Nutrition and Diet Therapy 9th Edition Debruyne Test Bank

Nutrition and Diet Therapy 9th Edition
DeBruyne Test Bank

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Chapter 07 - Weight Management - Overweight and Underweight
True / False
1. Genetics influences the way the body consumes, stores, and spends energy.
a. True
b. False
ANSWER: True
DIFFICULTY: Bloom’s: Understand
REFERENCES: 7.1 Causes of Obesity
QUESTION TYPE: True / False
LEARNING OBJECTIVES: NUTR.DEBR.16.7.1 - Discuss the genetic and environmental causes of obesity.
2. Genetics alone determines a person’s susceptibility to obesity.

a. True
b. False
ANSWER: False
DIFFICULTY: Bloom’s: Apply
3. Some research indicates that obese people have much more lipoprotein lipase activity in their fat cells than lean people
do.
a. True
b. False
ANSWER: True
4. A lean person’s fasting blood level of ghrelin is typically higher than in an obese person.
a. True
b. False
ANSWER: True
5. Most obese people have leptin deficiency.

a. True
b. False
ANSWER: False
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6. Ghrelin is a hormone produced in the stomach that acts much like leptin.
a. True
b. False
ANSWER: False
7. On a sensible weight-control program, meals and snacks should include whole-grain foods and fiber-rich vegetables.
a. True
b. False
ANSWER: True
REFERENCES: 7.5 Reasonable Strategies for Weight Loss
LEARNING OBJECTIVES: NUTR.DEBR.16.7.5 - Outline reasonable strategies for achieving and maintaining a healthy
body weight.
8. Television and sedentary video and computer entertainment contribute to obesity because they have mostly replaced
outdoor activity for many people.
a. True
b. False
ANSWER: True
9. Health-promoting built environments may result in a healthier and leaner population.

a. True
b. False
ANSWER: True
10. Herbal dietary supplements are automatically deemed safe because they are natural.
a. True
b. False
ANSWER: False

REFERENCES: 7.3 Inappropriate Obesity Treatments
LEARNING OBJECTIVES: NUTR.DEBR.16.7.3 - Describe some of the dangers of over-the-counter weight-loss
products.
Multiple Choice
11. The hormone _____ is produced by stomach cells, and promotes positive energy balance by stimulating appetite and
promoting efficient energy storage.
a. insulin
b. leptin
c. ghrelin
d. ephedra
e. lipase
ANSWER: c
QUESTION TYPE: Multiple Choice
12. The number of fat cells increases most rapidly _____.

a. when you eat a large breakfast
b. during late childhood and early puberty
c. if you are inactive
d. around the age of 40
e. in the womb
ANSWER: b
13. The theory that the body tends to maintain a certain weight by means of its own internal controls is referred to as the
_____ theory.
a. environmental stimuli
b. genetics
c. learned behavior
d. set-point
e. check-point
ANSWER: d
14. Which factor is an environmental stimulus that contributes to obesity?

a. lipoprotein lipase enzyme levels
b. genetics
c. energy-poor fast food
d. increase in meal portion sizes
e. the year-round availability of fresh fruits and vegetables
ANSWER: d
15. Fast food contributes to obesity because it generally provides _____.

a. nutrient-dense foods
b. smaller portions
c. plenty of low-kcalorie choices
d. large portions of energy-dense foods
e. too much salt and not enough sugar
ANSWER: d
16. The psychological desire to eat is referred to as _____.

a. satiety
b. appetite
c. hunger
d. obesity
e. hypothalamism
ANSWER: b
17. Which scenario illustrates the best example of the link between food behavior and emotions?
a. someone who eats fast food for lunch every day
b. someone who would rather sit home and eat than ask a friend to go to a movie and risk rejection
c. someone who always eats popcorn while watching a movie
d. a pregnant women who craves pickles
e. someone who eats funnel cake at the beach
ANSWER: b


18. Susie has been overweight for many years. She tends to eat when she is not really hungry and eats more food when
she is angry or depressed. Which theory could explain Susie’s problem of overweight?
a. lipoprotein lipase
b. set-point theory
c. learned behavior
d. genetics
e. aggravated satiety syndrome
ANSWER: c
19. The question of whether a person should lose weight depends on _____.
a. the neighborhood they live in
b. the monetary cost of weight loss
c. whether the FDA approves weight loss drugs
d. the individual's weight status
e. basal metabolic rate
ANSWER: d
REFERENCES: 7.2 Obesity Treatment: Who Should Lose?
LEARNING OBJECTIVES: NUTR.DEBR.16.7.2 - Explain why weight-loss advice does not apply equally to all
overweight people.
20. Due to harmful effects reported by consumers, the over-the-counter amphetamine-like substance _____ was banned by
the FDA.
a. ephedrine
b. pyruvate
c. chitosan
d. yohimbe
e. Xenical
ANSWER: a
products.

