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156
Chapter 9 – Weight Management: Overweight, Obesity, and Underweight
An. Page(s)/difficulty K = knowledge-level, A = application level
Multiple Choice
Questions for Section 9.1 Overweight and Obesity
considered overweight or obese?
a. 1/10
b. 1/6
c. 1/3
d. 2/3
overweight or obese?
a. 12
b. 33
c. 48
d. 68
a. Nowadays, obesity is not seen in developing countries
b. Prevalence of obesity has leveled out in the last few years
c. The cut-off figure of the BMI for obesity varies from country to country
d. The obesity in other countries does not seem to increase risks for chronic diseases
a. Underweight
b. Healthy weight
c. Overweight
d. Obese
a. The amount of fat in the body is substantially determined by the size of the fat cells
b. More and larger fat cells are found in obese people compared with healthy-weight
persons
c. Fat cell number increases most readily during early adulthood, when energy
expenditure declines
d. Fat cells may enlarge but not increase in number upon reaching the age of 50 in
males and reaching menopause in women
a. the number decreases when fat is lost from the body.
b. the size is larger in obese people than in normal-weight people.
c. the storage capacity for fat depends on both cell number and cell size.
d. the number increases several-fold during the growth years and tapers off when adult
status is reached.
157
steadily until at age 23, when he decided to lose weight. Tom successfully lost 50 pounds.
Which of the following most likely happened to Tom’s fat cells?
a. They shrank in size but did not decrease in number
b. They melted away when he burned all the excess fat
c. They decreased in number but did not decrease in size
d. They changed very little since fat cells shrink only with a weight loss greater than
100 pounds
following except
a. diet.
b. behavior.
c. physical activity.
d. adipocyte number.
a. Fat cell number increases dramatically after puberty
b. Fat cell number in an adult can decrease only by fasting
c. Fat cell number increases most readily in late childhood and early puberty
d. Weight gain from overeating in adults takes place primarily by increasing the
number of fat cells
a. Glucagon
b. Lipoprotein lipase
c. Cellulite synthetase
d. Lipoprotein synthetase
men readily store fat around the abdomen is gender differences in
a. blood insulin levels.
b. the activity of lipoprotein lipase.
c. circulating lipid transport proteins.
d. the activity of lipoprotein synthetase.
a. the rate of fat breakdown is higher in women than in men.
b. fat storage in adipose as well as muscle tissue is regulated by sex-specific hormones.
c. lipoprotein lipase enzyme activity is regulated by a gene that responds to weight loss.
d. fat storage in men develops primarily across the abdomen whereas in women it is
found chiefly around the hips and thighs.
a. Its activity decreases after weight loss but then rebounds quickly after resuming
normal food intake
b. Its activity can always increase but cannot decrease and is, in part, controlled by the
ratchet effect of metabolism
c. Its activities in men and women are sex-related and explain the differences in major
fat storage regions of the body
d. Its low activity in obese people explains, in part, the inability to mobilize storage fat
for energy when following an energy-restricted diet
158
a. hyperplastic obesity.
b. hypertrophic obesity.
c. idiopenthic leptinemia.
d. anaplastic hypometabolism.
as
a. lipotoxicity.
b. hyperplastic lipase.
c. set point susceptibility.
d. hyper-responsive ghrelin.
a. increase in fat absorption.
b. decrease in ketone formation.
c. increase in the size of fat cells.
d. increase in the number of fat cells.
a. hyperplastic obesity.
b. hypertrophic obesity.
c. idiopenthic leptinemia.
d. anaplastic hypometabolism.
a. Minimum weight of a person
b. Maximum weight of a person
c. Point at which a person’s weight plateaus before dropping again quickly
d. Point above which the body tends to lose weight and below which it tends to gain
weight
Questions for Section 9.2 Causes of Overweight and Obesity
a. Altered receptor activity for leptin
b. A genetic disorder resulting in obesity
c. Fat accumulation in the liver of gastric bypass patients
d. A failure to adapt to alternating periods of excess and inadequate energy intake
a. Obese people can change their genome but not their epigenome
b. Even mild exercise can minimize the genetic influence on weight gain
c. Genetics is the overwhelming factor that determines a person’s risk for weight gain
d. Identical twins are twice as likely to weigh the same compared with fraternal twins
a. Pancreas
b. Intestines
c. Adipocytes
d. Hypothalamus
159
a. Injection of leptin
b. Supplements of ghrelin
c. Long-term resistance exercise
d. Consumption of high-protein diets
a. Leptin and ghrelin both increase
b. Leptin and ghrelin both decrease
c. Leptin decreases while ghrelin increases
d. Leptin increases while ghrelin decreases
laboratory. Why is the leptin-deficient mouse much larger than its leptin-sufficient
counterpart?
