Module 8 - Energy Balance, Weight Management, & Eating Disorders

What is mindful (intuitive) eating? a. Only eating within an 8 hour daily window. b. Listening to your body and eating what, how much, and when you want. c. Avoiding dieting and burning calories through exercise instead. d. Only eating when you are really hungry.

Listening to your body and eating what, how much, and when you want.

Here are important components of a healthy weight loss plan:

Reduce calorie intake: A moderate calorie deficit of 500-750 calories daily, through food restriction and physical activity, is usually adequate to help most people lose weight. It is important not to reduce calorie intake too much, or the weight loss efforts may backfire. Consuming too few calories, especially less than 1,200 daily, will significantly impair the basal metabolic rate. These low calories also make it very challenging to meet the RDA's for vitamins and minerals, and it will not support energy demands for exercise. A higher percentage of muscle is lost through very low-calorie diets as well. Most women should aim for 1,200 to 1,500 calories per day, while men should aim for 1,500 to 1,800 calories for weight loss. Decrease intake of empty calories: Restricting calories for weight loss does not mean eliminating healthy foods. Evaluate the things you don't need in your diet when determining where to cut calories. Empty calorie foods such as sweetened beverages, desserts, added fats, and junk foods are not required for a healthy diet. Consume more fruits and vegetables: You've heard this one before! Fruits and vegetables don't just provide healthy nutrients to improve nutrition. They are also high in water content, meaning that most fruits and vegetables can help with satiety without many calories. Eating plentiful amounts of fruits and vegetables makes it less likely that you will over-indulge in high-calorie foods. Increase physical activity: Studies show that exercise does not help lose more pounds because most people do not consistently maintain the level of exercise needed to lose weight. However, exercise is the single most significant predictor of long-term weight management. In other words, if a person tries to lose weight by limiting calories and not exercising, the weight will inevitably be gained right back. For successful weight loss, aim for one hour of physical activity daily. MyPlate recommends that 150 minutes of exercise weekly is usually not enough for significant weight loss. A person should try to expend at least 2000 calories per week through exercise. Moderate-intensity exercises can be just as effective at burning calories as high-intensity activities, with aerobic exercise being best for burning calories. Resistance training (muscle building) activities are also very effective because they increase lean mass and improve BMR. A healthy weight loss plan includes both aerobic and resistance training exercises. Not only can exercise help improve body composition and help with weight loss, but it can also reduce the risk of obesity-related health problems such as Type 2 diabetes, hypertension, and cardiovascular disease. Drink more water: Many studies show that people who drink adequate amounts of water have lower rates of obesity. There may be several mechanisms involved. First, thirst is often confused with hunger. When hunger is perceived, sometimes drinking a cup of water will help. Drinking water before a meal will help take up volume in the stomach and decrease solid food intake. Water is naturally calorie-free and can displace beverages that contribute empty calories to the diet. Additionally, water will provide the necessary hydration to exercise efficiently and improve long-term weight management. Increase fiber intake: Although fiber is a carbohydrate, we do not have enzymes to break it down. So, we do not obtain the same calories as other carbohydrates. It also helps slow the digestion of other carbohydrates to prevent excess insulin response. Soluble fiber, in particular, can provide the feeling of fullness after a meal and keep you full for an extended period. Therefore, you are less likely to overeat on a high-fiber diet. Focus on consuming plentiful amounts of foods such as beans, oats, fruits, and vegetables. Eat slowly: Eating slowly usually means that you will eat less, and research shows that slow eaters tend to have lower rates of obesity. It takes time for your body to sense fullness. On average, your brain and stomach register a feeling of fullness after about 20 minutes. Think about how much food you can devour in 20 minutes if you eat quickly! Try putting your fork down after every bite. Chew and swallow that bite of food before picking your fork back up. This tactic will help you to eat more slowly. Follow a good eating schedule: Another way to decrease appetite and eat more slowly is to eat regularly. Going too long between meals will often cause you to build a ravenous appetite, resulting in rapid eating to satisfy those annoying hunger pangs. The odds are that you will overeat at the next meal. If you know there will be many hours between meals, it's OK to include healthy snacks to "bridge" the gap. Skipping meals typically decreases the basal metabolic rate. Studies show that regularly skipping breakfast, in particular, usually results in weight gain over time. Despite claims to the contrary, there is no evidence that eating after a specific time in the evening will result in weight gain. Address psychological problems: If you suffer from emotional issues such as depression or anxiety, this can sabotage your weight. It is hard to treat obesity without treating underlying depression first. Many people know the healthy ways to lose weight but do not have the power to enact those changes. Emotional issues can lead to chronic overeating, especially with comfort foods such as sweets and salty snacks. Seek medical attention if you think your weight problem may be psychologically related. Find a support system: Losing weight is a considerable challenge, and your weight loss efforts will likely fail without encouragement from the people around you. If you don't have any supportive persons at home, consider joining a weight loss support group. Many people have an easier time achieving a healthy diet and exercise goals when doing it with others with the same goals. Often corporate weight loss programs and support groups within the workplace can also be very effective.

