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Chapter 9-1
Chapter 9 – Weight Management: Overweight, Obesity, and Underweight

Learning Objectives
After completing Chapter 9, the student will be able to:
9.1 Describe how body fat develops and why it can be difficult to maintain weight gains and losses.
a. Define overweight and obesity using the body mass index.
b. Explain fat cell development and its role in obesity.
c. Discuss the role of lipoprotein lipase in obesity.
d. Discuss the set point theory of obesity.
9.2 Review some of the causes of obesity.
a. Discuss the role of genetics, leptin, and ghrelin in the development of obesity.
b. Identify environmental causes of obesity.
9.3 Discuss the physical, social, and psychological consequences of overweight and obesity.
a. Explain the risks of fad diets, dietary supplements, and herbs in the treatment of obesity.
9.4 Explain the risks and benefits, if any, of aggressive ways to treat obesity.
a. Explain the drugs used to treat obesity and their side effects.
b. Discuss the risks and benefits of surgery for obesity.
9.5 Outline reasonable strategies for achieving and maintaining a healthy body weight.
a. List diet planning strategies for successful weight loss.
b. Explain the role of exercise in weight management.
9.6 Summarize strategies for gaining weight.
a. Explain weight-grain strategies.
H9 Contrast the differences between popular fad diets and weight-loss diets based on sound nutrition.
Assignments and Other Instructional Materials

The following ready-to-use assignments are available in this chapter of the instructor’s manual:
• Updated! Case Study 9-1: Low-Energy-Density Dinner
• New! Case Study 9-2: Lifestyle Changes for Weight Loss
• Worksheet 9-1: Weight Management Medications1
• Worksheet 9-2: Clinical Application—Bariatric Surgery
• New! Worksheet 9-3: Strategies to Healthier Weight (Internet Exercise)
• Worksheet 9-4: Eating Attitudes Test
• Worksheet 9-5: Exploring Eating Habits
• Worksheet 9-6: Exploring Food and Activity Choices2
• Worksheet 9-7: Evaluation of a Commercial Weight-Loss Program
• Worksheet 9-8: Chapter 9 Crossword Puzzle3
• Critical thinking questions with answers
Other instructional materials in this chapter of the instructor’s manual include:
• Answer key for How To activities
• Classroom activities, featuring snack comparison activity (9-3)
• Worksheet answer keys (as appropriate)
• Handout 9-1: Proteins Involved in Regulation of Food Intake and Energy Homeostasis
• Handout 9-2: Weight-Loss Consumer Bill of Rights (An Example)
• Handout 9-3: Selected Herbal and Other Dietary Supplements Marketed for Weight Loss
• Handout 9-4: Recommendations for a Weight-Loss Diet
• Handout 9-5: The Claims and Truths of Fad Diets
• Handout 9-6: Guidelines for Identifying Fad Diets and Other Weight-Loss Scams
1 Worksheets 9-1, 9-2, and 9-3 contributed by Daryle Wane.

2 Worksheet 9-6 and Handouts 9-1, 9-2, 9-3, 9-4, 9-5, 9-6, 9-7, and 9-8 contributed by Sharon Rady Rolfes
3 Contributed by Carrie King.
© 2016 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.
Chapter 9-2
Visit the book’s instructor companion website to download:

• Handout 9-7: Very-Low-kCalorie Diets
• Handout 9-8: How to Change Behaviors to Support Weight Loss
Glossary
Chapter Key Terms
 behavior modification: the changing of behavior by the manipulation of antecedents (cues or
environmental factors that trigger behavior), the behavior itself, and consequences (the penalties or rewards
attached to behavior).
 brite adipocytes: white fat cells with brown fat cell characteristics; also called beige adipocytes.
 brown adipose tissue: masses of specialized fat cells packed with pigmented mitochondria that produce
heat instead of ATP.
 clinically severe obesity: a BMI of 40 or greater or a BMI of 35 or greater with additional medical
problems. A less preferred term used to describe the same condition is morbid obesity.
 epidemic (ep-ih-DEM-ick): the appearance of a disease (usually infectious) or condition that attacks many
people at the same time in the same region.
o epi = upon
o demos = people
 fad diets: popular eating plans that promise quick weight loss. Most fad diets severely limit certain foods
or overemphasize others (for example, never eat potatoes or pasta, or eat cabbage soup daily).
 gene pool: all the genetic information of a population at a given time.
 ghrelin (GRELL-in): a protein produced by the stomach cells that enhances appetite and decreases energy
expenditure.
o ghre = growth
 leptin: a protein produced by fat cells under direction of the ob gene that decreases appetite and increases
energy expenditure.
o leptos = thin
 lipoprotein lipase (LPL): an enzyme that hydrolyzes triglycerides passing by in the bloodstream and
directs their parts into the cells, where they can be metabolized or reassembled for storage.
 obesogenic (oh-BES-oh-JEN-ick) environment: all the factors surrounding a person that promote weight
gain, such as increased food intake, especially of unhealthy choices, and decreased physical activity.
 set point: the point at which controls are set (for example, on a thermostat). The set-point theory that
relates to body weight proposes that the body tends to maintain a certain weight by means of its own
internal controls.
 successful weight-loss maintenance: achieving a weight loss of at least 10 percent of initial body weight
and maintaining the loss for at least 1 year.
 underweight: body weight lower than the weight range that is considered healthy; generally defined as
BMI <18.5.
 weight management: maintaining body weight in a healthy range by preventing gradual weight gains over
time and losing weight if overweight, and by preventing weight losses and gaining weight if underweight.
Chapter 9-3
Lecture Presentation Outline

Key to instructor resource annotations (shown to the right of or below outline topics):
Website = Available for download from book companion website: HN = student handout
IM = Included in this instructor’s manual: CS = case study, WS = worksheet, CA = classroom activity
Introductory/whole chapter resources: PL figure JPEGs; Test Bank; IM WS 9-8, CA 9-1
I. Overweight and Obesity (Figure 9-1)

A. Fat Cell Development – Explain how fat cells develop, including:
1. Fat cell numbers (Figure 9-2)
a. Hyperplastic obesity
b. Apoptosis
2. Fat cell size
a. Hypertrophic obesity
B. Fat Cell Metabolism – Explain fat cell metabolism, including:
1. Lipoprotein lipase
2. Gender differences
C. Set-Point Theory
II. Causes of Overweight and Obesity
A. Genetics and Epigenetics IM HN 9-1
1. Explain and discuss epigenetics
2. Leptin – Define and explain leptin (Figure 9-3)
3. Ghrelin – Discuss ghrelin
4. Uncoupling Proteins – Explain uncoupling proteins
a. White adipose tissue
b. Brown adipose tissue
B. Environment – Explain the environmental influence over obesity, including:
1. Overeating
2. Physical Inactivity
III. Problems of Overweight and Obesity
A. Health Risks – Discuss health risks associated with overweight and obesity
1. Overweight in Good Health – Overweight people who are in good health may not need to lose weight
2. Obese or Overweight with Risk Factors – Obese or overweight people with risk factors could improve
health by losing weight; risk factors include:
a. Hypertension
b. Cigarette smoking
c. High LDL
d. Low HDL
e. Impaired glucose tolerance
f. Family history of heart disease
g. Men ≥ 45 years, women ≥ 55 years
3. Obese or Overweight with Life-Threatening Condition – Obese or overweight people with the
following life-threatening-conditions may improve health by losing weight:
a. Heart disease
b. Type 2 diabetes
c. Sleep apnea
B. Perceptions and Prejudices IM CA 9-2
1. Social Consequences
a. Prejudices and discrimination
b. Judged on appearance
c. Stereotypes
Chapter 9-4
2.
Psychological Problems
a. Feelings of rejection, shame, and depression
b. Ineffective treatments can lead to a sense of failure (Figure 9-4)
C. Dangerous Interventions IM HN 9-2, 9-3
1. Fad Diets
2. Weight-Loss Products
a. Ephedrine-containing products
b. Herbal laxatives
c. Current laws do not require safety tests and effectiveness tests
3. Other Gimmicks
IV. Aggressive Treatments for Obesity
A. Drugs IM WS 9-1
1. Orlistat
2. Phentermine, diethylpropion, and phendimetrazine
B. Surgery IM WS 9-2
1. Explain who is a candidate for surgery
2. Gastric surgery (Figure 9-5)
3. Liposuction
V. Weight-Loss Strategies IM CS 9-1, 9-2, WS 9-3, HN 9-4
A. Changes, Losses, and Goals
1. Small changes
2. Moderate losses
3. Reasonable goals
B. Eating Patterns – Explain the following: Website HN 9-7
1. Be Realistic about Energy Intake (Figure 9-6)
a. 300-500 kcalories/day reduction for BMI between 27 and 35
b. 500-1000 kcalories/day reduction for BMI ≥ 35
2. Emphasize Nutritional Adequacy
3. Eat Small Portions
4. Slow Down
5. Lower Energy Density IM CA 9-3
6. Remember Water
7. Focus on Fiber
8. Choose Fats Sensibly
9. Select Carbohydrates Carefully
10. Watch for Other Empty kCalories
B. Physical Activity – Discuss the following:
1. Activity and Energy Expenditure
2. Activity and Discretionary kCalories (Figure 9-7)
3. Activity and Metabolism
4. Activity and Body Composition
5. Activity and Appetite Control
6. Activity and Psychological Benefits
7. Choosing Activities
a. Choose activities that you enjoy
b. Low to moderate intensity for long duration
c. Daily routines
8. Spot Reducing
a. Regular aerobic exercise
b. Strength training
c. Stretching
Chapter 9-5
C. Environmental Influences – Explain how the following influence activity:

1. Atmosphere
2. Accessibility
3. Socializing
4. Distractions
5. Multiple Choices
6. Package and Portion Sizes
7. Serving Containers
D. Behavior and Attitude Website HN 9-8; IM WS 9-4, 9-5, 9-6, CA 9-4
1. Behavior modification
2. Become Aware of Behaviors (Figure 9-8)
3. Change Behaviors
a. Do not grocery shop when hungry
b. Eat slowly
c. Exercise while watching television
4. Cognitive Skills
5. Personal Attitude
6. Support Groups
E. Weight Maintenance
1. Successful weight-loss maintenance
2. Vigorous exercise and careful eating plans
3. Frequent self-monitoring
F. Prevention
1. Eat regular meals and limit snacking
2. Drink water in place of high-kcalorie beverages
3. Select sensible portion sizes and limit daily energy intake to energy expended
4. Limit sedentary activities and be physically active
G. Community Programs (Table 9-4)
VI. Underweight (BMI < 18.5)
A. Problems of Underweight – Discuss the problems associated with being underweight
B. Weight-Gain Strategies
1. Energy-Dense Foods
2. Regular Meals Daily
3. Large Portions
4. Extra Snacks
5. Juice and Milk
6. Exercising to Build Muscles
VII. Highlight: The Latest and Greatest Weight-Loss Diet—Again IM CA 9-5, 9-6, WS 9-7, HN 9-5, 9-6
A. Fad Diets’ Appeal – Fad diets involve misconceptions and distortions of facts
1. Don’t Count kCalories – Fad diets often require strict elimination of certain foods
2. Follow a Plan
a. Specific instruction and examples are needed
b. Specific plans will not be helpful for long-term changes
3. The Real Deal – Healthy weight loss requires long-term changes
Case Studies
Case Study 9-1: Low-Energy-Density Dinner4
Christine C. is 49-year-old nurse who works full-time at a senior health care center. She is 65 inches tall and her
usual weight is 150 pounds. Over the past year, Christine has gained 12 pounds although she is not aware of any
major changes in her eating or exercise habits. She has set a goal to eat three balanced meals a day with no more
4 Contributed by Barbara Quinn.
Chapter 9-6
than 500 calories per meal. Christine is tired and hungry from a long day at work. She is trying to decide between
the following items for a quick and easy dinner:
Canned beef chili with beans: 1 cup (247 grams), 305 kcalories, 11 grams fat, 6 grams dietary fiber, and 18 grams
protein.
Canned lentil vegetable soup: 1 cup (205 grams), 130 kcalories, 3 grams fat, 5 grams dietary fiber, and 6 grams
protein.
Cornbread: 1 piece (78 grams), 290 kcalories, 13 grams fat, 1 gram dietary fiber, 3 grams protein.
Sprouted whole-wheat bread: 2 slices (45 grams), 100 kcalories, 2 grams fat, 5 grams dietary fiber, 6 grams protein.
1. Use the formula discussed in this chapter to calculate the energy density of the four foods Christine is
considering for dinner.
2. Based on these calculations, which two foods provide the fewest calories “per bite”? Which two provide the
most calories “per bite”?
3. How might Christine use this information about energy density to help her select a satisfying meal within her
calorie goal?
4. What are some reasonable meals that Christine could prepare from these foods that would help her stay within
her kcalorie goal? (Use at least 2 of the 4 foods listed.)
5. What other foods might Christine consider adding to these convenience foods to create a more balanced meal
that remains low in energy density?
6. How might Christine use the serving size information on the Nutrition Facts label to help her with meal
planning?
Answer Key
1. Canned beef chili with beans: 305 kcalories/247 grams= 1.23; lentil vegetable soup: 130 kcal/205 grams = 0.63;
cornbread: 290 kcal/78 grams = 3.7; sprouted wheat bread: 100 kcal/45 grams = 2.2
2. Fewest calories per bite (per gram) sprouted wheat bread and lentil vegetable soup. Most calories per bite (per
gram): cornbread and canned beef chili with beans.
3. Answers will vary. Choosing more foods of lower energy density will enable Christine to eat satisfying portions
and still limit her kcalorie intake.
4. Answers may include: lentil vegetable soup and sprouted wheat bread (230 kcalories); canned chili with beans
and sprouted wheat bread (405 kcal); lentil vegetable soup and cornbread (420 kcal).
5. Answers will vary but should include the addition of a non-starchy vegetable, whole fruit, and/or low-fat or
non-fat milk.
6. Answers will vary. It may help her to eat smaller portions and thus take in fewer kcalories; or help her
understand the importance of portion control when eating calorie-dense foods.
Chapter 9-7
Case Study 9-2: Lifestyle Changes for Weight Loss

Sally is a 43-year-old mother of two who has gained 50 pounds over the past five years. She is 64 inches tall and
weighs 180 pounds with a BMI of 30.8. Her waist circumference is 37 inches. She acknowledges that she is not as
physically active as she would like to be. She also notes how recent stresses in her life have affected her sleep and
seem to have triggered her appetite for sweets. Sally’s father recently died from complications of type 2 diabetes and
her mother and sisters are overweight. Sally says she is very motivated to “not get diabetes” and is disturbed that her
recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels.
1. Sally wonders how much of a role genetics plays in determining her weight. She has heard about a gene, called
ob, that codes for a protein that maintains homeostasis by regulating food intake and energy expenditure in
response to adipose tissue. What is the name of the protein?
a. adipocyte
b. ghrelin
c. leptin
d. obesocyte
e. insulin
2. Sally considers taking herbal supplements to help her lose weight, reasoning that because they are natural, they
must be safe. What herbal stimulant sometimes taken for weight loss has been implicated in heart attacks and
seizures and has been banned by the FDA?
a. epinephrine
b. black cohosh
c. ephedrine
d. milk thistle
e. St. John’s wort
3. Sally also considers taking medication to help her lose weight. In reading about these, she notices that the side
effects for one popular medication include GI cramping, gas, frequent bowel movements, diarrhea, and reduced
absorption of fat soluble vitamins. What medication has that profile?
a. lorcaserin hydrochloride
b. phentermine
c. diethylpropion
d. orlistat
e. phendimetrazine
4. Sally’s friend, Monique, was morbidly obese and had surgery to help her lose weight. What should Sally know
about weight loss surgery?
a. About 25% of the excess weight will remain lost after 15 years.
b. Gastric banding suppresses hunger by changing production of gastrointestinal hormones.
c. The long-term safety and effectiveness of surgery depend, in large part, on compliance with dietary
instructions.
d. Advantages of gastric banding include being more durable, reliable, and effective.
e. Advantages of gastric bypass include being more ﬂexible, less invasive, and safer.
5. Based on the considerations discussed in your text, what would a reasonable six-month weight loss goal be for
Sally?
a. 10 pounds
b. 12 pounds
c. 14 pounds
d. 18 pounds
e. 20 pounds
Chapter 9-8
6. If Sally goes on a typical weight-loss diet for women, how many kcalories will it provide per day?
a. 800
b. 900
c. 1000
d. 1100
e. 1200
7. Given her current BMI of 30.8, what should Sally’s goal for her daily kcalorie deficit be?
a. 100 to 200
b. 200 to 300
c. 300 to 500
d. 500 to 750
e. 750 to 1000
Answer Key
1. c
2. c
3. d
4. c
5. d
6. e
7. c
Suggested Classroom Activities

This chapter provides an opportunity to relax, let students share experiences about eating habits and weight control,
and address plans for weight gain or loss. The completion of Chapter 9 is a good point at which to actively plan
diets.
Classroom Activity 9-1: Debates5

Key concept: Instructor’s choice Class size: Small to medium
Instructions: Have students research and debate a controversial topic such as causes of obesity or weight-loss
strategies including dangerous interventions, aggressive treatments, and eating plans. Greater interest in such topics
is often generated by debates than by straight lectures.
Classroom Activity 9-2: Evaluating the Impact of the Media on Body Image6
Key concept: Media’s influence on body image Class size: Any
Instructions: Before class, have students bring photos of models that appear in fashion magazines that they
commonly read. Some examples of magazines include Seventeen, Self, Shape, and Redbook. For men, magazines
pertaining to body building can be examined.
Present information about the eating disorders anorexia nervosa and bulimia nervosa. Discuss how society
influences body image and fosters, through advertising, an unhealthy desire to be overly thin.
Have students analyze magazines and look for anorexic appearances that contribute to pressures to be overly thin.
Discuss the implications and the prevalence of eating disorders in our society. Discuss other ways that students
internalize pressure to have perfect bodies. Next, have students present ways that these pressures affect self-concept
and how students can achieve a realistic body image.
5 Activity provided by: Virginia A. Beal, University of Massachusetts

6 Activity provided by: Jody Yates-Taylor, Portland Community College
Chapter 9-9
Classroom Activity 9-3: Snacking with a Purpose (Snack Comparison)7

Key concepts: Energy density; meal planning for weight loss/gain Class size: Any
Instructions: Read the case scenario to students, present the high-calorie and low-calorie snack examples to them,
and then use the discussion questions to guide them in considering how the energy density of food choices can be
manipulated to promote weight gain or weight loss/maintenance.
Case scenario: You are a registered dietitian in an outpatient clinic. A mother brings her two young daughters in to
see you. One daughter is underweight and needs suggestions for high-calorie snacks to promote weight gain. The
other daughter is at a normal weight and struggles with wanting to eat snacks each time her sister does. The family is
asking for help with balancing low-calorie snack ideas with high-calorie snack ideas, using basically the same
groceries.
High-calorie snacks: Low-calorie snacks:
1 cup whole-milk yogurt mixed with ¼ cup granola 1 cup low-fat yogurt
1 smoothie (1 cup berries, fresh or frozen, blended with 1 cup berries, fresh or frozen
½ cup ice cream and 1 cup whole milk)
1 ½ cups cereal (low sugar) with 1 cup whole milk ¾ cup cereal (low sugar) with 1 cup skim milk
½ English muffin spread with 2 tablespoons peanut ½ English muffin spread with 1 tablespoon jam
butter and ½ of a mashed banana
1 medium apple with ½ cup cottage cheese 1 small apple and 1 low-fat cheese stick
1 cup trail mix (1/3 cup nuts, 1/3 cup dried fruit, 1/3 cup ¼ cup trail mix (1 tablespoon nuts, 1 tablespoon dried
cereal) fruit, 2 tablespoons cereal)
Discussion questions:
1. What additional suggestions do you have for snack ideas that use similar foods and can be modified to be higher
or lower in calories?
2. What types of beverages should be recommended to help with weight gain? And to prevent weight gain?
3. What other suggestions do you have for promoting well-balanced nutrition for each child while achieving their
weight goals?
Answer key:
1. Answers will vary.
2. For weight gain: whole or 2% milk, 100% fruit juice; possibly liquid nutrition supplements. For weight
management: skim milk, water; prefer whole fruit over drinking juice.
3. Answers will vary. Possible examples: nutrient-dense foods should be emphasized for both children; energy-
dense foods should be emphasized for the underweight child.
Energy provided by snacks for instructor reference:
High-Calorie Snack kcal Low-Calorie Snack kcal
1 cup whole-milk yogurt mixed with ¼ cup 298 1 cup low-fat yogurt 137
granola
1 smoothie (1 cup berries, fresh or frozen, 365 1 cup berries, fresh or frozen 91
blended with ½ cup ice cream and 1 cup
whole milk)
1 ½ cups cereal (low sugar) with 1 cup whole 300 ¾ cup cereal (low sugar) with 1 cup skim milk 166
milk
½ English muffin spread with 2 tablespoons 315 ½ English muffin spread with 1 tablespoon 131
peanut butter and ½ of a mashed banana jam
1 medium apple with ½ cup cottage cheese 235 1 small apple and 1 low-fat cheese stick 135
1 cup trail mix (1/3 cup nuts, 1/3 cup dried fruit, 381 ¼ cup trail mix (1 tablespoon nuts, 1 80
1
/3 cup cereal) tablespoon dried fruit, 2 tablespoons cereal)
7
Contributed by Carrie King
Chapter 9-10
Classroom Activity 9-4: Food Diary and Examination of Eating Habits

Key concept: Eating habits/behaviors Class size: Any
Materials needed: Copy of standard food record form + copy of Worksheet 9-5 for each student
Instructions: Provide a food diary form for students to fill out. Have them calculate their kcalorie intakes for the day.
To examine eating patterns and habits, have students complete Worksheet 9-5: Exploring Eating Habits. This
worksheet examines when, where, and why foods are generally eaten. After students have completed these sections,
instruct them to write changes they want to make in their food behavior patterns. Discuss the major changes that
students want to make and encourage a discussion to provide suggestions for making changes.
Classroom Activity 9-5: Evaluation of a Weight-Loss Program

Key concept: Evaluating weight-loss programs Class size: Any
Materials needed: Copy of Worksheet 9-3 for each student
Instructions: Provide students with Worksheet 9-3: Evaluation of a Commercial Weight-Loss Program. This form
covers issues related to flexibility, adaptability, variety, cost, use of special foods, nutritional soundness, and long-
term effectiveness. Instruct students to select a weight-loss program and use the form to evaluate the safety and
effectiveness of the program. Discuss different programs and their usefulness and effectiveness.
Classroom Activity 9-6: Profiling Weight-Loss Scams8