21. Which statement could you credibly make for meaningful weight loss?
a. Laxatives promote weight loss.
b. Hot baths speed up metabolism.
c. Grapefruit juice melts body fat.
d. Unwise weight-loss techniques can be dangerous.
e. Certain creams rubbed on the skin can break up fat.
ANSWER: d
products.
22. The prescription weight loss drug _____ works on the brain’s neurotransmitters to suppress appetite.
a. orlistat
b. phentermine
c. Olestra
d. Xenical
e. Belviq
ANSWER: b
REFERENCES: 7.4 Aggressive Treatments of Obesity
LEARNING OBJECTIVES: NUTR.DEBR.16.7.4 - Explain the risks and benefits, if any, of drugs and surgery used to
treat obesity.
23. The prescription drug _____ is used to treat obesity by reducing the absorption of fat.
a. orlistat
b. topiramate
c. Olestra
d. Meridia
e. Qsymia
ANSWER: a
treat obesity.
24. The surgical approach to weight loss can often be justified in cases of _____.
a. BMI 25-30
b. uncontrolled diabetes
c. clinically severe obesity
d. peptic ulcer disease
e. Prader-Willi syndrome
ANSWER: c
treat obesity.
25. Weight-loss surgeries _____.

a. reduce the capacity of the stomach
b. are dangerous and should be avoided
c. have no complications
d. worsen existing health conditions associated with obesity
e. are only rarely successful
ANSWER: a
treat obesity.
26. A major complication of weight-loss surgery can include _____.

a. increased appetite
b. increased thirst
c. nutritional deficiencies
d. an inability to process calcium
e. the development of diabetes
ANSWER: c
treat obesity.
27. The long-term safety and effectiveness of gastric surgery largely depends on _____.
a. compliance with dietary instructions
b. avoidance of all fats
c. following recommended food combining patterns
d. regular monitoring of blood glucose levels
e. a baseline physical activity schedule of at least 30 minutes per day
ANSWER: a
treat obesity.
28. The secret to safe and permanent weight loss is a sensible approach involving _____.
a. physical activity and a healthy, low-kcalorie diet
b. hormone treatments and diet pills
c. a very-low-kcalorie diet combined with excessive exercise
d. herbal supplements and a low-kcalorie diet
e. herbal supplements and a high-kcalorie diet
ANSWER: a
body weight.
29. Severe kcalorie restriction and rapid weight loss can result in _____.
a. excessive hair loss
b. a higher basal metabolism
c. slow regain of weight
d. excessive loss of lean muscle tissue
e. excessive loss of fat tissue
ANSWER: d
body weight.
30. In order to lose one pound per week, you would need to reduce your food intake by about _____ kcalories per day.
a. 100
b. 250
c. 500
d. 1000
e. 1500
ANSWER: c
body weight.
31. Women following a weight-loss diet may need supplements of _____.

a. amino acids and/or essential fatty acids
b. iron and/or calcium
c. sodium and/or potassium
d. vitamin C and/or calcium
e. iron and/or herbs

ANSWER: b
body weight.
32. Donna would like to lose weight. How many kcalories should she consume daily in order to lose weight while also
meeting her nutritional needs?
a. 1200-1500
b. 1600-1800
c. 1500-1800
d. 1800-2000
e. 2000-2200
ANSWER: a
body weight.
33. Jill has asked to be placed on a weight-loss diet that will allow her to lose two pounds per week. You tell Jill that she
must cut about _____ kcalories/day in order to achieve this goal.
a. 500
b. 700
c. 1000
d. 1500
e. 2000
ANSWER: c
body weight.
34. Nutritional adequacy is difficult to achieve on fewer than _____ kcalories a day.
a. 1000
b. 1200
c. 1500
d. 1700
e. 1800
ANSWER: b

body weight.
35. Sarah is trying to lose 10 pounds. Which recommendation would you make?
a. Reduce your kcalorie intake by 100-200 kcalories a day and engage in 15 minutes of exercise per day.
b. Ask your physician for a prescription for orlistat.
c. Replace two meals each day with a bowl of cereal.
d. Reduce your kcalorie intake by 300-500 kcalories a day and engage in at least 250 minutes of physical activity
per week.
e. Drink smoothies at every meal and engage in at least 300 minutes of physical activity per week.
ANSWER: d
body weight.
36. As part of a sensible weight-loss plan, individuals should _____.

a. eat breakfast
b. eliminate some meals
c. always eat a few large meals instead of several small meals
d. restrict water intake
e. limit daily intake to less than 1200 kcal/day
ANSWER: a
body weight.
37. Compared to refined foods, high-fiber, unprocessed, or lightly processed foods aid in weight loss because they provide
_____.
a. less absorption, resulting in fewer kcalories
b. a faster transit time through the intestinal tract
c. the same number of kcalories in a larger amount of food
d. bulk and satiety for fewer kcalories
e. extra nutrients in smaller portions
ANSWER: d
body weight.
38. An appropriate food to consume before a meal to increase one’s feeling of fullness is _____.
a. a cup of cream of chicken soup

b. an unbuttered roll
c. a cup of vegetable soup
d. a breadstick dipped in olive oil
e. a slice of cheese wrapped in sliced deli meat
ANSWER: c
body weight.
39. Which food has the lowest energy density?