Which of the following persons is most likely to develop an eating disorder? a. 40 year old female vegetarian b. 16 year old female dancer c. 20 year old football player d. 50 year old male executive

16 year old female dancer

A person with a BMI over ____ is classified as obese. a. 19 b. 25 c. 28 d. 30

30

A man with central obesity will have a waist circumference above ________ inches. a. 30 b. 35 c. 40 d. 45

40

A sign to look for if you suspect a friend has bulimia is: a. extreme weight loss b. broken blood vessels in the face c. hemorrhoids d. consumption of only non-GMO, organic food

broken blood vessels in the face

Which of the following body changes usually occurs with age? a. decrease in resting metabolism b. increasing levels of testosterone and estrogen c. increase in muscle mass d. decrease in fat storage

decrease in resting metabolism

A person who is trying to lose weight should aim for at least: a. 150 minutes of exercise per week b. 45 minutes of exercise at least 4 times per week c. 30 minutes of exercise at least three times per week d. one hour of exercise daily

one hour of exercise daily

Severe anorexia nervosa can lead to: a. organ failure and death b. binge-eating c. increase in body fat percent d. righteous beliefs about their diet

organ failure and death

Which of the following has the most significant influence on long-term weight loss? a. carbohydrate restriction b. fat restriction c. protein restriction d. overall moderate calorie restriction

overall moderate calorie restriction

A common problem with having a lack of adequate body fat is: a. increased temperature b. high cancer risk c. decreased hunger d. poor bone density

poor bone density

Which macronutrient appears to have the largest thermic effect? a. carbohydrate b. fat c. protein d. fiber

protein

What is BMR?

rate at which the body expends energy for metabolic maintenance activities. Quite simply, it is the calories your body burns at rest. BMR is about two-thirds of the calories you expend daily.

Resistance training exercise is crucial for older people because it can: a. decrease the risk of Type 1 diabetes b. decrease HDL cholesterol c. reduce blood pressure d. increase visceral fat

reduce blood pressure

What is the most effective way to reduce body fat? a. low-calorie diet b. avoid foods high in fat c. resistance training exercise d. intermittent fasting diet

resistance training exercise

Not Approved Treatments for Obesity:

- Avoid foods containing fat - B12 injections - Avoid any beverages with caffeine - Strong diuretics to reduce water weight - Eat ONLY 2-3 times per day - Ephedra supplement to stimulate metabolism - Avoid muscle building exercise - Steam and sauna baths - COnsume ONLY 1,000 calories a day

Effective Strategy for Weight Gain

- Drink 100% fruit juice instead of water - Choose foods with higher energy density - Consume nutritious, high calorie shakes in between meals

Benefits of Resistance Training:

- Increases lean body mass (muscle) - Improves muscle strength, size, power, and endurance - Decreases visceral fat - Increases strength and coordination - Decreases lower back pain - Increases bone mineral density (helps prevent osteoporosis) - Improves glucose metabolism and insulin sensitivity - Decreases risk of Type 2 diabetes - Decreases blood triglycerides - Increases HDL cholesterol and decreases LDL cholesterol - Decreases risk of cardiovascular diseases - Reduces blood pressure - Improves cognition and self-esteem - Eases discomfort with arthritis and fibromyalgia - Enhances quality of life in older adults

Effective Treatments for Obesity:

- Limit alcohol consumption - Weight Training - Treat depression and anxiety - Eat slowly - 1 hour of physical activity - Gastric Bybass surgery IF BMI OVER 35 - Increase fiber intake - Reduction of 500+ calories a day - Drink mostly water for beverages -

Weighing too little can cause:

- Nutrient Deficiencies - Weakened immune system - Poor bone density - Lack of menstruation (women) Infertility (women) Pregnancy Problems (women) - Poor temperature regulation - Sexual dysfunction (men) - Anemia

Effective Strategy for Weight Loss

- Reduce empty cals from sugar and alcohol - Increase water intake - Get at least 250 minutes of exercise weekly - Choose foods with lower energy density

Effective Strategy for WEIGHT CHANGE

- Reduce exercise to no more than one hour per week - Consume more snack foods such as chips -Eat less than 1K cals a day

It is estimated that Derek, who is obese needs 2,800 calories to maintain his current weight. He would like to lose two pounds per week, if possible. What should his new daily calorie intake be? a. 1,200 b. 1,800 c. 2,300 d. 2,500

1,800

A healthy and realistic goal for weight loss is: a. 1-2 pounds per week b. 2-3 pounds per week c. 3-4 pounds per week d. 15 pounds per month

1-2 pounds per week

To lose about one pound per week, you need a deficit of approximately _______ calories daily. a. 100 b. 500 c. 1,000 d. 3,500

500

The least healthy place to store extra fat is in the: a. Abdomen b. Buttocks c. Thighs d. Extremities

Abdomen

Which of the following is likely to occur with anorexia nervosa? a. Compulsive eating b. Esophageal bleeding c. Obesity d. Absence of menstruation

Absence of menstruation

Problems with Low Body Fat

Amenorrhea: Amenorrhea refers to a lack of a menstrual cycle. Irregular or absent periods are often the first sign that a female's body fat is getting too low. Infertility: Hormonal disruption in women and drops in sperm count in men can lead to infertility. Poor bone density: Lack of body fat can interfere with the body's ability to properly absorb and use calcium and vitamin D. A decrease in bone density can eventually lead to full-blown osteoporosis. However, most young people suffering from poor bone density won't know it unless they get a DEXA scan or break a bone. Heart Problems: The heart rate may become too low, which can cause dizziness, passing out, and heart attack. Electrolyte imbalances can also lead to heart problems. Lack of Energy: Lack of energy (fat) reserves can cause fatigue and impair your ability to exercise. Decrease in thyroid hormone production: This can further contribute to fatigue. Impaired temperature regulation: You are always cold since there isn't enough fat for insulation. Muscles don't recover from exercise: Lack of body fat usually results in a lack of glycogen (glucose) storage. Glycogen is needed to help your muscles recover by refueling them. Excessive hunger: Levels of leptin decrease. Testosterone levels drop: Low leptin levels can lead to low testosterone levels. Muscles become weaker: Muscle gain is virtually impossible when body fat becomes very low. Sexual dysfunction: Low leptin and testosterone levels tell a man's body to shut down the reproductive system, and impotence may occur. Impaired immunity: Very low body fat may cause an increase in cortisol levels and therefore weaken immunity. Impaired mood: Essential fatty acid deficiency can cause irritability and mood swings. Brain fog: Essential fatty acid deficiency can cause mental fatigue and trouble concentrating. Bad skin: Lack of glycogen stores can lead to dehydration and dry and pasty skin.