Key concept: Evaluating weight-loss programs/products Class size: Small to medium
Instructions: For this highlight activity, have students search your local area drug stores, book stores and markets for
the latest and greatest weight-loss products (scams). Such products might include diet pills, programs, books, or
magazine articles. Ask the students to select three programs (preferably a variety of the three, e.g. a book, a diet pill,
and a magazine program). Each student should outline the points promoted for the diet program product, the strong
points for the product, and the weak points. Then, following the guidelines on Handout 9-6, ask the students to write
a paper that outlines why each dietary product is either a fad diet or weight-loss scam or when appropriate, follows
the “Healthy Diet Guidelines” (10 points per area). Depending on your time in class and the size of the class, it can
be fun and informative for the students to share their findings. Design the assignment in a manner that students will
select a variety of products, books, etc., minimizing the overlap of the same products.
How To “Try It” Activities Answer Key

How to Compare Foods Based on Energy Density
The egg has an energy density of 1.56 kcal per gram, and the tuna has an energy density of 1.16 kcal per gram,
making the egg 35% more energy dense.
How to Identify a Fad Diet or Weight-Loss Scam

The student will need to locate an advertisement for a weight-loss plan to critique, state whether or not he/she
perceives it as a fad diet, and then explain the basis for this judgment. A claim that the plan is a fad diet should be
supported by examples of how the plan resembles the one described in the How to box. If the plan is ruled not to be
a fad diet, the student should point out how it follows the healthy weight-loss guidelines in the chapter.
Study Card 9 Answer Key

1. a
2. Lipoprotein lipase (LPL) is an enzyme that hydrolyzes triglycerides passing by in the bloodstream and directs
their parts into both adipose and muscle cells, where they can be metabolized or reassembled for storage. This
enzyme is a major determinant in the development of obesity. Obese people generally have much more LPL
activity in their adipose cells than lean people do (their muscle cell LPL activity is similar, though). This high
LPL activity makes fat storage especially efficient. Consequently, even modest excesses in energy intake have a
more dramatic impact on obese people than on lean people. When obese people lose weight, their LPL activity
diminishes. After weight loss is less overweight people, however, adipose LPL activity increases, predisposing
the individual to weight regain. LPL activity also helps determine the locations where body fat is stored: In
women, fat cells in the breasts, hips, and thighs produce abundant LPL, storing fat in those body sites; in men,
8 Activity provided by Kathleen Rourke.
Chapter 9-11
fat cells in the abdomen produce abundant LPL, promoting central body fat deposition. Gender differences are
also apparent in the activity of the lipase enzymes controlling the release and breakdown of fat in various parts
of the body. The release of lower-body fat is less active in women than in men, whereas the release of upper-
body fat is similar. Furthermore, the rate of fat breakdown is lower in women than in men. Consequently,
women may have a more difficult time losing fat in general, and from the hips and thighs in particular.
3. d 4. a 5. b 6. b
7. People who combine diet and exercise typically lose more fat, retain more muscle, and regain less weight than
those who only follow a weight-loss diet. Those who exercise reap important health benefits—reduced
abdominal obesity and improved blood pressure, insulin resistance, and cardiorespiratory fitness—regardless of
weight loss. Physical activity increases discretionary kcalories, allowing for a more liberal diet. Activity also
contributes to energy expenditure by speeding up metabolism both immediately and over the long term.
Physical activity, even without weight loss, changes body composition: body fat decreases and lean body mass
increases. Appetite is suppressed after a workout and satiation during a meal and satiety between meals is
enhanced. Activity also helps reduce stress, which is especially helpful for people who respond to stress with
inappropriate eating.
8. Keeping a record will help to identify eating and exercise behaviors that may need changing, raise awareness of
them, and establishes a baseline against which to measure future progress. Behavior modification strategies
focus on learning desired eating and activity behaviors and eliminating unwanted behaviors. The individual can
start with small time-specific goals for each behavior and then practice these desired behaviors until they
become routine. Successful behavior changes depend in part on two cognitive skills—problem solving and
cognitive restructuring. Problem solving skills enable a person to identify the problem, generate potential
solutions, list the pros and cons of each, implement the most feasible solution, and evaluate whether behaviors
should be continued or abandoned. Cognitive restructuring requires a person to replace negative thoughts that
derail success with positive thoughts that support behavior change. Personal attitude is important because
overeating and being overweight may have become an integral part of the person’s identity, and fully
understanding his/her personal relationships with food improves chances of successful behavior changes.
Overeating may be an adaptive measure used by overweight people to deal with stress. If so, they must first
identify the particular stressors that trigger the urge to overeat, then learn and practice problem-solving skills
that will help them to respond appropriately to these triggers, using alternative coping mechanisms.
9. c 10. c 11. d 12. d 13. d 14. b 15. b
Critical Thinking Questions9

1. How can you modify an obseogenic environment?
2. How does the presence of risk factors potentiate the development of chronic disease for the overweight
individual?
3. Describe diet planning methods that would help to increase weight loss for overweight and obese individuals.
4. Many individuals hope to lose weight in certain areas, a concept commonly known as “spot reducing.” Based
on your understanding of metabolism, is this a realistic goal?
5. Why are weight-loss accomplishments hard to define for the average individual?
6. How does being underweight affect health? What factors would contribute to an individual becoming
underweight?
Answer Key
1. An obesogenic environment represents the direct/indirect influences that affect an individual’s daily struggle
with issues that “lead us to fatness.” When considering methods that would possibly modify this type of
environment, one should reflect on a variety of potential psychological and physiological interventions.
Psychological influences affect food-related behaviors. Society is based on interactions such that food intake
patterns are learned behaviors. Food not only provides sustenance but is seen as part of social communication.
9 Contributed by Daryle Wane.
Chapter 9-12
Snacking patterns have become such a staple of social communication that they have contributed to the
formation of an obseogenic environment. By limiting snacking and/or selecting healthier snacks, one may be
able to modify this factor. Portion control coupled with healthier food choices will help to offset this type of
environment. Physiological interventions such as increased physical activity may likewise neutralize an
obseogenic environment. Addition of physical activities on a daily basis will increase energy expenditure and
divert time from sedentary pursuits (and the mindless eating that often accompanies them).
2. Individuals who are overweight are already at risk for health problems. The presence of additional risk factors
such as smoking, significant family history, gender, and age dramatically increase the likelihood of health
problems. Smoking affects the entire body, leading to altered oxygenation status and the risk of cancer. A
significant family history inclusive of medical problems such as heart disease increases the likelihood from a
genetic standpoint that the individual will develop disease. In terms of gender and age, males and females of a
certain age (above 45 and 55, respectively) are more at risk for disease. Individuals who have hypertension
and/or alterations in glucose and lipid metabolism are prone to develop disease states. Certain risk factors can
be considered to be modifiable in that the individual has some control as to their relative influence if she or he
changes her/his behavior. Other risk factors are known as non-modifiable because the individual cannot change
the effects and/or outcomes.
3. Portion control is key for successful weight loss. By using this method, one can realistically decrease caloric
consumption and build a foundation of food intake based on appropriate portion sizes. Visualization of portions
using commonly known objects such as a deck of cards for a serving of protein will help an individual to
objectively quantify food intake. Including water as a main source of fluids in the daily diet will help to increase
weight loss. In addition to decreasing the amount of food needed during a meal to achieve satiety, water
provides hydration to body cells. Limiting and/or stopping soda consumption will help to decrease empty
calories in the diet. Along with water intake, one should also increase fiber intake. Foods that are high in fiber
will also contribute to satiety as well as provide vitamins and minerals. Lastly, decreasing fat intake by making
realistic choices will help to increase weight loss. Limiting intake of high-fat processed or fast foods in the diet
is a key factor in decreasing caloric intake.
4. Although the presence of fat in certain areas of the body has some association with gender (females typically
have more fat on their hips whereas males have more fat in their stomach area), the idea of spot reducing is
problematic based on metabolism. Fat in the body is released when needed for muscular work independent of
location. Therefore, spot reducing as a concept is not realistic. Working on specific locations of the body to help
tone up muscles requires a combination of aerobic exercise, flexibility training, and strength conditioning.
5. The weight-loss business is a multibillion dollar industry that utilizes a combination of products and
psychological methods to induce weight loss. Part of the reason why weight loss accomplishments are hard to
define for the average individual is inconsistent criteria used to denote progress among these methods. There are
several factors to consider. The first is the length of time that the weight loss has been maintained. The second
is the amount of weight loss that has been achieved and maintained. Many people lose weight but are likely to
get caught up in a weight cycling pattern due to the fact that they have not really changed their eating behaviors.
Their weight loss is due in part to their participation in a method without changing their underlying behavior.
Thus, when they are no longer on the diet plan, they revert back to their prior eating patterns and gain the
weight back. Lastly, one must consider not only eating behaviors but the amount of physical exercise and
activity performed in conjunction with an eating pattern. If one does not have a balance of physical activity in
conjunction with dietary intake, then he or she will be more likely to gain weight despite an initial weight loss
due to diet.
6. An individual who is underweight may have significant health concerns, for the body will not be able to sustain
metabolism in the absence of adequate fuel sources. If the person’s food intake is inadequate, her/his body will
break down nutrient stores (if available) to fuel itself. Cellular activity in the body will be compromised, leading
to alterations in energy balance. The functions of the body will be compromised, leading to risk for infection.
Nutrient deficiencies will arise.
While decreased dietary intake is commonly the etiology for an individual becoming underweight, consumption
of food can be mediated by other factors, most notably those related to disease processes. Acute as well as
chronic disease processes can affect nutrient intake and/or metabolism. Medical treatments such as
chemotherapy and radiation can lead to significant weight loss and malnutrition. Surgical interventions as a
result of diseases affecting the digestive tract can also affect nutrient absorption and metabolism. Psychological
Chapter 9-13
problems manifesting in eating disorders can lead to an individual becoming underweight. The impact of
society on one’s perception of body image can have far-reaching effects on one’s health and well being.
IM Worksheet Answer Key

Worksheet 9-1: Weight Management Medications10
Medication Classification Clinical Indication Monitoring Aspects
Megestrol Orexigenic Treatment of metastatic breast Monitor for side effects: increased
acetate agent cancer, metastatic endometrial appetite and weight gain, swelling,
(Megace) cancer; stimulation of appetite and hyperglycemia, headache, breast
promotion of weight gain in patients tenderness, impotence, decreased
with wasting due to AIDS or cancer sexual desire, elevated blood pressure
Dronabinol Orexigenic Prevention of nausea/vomiting Monitor for interactions with alcohol
(Marinol) agent during cancer treatment; stimulation and other depressant medications;
of appetite in AIDS patients side effects: dizziness,
lightheadedness, or fainting; mental
disturbances
Phentermine Anorectic agent Acceleration of weight loss in Monitor for interactions with
(Adipex-P, overweight patients; used for a antidepressant/-anxiety medications
Ionamin) limited period of time or alcohol; monitor for need to
change insulin dosages in diabetic
patients; side effects: increased blood
pressure, heart palpitations,
restlessness, tremor, insomnia, etc.
Orlistat Lipase inhibitor Weight loss/maintenance in Monitor for improvement of blood
(Xenical, alli) overweight patients glucose in diabetic patients; monitor
for compliance with fat-restricted diet
and daily multivitamin supplement;
monitor liver function
1. FDA (Food and Drug Administration)

