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132 Chapter 9 – Weight Management: Overweight, Obesity, and Underweight Multiple Choice 1. According to body mass index values, what fraction of the U.S. adult population is considered overweight or obese? a. 1/10 b. 1/6 c. 1/3 d. 2/3 2. According to body mass index figures, what percentage of people aged 2-19 years are overweight or obese? a. 12 b. 34 c. 48 d. 68 3. Which of the following describes a trend of worldwide obesity? a. Nowadays, obesity is not seen in developing countries b. Prevalence of obesity has leveled out in the last few years in the U.S. 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 4. What is the classification of a person who is 6 feet 4 inches tall and 202 lbs? a. Underweight b. Healthy weight c. Overweight d. Obese 5. 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 6. Which of the following does NOT describe the behavior of fat cells? 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 most rapidly in late childhood and early puberty 7. Tom was overweight when he was 13. During puberty he continued to gain weight 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 8. In the quest for achieving desirable body weight, adults have control over all of the following EXCEPT a. diet. b. behavior. c. physical activity. d. adipocyte number. 9. 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 133 10. Which of the following is known to promote fat storage in adipocytes? a. Glucagon b. Lipoprotein lipase c. Cellulite synthetase d. Lipoprotein synthetase 11. 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. 12. Which of the following is a characteristic of the lipoprotein lipase enzyme? a. In men, the enzyme activity is high in abdominal fat cells b. Obese people who lose weight show markedly higher enzyme activity c. Obese people have less enzyme activity in their adipocytes than lean people do d. In women, the enzyme activity is low in fat cells within the breasts, hips, and thighs 13. 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. 14. Which of the following is NOT a feature of fat cell metabolism in men and women? a. The rate of fat breakdown is higher in women than in men b. The release of lower-body fat is more active in men than in women 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 15. 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 sexrelated 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 16. Obesity resulting from an increase in the size of fat cells is termed a. hyperplastic obesity. b. hypertrophic obesity. c. idiopenthic leptinemia. d. anaplastic hypometabolism. 17. Adverse effects on organs such as the liver from the presence of excess body fat is known as a. lipotoxicity. b. hyperplastic lipase. c. set point susceptibility. d. hyper-responsive ghrelin. 18. Hyperplastic obesity is related to a(n) 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. 19. 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. 20. 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 134 21. 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 27. 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 22. Which of the following is a characteristic of the risk for obesity? a. It is higher in fraternal than identical twins b. It is associated more with environment than genetics c. It is usually higher in people with more brown adipose tissue d. It is higher in people who have obese friends, siblings, or a spouse 28. As a new assistant in a weight-loss research laboratory, you are given a tour of the mouse 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 23. 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 24. 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 25. On which organ or tissue does leptin primarily act? a. Pancreas b. Intestines c. Adipocytes d. Hypothalamus 26. Which of the following is known to cause a reduction in fat cell number in mice? a. Injection of leptin b. Supplements of ghrelin c. Long-term resistance exercise d. Consumption of high-protein diets 29. 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 30. Which of the following is a feature of leptin? 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 31. Which of the following is a feature of ghrelin? 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 135 32. 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 33. Which of the following is a feature of ghrelin? 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 34. What serves as the body’s chief storage site for lipids? a. Yellow fat b. Brown adipose tissue c. White adipose tissue d. High-density lipoproteins 35. 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 36. 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 37. 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 38. What primarily determines a person’s susceptibility to obesity? a. Heredity only b. Environment only c. Fat content of diet d. Heredity and environment 39. 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 40. Which of the following is NOT a characteristic of food portion sizes? 