Self-induced starvation leading to extreme weight loss

Anorexia Nervosa

The largest percentage of energy expended is through: a. TEF b. NEAT c. Exercise d. BMR

BMR

Compulsive eating of large quantities of food without purging behaviors

Binge-Eating Disorder

A healthy body composition is best measured by: a. BMI b. Weight c. Height d. Body fat %

Body fat %

Which of the following will increase the basal metabolic rate? a. Lose weight b. Reduce calorie intake c. Restrict carbohydrate intake d. Build muscle in the body

Build muscle in the body

Binging and Purging

Bulimia Nervosa

Carbohydrates = 4 kcals per gram Protein = 4 kcals per gram Fat = 9 kcals per gram *Alcohol = 7 kcals per gram (not a nutrient, but provides calories)

Carbohydrates = 4 kcals per gram Protein = 4 kcals per gram Fat = 9 kcals per gram *Alcohol = 7 kcals per gram (not a nutrient, but provides calories)

Which of the following is a recommended way to gain weight? a. Replace meals with high calorie shakes b. Eat only 3 large meals daily c. Snack on chips and candy frequently d. Drink juices and milk instead of water

Drink juices and milk instead of water

Recommendations for Weight Gain

Eat regularly scheduled meals and snacks: The goal is to increase total energy intake. Underweight people often lack appetite, so trying to eat large meals may be unrealistic. It is usually more helpful to aim for smaller, more frequent portions throughout the day. Consume high-calorie shakes in between meals: High-calorie shakes can be an easy way to boost extra calories. The key is to add the shakes to regular food intake, not replace meals with them. Many over-the-counter high-calorie shakes are convenient (Boost, Ensure, etc.). You can also make your own such as a smoothie with fresh fruit, protein powder, and oil. Focus on consuming beverages with calories, such as juices and milk: Instead of drinking water throughout the day, try beverages that provide calories. Juices and milk are preferred since they contain nutrients and hydrate like water. Avoid unhealthy drinks such as soda. Add healthy oils to food: Oils contain healthy unsaturated fat and provide a considerable boost in calories. Most oils have very little taste, so they can be added to most cooked foods without disrupting flavor. Adding oil to a shake or smoothie will also make it creamy. Avoid drinking water and other beverages before meals: Filling up on fluids right before mealtime will decrease appetite and lead to eating less solid foods. Engage in a resistance training exercise: Building muscle can help gain healthy weight. One cannot gain muscle mass without combining calorie surplus and resistance exercise.

LPL (lipoprotein lipase)

Enzyme that promotes very efficient fat storage in the body, which tends to be high in obese people

Which of the following is an effective way to reduce "stress eating"? a. Low carbohydrate diet b. Supplementation with omega-3 fatty acids c. Supplementation with probiotics d. Exercise

Exercise

Which of the following lowers the basal metabolic rate? a. Fasting b. Fever c. Cold environment d. Hot environment

Fasting

Here are some good snack combinations:

Fresh fruit with nuts Apple slices with peanut butter Fruit smoothie with a scoop of protein power Trail mix with nuts and dried fruit Whole grain bread with peanut butter Cucumber slices with hummus Carrot sticks and broccoli with yogurt-based dip

Many factors influence your BMR:

Gender: Men typically have higher BMRs than women due to the more significant lean muscle percent. Age: The older you get, the more your BMR is likely to decrease, primarily due to a decline in muscle mass. Body Composition: Muscle is more metabolically active than fat. Therefore, the more muscular the person is, the more calories they will burn. Body Size: The larger the person, the more calories they will burn. Extreme Temperature: Both extreme cold and extremely hot climates will speed up the BMR temporarily. Growth: During periods of development, the BMR increases. Hormones: Menstrual hormones secreted just before menstruation in women will increase the BMR. Thyroid hormones can also greatly influence BMR. Starvation and Food Deprivation: Although a person may initially lose weight under these circumstances, the body will eventually try to adapt by lowering the BMR. Illness: The BMR will significantly increase during fever or chronic illness, often leading to extreme weight loss. Smoking: Nicotine temporarily increases your BMR. Smoking should NOT be used as a method of weight control, however. Caffeine: Caffeine temporarily increases your BMR. Sleep: Your BMR is the lowest when you sleep. However, sleep deprivation over time will only lead to weight gain, not weight loss. Weight loss: When you lose weight, your BMR will naturally slow down since it takes less energy to support a smaller body.

