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29 Cards in this Set

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Distinguish between body composition and body weight
Body composition is more important than body weight. It is a better indicator of health status because it allows us to compare the % of body fat to lean tissue. It is a key element in determining energy expenditure. It is also important to know where the fat is located. Ex: Fat around organs is more harmful than fat under skin.
What assessment techniques are used to measure each?
For weight, we can use a height-weight table, a scale, the BMI, waist circumference, or risk factors for other conditions. For body composition, we have (1)Densitometry, (2)DEXA, (3) Skinfold thickness, and (4)Bioelectrical impedance.
What are the BMI values (kg/m2) considered to be consistent with underweight, normal weight, overweight, and obesity?
Underweight: less than 18.5
Normal weight: 18.5 to 25
Overweight: 25 to 30
Obesity: greater than 30
What health risks are associated with obesity?
There are many: heart disease, stroke, diabetes, hypertension, cancer, gallbladder disease, gout, atherosclerosis, sleep apnea, kidney diseases, and psychosocial problems. A modest amt. of weight loss (like 10% of weight) can improve symptoms and lower the risk.
What health risks are associated with underweight?
These risks are: deficits in proteins, vitamins, and minerals, as well as energy. These can cause fatigue to compromised immune function. It also may lead to cancer, spoil the appetitle, or interfere w/ digestion.
How do the fat cells change with weight loss and weight gain?
With weight gain, they increase in size and number. They are larger in obese ppl than those who are leaner. With weight loss, you lose the fat size, but not the number. This has effects on: appetite, hunger, satiety and so may lead to weight regain.
What factors contribe to weight gain and obesity?
The factors are: genetic predisposition, a sedentary lifestyle and other environmental factors, a high-fat diet, excess energy intake, ethnicity, psychological factors like distress and coping, and employment.
What factors contribute to weight loss and and underweight?
Those factors are physical activity, control of energy intake, addiction to alcohol and street drugs, bizarre diet patterns metabolic and hereditary factors, alter response to hunger and the senses, and factors in eating disorders.
What are the signs of a "fad" diet?
They have unbalanced diet patterns that deviate largely from the Food Pyramid. They offer claims of a "scientific breakthough" or quick "solutions." The food instructions are irrational and promise a cure for some disease along with weight loss. Some even eliminate food groups.
Why are fad diets ineffective in promoting long-term weight control?
They are unpleasant changes that one cannot live with in the long-term. This is no road to success. Long-term wt. management requied a blance diet, exercise, behavioral strategies, and attention to self-acceptance.
What medical (pharmaceutical) interventions have been used in the treatment of obesity?
There are many drugs. Those include:
diuretics- increases urine production, or water loss.
appetitite suppressants- OTC, but contain caffeine, fiber, or benzocaine
Xenical-blocks fat absorption (or normal workings of pancreatic lipase), but low-fat diet is required because of fat buildup and needs supplements
Meridia-a prescription appetite suppressant that had side effects like high BP and HR; its safety is questionable
herbal products-little evidence exists to support these and have no proof of efficacy
How successful is this to long-term weight management?
While these drugs have their limitations, they need to be used in conjunction with proper diet and exercise. However, they can be addictive and have a potential effect via combination of drugs. THEY ARE ONLY FOR OBESE PPL, NOT THOSE WHO WANT TO LOSE A FEW POUNDS. Also, sometimes these pills only lose water, which is regained after stopped usage. Only Meridia is approved for long-term use.
What surgical interventions have been used in the treatment of obesity?
While these should be used as a last ditch effort and for those with morbid obesity (BMI > 40), there are 3 types.
1. gastric bypass - you make the stomach smaller plus also connect it to a lower part of the s. intestine, which interferes w/ normal absorption and digestion of nutrients by limiting calorie availability. It also leads to lower levels of ghrenlin, the gasric hormone that increases food intake.
2. gastroplasty - you make the stomach smaller
3. liposuction - this removes fat, but is not effective for long-term weight loss. There are many risks to this.
How successful is this to long-term weight management?
The long-term effects here are the greatest, but they depend on how patiens manage their eating. With time, the pouch can increase. So diet, exercise, and good eating habits are important. The downside to this that that many will go have GI complications.
Discuss dietary strategies that are appropriate and inappropriate for achieving and maintaining a healthy body weight.
Do not engage in futile attemps to achieve an "ideal" body shape or weight. We need to establish healthy eating, good exercise patterns, and self-acceptance. Start with a weight loss goal of roughly 10 percent of body weight or to restore and maintain a "natural" weight. AIM FOR METABOLIC FITNESS, NOT A PARTICULAR WEIGHT. MOST WEIGHT PROBLEMS ARE LIFESTYLE PROBLEMS. You need to start making little changes, not drastic.