2. Yes
3. See “Monitoring Aspects” column of table.
4. For medications used to promote weight loss or gain, the clinician would monitor the patient’s weight, assess
body composition using appropriate techniques, and check for edema/dehydration (changes in fluid balance). If
the medication is being used to counteract wasting, a gain of weight (not attributable to fluid retention) would
indicate the medication is working. If it is being used to promote weight loss, then loss of weight at a reasonable
rate, improvement in blood lipid profile, reduction in blood pressure (for hypertensive patients), and
improvement in glycemic control (for diabetic patients) are indications that the medication is benefiting the
patient.
5. Sample pricing: Megestrol acetate = $52.99 for 100 40-mg tablets; Marinol = $441.97 for 60 2.5-mg capsules;
Adipex-P = $76.97 for 30 37.5-mg tablets; Xenical = $279.91 for 60 120-mg capsules; alli = $54.79 for “starter
pack” with 90 60-mg capsules
Worksheet 9-2: Clinical Application—Bariatric Surgery11

1. Answers will vary. An example of a reliable information source is Medline Plus
(http://www.nlm.nih.gov/medlineplus/).
10 Sources for answer key: Medline Plus: Drugs, Supplements, and Herbal Information. Accessed 4 April 2012 & 8
Nov. 2006, from: http://www.nlm.nih.gov/medlineplus/druginformation.html. Drugstore.com: Drug Information.
Accessed 4 April 2012, from: http://www.drugstore.com.
11 Source for answer key: National Institute of Diabetes & Digestive & Kidney Diseases. Weight-control
Information Network: Gastrointestinal Surgery for Severe Obesity. Accessed 4 April 2012 & 8 Nov. 2006 from:
http://win.niddk.nih.gov/publications/gastric.htm.
Chapter 9-14
2. A gastric bypass is a surgical procedure in which a route for food which bypasses the stomach, duodenum, and
part of the jejunum is created. The surgeon staples off most of the stomach to create a small pouch, and then
attaches this pouch directly to the small intestine. This results in both a restriction of the quantity of food that
can be eaten at one time and a reduction in the amount of energy-yielding and other nutrients absorbed from the
food.
3. Criteria include either (a) BMI of 40 or more (100 pounds overweight for men, or 80 pounds for women) or (b)
BMI of 35-39.9 and 1 or more serious comorbidities, plus an understanding of and willingness to comply with
the required lifestyle changes post-surgery.
4. $20,000 to $25,000
5. This depends on the patient’s state of residence and insurance provider.
6. Short term: bleeding, infection, leaks where intestines are sewn, embolism; long term: hernia, strictures,
“dumping syndrome,” anemia due to iron or vitamin B12 deficiencies, osteoporosis due to reduced calcium
absorption
7. Patients must take vitamin/mineral supplements to prevent deficiencies.
8. Most patients lose eight for 18 to 24 months after surgery, and many maintain a weight loss of 60%-70% of
their excess weight for 10 years or more. This weight loss may relieve comorbid conditions such as
hypertension, diabetes, and sleep apnea.
9. Answers will vary.
Worksheet 9-3: Strategies to Healthier Weight (Internet Exercise)

1. b 6. b
2. d 7. d
3. a
4. d
5. a
Worksheets 9-4, 9-5, 9-6, and 9-7 – Answers will vary.
Worksheet 9-8: Chapter 9 Crossword Puzzle

1. gastric bypass 5. fad diet 8. behavior 11. leptin
2. breakfast 6. set point 9. lipoprotein lipase 12. two
3. energy density 7. ghrelin 10. sixty 13. orlistat
4. modification
Chapter 9-15
Worksheet 9-1: Weight Management Medications
Medication Classification Clinical Indication Monitoring Aspects

Megestrol Orexigenic
acetate agent
(Megace)
Dronabinol Orexigenic
(Marinol) agent
Phentermine Anorectic agent

(Adipex-P,
Ionamin)
Orlistat Lipase inhibitor
(Xenical, alli)
For each of the medications listed above, look up both the clinical indications and the monitoring aspects associated
with a client taking this drug for his or her respective weight management issue.
After you have found the information, consider the following questions:
1. Which government agency is involved in the regulation of these medications?
2. Is ongoing monitoring required for the use of these medications?
3. What adverse effects could occur if a client is taking these medications?
4. How would you evaluate whether the client is improving with respect to treatment?
5. How expensive are the medications?
Chapter 9-16
Worksheet 9-2: Clinical Application—Bariatric Surgery
Consider the following scenario: Someone told you that she was considering having a “gastric bypass” and asked
you to explain to her exactly what that meant in terms of the surgical procedure and nutritional management. When
considering these questions, identify the resources that are available to people on the Internet.
1. How would you go about finding out about the surgical procedure?
2. What is meant by the term “gastric bypass”?
3. What criteria are used to determine if an individual should have this type of procedure?
4. How much does this procedure cost?
5. Will insurance cover the procedure?
6. What are the complications associated with this type of procedure?
7. What type of nutritional management will occur post procedure?
8. What will be the long-term effects of this type of procedure?
9. First, think of the answers that would be provided by a healthcare provider to a client and secondly, think of the
answers that a client might obtain independent of a healthcare provider. How would the answers differ? How
would you determine the resources’ scientific reliability and validity?
Chapter 9-17
Worksheet 9-3: Strategies to Healthier Weight (Internet Exercise)

Go to the following website to answer questions 1-6: http://www.cdc.gov/healthyweight/losing_weight/index.html.
Click on and read through, “Lose Weight,” “Getting Started” and “Improving Your Eating Habits.”
1. A weight loss of 5% does not offer any health benefits.

a. True
b. False
2. One pound is equal to ____ calories.

a. 100
b. 500
c. 1,200
d. 3,500
3. A healthy weight loss goal is to lose about one to two pounds per week.
a. True
b. False
4. Which habit is most likely to help you avoid weight gain?

a. standing while eating
b. skipping one meal a day
c. finishing what’s on your plate
d. having fruit for dessert
5. Healthy weight loss can improve general mood.

a. True
b. False
6. Setting one general goal such as, “Eat Less,” is a good strategy to weight loss.
a. True
b. False
Go to the following website to learn about portion sizes and then answer question 7:
http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000337.htm
7. Which food item portion is matched correctly with the description of its recommended size?
a. one serving of meat or poultry – tennis ball
b. one-half cup cooked rice or pasta – six dice
c. one medium apple – golf ball
d. two tablespoons of peanut butter – ping-pong ball
e. one serving cheese – rounded handful
f. one-fourth cup dried fruit or nuts – deck of cards
Chapter 9-18
Worksheet 9-4: Eating Attitudes Test

Answer these questions using the following responses:
A = Always U = Usually O = Often S = Sometimes R = Rarely N = Never
Response Score*
_____ _____ 1. I am terrified about being overweight.
_____ _____ 2. I avoid eating when I am hungry.
_____ _____ 3. I find myself preoccupied with food.
_____ _____ 4. I have gone on eating binges where I feel that I may not be able to stop.
_____ _____ 5. I cut my food into very small pieces.
_____ _____ 6. I am aware of the calorie content of the foods I eat.
_____ _____ 7. I particularly avoid foods with a high carbohydrate content.
_____ _____ 8. I feel that others would prefer if I ate more.
_____ _____ 9. I vomit after I have eaten.
_____ _____ 10. I feel extremely guilty after eating.
_____ _____ 11. I am preoccupied with a desire to be thinner.
_____ _____ 12. I think about burning up calories when I exercise.
_____ _____ 13. Other people think I am too thin.
_____ _____ 14. I am preoccupied with the thought of having fat on my body.
_____ _____ 15. I take longer than other people to eat my meals.
_____ _____ 16. I avoid foods with sugar in them.
_____ _____ 17. I eat diet foods.
_____ _____ 18. I feel that food controls my life.
_____ _____ 19. I display self-control around food.
_____ _____ 20. I feel that others pressure me to eat.
_____ _____ 21. I give too much time and thought to food.
_____ _____ 22. I feel uncomfortable after eating sweets.
_____ _____ 23. I engage in dieting behavior.
_____ _____ 24. I like my stomach to be empty.
_____ _____ 25. I enjoy trying new rich foods.
_____ _____ 26. I have the impulse to vomit after meals.
_____ Total score
*Scoring: 3 for never, 2 for rarely, 1 for sometimes, 0 for always, usually and often.
Total scores under 20 points indicate abnormal eating behavior.
Source: J. A. McSherry, Progress in the diagnosis of anorexia nervosa, Journal of the Royal Society of Health 106
(1986): 8-9. (Eating Attitudes Test developed by Dr. Paul Garfinkel.)
Chapter 9-19
Worksheet 9-5: Exploring Eating Habits
To explore your eating habits, check all the answers that describe your food intake patterns. Then, consider possible
areas for improvement.
When do I usually eat?
_______ At mealtime.
_______ While studying.
_______ While preparing meals or clearing the table.
_______ When spending time with friends.
_______ While watching TV or participating in other activities.
_______ Anytime.
Where do I usually eat?
_______ At home at the kitchen or dining room table.

_______ In the school cafeteria.
_______ In fast-food places.
_______ In front of the TV or while studying.
_______ Wherever I happen to be when I’m hungry.
Why do I usually eat?
_______ It’s time to eat.

_______ I’m hungry.
_______ Foods look tempting.
_______ Everyone else is eating.
_______ Food will get thrown away if I don’t eat it.
_______ I’m bored or frustrated.
Changes I want to make:
Source: U.S. Department of Agriculture, Dietary Guidelines and Your Health: Health Educator’s Guide to Nutrition
and Fitness (Washington, DC, US Government Printing Office, 1992).
Chapter 9-20
Worksheet 9-6: Exploring Food and Activity Choices
Does your BMI fall between 18.5 and 24.9? If so, you may want to maintain your weight. If not, you may need to
gain or lose weight to improve your fitness and health. Determine whether these food and activity choices are typical
of your lifestyle.
Food and activity choices Frequency per week
Promote weight gain:

Drink plenty of juice.
Eat energy-dense foods.
Eat large portions.
Eat peanut butter crackers between meals.
Eat three or more large meals a day.
Promote weight loss:

Drink plenty of water.
Eat nutrient-dense foods.
Eat slowly.
Eat small portions.
Limit snacks to healthful choices.
Limit television watching.
Participate in physical activity.
Select low-fat foods.
Share a restaurant meal or take home leftovers.
• On the average, do your lifestyle choices promote weight gain, weight loss, or weight maintenance?
Chapter 9-21
Worksheet 9-7: Evaluation of a Commercial Weight-Loss Program
1. Describe the food program promoted by the organization. Is the program flexible enough to allow people with
different foodways and lifestyles to use it successfully? Is it adaptable and easy to follow? Does it provide
variety? Does the program provide for weight maintenance after goal weight is achieved?
2. Describe how the plan works. Does it require substantial registration fees, mandatory purchase of various items
or foods, attendance at a minimum number of meetings?
3. Evaluate whether the plan offers a nutritionally sound way to lose weight. What characteristics make it sound or
unsound?
4. Describe any “case histories” you might overhear or learn about and your impressions of them. Do the stories
sound authentic? Do they sound as though the person’s weight loss was achieved sensibly? Do they present
facts? Do they contain any “magic bullets”?
5. Describe your overall impressions of the meeting, telling whether they were positive or negative and why. If
you had a weight problem, would you consider membership in this organization?
Chapter 9-22
Worksheet 9-8: Chapter 9 Crossword Puzzle

