Putting Prevention and Treatment of Childhood Obesity in Context

1. BMI is not fool-proof but it is the agreed- upon standard for diagnosing overweight and obesity. Which of the following statements about BMI trends are true?

a) Overall, BMI has trended up in Native youth throughout the 20th century
b) Overall BMI has trended up in US all races youth in the 20th century
c) Overall BMI has trended up in you in the richest nations in the 20th century.
d) Overall BMI has trended up in youth in nations of all socioeconomic levels in the 20th century.
e) All of the above

2. According to Dr. Kurland, lifestyle changes are thought to be the causes of increased BMI in youth. Which of the following lifestyle changes were identified by Dr. Kurland?

a) less physical work/activity
b) cheap, easy availability of calories/sugar
c) food engineered to be addictive
d) upsizing, changes in perception of food
e) high fructose corn syrup, sugar in everything
f) All of the above

3. Which of the following are known factors associated with child obesity?

a) Genetics: may partially explain some group’s higher rates, ie "thrifty genotype"
b) Environment: diet, physical activity, parental/family habits, built environment, sleep, our place in human
c) History: existing in an obesogenic time in history, etc.
d) Socioeconomics: poverty + obesity tracked together may partially explain some group’s higher rates
e) All of the above

4. Which of the following are likely factors associated with child obesity?

a) ‘metabolic programming’ (in utero environment, early infancy exposure/environment)
b) epigenetics (genes turned off or on by life events/exposures then passed on in that state-think personal and historical trauma)
c) a and b

5. Which of the following were described in the presentation as thoughts to consider when working with patients and families dealing with obesity in the primary care setting?

a) Start with HUMILITY
b) Can not determine all the factors which led this patient to be obese nor understand the child’s or their parents’ experience simply by looking at a growth chart
c) Childhood obesity is bigger than this one family, one community or one country medicine does not fully understand overweight/obesity; its not just calories in/calories out
d) We don’t have great interventions; the best programs aren’t available outside a study overweight/ obesity is absolutely a risk factor but a child’s health is not their BMI
e) Obesity is heavily stigmatized both within and outside healthcare; work to be aware of your own biases and assumptions
f) Focus on healthy behaviors rather than numbers and maintain the relationship
g) All of the above

6. Motivational Interviewing is a conversational approach directed at encouraging behavior change; its origins were in treatment of alcohol and substance abuse.

a) True
b) False

7. ZYEP uses a model called Encouraging Lasting Changes through the Self-Determination Theory, which includes: Amotivation, External Regulation, Introjected Regulation, Integrated Regulation and Intrinsic Regulation.

a) True
b) False