Chapter 9 – Weight Management: Overweight, Obesity, and Underweight
MULTIPLE CHOICE
1. What proportion of the U.S. adult population is considered overweight or obese?
a.
39%
b.
49%
c.
59%
d.
69%
e.
79%
2. Which of the following is a characteristic of fat cell development?
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.
e.
When energy out exceeds energy in, fat cell size and number both decrease.
3. What is the rationale for the fat cell theory of obesity?
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.
e.
Weight loss in adolescents and adults occurs when fat cells are lysed and their numbers
decrease.
4. Which of the following is known to promote fat storage in adipocytes?
a.
Glucagon
b.
Lipoprotein lipase
c.
Cellulite synthetase
d.
Lipoprotein synthetase
e.
Adipose lipase
5. The major function of lipoprotein lipase is to
a.
assist bile in the digestion of dietary lipids.
b.
remove triglycerides from blood for storage.
c.
trigger adipokine release from adipose tissue.
d.
release triglycerides from storage within adipocytes.
e.
stimulate the release of gherlin and leptin.
6. The most likely explanation for why women readily store fat around the hips whereas 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.
e.
women have different patterns of physical activity than men.
7. Which of the following is a feature of the lipoprotein lipase enzyme?
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.
e.
The release of upper-body fat that it triggers is more active in women than in men,
whereas the release of lower-body fat is similar.
8. Obesity resulting from an increase in the number of fat cells is termed
a.
hyperplastic obesity.
b.
hypertrophic obesity.
c.
idiopenthic leptinemia.
d.
anaplastic hypometabolism.
e.
multiplicative obesity.
9. Which of the following defines the body’s set point?
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
e.
Point at which the physical discomforts of severe obesity overcome the desire to eat
10. Which of the following is a characteristic of the rate of dietary fat oxidation?
a.
It is lower in obese people.
b.
It is independent of LPL activity.
c.
It is higher in females than males.
d.
It is independent of the body’s set point.
e.
It is consistent throughout the lifespan.
11. What is Prader-Willi syndrome?
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
e.
A genetic disorder triggered by environmental toxins that results in obesity
12. Which of the following is a feature of weight gain and genetics?
a.
Obese people can change their genome but not their epigenome.
b.
Exercise has little, if any, effect on the genetic influence on weight gain.
c.
Identical twins are half as likely to weigh the same compared with fraternal twins.
d.
Adopted children tend to have body weights more like their biological parents than their
adoptive parents.
e.
There is very little evidence that genetic factors contribute to obesity, except in the
presence of certain rare syndromes.
13. On which organ or tissue does leptin primarily act?
a.
Pancreas
b.
Intestines
c.
Adipocytes
d.
Hypothalamus
e.
Hippocampus
14. What are the observed effects of sleep deprivation on leptin and ghrelin?
a.
Leptin and ghrelin both increase
b.
Leptin and ghrelin both decrease
c.
Leptin decreases while ghrelin increases
d.
Leptin increases while ghrelin decreases
e.
Sleep deprivation only affects leptin and gherlin in very elderly or unhealthy individuals.
15. Which of the following describes a relationship between leptin and energy balance?
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.
e.
Blood levels of leptin only correlate with body fat at extremely high and low body masses.
16. Why, in part, is weight loss more successful with exercise and also after bypass surgery?
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.
e.
Leptin levels suppress the appetite.
17. What is the significance of the uncoupling proteins in adipose tissue?
a.
Increased loss of energy as heat
b.
Reduction of fat cell number
c.
Lowering of basal metabolism
d.
Proliferation of fat cell number
e.
Increased fat storage
18. Kirima is a Native Eskimo who lives in one of the coldest regions in the world. What 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
e.
Red
19. Which of the following is a characteristic of the body’s major types of adipose tissue?
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.
e.
White fat in adults is stored mostly around the neck and clavicles.
20. Which of the following is the best evidence that environment must play a role in obesity?
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.
e.