a. Leptin deficiency causes lower levels of ghrelin
b. Leptin deficiency enhances appetite and decreases energy expenditure
c. Leptin deficiency causes psychological depression, which leads to increased food
intake
d. Leptin deficiency reduces the desire to do physical activity, resulting in more excess
energy available for fat storage
a. Fat cell sensitivity to leptin is higher in obese people
b. A deficiency of leptin is characteristic of all obese people
c. Blood levels of leptin usually correlate directly with body fat
d. Major functions of leptin include an increase in hunger and a decrease in metabolic
rate
a. It is an enzyme
b. It is a satiety signal
c. It is usually deficient in obese people
d. It is secreted by the brain and acts on fat cells
a. It is a metabolic antagonist of leptin
b. It stimulates appetite and energy storage
c. The blood level in the fasting state correlates directly with body weight
d. It is released in high amounts from adipocytes during periods of excess energy intake
a. Ghrelin levels are relatively low
b. Adiponectin levels are relatively high
c. PYY release from the hypothalamus is suppressed
d. Leptin release from subcutaneous fat stores is enhanced
a. It inhibits inflammation
b. It is secreted from adipose tissue
c. It protects against type 2 diabetes
d. It is higher in obese people compared with lean people
160
a. High blood levels are found in obese people
b. Its major role in the body is in suppressing appetite
c. It is secreted by adipocytes and promotes negative energy balance
d. Its blood concentration is very high in people with anorexia nervosa
a. PYY
b. Leptin
c. Ghrelin
d. Cholecystokinin
a. PYY.
b. CCK.
c. leptin.
d. ghrelin.
a. Yellow fat
b. Brown adipose tissue
c. White adipose tissue
d. High-density lipoproteins
a. Increased loss of body heat
b. Reduction of fat cell number
c. Lowering of basal metabolism
d. Proliferation of fat cell number
type of adipose tissue is most effective at helping her to maintain warm body
temperatures during the coldest parts of the year?
a. Black
b. White
c. Brown
d. Yellow
a. Very little brown fat is found in adults whereas more is seen in infants
b. White adipose is especially important in infants as a moderator of temperature
extremes
c. The uncoupled reactions in brown and white adipose are the result of LPL-induced
hydrolysis of ATP
d. Among the three types of adipose, namely, white, yellow, and brown, the white
adipocytes account for the greatest amount of heat expenditure
a. Heredity only
b. Environment only
c. Fat content of diet
d. Heredity and environment
161
a. The rate of obesity has been rising while the gene pool has remained relatively
constant
b. The recognition that identical twins reared apart have body weights similar to their
biological parents
c. The development of precise body composition methodologies that define adipose
storage sites based on gender
d. The discovery of uncoupling proteins that explain the variations in energy
metabolism among lean and overweight people
a. they are both high in fat and large in size at restaurants.
b. they have increased in general and this change parallels the increasing prevalence of
obesity.
c. reducing portion size has a bigger impact than reducing energy density as a means of
lowering total energy intake.
d. they have increased most notably at fast-food restaurants compared with
conventional eating establishments.
a. basal metabolic rate.
b. thermic effect of food.
c physical activity level.
d. metabolic response to exercise.
a. There is a strong genetic component to reduced physical activity of overweight
people
b. Differences in the time obese and lean people spend lying, sitting, standing, and
moving account for about 350 kcalories per day
c. Although watching television correlates with weight gain, playing video games does
not, presumably due to the heightened excitement engendered by action games
d. Extraordinarily inactive people who lower their food intakes below that of their lean
counterparts activate brown adipose tissue uncoupling proteins that stimulate
hyperthermic weight loss
a. it promotes inactivity.
b. it promotes between-meal snacking.
c. it replaces time that could be spent eating.
d. it gives high exposure to energy-dense foods featured in the commercial
advertisements.
activities totaling
a. 20 minutes.
b. 60 minutes.
c. 1½ hours.
d. 3 hours.
