Nutrition Chapter 9: Weight Management (Overweight, Obesity, and Underweight)

True or False: Among individuals who have had surgery to help them lose weight, only about 25 percent of the excess weight remains lost after 15 years.

False

True or False: Even when used alone, weight-loss drugs are quite successful in promoting substantial weight loss.

False

True or False: Genetics plays a true causative role in a clear majority of cases of obesity.

False

True or False: Obesity develops when a person's fat cells increase in number, not in size.

False

True or False: People who are overweight by body mass index (BMI) standards, but otherwise in good health, will almost certainly benefit from losing weight.

False

True or False: You can assume that an herbal product or dietary supplement is safe or effective just because it is available on the market.

False

Weight Lost Drugs with their Side Effects: Saxenda

Nausea, diarrhea, constipation, increased heart rate, suicidal thoughts.

True or False: Americans spend an estimated $60 billion a year on weight-loss services and products.

True

True or False: An active, growing boy may need more than 4000 kcalories a day to maintain his weight and may be too busy to take time to eat adequately.

True

True or False: An estimated 70 percent of the adults in the United States are now considered overweight or obese.

True

True or False: For an underweight person to gain weight, meals must contain energy-dense foods and strength training exercise is necessary to build muscle.

True

True or False: Ghrelin is secreted primarily by the stomach cells and promotes eating and weight gain.

True

True or False: Most fad diets have enough going for them that they work for some people at least for a short time, but they fail to produce long-lasting results for most people.

True

True or False: People with extra fat cells tend to regain lost weight rapidly.

True

True or False: Rapid weight loss usually means excessive loss of lean tissue, a lower basal metabolic rate (BMR), and rapid weight regains to follow.

True

True or False: To prevent weight gains and support weight losses, current recommendations advise at least 60 minutes of moderate activity daily.

True

Which of the following is a characteristic of most fad diets? a. They limit food choices, thereby reducing energy intake. b. The result in long-lasting results just like healthy diets. c. They are balanced and thus do not require a dietary supplement. d. Their success depends on the ratios of macronutrients more so than the total energy amount. e. They are typically as healthy as more traditional weight-loss diets.

a. They limit food choices, thereby reducing energy intake.

Weight loss is recommended for those who are obese and for those who are overweight with one or more obesity-related risk factors. All of the following are obesity-related risk factors except: a. osteoporosis b. hypertension c. sleep apnea d. abnormal blood lipids e. diabetes or prediabetes

a. osteoporosis

Brown adipose tissue ____. a. releases stored energy as heat b. stores fat for other cells c. can become white adipose tissue d. contains very few brite adipocytes e. provides energy to other cells

a. releases stored energy as heat

Weight loss serves as a signal to the gene that produces _____, saying "Make more of the enzyme that stores fat." a. ghrelin b. lipoprotein lipase c. leptin d. serotonin e. CCK

b. lipoprotein lipase

In considering the environmental influences of weight loss, it is important to remember that ____. a. contrary to popular behavior, the size of the plate or bowl does not influence intake b. when offered a large assortment of foods, people tend to eat more c. people tend to eat less when socializing with others d. the more effort needed to obtain food, the more likely food will be eaten e. people pay more attention to how much they have eaten when others are around

b. when offered a large assortment of foods, people tend to eat more

A reasonable weight-loss strategy for overweight and obese adults is to increase activity and reduce food intake enough to create a deficit of ____ kcalories per day. a. 200-300 b. 750-1000 c. 300-500 d. 100-200 e. 500 to 750

e. 500 to 750

With gastric banding, the ____. a. outcomes are more reliable, durable, and effective b. transit through the jejunum is sharply restricted c. risk of malabsorption is increased d. transit through the duodenum is eliminated e. amount of food that can be comfortably eaten is limited

e. amount of food that can be comfortably eaten is limited

If energy intake continues to exceed energy expenditure, the _____ fat cells stimulate cell proliferation so fat cell number.

enlarged; increases The continual consumption of excess kcalories will only stimulate enlarged fat cells to proliferate, not normal size fat cells. Adipose cell proliferation will cause the number of fat cells to increase.

Initially, when energy intake exceeds expenditure, fat cells _____ size and _____ in number.

increase; do not change When the "energy in" exceeds the "energy out," much of the excess energy is stored in fat cells causing them to enlarge in size, but not increase in number.

Prevention of obesity is most critical during childhood/adolescence when fat cells increase in _____. People with _____ number of fat cells tend to regain lost weight more readily.

number; an increased During the growing years of late childhood and early puberty, the number of fat cells increases most rapidly. If the child/adolescent is in positive energy balance, an even greater number of fat cells may be formed. This would result in a greater tendency for obesity, especially if the child/adolescent continued to be in positive energy balance.

