Module 8 Obesity and Eating Disorders PDF

Pathophysiology of Obesity: Obesity is characterized by excessive fat accumulation due to a chronic imbalance between energy intake and expenditure. Adipose tissue (both white and brown) becomes dysregulated, resulting in increased adipocyte size (hypertrophy) and number...

Pathophysiology of Obesity: Obesity is characterized by excessive fat accumulation due to a chronic imbalance between energy intake and expenditure. Adipose tissue (both white and brown) becomes dysregulated, resulting in increased adipocyte size (hypertrophy) and number (hyperplasia), which promotes insulin resistance (IR), chronic inflammation, and metabolic disorders like type 2 diabetes (T2DM). Hormonal imbalances involving leptin resistance (reduced sensitivity to the satiety hormone) and ghrelin dysregulation (increased hunger) further exacerbate weight gain. High levels of cortisol due to stress and poor sleep patterns can increase abdominal fat. Microbiome disruption and gut dysbiosis are linked to metabolic endotoxemia, which promotes insulin resistance and weight gain. Strategies for Reducing Obesity: 1. Dietary Changes: o Implementing a calorie deficit of 500-750 kcal/day. o Emphasize low glycemic index (GI) and high-fiber diets with adequate protein. o Avoid processed foods, sugars, artificial sweeteners, and refined carbs. o Support gut health through a high-fiber diet (40-50 g/day) and probiotics. o Meal timing: Time-restricted feeding (TRF) and early dinner. 2. Exercise: o Daily moderate-intensity exercise increases insulin sensitivity and activates AMPK, promoting fat burning. 3. Sleep and Stress Management: o Adequate sleep supports glucose tolerance and balances ghrelin and leptin levels. o Reduce stress to lower cortisol and avoid stress-related overeating. Nutrients and Supplements for Obesity: 1. 5-HTP: 50-100 mg twice daily to enhance satiety and promote sleep. 2. Green Tea Extract (EGCG): 600-900 mg daily to promote thermogenesis and fat oxidation. 3. L-Carnitine: Up to 2000 mg daily to support fat metabolism and improve leptin resistance. 4. Conjugated Linoleic Acid (CLA): Up to 3.4 g daily to enhance fat oxidation and improve insulin sensitivity. 5. Chromium Picolinate: 200-1000 mcg daily to reduce carbohydrate cravings and support glucose metabolism. 6. Gymnema Sylvestre: 100 mg three times daily to regulate blood glucose and reduce sugar cravings. Summary of Eating Disorders: Types and Pathophysiology of Eating Disorders: 1. Anorexia Nervosa (AN): o Characterized by extreme calorie restriction, fear of weight gain, and distorted body image. o Leads to nutrient deficiencies, muscle atrophy, low body temperature, and hormonal imbalances (e.g., low serotonin and estrogen). o Long-term starvation can result in electrolyte imbalances, osteopenia, and cardiovascular complications. 2. Bulimia Nervosa (BN): o Involves binge eating followed by compensatory behaviors like purging, laxative abuse, or excessive exercise. o Results in erratic weight changes, tooth erosion, sore throat, and gastrointestinal issues. o BN is linked to acute tryptophan depletion, which reduces serotonin levels and increases the urge to binge. 3. Binge Eating Disorder (BED): o Similar to BN, but without compensatory behaviors. o Characterized by eating large amounts of food in a short period, often triggered by stress, food deprivation, or emotional distress. o Associated with obesity and psychological distress. Strategies, Nutrients, and Supplements for Eating Disorders: 1. Protein and Tryptophan: o Increase tryptophan-rich foods or supplements to enhance serotonin levels and reduce binge urges. Protein supplementation may accelerate recovery. 2. Zinc: 14-45 mg daily to support weight gain in AN and improve anxiety and depression. 3. Inositol: 18 g/day for BN and BED to improve serotonin receptor sensitivity and reduce binge episodes. 4. B Vitamins: To support neurotransmitter synthesis and improve mood regulation. 