Adoption studies show that adopted individuals have body mass more similar to their
adoptive parents than their birth parents.
21. Which of the following is a feature of taking diet histories to gauge energy intake?
a.
They correlate strongly with current and past energy intakes.
b.
Their accuracy correlates strongly with an obesogenic environment.
c.
Only overweight and obese people report inaccurate energy intakes.
d.
Both normal and obese people commonly misreport actual energy intakes.
e.
Although people try to be honest, their self-reports are poorly correlated with their actual
energy intake.
22. Compared with non-obese people, obese people have a lower
a.
thermogenesis potential.
b.
thermic effect of food.
c.
physical activity level.
d.
metabolic response to exercise.
e.
responsiveness to environmental stimuli about eating.
23. Which of the following is a feature of physical inactivity and energy balance?
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.
e.
Although extremely low levels of activity do increase risk of obesity, they do not affect
the risk of metabolic syndrome.
24. Tonya is an overweight cigarette smoker. Which of the following risk factors would make it especially
important for her to lose weight?
a.
hypotension
b.
low LDL
c.
high HDL
d.
age over 45 years
e.
family history of heart disease.
25. What percentage of people in the United States who use nonprescription weight-loss products have a
normal weight?
a.
5
b.
10
c.
20
d.
35
e.
45
26. What is the principal reason that the FDA has banned the sale of products containing 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.
e.
They were contaminated with substances that induced a Parkinson-like syndrome.
27. Clinically severe obesity is also known as
a.
morbid obesity.
b.
metabolic syndrome.
c.
leptin-resistant obesity.
d.
psychological-resistant syndrome.
e.
Prader-Willi syndrome
28. Which of the following is a feature of prescription drug use for treatment of obesity?
a.
Most drugs may be safely prescribed even in otherwise healthy obese people.
b.
Most experts believe that drugs should not be used because obesity is not a disease.
c.
Most currently available drugs are highly effective in both the short and long term.
d.
The use of “off-label” drugs is common to take advantage of their modest weight loss
effects.
e.
Although initially effective, most eventually raise the risk of cardiovascular disease to
unacceptable levels.
29. The prescription drug phentermine acts by regulating the utilization of
a.
blood insulin.
b.
norepinephrine.
c.
hormone-sensitive lipase.
d.
adipocyte lipoprotein lipase.
e.
gherlin and leptin.
30. Your patient, Mr. Sinclair, has a BMI of 43 and is taking drugs to lose weight. He has 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.
Phentermine
e.
Belviq
31. What is the primary action of orlistat, a weight-loss drug?
a.
It reduces taste sensation.
b.
It inhibits lipoprotein lipase.
c.
It inhibits pancreatic lipase.
d.
It alters circulating leptin concentrations.
e.
It enhances the release of epinephrine.
32. Which of the following is a feature of gastric surgery for the treatment of clinically severe obesity?
a.
It is almost never followed by weight regain.
b.
It is always an irreversible medical procedure.
c.
It is less effective than traditional liposuction.
d.
It diminishes the amount of food that can be eaten without GI distress.
e.
It has dramatic effects on physical and psychological health.
33. Which of the following is a characteristic of liposuction?
a.
It often improves blood pressure and insulin sensitivity.
b.
It results in a typical loss of body weight of 25 to 50 lbs.
c.
It results in a return of body fat within a year, primarily to the abdomen.
d.
It is considered a valid but slightly less effective alternative to gastric bypass.
e.
It is effective for weight loss in older but not younger people.
34. What proportion of U.S. adults have maintained a 10% weight loss for at least a year?
a.
1 in 600
b.
1 in 100
c.
1 in 60
d.
1 in 10
e.
1 in 6
35. In a weight reduction regimen, the most realistic time frame for losing 10% of initial body weight is
a.
6 weeks.
b.
3 months.
c.
6 months.
d.
9 months.
e.
1 year.
36. What is a safe rate of weight loss on a long-term basis for most overweight people?
a.