a. 15 fresh grapes
b. ½ cup rice
c. ½ cup ice cream
d. 16 baked chips
e. a baked potato with sour cream
ANSWER: a
body weight.
40. The average U.S. diet delivers an estimated _____ kcalories a day from sweetened beverages.
a. 50-75
b. 75-150
c. 160-185
d. 190-225
e. 230-250
ANSWER: b
body weight.
41. One benefit of physical activity is that it _____.

a. allows you to eat fattier foods without gaining weight
b. reminds you to eat less at every meal
c. reduces abdominal obesity
d. may help to increase enzyme levels in your blood
e. lowers basal metabolism
ANSWER: c

body weight.
42. One benefit of regular physical activity on weight loss is _____.

a. increased ghrelin levels
b. increased lipoprotein lipase levels
c. loss of glucose stores in your muscles
d. a long-term increase in basal metabolism
e. loss of lean body mass
ANSWER: d
body weight.
43. Resistance training develops muscular strength, power, and _____.

a. stimulates fat loss
b. lowers basal metabolic rate
c. endurance
d. helps one “spot reduce.”
e. helps you eat higher fat foods without guilt
ANSWER: c
body weight.
44. The American College of Sports Medicine recommends _____ minutes of moderate-intensity exercise per week for
weight gain prevention.
a. 60
b. 90
c. 120
d. 150
e. 200
ANSWER: d
body weight.
45. Basal metabolism remains elevated for _____ after intense and prolonged activity.
a. 30 minutes
b. 1 hour
c. greater than 1 hour
d. 72 hours
e. 4 days
ANSWER: c
body weight.
46. A good way to begin a safe and effective weight-loss program is to _____.
a. keep a food and activity diary
b. reduce energy intake to 800 kcalories per day
c. start on a Monday
d. recognize that the feelings of starvation are inevitable
e. commit to drinking 2 gallons of water per day
ANSWER: a
body weight.
47. The best form of physical activity for a person who is trying to lose weight is _____.
a. running 5 miles at least 3 times a week
b. walking 2 miles in 30 minutes
c. a daily workout at the gym
d. something he or she enjoys and will do regularly
e. cycling 10 miles every morning
ANSWER: d
body weight.
48. Lucie is practicing good cognitive skills for weight loss when she tells herself:
a. “I shouldn’t have eaten that ice cream yesterday... no wonder I’m fat.”
b. “I was able to walk on the treadmill 15 minutes longer today than I could 2 weeks ago... my fitness level is
improving.”
c. “I really, really want to lose weight; I just can’t seem to succeed no matter how hard I try.”
d. “I need to remember to stop by the grocery store and pick up some more fresh vegetables for salads, and some
light vinaigrette.”
e. “I could only do 10 sit-ups at the gym today. I’ll never lose my gut at this rate.”
ANSWER: b
body weight.
49. A key to preventing weight regain is to _____.

a. only check weight once a month
b. avoid thinking thoughts that promote self-efficacy
c. view weight maintenance as a lifestyle, not a goal
d. skip breakfast every day
e. check the scale every day and skip a meal if you gained a pound
ANSWER: c
body weight.
50. What would you recommend to a person who is too busy to eat enough to maintain a healthy weight?
a. Eat one supersized meal per day.
b. Plan meals in advance and eat energy-dense appetizers.
c. Replace one meal each day with a high fat snack.
d. Replace one meal each day with a glass of fruit juice.
e. Add an extra session of resistance training to build muscle mass.
ANSWER: b
REFERENCES: 7.6 Strategies for Weight Gain
LEARNING OBJECTIVES: NUTR.DEBR.16.7.6 - Summarize strategies for gaining weight.
51. James is trying to gain weight. Which strategy would you suggest to help James with his goal?
a. Choose milkshakes instead of milk.
b. Drink black coffee.
c. Skip beverages.
d. Skip dessert.
e. Don’t eat after 6 PM.
ANSWER: a
52. David has a difficult time gaining weight. What recommendation would you include?
a. “Eat all you want and avoid physical activity.”
b. “Limit low-kcalorie foods like fruits and vegetables.”
c. “Ask your doctor for a prescription for orlistat.”
d. “Consume energy-dense foods and engage in weight training.”
e. “Drink tea in the morning, but switch to lemon water the rest of the day.”
ANSWER: d
53. Zachary is trying to gain weight. He complains that he has a hard time eating a lot of food at one meal. You advise
him to _____.
a. eat energy-dense snacks between meals
b. eat more slowly
c. drink less water
d. eat a salad before his meal
e. eat from a smaller plate to trick his brain
ANSWER: a
54. For someone who is trying to gain weight, an easy way to add kcalories is to _____.
a. drink a lot of water
b. increase consumption of caloric beverages
c. use fat-free salad dressings freely
d. add more salt to food
e. cut out vegetables entirely
ANSWER: b
55. Behavior therapists often teach _____ skills, or new ways of thinking, to help overweight people solve problems and
correct false thinking that can undermine healthy eating behaviors.
a. chemo-absorptive
b. reverse psychology
c. body-awareness
d. cognitive
e. neurological
ANSWER: d
body weight.
56. To maintain weight, consume foods and drinks to _____, not _____, kcalorie needs.
a. meet; target
b. meet; exceed
c. exceed; meet
d. exceed; account for
e. meet; maintain
ANSWER: b
body weight.
57. Physical activity should be an _____ part of a weight-management program.

