Ch 9 Case Study: Lifestyle Changes for Weight Loss

1. Sally stated that recent stresses in her life are affecting her sleep and seemed to have triggered her appetite for sweets and comfort foods. Which of the following statements would be best to explain why her lack of sleep has increased her appetite? a. Lack of sleep increases levels of ghrelin which stimulates appetite and decreases levels of leptin which decreases appetite. b. The satiety hormone leptin increases with lack of sleep. c. Lack of sleep increases uncoupling protein. d. Lack of sleep decreases ghrelin levels. e. Levels of Neuropeptide Y, a brain chemical that causes carbohydrate cravings, are high and may contribute to her sleep problems.

a. Lack of sleep increases levels of ghrelin which stimulates appetite and decreases levels of leptin which decreases appetite.

2. Looking at Sally's health information, you need to tell her about all of the following health risks to encourage her to lose weight. Which health risk is incorrect? a. Her mildly elevated blood pressure increases the risk of hypertension in the near future, and hypertension is a major risk factor for heart disease. b. Her BMI of 30.5 indicates that she is overweight. c. Sally's 37 inch waist size indicates central obesity which increases the risk of heart attack and stroke. d. She is at increased risk of developing diabetes because she now has mildly elevated blood glucose levels and her father had type 2 diabetes. e. She has also gained more than 10 pounds since the age of 18, which doubles the risk of developing diabetes.

b. Her BMI of 30.5 indicates that she is overweight.

7. Applying the same principles as described in question 6 what dinner option would be best for Sally? a. 1 Cheese Quesadilla, 1 cup mixed vegetable salad made with low calorie dressing, 1 cup strawberries b. 1½ cups Spaghetti with meat sauce, 2 cups tossed green salad without croutons, 1 Tbsp lowfat Italian dressing, ½ cup kiwi slices c. 1½ cups Chicken Alfredo with 1 slice garlic bread, 2 cups Caesar salad, ½ cup berry parfait d. 2 cups Chicken Tortilla Soup, made with ½ cup chopped chicken, ¼ cup corn, pepper, and onions and topped with 4 baked tortilla chips, crumbled; 1 cup spinach salad with lowfat vinaigrette; 6 oz lowfat Greek yogurt e. 6 oz Chicken Wings, barbeque flavor, ½ cup corn, 1 cup melon cubes

d. 2 cups Chicken Tortilla Soup, made with ½ cup chopped chicken, ¼ cup corn, pepper, and onions and topped with 4 baked tortilla chips, crumbled; 1 cup spinach salad with lowfat vinaigrette; 6 oz lowfat Greek yogurt

3. Sally's friend, Monique, was morbidly obese and had surgery to help her lose weight. What should Sally know about weight loss surgery? a. Advantages of gastric bypass include being more flexible, less invasive, and safer. b. Gastric banding suppresses hunger by changing production of gastrointestinal hormones. c. About 25% of the excess weight will remain lost after 15 years. d. Bariatric surgery is only an option for those whose BMI ≥40 or BMI ≥ 35 with obesity-related health problems. e. Advantages of gastric banding include being more durable, reliable, and effective.

d. Bariatric surgery is only an option for those whose BMI ≥40 or BMI ≥ 35 with obesity-related health problems.

5. Sally's estimated energy requirement, based upon her age, height, and weight, is approximately 2000 kcalories per day. What is the maximum number of kcalories per day that she can consume to lose 3 pounds per month? Assume 1 month is 30 days. a. 1700 kcalories b. 1400 kcalories c. 1200 kcalories d. 1530 kcalories e. 1650 kcalories

e. 1650 kcalories

4. Based on the considerations discussed in your text, what would a reasonable 6-month weight loss goal be for Sally? a. 20 pounds b. 12 pounds c. 10 pounds d. 14 pounds e. 18 pounds

e. 18 pounds

6. Sally needs to learn about the importance of selecting low energy density foods that provide more satiety for fewer kcalories. Which of the following breakfast options would be best? Note: Most of the breakfast options contain the same number of kcalories. a. 2 frozen waffles, toasted with 2 Tbsp syrup, 8 oz orange juice b. 1 donut with cream filling, 8 oz orange juice, coffee with 2 Tbsp of half and half c. 16 oz cappuccino, one scone d. ½ cup of granola, ¾ cup lowfat milk, 8 oz orange juice e. breakfast burrito made with a small tortilla, 2 eggs, 1 Tbsp shredded lowfat cheese, peppers, onions, 1 oz avocado, 1 Tbsp lowfat sour cream; 1 cup strawberries, 6 oz lowfat yogurt

e. breakfast burrito made with a small tortilla, 2 eggs, 1 Tbsp shredded lowfat cheese, peppers, onions, 1 oz avocado, 1 Tbsp lowfat sour cream; 1 cup strawberries, 6 oz lowfat yogurt

8. Sally stated that she is sedentary. You need to convince her that in addition to following a diet featuring low-energy density foods, she also needs to incorporate 200-300 minutes of moderately intense physical activity per week. The benefits of combining diet and physical activity together include all of the following, except: a. Combining diet with exercise reduces abdominal obesity and improves blood pressure. b. Those who lost weight by diet and exercise retained more muscle compared to those who only followed a kcalorie-restricted diet. c. Those who lost weight by diet and exercise lost more body fat compared to those who only followed a kcalorie-restricted diet. d. Those who lost weight by diet and exercise regained less weight compared to those who only followed a kcalorie-restricted diet. e. Combining diet with exercise does not reduce stress, which is not helpful for those who respond to stress with inappropriate eating.

e. Combining diet with exercise does not reduce stress, which is not helpful for those who respond to stress with inappropriate eating.