0.5-2 lbs/week
b.
3-4 lbs/week
c.
5% body weight/month
d.
7.5% body weight/month
e.
10% body weight/month
37. What minimum amount of body weight loss (lbs) is shown to improve physical capabilities and quality
of life?
a.
5-10
b.
10–15
c.
15–20
d.
20–25
e.
25–30
38. As a general rule, what minimum number of kcalories per day is necessary to ensure nutritional
adequacy in an eating plan for reducing body weight in women?
a.
500
b.
800
c.
1200
d.
1600
e.
1800
39. As a general rule, what minimum number of kcalories per day is necessary to ensure nutritional
adequacy in an eating plan for reducing body weight in men?
a.
500
b.
800
c.
1200
d.
1600
e.
1800
40. Which of the following is a characteristic of breakfast eating?
a.
Breakfast skippers have higher BMRs up until their first meal of the day.
b.
Eating breakfast once per week conveys the same benefits as 5 times per week.
c.
People who eat breakfast frequently have a lower BMI than breakfast skippers.
d.
People who skip breakfast have lower 24-hour energy intakes than breakfast eaters.
e.
Younger people who skip breakfast have a lower BMI than those who eat it.
41. Which of the following would be most effective at lowering energy intake in a person on a weight
reduction program?
a.
Drink 8 ounces of water prior to each meal.
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
e.
Consume an alcoholic beverage with lunch and dinner.
42. Incorporating large quantities of low-energy-density foods in a diet is sometimes referred to as
a.
calometrics.
b.
minimetrics.
c.
densification.
d.
volumetrics.
e.
substitution.
43. Which of the following is a feature of meal eating?
a.
Taking large bites helps to reduce food intake.
b.
Faster eating correlates with higher body weight.
c.
Total kcal intake in higher when meals are eaten more slowly.
d.
Satiety hormones are blunted when meals are eaten more slowly.
e.
Eating on a smaller plate increases food intake.
44. What is the best approach to weight loss?
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.
e.
Fast at least two consecutive days each week.
45. An important aid in any weight-loss diet program is to
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.
e.
use herbal supplements to speed up metabolism.
46. Which of the following describes a connection between physical activity and energy expenditure?
a.
The number of kcalories spent in an activity depends on body weight, intensity, and
duration.
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
e.
If intensity and duration are the same, heavier individuals will expend less energy running
than will lighter individuals.
47. Which of the following is a feature of the use of artificial sweeteners to control body weight?
a.
They may lead to weight gain in some people.
b.
They automatically lower a person’s daily energy intake.
c.
They delay gastric emptying time, leading to enhanced satiety.
d.
They trigger epinephrine secretion, which suppresses appetite.
e.
They increase release of endogenous opiates.
48. Which of the following is a feature of the body’s response to engaging in physical 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.
e.
After intense exercise, gherlin secretion is typically elevated and remains so for several
hours.
49. A typical person who burns 200 kcalories during a 2-mile run would, in the postexercise period, burn
an additional
a.
10 kcalories.
b.
20 kcalories.
c.
30 kcalories.
d.
40 kcalories.
e.
50 kcalories.
50. What is the principal reason that appetite is turned off immediately after a person finishes 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.
e.
Leptin secretion is markedly increased.
51. What is the chief reason that health-care professionals advise people to engage only in
low-to-moderate intensity activities for prolonged duration rather than more intense, shorter routines?
a.
The cost is lower.
b.
Boredom is reduced.
c.
Compliance is better.
d.
Monitoring time is diminished.
e.
The overall results are more dramatic.
52. Which of the following is a relation of “spot reducing” to exercise?
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.
e.
Spot reducing works on cellulite but not on other fat.
53. Individuals who are able to lose weight and successfully keep it off for at least a year typically
a.
engage in 30 minutes of physical exercise daily.
b.
weigh themselves no more often than once a month.
c.
eat a diet with high energy density.
d.
eat a diet with low nutrient density.
e.
limit television to less than 10 hours per week.