162
Questions for Section 9.3 Problems of Overweight and Obesity
lose weight?
a. 10
b. 20
c. 40
d. 60
following risk factors?
a. Hypertension only
b. Cigarette smoking only
c. High LDL and low HDL
d. Impaired glucose tolerance only
a. Obese people often have feelings of rejection
b. Most obese people do not maintain their weight losses
c. In many cultures, obesity is viewed as a sign of robust health
d. Most weight-loss programs that use state-of-the-art techniques allow for long-term
weight loss
products have a normal weight?
a. 5
b. 10
c. 20
d. 35
a. fad diet.
b. discretionary diet.
c. spot reduction program.
d. aggressive bariatric program.
weight?
a. They have little, if any, effect on appetite
b. They have a low binding activity to dietary fat
c. They act on the large intestine rather than the small intestine
d. They often induce abdominal cramping and intestinal gas, thereby encouraging
rejection and noncompliance
ephedrine?
a. The costs are prohibitive
b. The products were found to be ineffective for weight loss
c. The products were implicated in several cases of heart attacks and seizures
d. The products were found to contain contaminants that were believed to be
responsible for inducing liver failure
163
a. leptin resistance.
b. ketone poisoning.
c. cravings for protein.
d. nausea and diarrhea.
loss in people?
a. Chitosan
b. Pyruvate
c. Yohimbine
d. Conjugated linoleic acid
fat as
a. lipomas.
b. lipidosis.
c. cellulite.
d. hyperphagic deposits.
a. Dietary supplements are not necessarily tested for safety or effectiveness
b. Body wraps and creams that have FDA approval are helpful for weight-reduction
regimes
c. Sauna baths may reach temperatures high enough to melt visceral but not
subcutaneous fat stores
d. Hot baths raise the metabolic rate by 5-10% for 1-2 hours and may serve as part of a
general weight-loss program
Questions for Section 9.4 Aggressive Treatments for Obesity
a. ketone production.
b. insulin to glucagon ratio.
c. leptin sensitivity of fat cells.
d. serotonin utilization in the brain.
a. morbid obesity.
b. metabolic syndrome.
c. leptin-resistant obesity.
d. psychological-resistant syndrome.
a. obesity.
b. combating fad diets.
c. severe underweight.
d. anorexia and bulimia.
a. serotonin.
b. blood insulin.
c. hormone-sensitive lipase.
d. adipocyte lipoprotein lipase.
164
heard that some drugs cause lots of gastrointestinal discomfort and would prefer to take
one that doesn’t give him any of these side effects. Which of the following should be
prescribed for Mr. Sinclair?
a. Olestra
b. Orlistat
c. Serotonin
d. Sibutramine
a. It reduces taste sensation
b. It inhibits lipoprotein lipase
c. It inhibits pancreatic lipase
d. It alters circulating leptin concentrations
weight loss in obese people except
a. BMI of at least 40.
b. presence of psychological problems.
c. ability to tolerate sibutramine, orlistat, or phentermine.
d. failure of diet and exercise to promote acceptable weight loss.
a. hunger is suppressed.
b. deficiencies of vitamins and minerals are common in the long term.
c. dramatic improvements are seen in blood lipids, diabetes, and blood pressure.
d. medical supervision in the postsurgery period is required only for the first 6-9
months.
Questions for Section 9.5 Weight-Loss Strategies
loss programs?
a. They were mostly satisfied with a 15% reduction in weight
b. They initially expected to lose unrealistic amounts of weight
c. They typically lost about 30% more weight than researchers predicted
d. They experienced fewer psychological benefits than expected after losing weight
body weight is
a. 6 weeks.
b. 3 months.
c. 6 months.
d. 1 year.
a. 0.5-2 lbs/week
b. 3-4 lbs/week
c. 5% body weight/month
d. 10% body weight/month
a. consume low-fat foods regularly.
b. eat rapidly to avoid prolonged contact with food.
c. adjust energy intake downward as weight loss progresses.
d. include vegetables, fruits, and grains as the mainstay of the diet.
