plateau
keep eating and exercising the same to maintain the weight
prevalence of successful weight loss is
difficult to determine
1 out of 6 maintained weight loss without
a specific goal
what are components of a successful weight loss
1)vigorous exercise
2)careful eating patterns
3)frequent self-monitoring
weight loss causes a ____ in metabolism
decrease
it takes more to prevent weight ___ than to prevent weight ____
regain, gain
how many low calorie meals should u eat per day?
4-5
to maintain weight u should eat food with
high nutrient density and low in energy density
what meal should u always eat
breakfast
you should monitor your weight…
frequently
how much tv should u watch per week?
less than 10 hours
who should u consult with
RD, physician or other supports
what can u possibly change your environment through?
public health laws
you need to stretch beyond individuals to
adress social networks, community institutions, and government policies
what effects no more than 2% of US adults
being underweight
to gain weight u need to combine
physical conditioning and high energy intakes
demand for energy contributes to
being underweight
physical activity and growth and development contribute to
being underweight
is it difficult to gain weight if u are underweight?
yes
why is it difficult to gain weight if u are underweight
adaptive thermogenesis
why would u need to learn to habits and try new foods?
to gain weight
is underweight the same thing as being ano?
no
what is the major difference from being underweight and being ano
ano people starve themselves
if you want to gain weight should u have adequacy and balance?
yes
when u want to have energy dense foods, regular meals daily, large portions, extra snacks, and juice and milk you are trying to
gain weight
why do people who need to gain weight exercise?
to build muscle
what makes outrageous claims to weight loss?
fad diets
what does not need requirements to prove claim?
fad diets
what does not need to be supported with credible research and the research is usually distorted
fad diets
how much do americans spend on fad diets?
$33billion a year
do fad diets tend to ignore dietary recommendations
yes
fad diets tend to work for only
a short period of time
what fails to produce long lasting results
fad diets
what claims to not count calories but it actually does
fad diets
fad diets are designed to have
low energy intake
fad diets tend to lack
variety and are monotonous
do fad diets often recommend dietary supplements
yes
what cannot support optimal health over time
fad diets
what tips the energy balance equation to greater energy expenditure
fad diets
if you are making long term lifestyle changes what are you trying to do
lose weight
a healthy weight loss plan should be
flexible and have variety