a. invitational
b. excessive
c. optional
d. integral
e. irrational
ANSWER: d
body weight.
58. People who eat _____, frequent meals can be as successful at weight loss and maintenance as those who eat _____
meals each day.
a. small; four
b. large; three
c. small; three
d. large; two
e. small; one
ANSWER: c
body weight.
59. A BMI greater than 40, or a BMI greater than 35 with one or more serious conditions such as hypertension, is referred
to as ____.
a. clinically severe obesity
b. moderately severe obesity
c. mild obesity
d. anorexia
e. gastric bypass syndrome
ANSWER: a
treat obesity.
60. Which weight loss strategy may be an option for people who are unable to achieve adequate weight loss with diet and
exercise?
a. fad diets
b. scare tactics
c. herbal remedies
d. weight loss drugs
e. negative self-talk
ANSWER: d
treat obesity.
61. Why doesn't weight-loss advice apply equally to all overweight people?
a. fad diets only work for overweight, but not obese, individuals
b. only severely obese individuals should exercise
c. people vary in their weight tendencies
d. diabetics should not restrict calorie intake
e. not all overweight people will benefit from weight loss
ANSWER: c
REFERENCES: 7.2 Obesity Treatment: Who Should Lose?
LEARNING OBJECTIVES: NUTR.DEBR.16.7.2 - Explain why weight-loss advice does not apply equally to all
overweight people.
62. Obese people observed closely are often seen to eat ____ than lean people, but they are sometimes so extraordinarily
_____ that they still manage to accumulate energy surplus.
a. less; active
b. less; inactive
c. more; inactive
d. more; active
e. about the same; active
ANSWER: b
63. Evidence that genes influence eating behavior and body composition comes from family, twin, and _____ studies.
a. adipose tissue
b. rat
c. infant
d. elderly
e. adoption
ANSWER: e
64. Which statement is representative of fad diets?

a. They are based on credible scientific research.
b. The FDA requires proof that they work and are safe.
c. They usually offer distorted bits of legitimate research, which makes them sound feasible.
d. Scientists have overlooked the obvious facts, while a lay-person has discovered the key to successful weight
loss.
e. They work because they often rely on more “natural” ingredients than regular diets.
ANSWER: c
REFERENCES: 7.7 Nutrition in Practice: Fad Diets
LEARNING OBJECTIVES: NUTR.DEBR.16.7.7 - Describe several popular fad diets and explain how to evaluate
weight-loss diets based on sound nutrition.
65. Quite simply, the key to weight loss is _____.

a. combining foods correctly at meals
b. not eating desserts
c. eating less carbohydrate
d. consuming fewer kcalories
e. eating less fat
ANSWER: d


66. Despite claims that each new fad diet is different and offers a new approach to weight loss, most fad diets simply
_____.
a. cut kcalories
b. eliminate animal foods
c. encourage skipping meals
d. are individualized
e. rely too heavily on fruits
ANSWER: a
67. Of the fad diets compared in the textbook, which one recommends the use of fat-burning herbs, supplements, and
green teas, despite the lack of scientific evidence that these products promote weight loss?
a. The Zen Diet Revolution
b. The Fast Diet
c. Cinch!
d. Biggest Loser Diet
e. The 4-Hour Body
ANSWER: a
68. What is the major drawback of most fad diets?

a. They promote false information about weight loss.
b. They do not create lifestyle changes to support long-term weight control.
c. They create false hopes among those who try them.
d. They usually require the purchase of dietary supplements.
e. They are usually endorsed by celebrities and so are very expensive.
ANSWER: b
69. Diet and health recommendations should be _____.

a. offered to the general public, who will later be surveyed to determine the efficacy of the program
b. based on years of scientific research
c. proposed first and proven later
d. offered by celebrities who have lost weight successfully
e. based on the elimination of a specific energy nutrient from the diet
ANSWER: b
70. Warning signs of an unsound weight-loss program include _____.

a. a diet that provides at least 1200 kcalories
b. recommendations to consume ordinary foods
c. requirements to purchase their brand of foods/supplements
d. encouragement to pursue physical activity
e. encouragement to eat a variety of foods
ANSWER: c
71. The Biggest Loser Diet stresses the importance of _____.