The energy density of a baked potato that weighs 122 grams and delivers 114 kcalories is ______ . The energy density of 1 oz of potato chips, which weigh 28 grams and deliver 154 kcalories, is ______ .

0.93 kcal/g ; 5.5 kcal/g See the "How To 9-1" Box for the method to calculate energy density. The energy density for the baked potato can be calculated as follows: Energy density = kcalories in the food divided by weight of the food in grams. Using the information for the baked potato: Energy density = 114 kcalories ÷ 122 g = 0.93 kcalories/g. The energy density for the potato chips = 154 kcalories ÷ 28 g = 5.5 kcalories/g

Fad diets often produce weight loss, at least initially, because they are designed to limit total kcalories to _____ kcalories or less per day.

1200 Fad diets are popular because many of them do, at least initially, produce weight loss. However, with a high-protein, low-carbohydrate diet, this initial weight loss is predominantly water, due to the breakdown of glycogen with limited carbohydrate intake. But ultimately, fad diets can lead to weight loss because they deliver approximately 1200 kcalories, despite the fact that you can eat all you want except eliminate foods from one or more food groups. Similar weight loss can occur by choosing nutrient-dense foods from each of the food groups while following a 1200-kcalorie diet. The latter method is preferred because the dieter is following a healthy eating pattern that can lead to permanent weight loss and reduce the risk of developing chronic disease.

A person is overweight (350 pounds) and desires to lose 35 pounds over a 6-month period. The total kcalorie intake restriction required to reach the weight-loss goal is _____ . f the weight loss time period is 27 weeks, the weekly kcalorie restrictions to achieve the goal are _____ and the daily kcalorie restrictions to achieve this goal are _____ .

122,500 kcals 4,537 kcals 648 kcals To calculate the total kcalorie intake restriction required to reach the weight-loss goal, recall that there are 3500 kcalories in a pound of fat. To determine total kcalories in 35 pounds, multiply 35 pounds by 3,500 kcalories per pound to get 122,500 kcalories. To calculate the weekly kcalorie restriction to achieve the goal in 27 weeks, divide 112,500 kcalories by 27 weeks to get a 4,537-kcalorie deficit in 1 week. To calculate the daily kcalorie restriction to achieve the goal in 27 weeks, divide the weekly 4,537 kcalories by 7 days per week to get 648 kcalories per day. This means the person must eat 648 fewer kcalories everyday than is required to maintain his current weight of 350 pounds.

In order to gain weight, a person must take in at least an extra _____ calories a day and use _____ training to ensure healthy weight gain.

500; strength In order to gain weight, an underweight person must focus on eating energy-dense foods to provide many kcalories in a small volume and exercise to build muscle. Strength training exercise is recommended. A minimum of 500 kcalories a day above normal energy needs can support the exercise as well as build muscle, leading to weight gain.

Which of the following is true about energy metabolism in formerly obese people who have lost weight? A. Energy requirements are lower than expected for their current body weight and body composition. B. Energy expenditure is the same as in people who were never obese. C.. Energy expenditure is the same per kilogram body weight compared with the obese state. D. Basal metabolic rates are higher after weight loss than during the obese state. E. Formerly obese people are less efficient at storing fat.

A. Energy requirements are lower than expected for their current body weight and body composition.

All of the following are sensible guidelines to achieve weight loss except: A.. Focus on plant-based foods B. Engage in at least 30 minutes of physical exercise daily. C. A minimum of 1200 kcalories are needed to ensure nutritional adequacy. D. Choose low energy density foods E. Eat rapidly to avoid prolonged contact with food.

E. Eat rapidly to avoid prolonged contact with food.

All of the following are true regarding weight-loss surgery except: A. Food intake is limited by reducing stomach capacity. B. Bariatric surgery suppresses hunger and alters metabolism by changing production of hormones. C. With limited food intake and reduced absorptive surfaces, vitamin and mineral deficiencies are common. D. Dramatic improvements are seen in blood lipids, lower blood pressure, and diabetes. E. Medical supervision is only required for the first 6-9 months after surgery.

E. Medical supervision is only required for the first 6-9 months after surgery.

Which of the following is true about the body's set point? A. Minimum weight of a person B. Point at which the physical discomforts of severe obesity overcome the desire to eat C. Maximum weight of a person D. Point at which a person's weight plateaus before dropping again quickly E. Point above which the body tends to lose weight and below which it tends to gain weight

E. Point above which the body tends to lose weight and below which it tends to gain weight

Variety

Eating a wide selection of foods.

