Weight Management

Weight Management Chapter Seven

Current Trends • The National Institutes of Health reports the following: • About 67% of American adults are overweight • More than 33% of American adults are obese • The number of obese adults more than doubled between 1971 and 2006 • By 2015, 75% of adults will be overweight and 41% will be obese • Controlling body weight is really a matter of controlling body fat • Managing body weight is not a mysterious process, even though it is not fully understood by many people • The “secret” is balancing calories consumed with calories expended in daily activities

Weight of Americans Age 20 and Older(Table 9.1) Percent Percent Group Overweight Obese Both sexes 66.7 33.4 All races, male 72.1 32.4 All races, female 61.3 34.3 White, male 71.8 32.9 White, female 57.9 31.6 African American, male 71.6 35.9 African American, female 79.8 53.4 Latino, male 75.8 29.5 Latino, female 73.9 41.8 Percent of poverty level Below 100%: 65.7 35.0 100%–less than 200%: 66.5 35.9 200% or greater: 66.8 32.3 SOURCE: National Center for Health Statistics. 2008. Health, United States, 2008, with Special Feature on the Health of Young Adults. Hyattsville, Md.: National Center for Health Statistics.

Health Implications of Overweight and Obesity • As rates increased in the United States, so has the prevalence of health conditions, including: • CVD • Hypertension • Certain forms of cancer • Type II diabetes • Premature deaths • Moderate weight loss can have a significant positive impact on health • A weight loss of just 5-10% can reduce the risk of these conditions in obese individuals

Factors Contributing to Excess Body Fat • Genetic Factors • Physiological Factors • Metabolism and energy balance • RMR • Hormones • Lifestyle Factors • Eating • Physical activity • Psychosocial factors • Binge eating

Adopting a Healthy Lifestyle for Successful Weight Management • Diet and Eating habits • Total calories • Portion sizes • Energy (calorie) density • Fat, protein, and carbohydrate amounts • Eating habits • Physical activity and exercise • Thoughts and emotions • Self-talk • Coping strategies Permanent weight loss is not something you start and stop. You need to adopt healthy behaviors.

Approaches to Overcoming a Weight Problem • Doing it yourself • Diet books • Dietary supplements and diet aids • Dietary supplements (can be dangerous and/or ineffective) • Formula drinks and food bars (long-term weight loss unlikely) • Herbal supplements (can be dangerous and/or ineffective) • Other supplements (can be dangerous and/or ineffective) • Weight-loss programs • Non-commercial programs • Commercial Weight-loss programs • Online Weight-loss Programs • Clinical Weight-loss Programs • Prescription drugs • Surgery • Psychological help

Body Image • Body image is the mental representation a person holds about her or his body • It consists of perceptions, images, thoughts, attitudes, and emotions • A negative body image is characterized by dissatisfaction with body in general or some part of the body in particular • Different cultures have different ideas of the “ideal” body type

Severe Body Image Problems • Poor body image can cause significant psychological distress • Body dysmorphic disorder (BDD) is: • Related to obsessive-compulsive disorder • Can lead to depression, social phobia, and suicide • Treated with medication and psychotherapy • Muscle dysmorphia is a disorder experienced by people who perceive themselves as having small, underdeveloped muscles despite being very muscular • Acceptance and change: Know the limits of healthy change and don’t measure self-worth on appearance

Eating Disorders • An eating disorder is a serious disturbance in eating pattern or behavior, characterized by a negative body image and concerns about body weight or body fat • Major types of eating disorders: • Anorexia nervosa • Bulimia nervosa • Binge-eating disorder • Eating disorders affect about 10 million American females and 1 million males

Anorexia Nervosa • Anorexia nervosa is an eating disorder characterized by a refusal to maintain body weight at a minimally healthy level and an intense fear of gaining weight or becoming fat • Affects 1% of Americans, or about 3 million Americans, 95% being female • Typically develops between ages 12 and 18 • Based on a distorted body image • Consequences result in severe medical complications, including death

Bulimia Nervosa • Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating and purging: Overeating and then using compensatory behaviors such as vomiting and excessive exercise to prevent weight gain • Begins in adolescence (11-12 years) or older (40-60 years) • Research suggests that about 5% of college-age women have bulimia • During a binge, a person may rapidly consume thousands of calories. • Binge-purge cycle places tremendous stress on the body

Binge-Eating Disorder • Binge-eating disorder is an eating disorder characterized by uncontrollable eating without any compensatory purging behavior • Affects about 2% of American adults • Common eating patterns are: • Eating very rapidly • Eating until uncomfortably full • Eating when not hungry • Eating alone • This is usually followed by feelings of guilt, shame, and depression

Treating Eating Disorders • Must address both problematic eating behaviors and the misuse of food to manage stress and emotions • Averting a medical crisis by restoring adequate body weight • Dealing with psychological aspects • Stabilizing eating habits • Changing behavior patterns and thoughts • Possibly involving medication and/or hospitalization For more suggestions, see the box “If Someone You Know Has an Eating Disorder”

Creating an Individual Weight-Management Plan • Assess your motivation and commitment • Set reasonable goals • Assess your current energy balance • Increase your level of physical activity • Make changes in your diet and eating habits • Put your plan into action • Write daily • Get others to help • Think positively

Chapter Nine Weight Management

Weight Management