a. low-fat foods
b. exercise
c. scare tactics
d. the buddy system
e. drinking water
ANSWER: b
72. The Dukan Diet _____ daily exercise and provides a(n) _____ structured plan
a. encourages; individually
b. discourages; loosely
c. encourages; loosely
d. discourages; highly
e. encourages; highly
ANSWER: e
Matching
a. an enzyme mounted on the surface of fat cells that hydrolyzes triglycerides in the blood into fatty acids and
glycerol for absorption into the cells
b. the buildings, roads, utilities, homes, fixtures, parks, and all other entities that form the physical characteristics of
a community
c. a hormone produced by fat cells that decreases appetite and increases energy expenditure
d. a hormone produced primarily by the stomach cells that signals the hypothalamus of the brain to stimulate appetite
and food intake
e. the feeling of satisfaction and fullness that occurs during a meal and halts eating
f. the physiological need to eat, experienced as a drive to obtain food
g. the psychological desire to eat
h. the theory that proposes that the body tends to maintain a certain weight by means of its own internal controls
i. the place where excess energy is stored in fat cells
j. urban and rural low-income areas with limited access to affordable and nutritious foods
k. a diet that is temporarily popular but offers no lasting weight loss strategy
l. a brain center that controls activities such as maintenance of water balance, regulation of body temperature, and
control of appetite
m. a person’s belief in his or her ability to succeed in an undertaking
n. all the factors surrounding a person that promote weight gain
o. sedentary time spent using an electronic device, such as a television, computer, or video game player
p. surgery that restricts stomach size and reroutes food form the stomach to the lower part of the small intestine
q. periods of returning to old habits
r. the feeling of fullness and satisfaction that occurs after a meal and inhibits eating until the next meal
QUESTION TYPE: Matching
73. adipose tissue

ANSWER: i
74. appetite
ANSWER: g
75. built environment

ANSWER: b
76. satiation
ANSWER: e
77. ghrelin
ANSWER: d
78. hunger
ANSWER: f
79. leptin
ANSWER: c
80. lipoprotein lipase

ANSWER: a
81. set-point theory

ANSWER: h
82. screen time

ANSWER: o
83. food deserts

ANSWER: j
84. satiety
ANSWER: r
85. obesogenic environment

ANSWER: n
86. hypothalamus
ANSWER: l
a community
and food intake
control of appetite
body weight.
87. self-efficacy
ANSWER: m
88. lapses
ANSWER: q
Matching
a community
and food intake
control of appetite


treat obesity.
89. gastric bypass

ANSWER: p
a community
and food intake
control of appetite
90. fad diet

ANSWER: k
Essay
91. Briefly describe the set-point theory and its role as a cause of obesity.
ANSWER: One popular theory of why a person may store too much fat is the set-point theory. The set-
point theory proposes that body weight, like body temperature, is physiologically regulated.
Researchers have noted that many people who lose weight quickly regain it all. This suggests
that somehow the body chooses a preferred weight and defends that weight by regulating
eating behaviors and hormonal actions. After weight losses, the body reduces its metabolic
rate. The decrease in metabolic rate after weight loss is greater than would be expected based
on body composition alone. This adaptation helps to explain why it can be difficult for an
overweight person to maintain weight losses. While set point answers some questions
regarding the biology of energy balance, it fails to explain the many other influences
contributing to the population’s obesity epidemic.
QUESTION TYPE: Essay
92. Discuss the role of environmental stimuli in the development of obesity.

ANSWER: Answers to this question will vary greatly, but the following are some of the key elements
students will likely discuss.
Obesity reflects the interaction between genes and the environment. An obesogenic
environment includes all of the circumstances that people encounter daily that push them
toward fatness. Over the past four decades, the demand for physical activity has decreased as
the abundance of food has increased.
People may overeat in response to stimuli in their surroundings—primarily, the availability
of many delectable foods. Most people in the United States find high-kcalorie foods readily
available, relatively inexpensive, heavily advertised, and reasonably tasty—thanks largely to
fast food. With around-the-clock access to rich palatable foods, we eat more and more often
than in decades past—and energy intakes have risen accordingly. Most alarming are the
extraordinarily large serving sizes and ready-to-go meals offered in supersize combinations.
People may be obese, not because they eat too much, but because they move too little—both
in purposeful exercise and in the activities of daily life. Obese people observed closely are
often seen to eat less than lean people, but they are sometimes so extraordinarily inactive that
they still manage to accumulate an energy surplus. Reducing their food intake further would
jeopardize health and incur nutrient deficiencies. Physical activity, then, is a necessary
component of nutritional health. People must be physically active if they are to eat enough
food to deliver all the nutrients needed without unhealthy weight gain.
Some aspects of the built environment, including buildings, sidewalks, and transportation
opportunities, can discourage physical activity. For example, most stairwells of modern
buildings are inconvenient, isolated, and unsafe. Roadways often lack sidewalks, crosswalks,
or lanes marked for bicycles. The air on roadways can be dangerously high in carbon
monoxide gas and other pollutants from gasoline engine emissions. Hot and cold weather
also pose hazards for outdoor commuters. In contrast, those with access to health-promoting
foods and built environments more easily make healthy choices. Safe, affordable biking and
walking areas and public exercise facilities help maintain health and body leanness.
DIFFICULTY: Bloom’s: Analyze
93. Discuss the pros and cons of gastric bypass and gastric banding surgeries for weight loss.
ANSWER: The prevalence of clinically severe obesity is increasing at an incredibly rapid rate. At this
level of obesity, lifestyle changes and modest weight losses can improve disease risks a little,
but the most effective treatment is surgery. Two procedures, gastric bypass and gastric
banding, have gained wide acceptance. Both procedures limit food intake by effectively
reducing the capacity of the stomach. In addition, gastric bypass suppresses hunger by
changing production of gastrointestinal hormones. The results are significant: depending on
the type of surgery, nearly 50 percent of the excess weight remains lost after 15 years. More
long-term studies are needed, but surgery with weight loss often brings immediate and lasting
improvements in blood lipids, diabetes, sleep apnea, heart disease, and hypertension.
Because the long-term safety and effectiveness of gastric surgery depend, in large part, on
compliance with dietary instructions, nutrition care plays an important role in follow-up
treatment. Common immediate postsurgical complications include infections, nausea,
vomiting, and dehydration; in the long term, vitamin and mineral deficiencies and
psychological problems are common. Lifelong medical supervision is necessary for those
who choose the surgical route, but in suitable candidates, the health benefits of weight loss
may prove worth the risks.
DIFFICULTY: Bloom’s: Remember
treat obesity.
94. Describe why physical activity is very important in a weight-loss program.