Which of the following is a major predictor of adult obesity? a. Excess leptin production b. Ghrelin resistance c. Obesity during the pre-adolescent years d. Being breastfed as an infant

Obesity during the pre-adolescent years

A disorder in which there is an obsession with healthy eating is known as: a. Bulimia Nervosa b. OCD c. Orthorexia d. Diabulimia

Orthorexia

Causes of Underweight:

Genetics: Some people are naturally thinner than others. This can be as simple as inheriting a high metabolism or how the body regulates appetite and energy storage. Undereating: Some people lack a good appetite to take in enough energy. This could be due to genes or emotional issues such as depression. Health problems can also cause a lack of appetite. Lack of senses such as taste and smell, common among the elderly, can also reduce the desire to eat. Poverty: Not everyone undereats by choice. Lack of access to adequate food is a significant contributor to worldwide malnutrition and being underweight. Even the United States is not immune to this problem. Drug Use: Substance abuse dramatically alters the diet and, in most cases, leads to irregular eating patterns and poor nutrition. The exception is marijuana, which tends to increase appetite. Alcoholism: People with severe alcoholism usually lose weight, as alcohol eventually starts replacing food. Excess physical activity: This is a common problem among athletes. It is often difficult for athletes to take in enough food to compensate for their enormous energy expenditure. Hyperthyroidism: An overactive thyroid will significantly increase the BMR, and weight loss usually results. Disease: Serious medical problems are one of the leading causes of rapid weight loss. In addition to losing appetite, metabolic stress can significantly increase the basal metabolic rate and potentially cause malabsorption. Psychological problems: Depression, anxiety, stress, sadness, and dementia can all affect food intake and lead to weight loss over time. Dental problems: Tooth pain and tooth loss can affect the ability to chew food and usually results in insufficient food intake. Inability to swallow properly can also decrease food intake, which is a common problem among the elderly. Eating disorders: Eating disorders such as anorexia nervous can result in serious weight loss.

Leptin

Hormone released after a meal in response to fat in blood, which inhibits hunger

Insulin

Hormone released to store glucose after a meal, and tells your body you are full

Ghrelin

Hormone secreted in response to low calorie intake, which increases huger and lowers metabolism

An obese person tends to have higher levels of: a. Ghrelin b. Leptin c. Testosterone d. Glucagon

Leptin

Which of the following is a benefit of bariatric surgery? a. Higher metabolism b. Less production of ghrelin c. Higher production of leptin d. Higher muscle mass

Less production of ghrelin

Skipping breakfast is considered: a. A great way to reduce calories for weight loss b. Likely to decrease metabolism and make weight loss hard c. Only necessary if you are morbidly obese d. Recommended for those going through weight loss surgery

Likely to decrease metabolism and make weight loss hard

Which of the following is true regarding weight loss supplements or medications? a. They are safe and effective for long-term weight management b. None have proven to be effective for weight loss c. They are well regulated and monitored by the FDA d. Most have side effects and some may be harmful

Most have side effects and some may be harmful

Which of the following is a serious complication of bulimia nervosa? a. Rapid weight loss b. Severe potassium deficiency c. Kidney failure d. Type 2 diabetes

Severe potassium deficiency

What happens to fat cells when you lose weight? a. Some are destroyed b. They shrink in size c. They turn into muscle mass d. They multiply, so it is easier to regain the lost weight

They shrink in size

Low carbohydrate diets usually lead to rapid weight loss in the beginning primarily due to: a. Muscle loss b. Water loss c. Fat loss d. Excess glycogen production

Water loss

Which of the following occurs when you restrict food intake too much? a. Your body holds on to fat b. BMR increases c. You lose weight and keep it off d. Cravings for foods you enjoy eventually goes away