1
4 5
10 11
12
13
Across: Down:
2. Eating _____ is associated with maintaining a 1. Considered to be the most reliable of the weight loss
healthy weight. surgeries
3. Foods with high _____ help to promote weight gain. 4. Techniques that address behaviors associated with
7. Protein that regulates appetite losing weight (2nd word of answer; 1st word is #8)
9. Enzyme that plays a key role in the development of 5. Weight-loss plan that promises quick results and
obesity can be dangerous
12. Maximum number of pounds recommended as safe 6. Theory that the body maintains weight at a
weight loss in one week particular level, like a thermostat
13. FDA-approved drug that blocks fat absorption 8. Techniques that address behaviors associated with
losing weight (1st word of answer; 2nd word is #4)
10. DRI to prevent weight gain is moderate physical
activity for _____ minutes daily
11. Protein that regulates energy balance in response to
the level of adipose tissue
Chapter 9-23
Handout 9-1: Proteins Involved in Regulation of Food Intake

and Energy Homeostasis
Protein Concentration Secreted from Action
Adiponectin Lower in obesity Adipose tissue Increases insulin
sensitivity
Ghrelin Increases with fasting Stomach Stimulates appetite
Decreases after a meal
Lower in obesity
Leptin Higher in obesity Adipose tissue Suppresses appetite
Increases energy
expenditure
Obestatin Lower in obesity Stomach Suppresses appetite
Oxyntomodulin Increases after a meal Central nervous system Suppresses appetite
GI tract
Pancreatic peptide (PP) Increases after a meal Pancreas Suppresses appetite
PYY Lower in obesity Small intestine Suppresses appetite
Increases after a meal
Resistin Higher in obesity Adipose tissue, bone Provides short-term
marrow, and immune satiety
system cells
Opposes insulin
Visfatin Higher in obesity Adipose tissue Mimics glucose-
(specifically visceral) lowering effects of
insulin
Sources: Adapted from S. S. Gropper, J. L. Smith, and J. L. Groff, Advanced Nutrition and Human Metabolism, 5th
ed. (Belmont, Calif.: Thomson Cengage, 2009) p. 299; M. H. Rokling-Andersen and coauthors, Effects of long-term
exercise and diet intervention on plasma adipokine concentrations, American Journal of Clinical Nutrition 86
(2007): 1293–1301; H. Xie and coauthors, Insulin-like effects of visfatin on human osteoblasts, Calcified Tissue
International 80 (2007): 201–210; M. E. Shills and coauthors, Modern Nutrition in Health and Disease, 10th ed.
(Philadelphia: Lippincott Williams and Wilkins, 2006); S. Tovar and coauthors, Central administration of resistin
promots short-term satiety in rats: A review, European Journal of Endocrinology 153 (2005): R1–R5; J. Berndt and
coauthors, Plasma visfatin concentrations and fat depot-specific mRNA expression in humans, Diabetes 54 (2005):
2911–2916.
Chapter 9-24
Handout 9-2: Weight-Loss Consumer Bill of Rights (An Example)
1. Warning: Rapid weight loss may cause serious health problems. Rapid weight loss is weight loss of
more than 1½ to 2 pounds per week or weight loss of more than 1 percent of body weight per week
after the second week of participation in a weight-loss program.
2. Consult your personal physician before starting any weight-loss program.
3. Only permanent lifestyle changes, such as making healthful food choices and increasing physical
activity, promote long-term weight loss and successful maintenance.
4. Qualifications of this provider are available upon request.
5. You have a right to:

• Ask questions about the potential health risks of this program and its nutritional content,
psychological support, and educational components.
• Receive an itemized statement of the actual or estimated price of the weight-loss program,
including extra products, services, supplements, examinations, and laboratory tests.
• Know the actual or estimated duration of the program.
• Know the name, address, and qualifications of the dietitian or nutritionist who has reviewed and
approved the weight-loss program.
Chapter 9-25
Handout 9-3: Selected Herbal and Other Dietary Supplements

Marketed for Weight Loss
Product Claims Research Findings Risks
Bitter orange a (Citrus Stimulates weight loss; Little evidence available May increase blood
aurantium, a natural flavoring provides an alternative pressure; may interact with
that contains synephrine, a to ephedra drugs
compound structurally similar
to epinephrine)
Chitosan b (pronounced Binds to dietary fat, Ineffective Impaired absorption of fat-
KITE-oh-san; derived from preventing digestion soluble vitamins
chitin, the substance that and absorption
forms the hard shells of
lobsters, crabs, and other
crustaceans)
Chromium (trace mineral) Eliminates body fat Ineffective; weight gain Headaches, sleep
reported when not disturbances, and mood
accompanied by exercise swings; hexavalent form is
toxic and carcinogenic
Conjugated linoleic acid Reduces body fat and Some evidence in animal None known
(CLA; a group of fatty acids suppresses appetite studies, modest fat loss in
related to linoleic acid, but human studies
with different cis- and trans-
configurations)
Ephedrine c (amphetamine- Speeds body’s Short-term weight loss Insomnia, tremors, heart
like substance derived from metabolism and dangerous side effects attacks, strokes, and death;
the Chinese ephedra herb ma FDA has banned the sale of
huang) these products
Fucoxanthin d (derived from Speeds metabolism; No evidence available None known
seaweed) burns fat
Hoodia (derived from cactus) Suppresses appetite Little evidence available None known
Hydroxycitric acid e (active Inhibits the enzyme that Ineffective Toxicity symptoms
ingredient derived from the converts citric acid to reported in animal studies;
rind of the tropical fruit fat; suppresses appetite headaches, respiratory and
Garcinia cambogia) gastrointestinal distress in
humans
Pyruvate f (3-carbon Speeds body’s Modest weight loss with GI distress
compound produced during metabolism high doses
glycolysis)
Yohimbine (derived from the Promotes weight loss Ineffective Nervousness, insomnia,
bark of a West African tree) anxiety, dizziness, tremors,
headaches, nausea,
vomiting, hypertension
a
Marketed under the trade names Xenadrine EFX, Metabolife Ultra, NOW Diet Support.
b
Marketed under the trade names Chitorich, Exofat, Fat Breaker, Fat Blocker, Fat Magnet, Fat Trapper, and Fatsorb.
c
Marketed under the trade names Diet Fuel, Metabolife, and Nature’s Nutrition Formula One.
d
Marketed under the trade name FucoThin.
e
Marketed under the trade names Ultra Burn, Citralean, CitriMax, Citrin, Slim Life, Brindleslim, Medislim, and
Beer Belly Busters.
f
Marketed under the trade names Exercise in a Bottle, Pyruvate Punch, Pyruvate-c, and Provate.
Note: The FDA has not approved the use of any of these products; most products are used in conjunction with a
1000- to 1800-kcalorie diet.
Chapter 9-26
Handout 9-4: Recommendations for a Weight-Loss Diet

Nutrient Recommended Intake
kCalories
For people with BMI ≥35 Approximately 500 to 1000 kcalories per day
reduction from usual intake
For people with BMI between 27 and 35 Approximately 300 to 500 kcalories per day
reduction from usual intake
Total fat 30% or less of total kcalories
a
Saturated fatty acids 8 to 10% of total kcalories
Monounsaturated fatty acids Up to 15% of total kcalories
Polyunsaturated fatty acids Up to 10% of total kcalories
Cholesterol a 300 mg or less per day
b
Protein Approximately 15% of total kcalories
Carbohydrate c 55% or more of total kcalories
Sodium chloride No more than 2400 mg of sodium or approximately
6 g of sodium chloride (salt) per day
Calcium 1000 to 1500 mg per day
Fiber c 20 to 30 g per day
a
People with high blood cholesterol should aim for less than 7 percent kcalories from saturated fat and
200 milligrams of cholesterol per day.
b
Protein should be derived from plant sources and lean sources of animal protein.
c
Carbohydrates and fiber should be derived from vegetables, fruits, and whole grains.
Source: National Institutes of Health Obesity Education Initiative, The Practical Guide: Identification,
Evaluation, and Treatment of Overweight and Obesity in Adults (Washington, D.C.: U.S. Department of
Health and Human Services, 2000), p. 27.
Chapter 9-27
Handout 9-5: The Claims and Truths of Fad Diets

The Claim: You can lose weight “easily.”
The Truth: Most fad diet plans have complicated rules that require you to calculate protein
requirements, count carbohydrate grams, combine certain foods, time meal intervals,
purchase special products, plan daily menus, and measure serving sizes.
The Claim: You can lose weight by eating a specific ratio of carbohydrate, protein, and fat.
The Truth: Weight loss depends on expending more energy than you take in, not on the proportion of
energy nutrients.
The Claim: This “revolutionary diet” can “reset your genetic code.”
The Truth: You inherited your genes and cannot alter your genetic code.
The Claim: High-protein diets are popular, selling more than 20 million books, because they work.
The Truth: Weight-loss books are popular because people grasp for quick fixes and simple solutions
to their weight problems. If book sales were an indication of weight-loss success, we
would be a lean nation—but they’re not, and neither are we.
The Claim: People gain weight on low-fat diets.

The Truth: People can gain weight on low-fat diets if they overindulge in carbohydrates and proteins
while cutting fat; low-fat diets are not necessarily low-kcalorie diets. But people can also
lose weight on low-fat diets if they cut kcalories as well as fat.
The Claim: High-protein diets energize the brain.

The Truth: The brain depends on glucose for its energy; the primary dietary source of glucose is
carbohydrate, not protein.
The Claim: Thousands of people have been successful with this plan.
The Truth: Authors of fad diets have not published their research findings in scientific journals.
Success stories are anecdotal and failures are not reported.
The Claim: Carbohydrates raise blood glucose levels, triggering insulin production and fat storage.
The Truth: Insulin promotes fat storage when energy intake exceeds energy needs. Furthermore,
insulin is only one hormone involved in the complex processes of maintaining the body’s
energy balance and health.
The Claim: Eat protein and lose weight.