Discuss dietary strategies that are appropriate and inappropriate for achieving and maintaining a healthy body weight. (CONTINUED)
1. Total calories - make small changed, or better yet, limit your portion sizes
2. Don't go on a crash diet becuz it's not sumthing you can't live with
3. Avoid overeating fatty foods becuz some ppl are better fat burners
4. Eating complex carbs is good because those rich in fiber provide a feeling of satiation, or fullness
5. Sparingly eat simple sugars and refined carbs
6. Eat moderate amts. of protein because foods high in protein are also high in fat
7. Follow a regular pattern of eating and set up some "decison rules."
What is the role of behavior modification?
This means being aware of your behaviors and patterns. It is an importance factor for success. We need to challenge irrational beliefs and replace them with realistic ones. Positive self-talk, self-monitoring, reward, social support, managing emotions, negative reinforcement, avoiding triggers, or developing alternate behaviors ALL HELP YOU TO MANAGE OBESITY ALONG WITH SELF-ACCCEPTANCE.
What is the role of physical activity?
It is critical to weight management, but also promotes fitness and good health. It also reduces stresss, produces positive feelings and a sense of accomplishment. Adults should aim for 60 min. of moderate-intensity exercise each day. Then move up to a formal exercise program.
Describe the success rates of most diets for long-term weight control.
It is low, or less than 10%.
What measures improve success?
Weight maintenance is improved when you add exercise, support, and self-monitoring and behavior modification.
Why are success rates so low?
People make aggressive, unpleasant changes. They need ot make small, but sustainable changes.
What is a sound approact to long-term weight management?
You need to develop a (1)a balanced diet w/ moderate calorie restriction, (2) have adequate exercide, (3)good cognitive behavior change strategies, (4)self-acceptable, and (5)a desire for change.
Describe anoxrexia nervosa, in terms of diagnostic criteria, prevalence, and practices.
D.C. - they refuse to maintain body weight above a minimal level. They restrict food intake through a combination of binging and purging. They have an intense fear of weight gain, amenorrhea, and a disturbance in body image. Hallmark is dramatic loss in weight.
PRACTICES: Include eating minimal amts. excessive exercise and fasting, OBSESSION w/ food, avoid social sitiations that may expose their behavior
PREVALANCE: Among females and in industralized nations that share an abundance of food and beauty values; female is upper-class Caucasian, activities that emphasize leannesss
Describe anoxrexia nervosa, in terms of consequences and treatment.
CONSEQ: amenorrhea and osteoporosis, reduced body temperature as fat is lost, changes to hair and skin, fluid balance and BP affected, decreased heart rate, malnutrition
TREATMENT: No treatment, but w/ intensive therapy, normal weight can be achieved, family and friends must intervene, there are many goals of treatment
Describe bulimia nervosa, in terms of diagnostic criteria, prevalence, and practices.
DC: Includes recurrent bingle eating, the "HallMark". Persn has lack of control in stopping, have recurrent compensatory behavior to make up for the binge via purging and non-purging. They are concerned w/ body shape and weight, not image and are always thinking about food and planning their next binge. Body weight shows through.
MUST OCCUR 2/WEEK FOR 3 MONTHS
PRACTICES: Include binging and purging, food is a source of comfort, are very secretive
PREVALENCE: High in females
Describe bulimia nervosa, in terms of consequences and treatment.
CONSEQ: Include erosion of tooth enamel, GI dysfunction, esophagela problems, electrolyte imbalances, and death, fatigue, weakness, seizures.
TREATMENT: It's easier to treat than anorexia because patients realize their behavior is abnormal. Tx is medication, treating depression, controllong substance abuse, etc.
Describe binge-eating, in terms of diagnostic criteria, prevalence, and practices.
DC: Recurrent binge eating and lack of control, guilting about binging BUT NO RECOMPENSATION. Distress causes rebinging and 2 bingles/week for 6 months. They are not anorexic or bulimic.
PREVALENCE: Most common of the three. Common in industralized nations.
PRACTICES: They feel helpness in changing the course of events of behaviors of others around them. This is a reflief response to stress. Satisfy all their emotional needs w/ food.
Describe binge-eating, in terms of consequences and treatment.
CONSEQ: obesity, type 2 diabetes, hypertension, heart disease, degenerative joint disease, and even cancers
TX: Require therapy first to separate biological hunger from emotional hunger and weight loss second. Long-term support is key. Self-help groups, hospitals and clinics, and medications can help.
How does the typical profile of an individual with anorexia nervosa differ from one with buliminia nervosa?
Both have a persistent inability to eat in moderation, they are all or nothing thinkers, eat secretively. On the other hand, anorexics are perfectionistics and high-achivers who have low self-esteen and feel aspects of their life are out of control. They are underweight. Bulimics, however are usually normal weight, have difficulty w/ impulse control and engage in alcohol abuse and shopplifting.