54. Approximately how many kcalories per week should be expended in physical activity in order to
maintain a weight loss?
a.
2500
b.
3500
c.
4500
d.
5500
e.
6500
55. To help maximize the long-term success of a person’s weight-loss program, which of the 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
e.
Keep weight loss plans a private matter and not share goals or progress with others
56. An example of a behavior modification technique for weight control is to
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.
e.
cook your own meals.
57. Which of the following is a feature of smoking and weight maintenance?
a.
Smokers on average weigh about 5 lbs more than nonsmokers.
b.
Smoking a cigarette increases the appetite for energy-dense foods.
c.
People who give up smoking gain an average of 10 lbs in the first year.
d.
Psychotherapy is effective at reducing either smoking or body weight but not both at the
same time.
e.
Trying to stop smoking at the same time as trying to lose weight effectively guarantees
neither effort will succeed.
58. Which of the following is a feature of energy metabolism in formerly obese people who have lost
weight?
a.
Their basal metabolic rates are higher after weight loss than 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 as compared with the obese state.
e.
Their basal metabolic rate is effectively reset to a normal range by weight loss.
59. How many calories does a 16 ounce cafe mocha have?
a.
200
b.
300
c.
400
d.
500
e.
600
60. What is the energy density of hard-boiled egg weighing 50 grams and delivering 78 kcalories?
a.
0.8
b.
1.6
c.
2.4
d.
2.8
e.
3.2
61. Because obesity apparently has many causes, even in a single individual, the best approach seems to
be
a.
fasting.
b.
medicines.
c.
prevention.
d.
genetic counseling.
e.
holistic.
62. Approximately what percentage of U.S. adults are classified as underweight?
a.
0.2
b.
2
c.
5
d.
10
e.
15
63. The classification of underweight is achieved when the BMI first drops below
a.
14.
b.
18.5.
c.
20.
d.
22.5.
e.
25.5
64. Among the following, which is the most important strategy for an underweight person 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
e.
High-protein, high-kcalorie diet and minimal exercise
65. Of the following, which is among the recommended strategies for weight gain in an underweight
person?
a.
Behavior modification training
b.
Punishment of any weight losses
c.
Forced awakening during the night for supplemental meals and snacks
d.
Tube feeding during the night
e.
Increased alcohol consumption
66. What is the best meal-planning strategies for underweight people who desire to gain weight?
a.
Eat only one large meal per day, just before bed.
b.
Eat meaty appetizers rather than salads.
c.
Refrain from between-meal snacking, especially energy drinks.
d.
Decrease the amount of food consumed within the first 20 minutes of a meal.
e.
Eat the same amount as before, but spread it out over the entire day.
67. Which of the following would be part of a successful program of weight gain in an underweight
individual?
a.
Eat energy-dense foods.
b.
Drink alcohol regularly.
c.
Eat a large number of small meals.
d.
Refrain from regular physical exercise.
e.
Refrain from between-meal snacking.
68. Fad diets often produce weight loss, at least initially, because they
a.
dictate the correct distribution of energy among the macronutrients.
b.
prevent rapid spikes and declines in one’s blood glucose level.
c.
don’t require people to count kcal, and are thus easier to stick to.
d.
are designed to limit energy intake to around 1200 kcal/day.
e.
are so enthusiastically followed by individuals on them.
69. Which of the following is a characteristic of most fad diets?
a.
They produce long-lasting results just like healthy diets.
b.
They limit food choices, thereby reducing energy intake.
c.
They are balanced and therefore do not require a dietary supplement.
d.
Their success depends on the ratios of macronutrients more so than the total energy value.
e.
They are typically as healthy as more traditional weight-loss diets.
70. Jody is taking a nutrition class, and has been assigned to evaluate a popular diet plan. She 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.
“On this plan, you can lose up to 2 pounds per week!”
b.
“Once you complete this 6-month plan, you’ll never have to diet again.”