165
nutritional adequacy in an eating plan for reducing body weight?
a. 500
b. 800
c. 1200
d. 1600
a weight reduction program?
a. Decrease portion size
b. Select less energy-dense foods
c. Restrict fiber intake as a means to reduce excess water retention
d. Consume a small high-fat snack before each meal to reduce appetite
a. fat.
b. short-chain fats.
c. simple carbohydrates.
d. complex carbohydrates.
a. Avoid foods containing carbohydrates
b. Eliminate all fats from the diet and decrease water intake
c Greatly increase protein intake to prevent body protein loss
d Reduce daily energy intake and increase energy expenditure
a. decrease water intake.
b. increase physical activity.
c. speed up thyroid activity with metabolic enhancers.
d. develop ketosis by keeping carbohydrate intake as low as possible.
expenditure?
a. Walking a mile uses about the same energy as running a mile
b. Walking a mile uses about half as much energy as running a mile
c. Exercising the leg muscles is effective at burning away fat primarily around the
thighs and hips
d. Exercising the abdominal muscles is effective at burning away fat primarily around
the abdomen
kcalories in that hour?
a. 115
b. 270
c. 410
d. 850
166
activity?
a. After an intense and vigorous workout, metabolism remains elevated for several
hours
b. Lower body fat is more readily lost from vigorous exercises that work primarily the
hip and leg muscles
c. Blood glucose and fatty acid levels are low immediately after working out, but
thereafter recover on their own
d. After an intense workout, most people immediately feel the urge to eat a large
carbohydrate meal to replace glycogen stores
period, burn an additional
a. 30 kcalories.
b. 75 kcalories.
c. 150 kcalories.
d. 300 kcalories.
an intense workout?
a. The feeling of thirst overpowers the desire for food
b. The elevated blood lactate level antagonizes ghrelin
c. Glucose and fatty acids are still abundant in the blood
d. The senses of smell and taste are suppressed for at least one hour
except
a. it curbs appetite.
b. it stimulates digestive function in the postexercise period.
c. it increases energy expenditure in the postexercise period.
d. it triggers release of lipids from adipocytes from all over the body.
low-to-moderate intensity activities for prolonged duration rather than more intense,
shorter routines?
a. Cost is lower
b. Boredom is reduced
c. Compliance is better
d. Monitoring time is diminished
a. No exercise can target fat removal from any specific area of the body
b. Upper body fat is mostly unaffected by exercising lower body muscles
c. Lower body fat in women is depleted at a faster rate than abdominal fat
d. Abdominal fat in men is released more readily with anaerobic exercise
walking a mile at a moderate pace?
a. 0.1
b. 1
c. 2.5
d. 5
167
order to maintain a weight loss?
a. 2000
b. 4000
c. 6000
d. 9000
behaviors?
a. Eating while viewing television promotes overconsumption
b. Socializing with strangers during a meal often leads to reduced food intake
c. The mere sight of food can signal a person to commence eating, regardless of hunger
d. Being in a pleasant atmosphere often lengthens the time of the meal but not the
amount of food eaten
a. shopping only when not hungry.
b. eating only in one place and in one room.
c. participating in activities such as television viewing only when not eating.
d. taking smaller portions of food but always eating everything on the plate quickly.
following personal attitudes should be encouraged in the individual?
a. Strongly believing that weight can be lost
b. Viewing the body realistically as being fat rather than thin
c. Refraining from expressing overconfidence in ability to lose weight
d. Accepting that little or no exercise is a part of the lifestyle of most overweight people
a. keeping food out of sight is an effective way to eat less.
b. people underestimate the amount of a snack eaten when it is a short distance away.
c. people eat more of a snack when it is on their desk than when situated only 6 feet
away.
d. people at home would rather travel to the store to obtain new food than eat the
leftovers.
a. distractions generally appear to reduce food intake.
b. the greater the number of foods at a meal, the more likely people will overeat.
c. the mere sight or smell of food prompts people to commence eating even if they are
not hungry.