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 fastfood restaurants compared with conventional eating establishments 41. 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 42. Which of the following is a feature of NEAT? a. It is the kcal expended in vigorous activity b. It is the time (minutes/day) spent in vigorous exercise c. It is about 350 kcal/day higher in lean than obese people d. It activates brown adipose tissue in response to moderate but sustained physical activity © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 136 43. Compared with non-obese people, obese people have a lower a. basal metabolic rate. b. thermic effect of food. c physical activity level. d. metabolic response to exercise. 44. 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 45. Television watching contributes to obesity for all of the following reasons EXCEPT 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. 46. To help prevent body fat gain, the DRI suggests daily, moderately intense, physical activities totaling a. 20 minutes. b. 60 minutes. c. 1 1/2 hours. d. 3 hours. 47. At any given time, approximately what percentage of all U.S. adults are attempting to lose weight? a. 10 b. 20 c. 40 d. 60 48. Aggressive treatment should be introduced in overweight people if they have which of the following risk factors? a. Hypertension only b. Cigarette smoking only c. High LDL and low HDL d. Impaired glucose tolerance only 49. Which of the following is NOT a characteristic of obese people? a. Most obese people maintain their weight losses b. Obese people often have feelings of rejection c. In many cultures, obesity is viewed as a sign of robust health d. Most weight-loss programs emphasize willpower and hard work to achieve longterm weight loss 50. 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 51. A popular eating plan that promises quick weight loss is known as a(n) a. fad diet. b. discretionary diet. c. spot reduction program. d. aggressive bariatric program. 52. Which of the following is NOT a feature of nonprescription weight-loss products? a. Few are effective b. Many are shown to be dangerous c. By law, all of them must explain the risks associated with their plans d. They lead to physical, metabolic, and psychosocial problems in their customers 53. 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 137 54. Which of the following is a feature of weightloss remedies? 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 55. Clinically severe obesity is also known as a. morbid obesity. b. metabolic syndrome. c. leptin-resistant obesity. d. psychological-resistant syndrome. 56. 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 57. The prescription drug phentermine acts by regulating the utilization of a. blood insulin. b. norepinephrine. c. hormone-sensitive lipase. d. adipocyte lipoprotein lipase. 58. 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 59. What is the primary action of orlistat, a weightloss drug? a. It reduces taste sensation b. It inhibits lipoprotein lipase c. It inhibits pancreatic lipase d. It alters circulating leptin concentrations 60. Which of the following is NOT one of the factors that meet the conditions for surgical intervention for weight loss in obese people? a. BMI of at least 40 b. Absence of psychological problems c. Ability to tolerate phendimetrazine, orlistat, or phentermine d. Failure of diet and exercise to promote acceptable weight loss 61. All of the following are characteristics of the results of weight-loss surgery EXCEPT 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. 62. Which of the following is a feature of gastric surgery for the treatment of clinically severe obesity? a. Weight regain almost never occurs 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 63. Which of the following is a characteristic of liposuction? a. It often improves blood pressure and insulin sensitivity b. The typical loss of body weight ranges from 25 to 50 lbs c. Within a year, body fat returns, primarily to the abdomen d. It is considered a valid but slightly less effective alternative to gastric bypass © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 138 64. Which of the following describes the research results regarding obese women in weight-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 65. 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. 1 year. 66. 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. 10% body weight/month 67. What minimum amount of body weight loss (lbs) is shown to improve physical capabilities and quality of life? a. 5-10 b. 20-25 c. 35-40 d. 55-60 68. Which of the following is NOT a sensible guideline for diet plans? 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 69. 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 70. 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 71. 