Obesity Weight Management – Flashcards
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Body Composition
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the proportions of muscle, bone, fat, and other tissue that make up a persons total body weight
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How do most researches asses body composition
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body weight-fat and lean tissue (including water)
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defining a healthy body weight
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-a weight within the suggested range for height -a fat distribution pattern that is associated with a low risk of illness and premature death -a medical history free from risk factors associted with obesity
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Health risks of overweight and obesity
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diabetes- 3 times greater hypertension High blood lipids (HDL and LDL ) cardiovascular disease- links with high blood pressure and high cholesterol sleep apnea flat feet complications in pregnancy and surgery liver malfunctions osteoarthritis- pressure on joints
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HDL
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high density lipoprotein- good gets rid of excess cholesterol *cant eat produced by liver
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LDL
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low density liproprotein - bad because stores or positions around the body *cant eat produced by liver
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Bioelectrical impedence
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way to mesaure body fat. fat has more water and can conduct electricity
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visceral fat
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fat protection from organs bad if too much cause effects function of organ
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how many people are considered over weight in the us?
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over 2 thirds of adults
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who is the prevalance of over weight higher in?
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women, the poor, african americans, and latin americans
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what does the amount of fat in the body reflect?
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the number and size of the fat cells
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when does the number of fat cells increase most rapidly?
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in obease children than in lean children -obease children entering there teens may have as many fat cells as an adult
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what happens to fat cells?
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they expand as they fill with fat and then they may divide.. they can increse there size by 20 fold and their numbers by several thousand fold
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what happens to fat cells with fat loss?
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the size of the fat cell shrinks but not the number.. obesity is critical during the growing years when fat cells increase in number
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LPL (lipoprotein lipase)
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promotes fat storage in adipose and in muscle cells high LPL- store fat more effectively
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Is lipoprotein lipase gender specific?
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yes more in women and in areas where fat calls are most abundant
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What is different about fat in lower parts of the body?
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there are differences in activity of enzymes controlling fat breakdown in different parts of the body.fat it lower parts of the body are less resistant to fat breakdown
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what happens after weight loss?
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lipoprotein lipase activity increases and most dramatically in those who lose more weight
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What happens if both parents are obease?
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80% risk children are obease
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what happends if neither parent is obease?
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10% chance
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Twin studies on obesity
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identical twins are more likely to weigh the same as faternal twins even when spread apart
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What are all influenced by genetics?
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food intake, tastes, BMR, number of fat cells, enzymes
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causes of obesity
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-lipoprotein lipase- enzyme which promotes fat storage in fat cells and muscle celss leptin- hormone which influences appetite and energy balance -uncoupling protein -environmental stimuli -learned behavior -physical inactivity
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leptin
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obesity gene (ob) -acts as a hormone in hypothalamus
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what does leptin signal?
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sufficent energy stores and promotes negative energy balance by suppressing appetite and increasing energy expenditure
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Leptins action on the body
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leptin suppresses food intake and increases energy expenditure
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What are the two kinds of fat?
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white fat and brown fat
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white fat
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stores fat for other cells to use for energy
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brown fat
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releases stored energy as heat
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what happens when fat is oxidized?
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some energy is released as heat, and some is captured in ATP
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What happens when brown fat is oxidized?
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only heat is released
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Who has high amounts of brown fat? small amounts?
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-newborns, people living in cold climates, and hibernating animals -most adults have small amounts
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What is in brown and white fat?
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a gene that codes for a protein that uncouples reactions and appers to influence BMR and resist in weight gain
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Non- drug ways of losing weight
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goals-lose weight for health not for looks dangers of weight loss -weight cycling- yo-yo dieting -psychological problems- told to lose weight just based on will power and hard work
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Aggressive Treatments of obesity
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drugs- over the counter: diuretics, appetite supressor, herbal supplements -prescriptions- sibutramine inhibits uptake of serotonin, most effective in combination with reduction of calories and exercise -low kilocalore diets -surgery --stomach stapling, gastric bypass, lap band
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What is the one drug FDA has approved?
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Benzocaine (anesthetizes the tounge)
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What does your BMI need to be inorder to get weight loss surgery?
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BMI of greater then 40 or 35 -for patients where medical therapy has failed
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The surgeon constructs a small gasteric pouch and restricts the outlet from the stomach to the intestine
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vertical band gastroplasty
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The sergeon constructs a small gasteric pouch and creates an outlet directly to the jejunum
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gastric bypass
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How is vitamin B12 absorbed?
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-in stomach, HCL and pepsin release B12 from the proteins to which it is bound -in top of small intesine- B12 binds to Intrinsic factor and travels to end of intestine -at the end of small intestine intrinsic factor is degraded and vitamin B12 is gradually absorbed in to the blood stream
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Reasonable strategies for weight loss
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1. realistic energy intake 2. nutritional adequacy 3. small portions 4. carbs, not fats 5. limit sugar and alcohol 6. adequate water 6. physical activity
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What can physical activity help
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increase energy expenditure protects and builds lean body mass improves psychological factors reduces risk of morbidity and mortality
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what is physical activitys impact on comorbidities
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enhances cardiorespiratory fitness improves lipid profile reduces blood pressure increases insulin sensitivity improves blood glucose control
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Behavior Therapy
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b t
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self monitoring
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keep records of the amount and types of food eaten physical activity
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stress management
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get out of situations that lead to overeating: -coping strategies -meditation -relaxation techniques
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problem-solving
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relize you need to lose weight and figure out how
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stimuls conrol
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change techniques -learn to shop for heathy foods keep high-calorie foods out of the home -limit the times and places of eating
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contingency management
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use of rewards for specific actions
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cognitive restructuring
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good thoughts instead of negative ones
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socail support
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positive reinforcement from family friends and collegues