d. small portions of food on large plates lead people to underestimate the amount of
food eaten.
a. feel guilty after you overeat.
b. keep a record of your eating habits.
c. always clean your plate when you eat.
d. have someone watch you to prevent overeating.
have lost weight?
a. Basal metabolic rates are higher than those during the obese state
b. Energy expenditure is the same as in people who were never obese
c. Energy requirements are lower than expected for their current body weight
d. Energy expenditure is the same per kg body weight compared with the obese state
168
able to maintain the weight loss for at least one year?
a. 25
b. 50
c. 75
d. 90
lost 20 lbs must hold the loss for at least
a. 3 months.
b. 6 months.
c. 1 year.
d. 2 years.
seems to be
a. fasting.
b. medicines.
c. prevention.
d. genetic counseling.
Questions for Section 9.6 Underweight
a. 5
b. 10
c. 20
d. 25
a. 14.
b. 18.5.
c. 20.
d. 22.5.
who wishes to achieve a healthy body weight?
a. A high-kcalorie diet plus regular exercise
b. A high-kcalorie diet and minimal exercise
c. A high-protein diet plus regular exercise
d. Total elimination of alcohol and exercise
underweight person?
a. Behavior modification training
b. Increased physical activity, especially strength training
c Forced awakening during the night for supplemental meals and snacks
d. Consumption of regular meals and snacks that provide high-kcalorie foods in small
volumes
169
gain weight except
a. they should eat at least 3 healthy meals daily.
b. they should eat meaty appetizers rather than salads.
c. they should refrain from between-meal snacking, especially energy drinks.
d. they should increase the amount of food consumed within the first 20 minutes of a
meal.
underweight individual?
a. Eat energy-dense foods
b. Drink energy-dense beverages
c. Eat a large number of small meals
d. Engage in regular physical exercise
Questions for Section 9.7 The Latest and Greatest Weight-Loss Diet—Again
a. they dictate the correct distribution of energy among the macronutrients.
b. they prevent rapid spikes and declines in one’s blood glucose level.
c. they don’t require people to count kcal, and are thus easier to stick to.
d. they are designed to limit energy intake to around 1200 kcal/day.
finds a description of a plan for her assignment in a magazine at the grocery store. Which
of the following statements in the magazine would suggest that this plan is an unsound,
fad diet?
a. “Keep fresh fruit or carrot sticks in the fridge at work so you won’t be tempted to
raid the vending machine for a snack.”
b. “Once you complete this 6-month plan, you’ll never have to diet again.”
c. “Starting an aerobic exercise plan may seem daunting, but you can start out with
shorter, easier sessions and then build up to 3 or more hours a week.”
d. “On this plan, you can lose up to 2 pounds per week!”
170
Matching
F 271 01. Percentage of U.S. adults considered overweight
R 272 02. An enzyme that promotes fat storage
T 273 03. A term that describes an increase in fat cell number in obesity
K 273 04. A theory that the body tends to maintain a certain weight by internal controls
S 273 05. A term that describes an increase in fat cell size in obesity
G 274 06. Hormone that suppresses appetite
I 275 07. Hormone that stimulates appetite
M 275 08. Adipose tissue substance that inhibits inflammation
L 276 09. Type of adipose that primarily stores fat
N 276 10. Type of adipose that primarily produces heat
C 280 11. Percentage of nonprescription weight-loss product users in the United States who are at a
normal weight
O 281 12. Substance in some herbs that may cause heart attacks and seizures
J 282 13. A fraudulent term to describe lumpy fat
Q 282 14. A drug that interferes with serotonin metabolism
H 283 15. Inhibitor of pancreatic lipase
D 283 16. Minimum BMI of a clinically severe obese person
P 284 17. A cosmetic surgical procedure
A 285 18. Safe rate of weight loss, in pounds per week
E 289 19. Recommended minimum number of minutes per day of moderately intense physical
activity to prevent weight gain
B 298 20. Percentage of U.S. adults classified as underweight
Essay
Page(s)
272-273 01. Discuss differences in fat cell metabolism between males and females.
272-273 02. Explain the role of lipoprotein lipase enzyme in fat cell metabolism.