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 24hour energy intakes than breakfast eaters 72. Which of the following would be most effective at lowering energy intake in a person on a weight reduction program? a. Decrease portion sizes 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 73. The feeling of satiety from weight-loss diets is best achieved by diets rich in a. long-chain fats only. b. short-chain fats only. c. simple carbohydrates. d. complex carbohydrates. 74. 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 75. 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 139 76. 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. 77. Which of the following describes a connection between physical activity and energy 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 78. 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 79. A person who weighs 150 lbs. and walks at a pace of 3 miles/hr expends about how many kcalories in that hour? a. 115 b. 270 c. 410 d. 850 80. 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 81. A typical person who burns 200 kcalories during a 2-mile run would, in the postexercise period, burn an additional a. 30 kcalories. b. 75 kcalories. c. 150 kcalories. d. 300 kcalories. 82. 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 83. Which of the following is NOT a feature of the adaptive response to regular physical exercise? 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 84. 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. Cost is lower b. Boredom is reduced c. Compliance is better d. Monitoring time is diminished © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 140 85. 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 86. Approximately how many kcalories are expended per kilogram body weight when walking a mile at a moderate pace? a. 0.1 b. 1 c. 2.5 d. 5 87. Approximately how many kcalories per week should be expended in physical activity in order to maintain a weight loss? a. 2000 b. 4000 c. 6000 d. 9000 88. Which of the following does NOT represent a common environmental influence on eating 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 89. Which of the following is NOT a common behavior modification for losing weight? 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 90. 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 91. Which of the following is NOT a feature of the effect of food accessibility on food intake? 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 92. Which of the following is NOT an association between the environment and food intake? 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 93. 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. 94. 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 141 95. Approximately what percentage of overweight people in the United States have NOT been successful at maintaining ≥10% weight loss for ≥1 year? a. 5 b. 25 c. 55 d. 85 96. Which of the following is generally NOT a strategy associated with successful weight loss efforts? a. Eating breakfast b. Weighing yourself infrequently c. Consulting a support person or group d. Limiting television viewing time to <10 hrs/week 97. 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 98. Approximately what percentage of overweight people who intentionally lose weight are able to maintain at least a 10% weight loss for at least one year? a. 5 b. 17 c. 50 d. 85 99. To qualify for successful weight-loss maintenance, a 200-pound person who intentionally lost 20 lbs must hold the loss for at least a. 3 months. b. 6 months. c. 1 year. d. 2 years. 100. 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. 101. Approximately what percentage of U.S. adults are classified as underweight? a. 0.2 b. 2 c. 5 d. 10 102. The classification of underweight is achieved when the BMI first drops below a. 14. b. 18.5. c. 20. d. 22.5. 103. 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 104. Of the following, which is NOT among the recommended strategies for weight gain in an 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 105. All of the following are meal-planning strategies for underweight people who desire to 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. 106. Which of the following would NOT be part of a successful program of weight gain in an 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 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 142 107. Fad diets often produce weight loss, at least initially, because 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. 108. 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 109. 