The Truth: For every complicated problem, there is a simple—and wrong—solution.
Chapter 9-28
Handout 9-6: Guidelines for Identifying Fad Diets

and Other Weight-Loss Scams
Fad Diets and Weight-Loss Scams Healthy Diet Guidelines
They promise dramatic, rapid weight loss. Weight loss should be gradual and not exceed 2 pounds
per week.
They promote diets that are nutritionally unbalanced Diets should provide:
or extremely low in kcalories. • A reasonable number of kcalories (not fewer than
1000 kcalories per day for women and 1200 kcalories
per day for men)
• Enough, but not too much, protein (between the RDA
and twice the RDA)
• Enough, but not too much, fat (between 20 and 35%
of daily energy intake from fat)
• Enough carbohydrates to spare protein and prevent
ketosis (at least 100 grams per day) and 20 to 30
grams of fiber from food sources
• A balanced assortment of vitamins and minerals from
a variety of foods from each of the food groups
• At least 1 liter (about 1 quart) of water daily or 1
milliliter per kcalorie daily—whichever is more
They use liquid formulas rather than foods. Foods should accommodate a person’s ethnic background,
taste preferences, and financial means.
They attempt to make clients dependent upon special Programs should teach clients how to make good choices
foods or devices. from the conventional food supply.
They fail to encourage permanent, realistic lifestyle Programs should teach physical activity plans that involve
changes. expending at least 300 kcalories a day and behavior-
modification strategies that help to correct poor eating
habits.
They misrepresent salespeople as “counselors” Even if adequately trained, such “counselors” would still
supposedly qualified to give guidance in nutrition be objectionable because of the obvious conflict of interest
and/or general health. that exists when providers profit directly from products
they recommend and sell.
They collect large sums of money at the start or Programs should be reasonably priced and run on a pay-as-
require that clients sign contracts for expensive, long- you-go basis.
term programs.
They fail to inform clients of the risks associated with They should provide information about dropout rates, the
weight loss in general or the specific program being long-term success of their clients, and possible diet side
promoted. effects.
They promote unproven or spurious weight-loss aids They should focus on nutrient-rich foods and regular
such as human chorionic gonadotropin hormone exercise.
(HCG), starch blockers, diuretics, sauna belts, body
wraps, passive exercise, ear stapling, acupuncture,
electric muscle-stimulating (EMS) devices, spirulina,
amino acid supplements (e.g., arginine, ornithine),
glucomannan, methylcellulose (a “bulking agent”),
“unique” ingredients, and so forth.
They fail to provide for weight maintenance after the They should provide a plan for weight maintenance after
program ends. successful weight loss.
Sources: Adapted from American College of Sports Medicine, ACSM’s Guidelines for Exercise Testing and
Prescription (Baltimore: Williams & Wilkins, 1995), pp. 218–219; J. T. Dwyer, Treatment of obesity: Conventional
programs and fad diets, in Obesity, ed. P. Björntorp and B. N. Brodoff (Philadelphia: J.B. Lippincott, 1992), p. 668;
National Council Against Health Fraud Newsletter, March/April 1987, National Council Against Health Fraud, Inc.
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"Too bad. I wonder if it'll carry people."
"Darling," drawled Arden, "don't you think you'd better catch your
rabbit first?"
"Not too bad a thought," agreed Don. "Walt, have you got any rabbit
traps out?"
"A couple. I've been tinkering a bit. I know we can disintegrate matter
through a power-tube of slight modification, and reintegrate it with
another. At the present state of the art, it is a mess."
"A nice mess," laughed Don. "Go ahead, though. We'll pitch in when
the going gets hard."
"That's where I stand now. The going is tough."
"What's the trouble?"
"Getting a perfect focus. I want it good enough so that we can scan a
polished sheet of steel—and it'll come out as slick as the original."
"Naturally. We'd better get Wes Farrell on the job."
"I wonder what by-product he'll get this time?"
"Look, Walt. Quit hoping. If you get this thing running right, it'll put
your name in history."
"After all," grinned Walt, "I've got to do something good enough to
make up for that Channing Layer."
"Kingman is still fuming over the Channing Layer. Sometimes I feel
sorry that I did it to him like that."
"Wasn't your fault, Don. You didn't hand him the thing knowing that
the Channing Layer would inhibit the transmission of energy. It
happened. We get power out of Sol—why shouldn't they? They
would, except for the Channing Layer."
"Wonder what your idea will do."
"About the Channing Layer? Maybe your spaceline competition is
not as good as it sounds."
"Well, they use the power-transmission tubes all over the face of the
Solar System. I can't see any reason why they couldn't ship stuff
from Sydney to Mojave and then space it out from there."
"What an itinerary! By Franks' matter transmitter to Mojave.
Spacecraft to Luna. More matter transmission from Luna to Phobos.
Then trans-shipped down to Lincoln Head, and by matter transmitter
to Canalopsis. Whoosh!"
"Do we have time to go into the old yarn about the guy who listened
in and got replicas?" asked Arden.
"That's a woman's mind for you," grinned Channing. "Always making
things complicated. Arden, my lovely but devious-minded woman,
let's wait until we have the spry beastie by the ears before we start to
make rabbit pie."
"It's not as simple as it sounds," warned Walt. "But it's there to worry
about."
"But later. I doubt that we can reason that angle out."
"I can," said Arden. "Can we tap the power beams?"
"Wonderful is the mind of woman," praised Don. "Positively
wonderful! Arden, you have earned your next fur coat. Here I've
been thinking of radio transmission all this time. No, Arden, when
you're set up for sheer energy transmission, it's strictly no dice. The
crimped up jobs we use for communications can be tapped—but not
the power transmission beams. If you can keep the gadget working
on that line, Walt, we're in and solid."
"I predict there'll be a battle. Are we shipping energy or
communications?"
"Let Kingman try and find a precedent for that. Brother Blackstone
himself would be stumped to make a ruling. We'll have to go to work
with the evidence as soon as we get a glimmer of the possibilities.
But I think we have a good chance. We can diddle up the focus, I'm
certain."
Arden glowered. "Go ahead—have your fun. I see another couple of
weeks of being a gadgeteer's widow." She looked at Walt Franks. "I
could stand it if the big lug only didn't call every tool, every part, and
every effect either she or baby!"
Walt grinned. "I'd try to keep you from being lonely, but I'm in this,
too, and besides, you're my friend's best wife."
"Shall we drag that around a bit? I think we could kill a couple of
hours with it sometime."
"Let it lie there and rot," snorted Channing cheerfully. "We'll pick it up
later. Come on, Walt. We've got work to do."
Mark Kingman glowered at the 'gram and swore under his breath.
He wondered whether he might be developing a persecution
complex; it seemed as though every time he turned around, Venus
Equilateral was in his hair, asking for something or other. And he was
not in any position to quibble about it. Kingman was smart enough to
carry his tray very level. Knowing that they were waiting for a chance
to prove that he had been connected with the late Hellion Murdoch
made him very cautious. There was no doubt in any mind that
Murdoch was written off the books, but whether Murdoch had made
a sufficiently large impression on the books of Terran Electric to have
the connection become evident—that worried Kingman.
So he swore at each telegram that came in, but quietly, and followed
each request to the letter. Compared to his former attitude toward
Venus Equilateral, Mark Kingman was behaving like an honor
student in a Sunday school.
Furthermore, behaving himself did not make him feel good.
He punched the buzzer, told his secretary to call in the shop
foreman, and then sat back and wondered about the 'gram.
He was still wondering when the man entered. Kingman looked up
and fixed his superintendent with a fishy glance. "Horman, can you
guess why the Venus Equilateral crowd would want two dozen
gauge blocks?"
"Sure. We use Johannson blocks all the time."
"Channing wants twenty-four blocks. All three inches on a side—
cubes. Square to within thirty seconds of angle, and each of the six
faces optically flat to one-quarter wave length of cadmium light."
"Whoosh!" said Horman. "I presume the three-inch dimension must
be within a half wave length?"
"They're quite lenient," said Kingman bitterly. "A full wave length!"
"White of them," grunted Horman. "I suppose the same thing
applies?"
"We're running over thin ice," said Kingman reflectively. "I can't afford
to play rough. We'll make up their blocks."
"I wonder what they want 'em for?"
"Something tricky, I'll bet."
"But what could you use two dozen gauge blocks for? All the same
size."
"Inspection standards?" asked Kingman.
"Not unless they're just being difficult. You don't put primary blocks
on any production line. You make secondary gauges for production
line use and keep a couple of primaries in the check room to try the
secondaries on. In fact, you usually have a whole set of gauge
blocks to build up to any desired dimension so that you don't have to
stock a half-million of different sizes."
"It's possible that they may be doing something extremely delicate?"
"Possible," said Horman slowly. "But not too probable. On the other
hand, I may be one hundred percent wrong. I don't know all the
different stuff a man can make, by far. My own experience indicates
that nothing like that would be needed. But that's just one man's
experience."
"Channing and that gang of roughneck scientists have been known
to make some fancy gadgets," said Kingman grudgingly.
"If you'll pardon my mentioning the subject," said Horman in a
scathing tone, "you'd have been far better off to tag along with 'em
instead of fighting 'em."
"I'll get 'em yet."
"What's it got you so far?"
"I'm not too bad off. I've come up from the Chief Legal Counsel of
Terran Electric to controlling the company."
"And Terran Electric has slid down from the topmost outfit in the
system to a seventh rater."
"We'll climb back. At any rate, I'm better off personally. You're better
off personally. In fact, everybody that had enough guts to stay with
us is better off."
"Yeah—I know. It sounds good on paper. But make a bum move
again, Kingman, and we'll all be in jail. You'd better forget that hatred
against Venus Equilateral and come down to earth."
"Well, I've been a good boy for them once. After all, I did point out
the error in their patent on the solar beam."
"That isn't all. Don't forget that Terran Electric's patent was at error,
too."
"Frankly, it was a minor error. It's one of those things that is easy to
get caught on. You know how it came about?"
"Nope. I accepted it just like everybody else. It took some outsider to
laugh at me and tell me why."
Kingman smiled. "It's easy to get into easy thinking. They took power
from Sirius—believe it or not—and then made some there-and-back
time measurements and came up with a figure that was about the
square of one hundred eighty-six thousand miles per second. But
you know that you can't square a velocity and come up with anything
that looks sensible. The square of a velocity must be some concept
like an expanding area."
"Or would it be two spots diverging along the sides of a right angle?"
queried Horman idly. "What was their final answer?"
"The velocity of light is a concept. It is based on the flexibility of
space—its physical constants, so to speak. Channing claims that the
sub-etheric radiation bands of what we have learned to call the driver
radiation propagates along some other medium than space itself. I
think they were trying to establish some mathematical relation—
which might be all right, but you can't establish that kind of relation
and hope to hold it. The square of C in meters comes out differently
than the square of C in miles, inches, or a little-used standard, the
light-second, in which the velocity of light is unity, or One. Follow?
Anyway, they made modulation equipment of some sort and
measured the velocity and came up with a finite figure which is
slightly less than the square of one hundred eighty-six thousand
miles per second. Their original idea was wrong. It was just
coincidence that the two figures came out that way. Anyway," smiled
Kingman, "I pointed it out to them and they quick changed their
patent letters. So, you see, I've been of some help."
"Nice going. Well, I'm going to make those gauges. It'll take us one
long time, too. Johannson Blocks aren't the easiest things in the
world to make."
"What would you make secondary standards out of?"
"We use glass gauges, mostly. They don't dinge or bend when
dropped—they go to pieces or not at all. We can't have a bent gauge
rejecting production parts, you know, and steel gauges can be bent.
Besides, you can grind glass to a half wave length of light with ease,
but polishing steel is another item entirely."
"I'm going to call Channing and ask him about glass blocks. It may
be that he might use them. Plus the fact that I may get an inkling of
the ultimate use. They have no production lines running on Venus
Equilateral, have they?"
"Nope. Not at all. They're not a manufacturing company."
"Well, I'm going to call."
Kingman's voice raced across Terra to Hawaii, went on the
communications beams of the sky-pointing reflectors, and rammed
through the Heaviside Layer to Luna. At the Lunar Station, his voice
was mingled in multiplex with a thousand others and placed on the
sub-ether beams to Venus Equilateral.
Don Channing answered the 'phone. "Yes?"
"Kingman, Dr. Channing."
Don grunted. He did not like to be addressed by title when someone
who disliked him did it. His friends did not; Kingman's use of the title
made it an insult.
"Look," said Kingman, "what do you want to use those blocks for?"
"We've got a job of checking dimensions."
"Nothing more? Do you need the metal for electrical reasons?"
"No," said Don, "what have you in mind?"
"Our tool shop is nicely equipped to grind glass gauges. We can do
that better than grinding Jo-blocks. Can you use glass ones?"
"Hang on a minute." Channing turned to Walt. "Kingman says his
outfit uses glass gauges. Any reason why we can't?"
"See no reason why not. I've heard of using glass gauges, and
they've got some good reasons, too. Tell him to go ahead."
"Kingman? How soon can we get glass ones?"
"Horman, how soon on the glass blocks?"
"Two dozen? About a week."
"We'll have your blocks on the way within four days, Channing. Four
days minimum, plus whatever wait is necessary to get 'em aboard a
spacer."
"We'll check from this end on schedules. We need the blocks, and if
the wait is too long, we'll send the Relay Girl in for 'em."
Don hung up and then said: "Glass ones might be a good idea. We
can check the transmission characteristics optically. I think we can
check more, quicker, than by running analysis on steel."
"Plus the fact that you can get the blocks back after test," grinned
Walt. "Once you tear into a steel block to check its insides, you've
lost your sample. I don't know any better way to check homogeneity
than by optical tests."
"O.K. Well, four days for glass blocks will do better than a couple of
months on steel blocks."
"Right. Now let's look up Wes and see what he's come up with."
They found Farrell in one of the blister laboratories, working on a
small edition of the power transmission tubes. He was not dressed in
spacesuit, and so they entered the blister and watched him work.
"Have a little trouble getting the focus to stay sharp through the
trace," complained Wes. "I can get focus of atomic proportions—the
circle of confusion is about the size of the atom nucleus, I mean—at
the axis of the tube. But the deflection of the cone of energy
produces aberration, which causes coma at the edges. The corners
of an area look fierce."
"I wonder if mechanical scanning wouldn't work better."
"Undoubtedly. You don't hope to send life, do you?"
"It would be nice—but no more fantastic than this thing is now.
What's your opinion?"
Wes loosened a set screw on the main tube anode and set the
anode forward a barely perceptible distance. He checked it with a
vernier rule and tightened the screw. He made other adjustments on
the works of the tube itself, and then motioned outside. They left the
blister, Wes closed the air-tight, and cracked the valve that let the air
out of the blister. He snapped the switch on the outside panel and
then leaned back in his chair while the cathode heated.
"With electrical scanning, you'll have curvature of field with this
gadget. That isn't too bad, I suppose, because the restorer will have
the same curvature. But you're going to scan three ways, which
means correction for the linear distance from the tube as well as the
other side deflections and their aberrations. Now if we could scan the
gadget mechanically, we'd have absolute flatness of field, perfect
focus, and so forth."
Walt grinned. "Thinking of television again? Look, bright fellows, how
do you move an assembly of mechanical parts in quanta of one
atomic diameter? They've been looking for that kind of a gadget for
centuries. Dr. Rowland and his gratings would turn over in their
graves with a contrivance that could rule lines one atom apart."
"On what?" asked Don.
"If it would rule one atom lines, brother, you could put a million lines
per inch on anything rulable with perfection, ease, eclat, and savoir
faire. You follow my argument? Or would you rather take up this slip
of my tongue and make something out of it?"
"O.K., fella, I see your point. How about that one, Wes?"
Wes Farrell grinned. "Looks like I'd better be getting perfect focus
with the electrical system here. I hadn't considered the other angle at
all, but it looks a lot tougher than I thought."
He squinted through a wall-mounted telescope at the set-up on the
inside of the blister. "She's hot," he remarked quietly, and then set to
checking the experiment. Fifteen minutes of checking, and making
notes, and he turned to the others with a smile. "Not too bad that
way," he said.
"What are you doing?"
"I've established a rather complex field. In order to correct the
aberrations, I've got non-linear focussing fields in the places where
they tend to correct for the off-axis aberrations. To correct for the