Weight Lost Drugs with their Side Effects: Alli

GI cramping, diarrhea, rare cases of liver injury

Weight Lost Drugs with their Side Effects: Belviq

Headaches, dizziness, dry mouth and constipation; high doses cause hallucinations.

Leptin

Hormone that maintains homeostasis by regulating food intake and energy expenditures in response to adipose tissue. Leptin is a protein hormone synthesized by adipose tissue. It acts at the hypothalamus to suppress appetite. It also increases energy expenditure. However, the amount of leptin circulating in the blood is dependent upon the amount of adipose tissue present. As one loses weight, the amount of leptin produced decreases, which stimulates appetite and suppresses energy expenditure. Thus, leptin is considered to be a hormone that maintains homeostasis by regulating food intake and energy expenditure in response to the amount of adipose tissue present.

Ghrelin

Hormone that promotes eating and weight gain by increasing smell sensitivity, stimulating appetite, and promoting energy storage. Ghrelin is a protein produced by stomach cells and also acts as a hormone. It stimulates appetite and decreases energy expenditure, promoting energy storage.

Weight Lost Drugs with their Side Effects: Qsymia

Increase heart rate, birth defects in early pregnancy, suicidal thoughts.

Brown Adipose Tissues

Masses of specialized fat cells packed with pigmented mitochondria that produce heat instead of ATP. Brown adipose tissue is a type of adipose tissue that releases stored energy as heat instead of capturing the stored energy to make ATP (and some heat), as normally occurs when fat is oxidized. Brown fat and heat production is important in newborn infants, but adults have little brown fat.

Nutrient Density

Measure of the nutrients a food provides relative to the energy it provides.

Irisin

Protein that triggers transformation of white fat cells into brite fat cells. Irisin is a protein released by muscle cells that triggers the transformation of white fat cells into brite fat cells, which take on the characteristics of brown fat.

Adequacy

Providing all essential nutrients.

Balance

Providing different types of foods in proportion to one another.

Moderation

Providing enough but not too much of a given food or substance.

kCalorie Control

Selecting foods if high nutrient density.

An individual is considered obese if his or her body mass index is equal to or greater than ____. a. 40 b. 30 c. 25 d. 35 e. 20

b. 30

Depending on initial body weight, a reasonable rate of weight loss for adults is ____ of body weight over 6 months. a. 11-14 percent b. 5-10 percent c. 15-20 percent d. 3-4 percent e. 1-2 percent

b. 5-10 percent

With weight loss, fat cells _______. a. decrease in size, but increase in number b. decrease in size only c. decrease in both number and size d. decrease in number, but increase in size e. decrease in number only

b. decrease in size only

Which substance is secreted primarily by the stomach cells and promotes eating and weight gain by increasing smell sensitivity, stimulating appetite, and promoting efficient energy storage? a. lipoprotein lipase b. ghrelin c. cholecystokinin (CCK) d. leptin e. serotonin

b. ghrelin

Fast-food restaurants have significantly contributed to the development of obesity for all of the following reasons except: a. A "supersize" portion of fries delivers more than 600 kcalories. b. Energy-dense foods in combination with large portion sizes are offered. c. Close proximity of fast-food establishments does not increase the risk of obesity. d. Portion sizes are currently two to eight times larger than standard serving sizes. e. People buy large portions and combinations, perceiving them to be a great value.

c. Close proximity of fast-food establishments does not increase the risk of obesity.

Which weight-loss drug increases the release of norepinephrine? a. Xenical b. orlistat c. Qsymia d. lorcaserin hydrochloride e. Belviq

c. Qsymia

A good strategy for weight gain in underweight individuals is to ____. a. select foods with high levels of trans fats b. avoid exercise, especially strength training c. eat energy-dense foods d. eat small portions to prevent feeling overwhelmed e. avoid scheduled meals and eat throughout the day

c. eat energy-dense foods

"Natural" herbal products and dietary supplements promoting weight loss _____ be considered safe or effective just because they are available in the market.

cannot Many consumers are looking for the "magic pill" to lose weight. They turn to "natural" herbal products and other dietary supplements, which claim that they promote weight loss. Very few of these products have been proven to be effective, and many have proven to be harmful. Consumers must understand that dietary supplement, including herbal supplements, do not need FDA approval, and that manufacturers are not required to test the safety or efficacy of any product.

What substance maintains homeostasis by regulating food intake and energy expenditure in response to adipose tissue? a. serotonin b. cholecystokinin (CCK) c. lipoprotein lipase d. leptin e. ghrelin

d. leptin

When body weight decreases, fat cells _______ in size, and the number of fat cells _____ .

decrease; remains the same When body weight is lost, the fat cells shrink in size, but they do not disappear; the number always remains the same.