Chapter 9: Weight Management

Approximately what percentage of Americans are classified as obese?

>40%

Overweight is when one's BMI exceeds...

25

Approximately what percentage of Americans are classified as overweight or obese?

70%

List 4 factors why Americans are more overweight/obese in recent decades?

- high consumption of processed/fast foods

- larger portion sizes

- limited access to healthy food

- sedentary lifestyle

The amount of fat in adipose tissue reflects both the

number and size of fat cells

What does the size of an adipocyte depend on?

its triglyceride count

Fat cells only increase in size in overweight or obese fat cells?

overweight

Fat cells increase in size and number in overweight or obese fat cells?

obese

Fat is stored when energy balance is ________

positive

As fat cells enlarge, they stimulate cell _____________

proliferation (division)

- number of cells increases

If energy balance becomes ________, the number of cells remains the same

negative

With fat loss, the size of fat cells shrinks but...

the number doesn't change

What two roles does lipoprotein lipase (LPL) play?

transport and metabolism of fat

Do obese people have more LPL activity in their fat cells compared to lean people?

yes

Where do women have higher LPL levels?

breasts, thighs, and hips

Where do men have higher LPL levels?

abdominal fat cells

1. burning more fat means ____ storage of fat

2. Burning less fat means ____ storage of fat

1. less

2. more

Why do some people accumulate more fat?

- excess food intake

- genetic factors

- environmental factors

True or False? Genes play a role in metabolic pathways that influence energy balance and expenditure

True

What two factors influence gene expression?

diet and physical activity

What are three examples of proteins (genes) that regulate appetite and energy expenditure?

- Leptin

- Ghrelin

- uncoupling proteins

What gene codes for the leptin hormone?

ob

What does leptin do?

supresses appetite

- hormone in hypothalamus

- produced in adipocytes

What does ghrelin do?

increases appetite

- acts in hypothalamus

- produced by stomach cells

What are the three fat cell types?

- white adipose

- brown adipose

- brite adipose

What do white adipose cells do?

stores fat for use by other cells

What do brown adipose cells do?

releases stored energy as heat

- no ATP production

- controls body temp

What role do uncouples proteins have in brown adipose cells?

activity of uncoupled proteins allow brown adipose tissue to produce heat

What do brite adipocytes do?

triggered by exercise

- "browning" of white adipose cells happens

- take on characteristics of brown adipose

What is an obesogenic environment?

an environment that promotes obesity

- overeating + less physical activity

- promote fat storage

People may become obese from __________ and following a _________ lifestyle

overeating; sedentary

What is the recommended daily amount of moderately intense physical activity?

60 minutes

What two diseases does obesity predispose people to?

cardiovascular disease and diabetes

What are the three health risk indicators used by healthcare professionals?

- BMI

- waist circumference

- disease risk profile

What does a disease risk profile consist of?

- family history

- life threatening diseases

- common chronic disease risk factors

List the risk factors that lead to weight loss recommendation when paired with obesity/overweight

- hypertension

- fatty liver

- abnormal blood lipids

- diabetes

- prediabetes

When is weight loss recommended?

If the BMI falls into the danger zone, and the person has two or more risk factors or life threatening condition

What are some social consequences of trying to lose weight?

- perceptions at work, school, social situations

- people judge appearances

What are some psychological problems of trying to lose weight?

- embarrassment

- feeling of rejection, depression, or other

- ineffective treatments

What are some unproductive weight loss strategies?

- diet books and weight loss programs

- fad diets

- weight loss products

- herbal products

What are two more productive but more high stake weight loss strategies?

drugs or surgery

In what situation would drugs be most beneficial for someone trying to lose weight?

- part of long term comprehensive weight loss program

- for people with medical risks

- assist with modest weight loss

Orlistat (Alli, Xenical)

inhibits pancreatic and gastric lipase

- side effects include GI cramping, diarrhea, gas

Phentermine

enhances release of norepinephrine, suppressing appetite

- side effects include increased b.p. and heart rate

Lorcaserin (Belviq)

interacts with brain serotonin receptors to increase satiety

- side effects include headache, dizziness, fatigue

Phentermine/Topiramate (Qsymia)

increases norepinephrine which suppresses appetite

- side effects increased heart rate

In what situation would surgery be most beneficial for someone trying to lose weight?

option for excessive obesity: BMI >40

- gastric surgeries decreases stomach size, limits food intake

- gastric bypass changes hormone production

How is gastric banding done?

using a gastric band to create small pouch

- size of opening can be adjusted by inflating/deflating the band

- port placed in abdomen just beneath the skin

How is a gastric bypass done?

small pouch constructed, outlets directly to small intestine

- bypasses most of stomach, entire duodenum, and some jejunum

What are some characteristics of successful weight loss?

- embracing change

- celebrate losses

- set goals

- psychosocial support

Why is rapid weight loss and restrictive eating not recommended?

- nutrition likely to be compromised

- often results in loss of lean tissue leading to lower BMR and rapid weight regain

a deficit of ___to ___kcal/day is recommended

500 to 750

What food recommendations could assist in a healthy diet to prevent being overweight and obesity?

- focus on fiber rich food

- fat content in foods

- select carbohydrates carefully

- watch for empty kcalories

What is the best approach to weight management?

physical activity

What are the benefits of a healthy diet and physical activity combines?

- lose more fat

- retain more muscle

- regain less weight

- reduction of abdominal fat

What is kcalorie expenditure influenced by?

body weight, intensity, and duration

What happens to appetite after an aerobic exercise?

it is suppressed

- can help curb inappropriate appetite caused by boredom or eating

What are the psychological benefits of working out?

- self esteem

- stress management

- improvement of body image

What behaviors can be made to improve body weight/image?

- becoming aware and keeping track of habits

- setting small, time-specific goals

- practice

- reward

What cognitive skills can be made in losing weight?

- problem solving attitudes

- replacing negative thoughts

- understanding personal relationship with food

What are some components of successful weight loss?

- vigorous exercise regimens

- careful eating patterns

- frequent self monitoring

What is the golden rule?

forming beneficial eating and activity habits early is easier than breaking poor habits later

With weight loss, ________ involved in appetite regulation shift in a way that __________ weight gain

hormones; encourage

It takes ____ effort to prevent weight regain than to prevent weight gain

more

What weight loss efforts can be made outside of an individual level?

- social networks

- community institutions

- government policies

What are some benefits of national strategies to prevent obesity?

- make physical activity an integral and routine part of life

- ensure healthy foods/beverages are accessible

- encourage media messages

- support healthcare providers

- make schools centers for health and wellness

What is the percentage of underweight people in the US

2% of adults

What is a BMI that is considered underweight?

<18.5

What are some methods to preventing underweight

- focus on energy dense foods to meet kcal needs

- exercise and build muscle

- ensure that meals are eaten regularly and add snacks

Difference between underweight and anorexia nervosa

anorexia nervosa is voluntary

What are fad diets?

sold as the best and fastest approach to losing weight

What are some flaws of fad diets?

- ignore sound dietary recs

- sophisticated and erroneous explanations

- fail to produce long lasting results