height-effect, I'm putting a variable corrector to control the whole
cone of energy, stretching it or shortening it according to the needs. I
think if I use a longer focal length I'll be able to get the thing running
right.
"That'll lessen the need for correction, too," he added, cracking the
blister-intake valve and letting the air hiss into the blister. He opened
the door and went inside, and began to adjust the electrodes. "You
know," he added over his shoulder, "we've got something here that
might bring a few dollars on the side. This matter-bank affair
produces clean, clear, and practically pure metal. You might be able
to sell some metal that was rated 'pure' and mean it."
"You mean absolutely, positively, guaranteed, uncontaminated,
unadulterated, perfectly chemically pure?" grinned Don.
"Compared to what 'chemically pure' really means, your selection of
adjectives is a masterpiece of understatement," laughed Walt.
"I'm about to make one more try," announced Wes. "Then I'm going
to drop this for the time being. I've got to get up to the machine shop
and see what they're doing with the rest of the thing."
"We'll take that over if you wish," said Don.
"Will you? I'll appreciate it. I sort of hate to let this thing go when I
feel that I'm near an answer."
"We'll do it," said Walt, definitely.
They left the laboratory and made their way to the elevator that
would lift them high into the relay station where the machine shop
was located. As they entered the elevator Don shook his head.
"What's the matter?"
"Well, friend Wes is on the beam again. If he feels that we're close to
the answer, I'll bet a hat that we're hanging right on the edge. Also,
that kind of work would kill me dead. He likes to stick on one thing till
the bitter end, no matter how long it takes. I couldn't do it."
"I know. About three days of this and you're wanting another job to
clear your mind. Then you could tackle that one for about three
hours and take back on the first."
"Trying to do that to Farrell would kill both him and the jobs," said
Don. "But you and I can keep two or three projects going strong. Oh,
well, Wes is worth a million."
"He's the best we've got," agreed Walt. "Just because he has a
peculiar slant on life is no sign he's not brilliant."
"It's you and I that have the cockeyed slant on life," grinned Don.
"And frankly, I'm proud of it." He swung the elevator door aside and
they walked down the corridor. "This isn't going to be much to see,
but we'll take a look."
The machine shop, to the man, was clustered around the one
cabinet under construction. They moved aside to permit the entry of
Channing and Franks.
"Hm-m-m," said Don. "Looks like a refrigerator and incinerator
combined."
It did. It stood five feet tall, three feet square, and was sealed in front
by a heavy door. There was a place intended for the tube that Farrell
was tinkering in the blister, and the lines to supply the power were
coiled behind the cabinet.
"Partly wired?" asked Don.
"Just the power circuits," answered Warren, "We'll have this finished
in a couple of days now. The other one is completed except for Wes
Farrell's section."
Channing nodded, and said: "Keep it going." He turned to Walt and
after the passage of a knowing glance the pair left. "Walt, this is
getting on my nerves. I want to go down to Joe's and drink myself
into a stupor which will last until they get something cogent to work
on."
"I'm with you, but what will Arden say?"
"I'm going to get Arden. Self-protection. She'd cut my feet off at the
knees if I went off on a tear without her."
"I have gathered that," grinned Walt. "You're afraid of her."
"Yeah," drawled Don. "After all—she's the cook."
"I'm waiting."
"Waiting for what?"
"If and when. If you two go on as you have for another year without
one of you turning up with a black eye, I may be tempted to go forth
and track me down a babe of my own."
The cabinet stood in the north end of Venus Equilateral but it was not
alone. It may even be the record for all times; certainly no other
cabinet three by three by five ever had twenty-seven men all
standing in a circle awaiting developments. The cabinet at the south
end of Venus Equilateral was no less popular, though the number of
watchers was less by one. Here, then, were winner and runner-up of
inanimate popularity for the ages. The communicator system set in
the walls of the two rooms carried sounds from the north room to the
south, and those sounds in the south room could be heard in the
north room. Channing grinned boyishly at Arden.
"This, my love, is a device which may make it quite possible for me
to send you back to mother."
Arden smiled serenely. "No dice," she said. "Mother went back to
grandmother last week. When is this thing going to cook?"
"Directly."
"What are we waiting for?"
"Walt."
"I'm ready," came Walt's voice through the speaker.
"About time, slowpoke."
"Really, it was not his fault," objected Wes. "I wanted to check the
scanner-synchronization."
"He's precious," chortled Arden in Don's ear. "He wouldn't think of
letting Walt, the big bum, take the blame for anything that wasn't
Walt's fault."
"That's a good line," grinned Don. "Walt's faults. After we set this
thing aside as a finished project, we'll set that 'Walt's Faults' to
music. Ready, Walt?"
"Right. I am now slipping the block into the cabinet. The door is
closed. Have you got the preliminary synchronizing signal in tick?"
Channing called: "Wait a minute, I'm lagging a whole cycle."
"Cut your synchronization input and let the thing catch up."
"O.K. Um-m-m—Now, Walt."
"Has anyone any last words to say?" asked Walt.
No answer.
"Then since no one has any objections at this time, I assume that
everything may be run off. Silence, people, we are going on the air!"
"There was a very faint odor of corn in Walt's last remark," said Don.
"I think the corn was on his breath," said Arden.
"Done!" announced Walt. "Don, crack the door so that the rest of us
can laugh if it don't work."
Channing swaggered over and opened the door. He reached inside
and took out the—object.
He held it up.
"Walt," said he, "what are you giving me?"
"Huh?"
"I presume that you shipped me one of the cubes?"
"Right."
"Well, what we got at this end would positively scare the right arm off
of a surrealist sculptor."
"Hang onto it. I'll be right up."
"Hang on to it?" laughed Don. "I'm afraid to touch it."
It was three miles from one end of Venus Equilateral to the other and
Walt made it in six minutes from the time he stepped into the little
runway car to the time he came into the north-end laboratory and
looked over Channing's shoulder at the—thing—that stood on the
table.
"Um," he said. "Sort of distorted, isn't it?"
"Quite," said Don. "This is glass. It was once a three-inch cube of
precision, polish, and beauty. It is now a combination of a circular
stairway with round corners and a sort of accordion pleat. Hell's
bells!"
"Be not discouraged," gurgled Walt. "No matter what it looks like, we
did transmit matter."
Arden tapped Don on the shoulder. "May I say it now?"
"You do—!"
"Then I won't say it doesn't matter."
"I'm ignoring your crude remark. Walt, we did accomplish something.
It wasn't too good. Now let's figure out why this thing seems to have
been run over with a fourth dimensional caterpillar-tread truck."
"Well, I can hazard a guess. The synchronizing circuits were not
clamped perfectly. That gives the accordion-pleat effect. The starting
of the trace was not made at the same place each time due to
slippage. We'll have to beef up the synchronization impulse. The
circular staircase effect was probably due to phase distortion."
"Could be," said Don. "That means we have to beef up the
transmission band so it'll carry a higher frequency."
"A lower impedance with corrective elements?"
"Might work. Those will have to be matched closely. We're not
transmitting on a line, you know. It's sheer transmission-tube stuff
from here to there. Well, gang, we've had our fun. Now let's widen
the transmission band and beef up the sync. Then we'll try number
two."
Number two was tried the following afternoon. Again, everybody
stood around and watched over Don's shoulder as he removed the
cube from the cabinet.
"Nice," he said, doing a little war dance.
Franks came in puffing, took the cube from Don's fingers and
inspected it. "Not too bad," he said.
"Perfect."
"Not by a jug full. The index of refraction is higher at this edge than
at the other. See?" Walt held the cube before a newspaper and they
squinted through the glass block.
"Seems to be. Now why?"
"Second harmonic distortion, if present, would tend to thin out one
side and thicken up the other side. A sine-wave transmission would
result in even thickness, but if second harmonic distortion is present,
the broad loops at the top create a condition where the average from
zero to top is higher than the average from zero to the other peak.
Follow?"
"That would indicate that the distortion was coming in at this end. If
both were even, they would cancel."
"Right. Your scanning at one end is regular—at the other end it is
irregular, resulting in non-homogeneity."
"The corners aren't sharp," objected Arden.
"That's an easy one. The wave-front isn't sharp either. Instead of
clipping sharply at the end of the trace, the signal tapers off. That
means higher frequency response is needed."
"We need a term. Audio for sonics; radio for electronics; video for
television signals—"
"Mateo," said Arden.
"Um—sounds sort of silly," grinned Walt.
"That's because it's strange. Mateo it is," said Don. "Our mateo
amplifier needs higher frequency response in order to follow the
square wave-front. Might put a clipper circuit in there, too."
"I think a clipper and a sharpener will do more than the higher
frequency," said Farrell. He was plying a vernier caliper, and he
added: "I'm certain of that second harmonic stuff now. The
dimension is cockeyed on this side. Tell you what, Don. I'm going to
have the index of refraction measured within an inch of its life. Then
we'll check the thing and apply some high-powered math and see if
we can come up with the percentage of distortion."
"Go ahead. Meanwhile, we'll apply the harmonic analyzer to this
thing and see what we find. If we square up the edges and make her
homogeneous, we'll be in business."
"The space lines will hate you to pieces," said Arden.
"Nope. I doubt that we could send anything very large. It might be
more bother to run a huge job than the money it costs to send it by
spacer. But we have a market for small stuff that is hard to handle in
space because of its size."
"I see no reason why Keg Johnson wouldn't go for a hunk of it,"
offered Wes Farrell.
"I've mentioned it to Keg; the last time I was in Canalopsis," said
Walt. "He wasn't too worried—provided he could buy a hunk."
"Interplanet is pretty progressive," mused Don. "There'll be no
reason why we can't make some real handy loose change out of
this. Well, let's try it again tomorrow."
"O.K. Let's break this up. Will we need any more blocks from Terran
Electric?"
It was less than a month later that a newspaper reporter caught the
advance patent notice and swallowed hard. He did a double take,
shook his head, and then read the names on the patent application
and decided that someone was not fooling. He took leave and made
the run to Venus Equilateral to interview the officials. He returned not
only with a story, but with a sample glass block that he had seen run
through the machine.
The news pushed one hatchet murder, a bank robbery, a football
upset, and three political harangues all the way back to page seven.
In terms more glowing than scientifically accurate, the matter
transmitter screamed in three-inch headlines, trailed down across
the page in smaller type, and was embellished with pictures,
diagrams, and a description of the apparatus. The latter had been
furnished by Walt Franks, and had been rewritten by the reporter
because Walt's description was too dry.
The following morning Venus Equilateral had nine rush telegrams.
Three were from cranks who wanted to go to Sirius and set up a
restorer there to take people; four were from superstitious nuts who
called Channing's attention to the fact that he was overstepping the
rights given to him by his Creator; one was from a gentleman who
had a number of ideas, all of which were based on the idea of getting
something for nothing and none of which were legal; and the last one
was a rather curt note from Terran Electric, pointing out that this
device came under the realm of the power-transmission tube and its
developments and that they wanted a legal discussion.
"Have they got a leg to stand on?" asked Walt.
"I doubt it."
"Then to the devil with them," snapped Walt. "We'll tell 'em to go
jump in the lake."
"Nope. We're going to Terra and slip them the slug. If we clip them
now, they'll have nothing to go on. If we wait till they get started,
they'll have a fighting chance. Besides, I think that all they want to do
is to have the facts brought out. Are we or are we not under the
terms of that contract?"
"Are we?"
"We're as safe as Sol. And I know it. That contract pertained to the
use of the solar beam only, plus certain other concessions pertaining
to the use of the power-transmission tubes and other basic effects as
utilized in communications."
"Why can't we tell them that?"
"It's got to be told in a court of law," said Don. "Kingman's mind runs
to legal procedure like Blackstone."
"We'll take the gadgets?"
"Right. What are you using for power?"
"What other? Solar beams, of course. We don't bother about running
stuff around any more. We plug it in the 115-volt line, it energizes the
little fellows just long enough to make them self-sustaining from Sol.
All the 115-volt line does is to act as a starting circuit."
"You and Farrell had better dream up a couple of power supplies
then. We can't use the solar beam on Terra."
"I know. We're a little ahead of you on that. Wes and one of the
Thomas boys cooked up a beam-transducer power supply that will
get its juice from any standard 115-volt, sixty-cycle line socket.
We've got two of them—and they run the things easily."
"Good. I'll 'gram Terran Electric and let 'em know we're on our way
for the legal tangle. You load up the Relay Girl and we'll be on our
way. Stock up the usual supply of bars, blocks, gadgets, and traps.
Might include a bar magnet. When we show that it is still
magnetized, we'll gain a point for sure."
"If we take a magnet, we'd better take the fluxmeter to show that the
magnetic field hasn't dropped."
"Right. Take anything you can think of for a good show. We can
knock them dead!"
Mark Kingman put his assistant legal counsel on the witness stand.
"You will state the intent of the contract signed between Terran
Electric and Venus Equilateral."
"The contract holds the following intent: 'Use of the power-
transmission tubes for communications purposes shall fall under the
jurisdiction of Venus Equilateral. For power transmission, the tubes
and associated equipment shall be under the control of Terran
Electric. In the matter of the solar beam tubes, the contract is as
follows: Venus Equilateral holds the control of the solar beam in
space, on man-made bodies in space, and upon those natural
bodies in space where Venus Equilateral requires the solar power to
maintain subsidiary relay stations.'"
"Please clarify the latter," said Kingman. "Unless it is your intent to
imply that Terra, Mars, and Mercury fall under the classification of
'places where Venus Equilateral requires power.'"
"Their control on natural celestial objects extends only to their own
installations and requirements. Basically, aside from their own power
requirements, Venus Equilateral is not authorized to sell power. In
short, the contract implies that the use of the sub-etheric phenomena
is divided so that Venus Equilateral may use this region for
communications, while Terran Electric uses the sub-ether for power.
In space, however, Venus Equilateral holds the rights to the power
beam."
Frank Tinken, head legal man of Venus Equilateral, turned to Don
and said: "We should have this in a technical court."
Don turned his attention from the long discussion of the contract and
asked: "Why not change?"
"Judges hate people who ask for changes of court. It is bad for the
requestee—and is only done when the judge's disinterest is open to
question—and also when the suspicion of dislike is less dangerous
than the judge himself."
"Well, this should be in a technical court."
"Want to chance it?"
"I think so. This is more than likely to turn up with differential
equations, physics experts, and perhaps a demonstration of atom
smashing."
Kingman finished his examination and turned away. The judge
nodded sourly at Tinken. "Cross-examination?"
Tinken faced the witness, nodded, and then faced the court.
"The witness' statements regarding the contract are true. However,
Judge Hamilton, I will attempt to show that this case is highly
technical in nature and as such falls under the jurisdiction of the
Technical Court. May I proceed?"
"Counsel for the plaintiff assures me that this is not truly a technical
case," snapped Hamilton. "However, if you can definitely prove that
the case in point hinges on purely technical matters, what you say
may be instrumental in having this hearing changed. Proceed."
"Thank you." Tinken turned to the witness. "Exactly what is the point
in question?"
"The point in question," said the witness, "is whether or not the
matter transmitter falls under Terran Electric's contract or Venus
Equilateral's contract."
"Isn't the question really a matter of whether the basic effect is
technically communication or power transmission?"
"Objection!" barked Kingman. "The counsel is leading the witness."
"Objection permitted—strike the question from the record."
"I was merely trying to bring out the technical aspect of the case,"
explained Tinken, "I'll rephrase the question. Is it not true that the
contract between Terran Electric and Venus Equilateral is based
upon a certain technology?"
"Certainly."
"Then if the case is based upon technical aspects—"
"Objection!" marked Kingman. "More than half of all manufacturing
contracts are based upon technical background. I quote the case of
Hines versus Ingall in which the subject matter was the development
of a new type of calculating machine. This case was heard in a legal
court and disposed of in the same."
"Objection permitted."
"No further examination," said Tinken. He sat down and turned to
Don, "We're in trouble. Hamilton does not like us."
"Well, we still have the whip hand."
"Right, but before we get done we'll have trouble with Hamilton."
"Before we get done, Kingman will have trouble with us," said Don.