ANSWER: The best approach to weight management includes physical activity. Either energy restriction
or physical activity alone can produce some weight loss. Clearly, however, the combination
is most effective. People who combine diet and physical activity are more likely to lose more
fat, retain more muscle, and regain less weight than those who only diet. Even without weight
loss, physical activity may also help counteract some of the negative effects of excess body
weight on health. For example, physical activity reduces abdominal obesity, and this change
improves blood pressure, insulin resistance, and fitness of the heart and lungs, even without
weight loss. The goal is to expend as much energy as time allows; the greater the energy
deficit created by physical activity, the greater the fat loss. A word of caution, however:
people who reward themselves with high-kcalorie foods for “good behavior” can easily
negate any kcalorie deficits incurred with physical activity.
body weight.
95. Describe strategies for successful weight gain.

ANSWER: Underweight is far less prevalent than overweight, affecting about 2 percent of U.S. adults.
Whether the underweight person needs to gain weight is a question of health and, like weight
loss, a highly individual matter. People who are healthy at their present weight may stay
there; there are no compelling reasons to try to gain weight. Those who are thin because of
malnourishment or illness, however, might benefit from a diet that supports weight gain.
Medical advice can help make the distinction.
The person who wants to gain weight should use resistance training primarily. As activity is
increased, energy intake must be increased to support that activity. Eating extra food will
then support a gain of both muscle and fat.
Energy-dense foods (the very ones eliminated from a successful weight-loss diet) hold the
key to weight gain. Pick the highest-kcalorie items from each food group—that is, milk
shakes instead of fat-free milk, peanut butter instead of lean meat, avocados instead of
cucumbers, and whole-wheat muffins instead of whole-wheat bread. Because fat contains
more than twice as many kcalories per teaspoon as sugar does, fat adds kcalories without
adding much bulk.
People wanting to gain weight should eat at least three healthy meals a day. It is also
important for the underweight person to learn to eat more food at each meal: have two
sandwiches for lunch instead of one, drink milk from a larger glass, and eat cereal from a
larger bowl. Expect to feel full. Because a substantially higher energy intake is needed each
day, in addition to eating more food at each meal, it is necessary to eat more frequently.
Between-meal snacking offers a solution. Beverages provide an easy way to increase energy
intake. Consider that 6 cups of cranberry juice add almost 1000 kcalories to the day’s intake.
kCalories can be added to milk by mixing in powdered milk or packets of instant breakfast.
96. Why are fad diets appealing to a lot of people?