5. Probiotics: Use Lactobacillus strains to improve digestion and immune function during recovery. Flashcards: Flashcard 1 Question: What is obesity? Answer: Obesity is the excessive accumulation of fat, defined as a BMI over 30, which poses a risk to health. Flashcard 2 Question: What hormone is associated with satiety but becomes resistant in obesity? Answer: Leptin. Flashcard 3 Question: What hormone increases hunger, especially in those with poor sleep? Answer: Ghrelin. Flashcard 4 Question: How does the microbiome affect obesity? Answer: Gut dysbiosis can lead to metabolic endotoxemia, disrupting insulin signaling and promoting fat storage. Flashcard 5 Question: What is a key strategy for improving insulin sensitivity in obesity? Answer: Regular moderate exercise increases insulin sensitivity and reduces fat accumulation. Flashcard 6 Question: What is the recommended daily dose of L-carnitine for fat metabolism? Answer: Up to 2000 mg daily. Flashcard 7 Question: What supplement improves fat oxidation and reduces cravings for carbohydrates? Answer: Chromium picolinate (200-1000 mcg/day). Flashcard 8 Question: What role does green tea play in weight loss? Answer: Green tea polyphenols, especially EGCG, promote thermogenesis and fat oxidation. Flashcard 9 Question: How does sleep deprivation contribute to obesity? Answer: It disrupts the balance of ghrelin and leptin, promoting hunger and weight gain. Flashcard 10 Question: What eating disorder involves binge eating without compensatory behaviors? Answer: Binge Eating Disorder (BED). Flashcard 11 Question: What eating disorder is characterized by extreme fear of gaining weight and caloric restriction? Answer: Anorexia Nervosa (AN). Flashcard 12 Question: What nutrient is crucial for weight gain in Anorexia Nervosa? Answer: Zinc supplementation is crucial, recommended at 14 mg daily. Flashcard 13 Question: What neurotransmitter is depleted during acute tryptophan depletion, increasing binge urges? Answer: Serotonin. Flashcard 14 Question: What is the primary compensatory behavior seen in Bulimia Nervosa? Answer: Purging, including vomiting or laxative abuse. Flashcard 15 Question: How does protein intake affect recovery in Bulimia Nervosa? Answer: Protein-rich supplements aid in recovery by increasing satiety and reducing binge urges. Flashcard 16 Question: What are common nutrient deficiencies in Anorexia Nervosa? Answer: Deficiencies include zinc, magnesium, B vitamins, and omega-3 fatty acids. Flashcard 17 Question: What supplement can reduce binge episodes in Bulimia Nervosa and BED? Answer: Inositol (18 g/day). Flashcard 18 Question: What triggers binge eating in Binge Eating Disorder? Answer: Stress, food deprivation, and fluctuations in serotonin levels. Flashcard 19 Question: What strategy helps reduce binge urges in Bulimia Nervosa and BED? Answer: Eating regular meals to prevent blood sugar fluctuations. Flashcard 20 Question: What hormone, produced in adipose tissue, regulates energy homeostasis but becomes dysregulated in obesity? Answer: Leptin. Flashcard 21 Question: What supplement can be used to improve glucose metabolism and reduce cravings for sweets? Answer: Gymnema Sylvestre (100 mg 3 times daily). Flashcard 22 Question: What is the role of cortisol in obesity? Answer: Chronic high cortisol levels promote abdominal fat deposition and stress-related overeating. Flashcard 23 Question: What is refeeding syndrome, and how does it affect anorexic patients? Answer: Refeeding syndrome occurs when malnourished patients rapidly reintroduce food, leading to fluid imbalances and potential cardiovascular complications. Flashcard 24 Question: What natural remedy can reduce body shame and promote self-acceptance in patients with eating disorders? Answer: Crab Apple (Bach flower remedy). Flashcard 25 Question: What is the suggested supplement dose of CLA (Conjugated Linoleic Acid) for fat loss? Answer: Up to 3.4 g daily. Flashcard 26 Question: What neurotransmitter is associated with increased appetite when its levels are low in stress-related obesity? Answer: Dopamine. Flashcard 27 Question: What are the core symptoms of Anorexia Nervosa? Answer: Extreme calorie restriction, distorted body image, and fear of weight gain. Flashcard 28 Question: What is a typical behavioral symptom in Bulimia Nervosa? Answer: Binge eating followed by self-induced vomiting or purging. Flashcard 29 Question: What is the primary aim of nutritional therapy in Anorexia Nervosa? Answer: To reintroduce a diverse range of foods and correct nutrient deficiencies. Flashcard 30 Question: How can clients identify binge triggers in Binge Eating Disorder? Answer: By keeping a food, symptom, and emotional diary to track triggers.