273 03. Explain the set point theory of weight change.
273-274 04. Discuss the role of genetics in promoting excess weight gain and in discouraging
weight loss.
273-278 05. List the major factors involved in obesity. Which ones can be controlled by dietary
changes or behavior modification?
274-276 06. Discuss the roles of leptin, ghrelin, adiponectin, and PYY in the regulation of food
intake and energy storage.
274-276 07. Discuss the interactive roles of leptin, ghrelin, and PYY in food intake control.
171
276-277 08. Explain the significance and models of action of uncoupling reactions in energy
metabolism.
276-277 09. Explain the association between ghrelin secretion and sleep.
276-277 10. Contrast the metabolic roles of white adipose tissue and brown adipose tissue.
277 11. In understanding food habits in obese people, what is the importance of the energy-
balance equation over time?
277 12. Discuss the limitations of using diet histories to ascertain eating habits.
277-278 13. Explain the factors involved in the promotion of obesity by high-fat diets and food
portion sizes.
277-278 14. Discuss the role of the restaurant industry in promoting excess food consumption.
278 15. Discuss the various factors related to the role of insufficient physical activity in
energy balance.
278-280 16. List several health risks associated with being underweight and with being
overweight.
279 17. Discuss the recommendations for losing weight in population groups who are either
overweight in good health, obese or overweight with risk factors, or obese or
overweight with a life-threatening condition.
279-280 18. Describe psychological problems encountered by obese people in their attempts to
lose weight.
279-280 19. Outline the cycle of behavior associated with the psychology of weight cycling in
relation to the high failure rate of weight-loss programs.
280 20. What types of information might be found in a weight-loss consumer “bill of rights”?
280-282 21. Explain the attraction of unsound weight-loss procedures and plans to obese people.
280-282 22. Discuss the use of herbal products for weight loss.
280-282 23. List several factors that help identify inappropriate, unsound, and possibly dangerous
commercial weight-loss programs.
282-283 24. Discuss the use of prescription drugs for the treatment of obesity, including modes of
action and adverse side effects.
283-284 25. Describe the approaches for weight loss by surgery. What are the benefits and what
are the adverse side effects of these procedures?
284-289 26. Describe a good weight-reduction diet in relation to energy content, meal size,
carbohydrate and fat levels, and water intake.
284-289 27. Outline the recommendations for a successful weight-loss diet.
285-286 28. What are the findings from studies of people on weight-loss diets who skip meals?
172
288 29. Discuss ways in which an increase in the water content of the diet plays an important
role in body weight management.
288 30. Explain the role of fiber in assisting weight loss.
288-289;287 31. What are the results of research studies concerning the importance of low-fat diets in
weight-reduction regimes?
289 32. Discuss the importance of carbohydrate selection and of sugar alternatives in a
weight-loss program.
289-292 33. Explain the changes in metabolism consequent to a decrease in energy intake. How
are these changes modified by regular physical exercise?
289-292 33. Describe the benefits of regular physical activity as an aid to weight-loss dieting.
291-292 34. Explain the relationship of physical activity and appetite control.
292 35. Explain what is meant by “spot reducing” and discuss its effectiveness in altering
body fat content.
293 36. Describe the effects of socializing during meal times on quantity of food consumed.
293 37. Provide an explanation for the higher food consumption of people who eat in the
presence of others.
293-294 38. Discuss the role of environmental influences on food intake.
294 39. How do package sizes and serving containers influence food intake?
294-295 40. Explain the role of behavior modification in weight reduction programs.
296-297 41. Discuss public health strategies designed to help people reduce body weight and
prevent a re-gain.
298 42. List circumstances under which some people would benefit from having more body
fat.
298-299 43. Present a sound diet plan for weight gain in the underweight person.
306 44. Provide an appropriate response to each of these two comments: “This new diet
discovery can alter your genetic code for energy metabolism” and “High-protein
diets are brain food.”
306 45. Discuss the role of insulin and the glycemic index in association with fad diets.
307;309 46. Compare and contrast the theory, applicability, and success of the Atkins diet with
that of the Ornish diet.
308 47. List 5 guidelines each for identifying a fad diet and a healthy diet.