ANSWER: Probably the greatest appeal of some fad diets is that they tend to ignore current diet
recommendations. Foods such as meats and milk products that need to be selected carefully
to limit saturated fat can now be eaten with abandon. Whole grains, legumes, vegetables, and
fruits that should be eaten in abundance can now be bypassed. For some people, this is a
dream come true: steaks without the potatoes, ribs without the coleslaw, and meatballs
without the pasta. Who can resist the promise of weight loss while eating freely from a list of
favorite foods? Dieters are also lured into fad diets by sophisticated—yet often erroneous—
explanations of the metabolic consequences of eating certain foods. Terms such as
eicosanoids or adipokines are scattered about, often intimidating readers into believing that
the authors must be right given their brilliance in understanding the body. With over half of
our nation’s adults overweight and many more concerned about their weight, weight-loss
books and products are a $33 billion-a-year business. Even a plan that offers only minimal
weight-loss success easily attracts a following.
DIFFICULTY: Bloom’s: Evaluate
97. Summarize how you might advise someone about the steps they could take to assess their current overall weight and
health and make any necessary changes.
ANSWER: Answers to this question will vary considerably, but many students may rely on something
like the following from the text:
To enjoy good health and maintain a reasonable body weight, you need to combine sensible
eating habits and regular physical activity. This exercise allows you to evaluate your current
body weight and consider some lifestyle factors important for weight management. First,
check to see whether your current body weight falls within the “healthy weight” range, which
usually equates to a BMI range of 18.5 to 24.9. In a proper BMI table, find your height in the
left-hand column of the table and look across the row to find your weight. Alternatively, you
can calculate your BMI. What is your BMI? Does it fall within the healthy range? If your
BMI falls within the underweight, overweight, or obese range, you may want to gain or lose
weight to improve your health. Even if your BMI is within the healthy range, you may wish
to improve your eating habits or fitness level. Create your own food and activity record
(listing time, place, activity or food eaten, people present, and mood) for at least a 24-hour
period.
-Make a list of the habits that support maintaining or achieving a healthy weight. For
example, do you drink water rather than soda throughout the day and limit the time you
spend watching television or playing computer games?
-Make a list of the habits that do not support maintaining or achieving a healthy weight. For
example, do you eat when you aren’t hungry or regularly choose fast food or vending
machine food?
-What changes would you like to make in your daily habits to improve your health and
nutrition?
98. Describe how behavior and attitude modification might be useful in making different diet and exercise choices.
ANSWER: Behavior-modification therapy provides ways to overcome barriers to making dietary
changes and increasing physical activity. Behavior-modification therapy does more than help
people decide which behaviors to change: it also teaches them how to change. Behavior and
attitude are important supporting factors in achieving and maintaining appropriate body
weight and composition. Changing the behaviors of overeating and under-exercising that lead
to, and perpetuate, obesity requires time and effort. A person must commit to take action.
A person who is aware of all the behaviors that create a problem has a head start on
developing a solution. First, the person needs to establish a baseline (a record of present
eating and physical activity behaviors) against which to measure future progress. It is best to
keep a diary that includes the time and place of meals and snacks, the type and amount of
foods eaten, the persons present when food is eaten, and a description of the individual’s
feelings when eating. The diary should also record physical activities: the kind, the intensity
level, the duration, and the person’s feelings about them. These entries will help the
individual identify possible behaviors to change. Many companies have developed weight-
loss applications for smartphones and other mobile devices to help users manage their daily
food and physical activity behaviors. Applications include diet analysis tools that can track
eating habits, scanning devices that can quickly enter food data, customized activity and meal
plans that can be sent to users, and support programs that deliver encouraging messages and
helpful tips. Social media sites allow users to upload progress reports and receive texts. Using
these applications can help a person become more aware of behaviors that lead to weight
gains and losses.
Behavior modification strategies focus on learning desired eating and exercise behaviors and
eliminating unwanted behaviors. With so many possible behavior changes, a person can feel
overwhelmed. Start with small time-specific goals for each behavior—for example, “I’m
going to take a 30-minute walk after dinner every evening” instead of “I’m going to run a
marathon someday.” Practice desired behaviors until they become routine.
A paradox of making a change is that it takes belief in oneself and honoring of oneself to lay
the foundation for changing that self. That is, self-acceptance predicts success, while self-
loathing predicts failure. “Positive self-talk” is a concept worth cultivating—many people
succeed because their mental dialogue supports, rather than degrades, their efforts. Negative
thoughts (“I’m not getting thin anyway, so what is the use of continuing?”) should be viewed
in light of empirical evidence (“my starting weight: 174 pounds; today’s weight: 163
pounds”).
For many people, overeating and being overweight may have become an integral part of their
identity. Changing diet and activity behaviors without attention to a person’s self-concept
invites failure. Many people overeat to cope with the stresses of life. To break out of that
pattern, they must first identify the particular stressors that trigger their urges to overeat.
Then, when faced with these situations, they must learn to practice problem-solving skills.
When the problems that trigger the urge to overeat are dealt with in alternative ways, people
may find that they eat less. The message is that sound emotional health supports the ability to
take care of health in all ways—including nutrition, weight management, and fitness.
DIFFICULTY: Bloom’s: Analyze