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.” c. “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.” d. “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.” Matching 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Percentage of U.S. adults considered overweight or obese An enzyme that promotes fat storage A term that describes environmental influences that promote weight gain A theory that the body tends to maintain a certain weight by internal controls Substitution of positive, supportive thoughts for negative, self-defeating thoughts Hormone that regulates appetite in response to body fat levels Hormone that stimulates appetite Name of a low-fat diet Type of adipose that primarily stores fat Type of adipose that primarily produces heat Percentage of nonprescription weight-loss product users in the United States who are at a normal weight Substance in some herbs that may cause heart attacks and seizures Name of a high-fat diet Surgical procedure on the stomach Inhibitor of pancreatic lipase Minimum BMI of a clinically severe obese person A cosmetic surgical procedure Safe rate of weight loss, in pounds per week Recommended minimum number of minutes per day of moderately intense physical activity to prevent weight gain 20. Percentage of U.S. adults classified as underweight A. B. C. D. E. F. G. 1 2 10 40 60 68 Leptin H. I. J. K. L. M. N. Orlistat Ghrelin Atkins Set point White fat Ornish Brown fat O. P. Q. R. S. T. Ephedrine Liposuction Bypass Lipoprotein lipase Cognitive restructuring Obesogenic © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 143 Essay 1. Summarize the trends in overweight and obesity in the United States and worldwide. 2. Discuss differences in fat cell metabolism between males and females. 3. Explain the role of lipoprotein lipase enzyme in fat cell metabolism. 4. Explain the set point theory of weight change. 5. Discuss the role of genetics and epigenetics in promoting excess weight gain and in discouraging weight loss. 6. List the major factors involved in obesity. Which ones can be controlled by dietary changes or behavior modification? 7. Discuss the roles of leptin and ghrelin in the regulation of food intake and energy storage. 8. Discuss the interactive roles of leptin and ghrelin in food intake control. 9. Explain the significance and models of action of uncoupling reactions in energy metabolism. 10. Explain the association between ghrelin secretion and sleep. 11. Contrast the metabolic roles of white adipose tissue and brown adipose tissue. 12. Discuss the meaning and significance of the term “obesogenic environment.” 13. Explain the factors involved in the promotion of obesity by high-fat diets and food portion sizes. 14. Discuss the role of the restaurant industry in promoting excess food consumption. 15. Discuss the various factors related to the role of insufficient physical activity in energy balance. 16. What is “nonexercise activity thermogenesis” and what role does it play in energy balance regulation? 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. 18. Describe psychological problems encountered by obese people in their attempts to lose weight. 19. Explain the attraction of unsound weight-loss procedures and plans to obese people. 20. List several factors that help identify inappropriate, unsound, and possibly dangerous commercial weight-loss programs. 21. Outline several weight-loss strategies that are considered dangerous. 22. Discuss the use of prescription drugs for the treatment of obesity, including modes of action and adverse side effects. 23. Discuss the safety and efficacy of liposuction as a means of body fat reduction. 24. Describe the approaches for weight loss by surgery. What are the benefits and what are the adverse side effects of these procedures? 25. In obese people, what are the physical and metabolic advantages from as little as a 5- to 10-lb loss of weight? 26. Describe a good weight-reduction diet in relation to energy content, meal size, carbohydrate and fat levels, and water intake. 27. Outline the recommendations for a successful weight-loss diet. 28. What are the findings from studies of people on weight-loss diets who skip meals? 29. Discuss ways in which an increase in the water content of the diet plays an important role in body weight management. 30. Explain the role of fiber in assisting weight loss. © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 144 31. What are the results of research studies concerning the importance of low-energy-dense diets in weightreduction regimes? 32. Discuss the importance of carbohydrate selection and of sugar alternatives in a weight-loss program. 33. Describe the benefits of regular physical activity as an aid to weight-loss dieting. 34. Explain the relationship of physical activity and appetite control. 35. Explain what is meant by “spot reducing” and discuss its effectiveness in altering body fat content. 36. Describe the effects of socializing during meal times on quantity of food consumed. 37. Provide an explanation for the higher food consumption of people who eat in the presence of others. 38. Discuss the role of environmental influences on food intake. 39. How do package sizes and serving containers influence food intake? 40. Explain the role of behavior modification in weight reduction programs. 41. Why is cognitive behavior therapy an effective approach in helping overweight smokers? 42. Discuss the reasons why formerly overweight people may require less energy intake to maintain body weight than their counterparts who were never overweight. 