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Understanding Nutrition 14th Edition

Whitney Solutions Manual

Understanding Nutrition 14th Edition Whitney Test Bank

Understanding Nutrition 13th Edition Whitney Solutions

Understanding Nutrition Canadian 2nd Edition Whitney

Understanding Nutrition 15th Edition Whitney Test Bank

Understanding Nutrition 3rd Edition Whitney Test Bank

Understanding Nutrition Canadian 2nd Edition Whitney

Understanding Nutrition CANADIAN Edition Canadian 1st

Nutrition Concepts and Controversies 14th Edition Sizer

Chapter 9 – Weight Management: Overweight, Obesity, and Underweight

Assignments and Other Instructional Materials

1 Worksheets 9-1, 9-2, and 9-3 contributed by Daryle Wane.

Visit the book’s instructor companion website to download:

Lecture Presentation Outline

Introductory/whole chapter resources: PL figure JPEGs; Test Bank; IM WS 9-8, CA 9-1

I. Overweight and Obesity (Figure 9-1)

C. Environmental Influences – Explain how the following influence activity:

4 Contributed by Barbara Quinn.

Case Study 9-2: Lifestyle Changes for Weight Loss

Suggested Classroom Activities

Classroom Activity 9-1: Debates5

5 Activity provided by: Virginia A. Beal, University of Massachusetts

Classroom Activity 9-3: Snacking with a Purpose (Snack Comparison)7

Classroom Activity 9-4: Food Diary and Examination of Eating Habits

Classroom Activity 9-5: Evaluation of a Weight-Loss Program

Classroom Activity 9-6: Profiling Weight-Loss Scams8

How To “Try It” Activities Answer Key

How to Identify a Fad Diet or Weight-Loss Scam

Study Card 9 Answer Key

8 Activity provided by Kathleen Rourke.

Critical Thinking Questions9

9 Contributed by Daryle Wane.

IM Worksheet Answer Key

1. FDA (Food and Drug Administration)

Worksheet 9-2: Clinical Application—Bariatric Surgery11

Worksheet 9-3: Strategies to Healthier Weight (Internet Exercise)

Worksheets 9-4, 9-5, 9-6, and 9-7 – Answers will vary.

Worksheet 9-8: Chapter 9 Crossword Puzzle

Worksheet 9-1: Weight Management Medications

Medication Classification Clinical Indication Monitoring Aspects

Phentermine Anorectic agent

1. Which government agency is involved in the regulation of these medications?

2. Is ongoing monitoring required for the use of these medications?

3. What adverse effects could occur if a client is taking these medications?

5. How expensive are the medications?

Worksheet 9-2: Clinical Application—Bariatric Surgery

2. What is meant by the term “gastric bypass”?

4. How much does this procedure cost?

5. Will insurance cover the procedure?

6. What are the complications associated with this type of procedure?

7. What type of nutritional management will occur post procedure?

8. What will be the long-term effects of this type of procedure?

Worksheet 9-3: Strategies to Healthier Weight (Internet Exercise)

1. A weight loss of 5% does not offer any health benefits.

2. One pound is equal to ____ calories.

4. Which habit is most likely to help you avoid weight gain?

5. Healthy weight loss can improve general mood.

Worksheet 9-4: Eating Attitudes Test

_____ Total score

Worksheet 9-5: Exploring Eating Habits

When do I usually eat?

Where do I usually eat?

_______ At home at the kitchen or dining room table.