body weight.
99. Why is nutritional adequacy difficult to achieve on fewer than 1200 kcalories per day?
ANSWER: Nutritional adequacy is difficult to achieve on fewer than 1200 kcalories a day, and most
healthy adults need never consume any less than that. A plan that provides an adequate intake
supports a healthier and more successful weight loss than a restrictive plan that creates
feelings of starvation and deprivation, which can lead to an irresistible urge to binge.
Such an intake would allow most people to lose weight and still meet their nutrient needs
with careful, low-kcalorie, nutrient-dense food selections. Healthy eating patterns for weight
loss should provide all of the needed nutrients in the form of fresh fruits and vegetables; low-
fat milk products or substitutes; legumes; small amounts of lean protein foods; nuts; and
whole grains. These foods are necessary for adequate protein, carbohydrate, fiber, vitamins,
and minerals and are generally associated with leanness. They are also best for managing
weight.
Wholesome, high-fiber, unprocessed or lightly processed foods offer bulk and satiety for
fewer kcalories than smooth, quickly consumed refined foods. Thus, choosing whole grains
and fiber-rich vegetables in place of most refined grains and added sugars benefits both
weight and nutrition.
Choose fats sensibly by avoiding most solid fats and including enough unsaturated oils to
support health but not so much as to oversupply kcalories. Nuts provide unsaturated fat and
protein, and people who regularly eat nuts often maintain a healthy body weight. Lean meats
or other low-fat protein sources also play important roles in weight loss and provide satiety.
Sufficient protein foods may also help to preserve lean tissue, including muscle tissue, during
weight loss.
A dietary supplement providing vitamins and minerals—especially iron and calcium for
women—at or below 100 percent of the Daily Values can help people following low-kcalorie
eating patterns to achieve nutrient adequacy. A person who plans resolutely to include all of
the foods from each group needed each day will be satisfied, be well-nourished, and have
little appetite left for high-kcalorie treats.
body weight.
100. Discuss the nuances of over-the-counter weight-loss products, both in terms of what they promise and the federal
regulatory climate.
ANSWER: Millions of people in the United States use over-the-counter (OTC) weight-loss products,
believing them to be safe. Most of the people who use such products are women, especially
young overweight women, but almost 10 percent are of normal weight. Promoters and
marketers of weight-loss products make all kinds of claims for their products with only one
intention—profit. Such claims as “eat all you want and lose weight,” “take three pills before
bedtime and watch the fat disappear,” “blocks carbs,” “blocks fat,” and many more lure
people into believing that maybe this time a product will really work.
In an investigation of OTC weight-loss pills, powders, and other “dietary supplements,” the
FDA found that an alarming number of products illegally contained prescription medications.
Strong diuretics, unproven experimental drugs, psychotropic drugs used to treat mental
illnesses, and even drugs deemed unsafe and so banned from U.S. markets were among those
discovered, and all pose serious health risks.

In their search for weight-loss magic, some consumers turn to “natural” herbal products and
dietary supplements, even though few have proved to be effective. People mistakenly believe
that “natural” herbs are not harmful to the body, but many herbs contain toxins. Belladonna
and hemlock are infamous examples, but many lesser-known herbs, such as sassafras, contain
toxins as well. Furthermore, because herbs are marketed as “dietary supplements,”
manufacturers need not present scientific evidence of their safety or effectiveness to the FDA
before marketing them. Evidence about their safety is gathered only through reports of
consumers who sicken or die after using the remedies.
A now familiar example is ephedra (also called ma huang), an herb that showed promise as a
weight-loss drug in preliminary studies. Immediately, ephedra-containing products for dieters
and athletes flooded the market. Many consumers of these products reported ill effects
including cardiac arrest, abnormal heartbeats, hypertension, strokes, and seizures; the
supplements have been linked to some deaths as well. For this reason, the FDA has banned
the sale of dietary supplements containing ephedra and its active constituent, ephedrine.
OTC weight-loss pills, powders, herbs, and other “dietary supplements” are not associated
with successful weight loss and maintenance. Anyone using dietary supplements for weight
loss should first consult a physician.
products.

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2. Genetics alone determines a person’s susceptibility to obesity.

5. Most obese people have leptin deficiency.

QUESTION TYPE: True / False

9. Health-promoting built environments may result in a healthier and leaner population.

DIFFICULTY: Bloom’s: Understand

12. The number of fat cells increases most rapidly _____.

14. Which factor is an environmental stimulus that contributes to obesity?

15. Fast food contributes to obesity because it generally provides _____.

16. The psychological desire to eat is referred to as _____.

Copyright Cengage Learning. Powered by Cognero. Page 4

DIFFICULTY: Bloom’s: Understand

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25. Weight-loss surgeries _____.

26. A major complication of weight-loss surgery can include _____.

31. Women following a weight-loss diet may need supplements of _____.

e. iron and/or herbs

QUESTION TYPE: Multiple Choice

36. As part of a sensible weight-loss plan, individuals should _____.

a. a cup of cream of chicken soup

39. Which food has the lowest energy density?

41. One benefit of physical activity is that it _____.

DIFFICULTY: Bloom’s: Understand

42. One benefit of regular physical activity on weight loss is _____.

43. Resistance training develops muscular strength, power, and _____.

49. A key to preventing weight regain is to _____.

LEARNING OBJECTIVES: NUTR.DEBR.16.7.6 - Summarize strategies for gaining weight.

57. Physical activity should be an _____ part of a weight-management program.

64. Which statement is representative of fad diets?

65. Quite simply, the key to weight loss is _____.

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DIFFICULTY: Bloom’s: Understand

68. What is the major drawback of most fad diets?

weight-loss diets based on sound nutrition.

69. Diet and health recommendations should be _____.

70. Warning signs of an unsound weight-loss program include _____.

71. The Biggest Loser Diet stresses the importance of _____.

73. adipose tissue

75. built environment

80. lipoprotein lipase

81. set-point theory

82. screen time

83. food deserts

85. obesogenic environment

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QUESTION TYPE: Matching

89. gastric bypass

90. fad diet

92. Discuss the role of environmental stimuli in the development of obesity.

94. Describe why physical activity is very important in a weight-loss program.

95. Describe strategies for successful weight gain.

96. Why are fad diets appealing to a lot of people?

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REFERENCES: 7.5 Reasonable Strategies for Weight Loss

discovered, and all pose serious health risks.

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