Your body holds on to fat

What is the Food Police? a. People you know who educate you on healthy diet and weight loss b. Your inner voice that judges and tells you if you are making "good" or "bad" food choices c. Friends and family who reprimand you for eating what you want d. Dietitians and Nutrition Professors

Your inner voice that judges and tells you if you are making "good" or "bad" food choices

What classification would be used for a 56 year old man with a sedentary lifestyle and a BMI of 24? a. underweight b. normal weight c. overweight d. obese

b. normal weight

A person with a BMI of 18 is classified as: a. Underweight b. Normal weight c. Overweight d. Obese

a. Underweight

When you walk by a store, what makes you want to eat when you smell food? a. hunger b. satiety c. appetite d. disordered eating

appetite

Which of the following problems is likely to occur with men who are underweight? a. erectile dysfunction b. gout c. heart disease d. hypertension

erectile dysfunction

The effect of lipoprotein lipase (LPL) with respect to fat cell metabolism: a. It is triggered by weight gain. b. explains why people who experience weight loss are more likely to gain weight. c. is responsible for the rate of fat breakdown being lower in men than women d. explains why women produce more of this enzyme in their abdomen, leading to increased waist size.

explains why people who experience weight loss are more likely to gain weight.

Which of the following hormones increases appetite and energy storage? a. leptin b. ghrelin c. cortisol d. estrogen

ghrelin

What dietary measure is helpful for individuals who need to gain weight? a. limiting fluid intake to water. b. eating only when you are hungry. c. increasing the amount of energy-dense foods in the daily diet. d. limiting daily exercise to 5 minutes a day.

increasing the amount of energy-dense foods in the daily diet.

Which of the following is likely to occur if a woman's BMI is too low? a. heart disease b. gallstones c. infertility d. gout

infertility

Fat loss primarily occurs when a person: a. restricts carbohydrate intake b. gets high-intensity exercise c. is in a calorie deficit d. exercises in the "fat-burning zone"

is in a calorie deficit

What effect does sleep deprivation have on weight management? a. lack of sleep usually results in weight loss, due to increased hours of physical activity b. lack of sleep increases leptin production, leading to weight loss over time c. lack of sleep increases ghrelin production, leading to weight gain over time d. lack of sleep decreases insulin production, which can lead to Type 2 diabetes and rapid weight gain

lack of sleep increases ghrelin production, leading to weight gain over time

Binge-eating disorder often results in: a. calloused knuckles b. fear of gaining weight c. extreme weight loss d. obesity

obesity

Thermic Effect of Exercise (TEE)

the calories expended through physical activity. These are the calories you have the most control over and usually account for about 20% of energy burned daily. However, with a very active person or an athlete, 30% or more of energy expended daily can be through the TEE. Conversely, a sedentary person will expend less than 20% of their calories through activity.

Appetite is can be stimulated by

the desire to eat - by the sight and smell of food and emotional state. You can have hunger without appetite (those who "eat to live"), just as you can have appetite without real hunger (those who "live to eat"). The odds are that you know people in both categories. In general, people who have large appetites are more likely to be overweight or obese. Therefore, it is essential to assess whether a person who says they are hungry is really experiencing boredom or stress that affects appetite rather than hunger. A healthy person will usually have a balance between hunger and appetite. Most people eat to the point of achieving satiety, the feeling of being satisfied.

Every time you eat, you will burn calories. The TEF is:

the increase in energy expenditure (above your resting metabolic rate) that occurs after eating due to your body digesting and processing nutrients. The TEF is often referred to as diet-induced thermogenesis (DIT), accounting for about 5-15% of the energy expended daily in a mixed diet of carbohydrates, protein, and fat. eating regularly scheduled meals and snacks may help you burn a few more calories throughout the day, which could potentially affect your weight over long periods. The increased metabolism is part of the rationale for the expression "you need to eat to lose".

Some people are obese because: a. they don't produce any leptin b. they are resistant to leptin c. they naturally make an overabundance of ghrelin d. they have no ghrelin activity

they are resistant to leptin