43. List 5 strategies common to people who have beers successful at maintaining their weight loss. 44. Present a sound diet plan for weight gain in the underweight person. 45. Why are fad diets so popular? 46. Compare and contrast the theory, strong points, and weak points of the Atkins diet with those of the Ornish diet. 47. List 5 guidelines each for identifying a fad diet and a healthy diet. Answer Key (ANS = correct answer, REF = page reference, DIF = difficulty, OBJ = learning objective) Multiple Choice 1. ANS: d 2. ANS: b 3. ANS: b 4. ANS: b 5. ANS: b 6. ANS: a 7. ANS: a 8. ANS: d 9. ANS: c 10. ANS: b 11. ANS: b 12. ANS: a 13. ANS: b 14. ANS: a 15. ANS: c 16. ANS: b 17. ANS: a 18. ANS: d 19. ANS: a 20. ANS: d 21. ANS: a 22. ANS: d 23. ANS: b REF: 262 REF: 262 REF: 262 REF: 263 REF: 262 REF: 262 REF: 262 REF: 262 REF: 262 REF: 262 REF: 262 REF: 262-263 REF: 262-263 REF: 262-263 REF: 262-263 REF: 262 REF: 262 REF: 262 REF: 262 REF: 263 REF: 263 REF: 264|266 REF: 264 DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.1 OBJ: 9.2 OBJ: 9.2 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 145 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. 74. 75. 76. 77. 78. 79. ANS: d ANS: d ANS: a ANS: c ANS: b ANS: c ANS: b ANS: b ANS: a ANS: d ANS: c ANS: a ANS: c ANS: a ANS: d ANS: a ANS: c ANS: d ANS: c ANS: c ANS: b ANS: c ANS: b ANS: d ANS: c ANS: a ANS: b ANS: a ANS: c ANS: c ANS: a ANS: a ANS: d ANS: b ANS: d ANS: c ANS: c ANS: d ANS: d ANS: c ANS: b ANS: c ANS: a ANS: a ANS: b ANS: c ANS: c ANS: c ANS: b ANS: d ANS: b ANS: d ANS: b ANS: a ANS: a ANS: b REF: 264 REF: 264 REF: 264 REF: 265 REF: 264-265 REF: 264-265 REF: 264 REF: 265 REF: 265 REF: 265 REF: 266 REF: 265-266 REF: 266 REF: 266 REF: 266 REF: 266 REF: 267 REF: 266 REF: 267 REF: 267 REF: 267 REF: 267 REF: 267 REF: 268 REF: 268 REF: 269 REF: 269 REF: 269 REF: 269-270 REF: 269-270 REF: 270 REF: 270 REF: 270-271 REF: 271 REF: 271 REF: 271 REF: 271 REF: 271 REF: 271-272 REF: 271 REF: 273 REF: 273 REF: 273 REF: 273 REF: 274-277|284 REF: 274 REF: 276 REF: 274 REF: 274-275 REF: 275-276 REF: 275 REF: 274-278 REF: 275-278 REF: 278|280 REF: 277 REF: 278|279 DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Application-level OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 146 80. ANS: a 81. ANS: a 82. ANS: c 83. ANS: b 84. ANS: c 85. ANS: a 86. ANS: b 87. ANS: a 88. ANS: d 89. ANS: d 90. ANS: a 91. ANS: d 92. ANS: a 93. ANS: b 94. ANS: c 95. ANS: d 96. ANS: b 97. ANS: c 98. ANS: b 99. ANS: c 100. ANS: c 101. ANS: b 102. ANS: b 103. ANS: a 104. ANS: c 105. ANS: c 106. ANS: c 107. ANS: d 108. ANS: b 109. ANS: b REF: 279 REF: 279 REF: 279 REF: 279 REF: 279 REF: 280 REF: 279 REF: 279 REF: 280 REF: 281 REF: 281-282 REF: 280 REF: 280-281 REF: 281 REF: 282 REF: 283 REF: 284 REF: 284 REF: 283 REF: 283 REF: 284 REF: 285 REF: 285 REF: 286 REF: 286 REF: 286 REF: 286 REF: 294 REF: 294 REF: 295 DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level DIF: Application-level DIF: Application-level DIF: Application-level DIF: Knowledge-level DIF: Knowledge-level DIF: Application-level OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.6 OBJ: 9.6 OBJ: 9.6 OBJ: 9.6 OBJ: 9.6 OBJ: 9.6 OBJ: 9.7 OBJ: 9.7 OBJ: 9.7 Matching 1. ANS: F 2. ANS: R 3. ANS: T 4. ANS: K 5. ANS: S 6. ANS: G 7. ANS: I 8. ANS: M 9. ANS: L 10. ANS: N 11. ANS: C 12. ANS: O 13. ANS: J 14. ANS: Q 15. ANS: H 16. ANS: D 17. ANS: P 18. ANS: A 19. ANS: E 20. ANS: B REF: 262 REF: 262|263 REF: 266 REF: 263 REF: 282 REF: 264 REF: 265 REF: 293 REF: 266 REF: 266 REF: 269 REF: 269-270 REF: 292 REF: 272 REF: 271 REF: 270 REF: 271 REF: 273 REF: 267 REF: 285 DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level OBJ: 9.1 OBJ: 9.1 OBJ: 9.2 OBJ: 9.1 OBJ: 9.5 OBJ: 9.2 OBJ: 9.2 OBJ: 9.7 OBJ: 9.2 OBJ: 9.2 OBJ: 9.3 OBJ: 9.3 OBJ: 9.7 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.5 OBJ: 9.2 OBJ: 9.6 DIF: Knowledge-level DIF: Knowledge-level OBJ: 9.1 OBJ: 9.1 Essay 1. REF: 261-262 2. REF: 262-263 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use. 147 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. REF: 262-263 REF: 263 REF: 264-266 REF: 262-268 REF: 264-265 REF: 264-265 REF: 265-266 REF: 265 REF: 265-266 REF: 266-267 REF: 266-267 REF: 266-267 REF: 267 REF: 267 REF: 268 REF: 269 REF: 269-270 REF: 269-270|295 REF: 269-270 REF: 270-271 REF: 271 REF: 271-272 REF: 273 REF: 274-277 REF: 274-277 REF: 274 REF: 275-276 REF: 275-276 REF: 275-276 REF: 277 REF: 277-279 REF: 279 REF: 280 REF: 280 REF: 280 REF: 280-281 REF: 281 REF: 281-283 REF: 282 REF: 283-284 REF: 284 REF: 286 REF: 292-294 REF: 292-293|294 REF: 294-295 DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level DIF: Knowledge-level OBJ: 9.1 OBJ: 9.1 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.2 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3 OBJ: 9.3|9.7 OBJ: 9.3 OBJ: 9.4 OBJ: 9.4 OBJ: 9.4 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.5 OBJ: 9.6 OBJ: 9.7 OBJ: 9.7 OBJ: 9.7 © 2013 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a license distributed with a certain product or service or otherwise on a password-protected website for classroom use.