Weight Management

1. Weight Management Chapter 11

2. Introduction • National Institutes of Health • 66% of American adults are overweight • Including more than 32% who are obese • 2030 • Estimated that the entire American adult population will be overweight or obese

3. Prevalence of overweight and obesity among Americans(Figure 11-1)

4. Basic Concepts • 1 pound of fat = 3500 calories • Body Composition • Lean Body Mass • Body Fat • Essential fat 3-5% of total fat in men, 8-12% in women • Nonessential fat-(storage) –Located just below the skin • Depends on many factors: • Gender • Age • Heredity • Metabolism • Diet activity level • Women: <8% at risk, Average 23%, > 32% at risk • Men: < 5% at risk, Average 15%, > 25% at risk

5. Energy Balance • Crucial to keep a healthy ratio of fat and lean body mass • Energy • Consumption and/or expenditure of calories • Control over intake of calories • Negative energy balance • Positive energy balance • Neutral energy balance

7. Evaluating Body Weight and Body Composition • Percent body fat and distribution of body fat = weather a change on body composition would improve health. • Overweight –above recommended range for good health • Obesity – a more serious degree of overweight • Height-Weight charts • Body Mass Index (BMI) • Weight in pounds X 703 / Height in inches (squared) • Body Composition

8. Body Mass Index (BMI) • National Institutes of Health • Under 18.5 is classified underweight • Between 18.5 and 24.9 is healthy • Greater than 25 is overweight • Greater than 30 is obese • Measurement. Example: 5’6” tall, 150 pounds • Multiply weight (in pounds) by 704 • 150 X 704 =105,600 • Multiply height (in inches) by height (in inches) • 66 X 66 = 4,356 • Divide the answer in step 1 by the answer in step 2 to obtain a value for BMI • BMI = 105,600 / 4,356 = 24.2

10. Body Composition Analysis • Hydrostatic (underwater) weighing • Most accurate • Skinfold measurements • Thickness of fat under the skin • Electrical Impedance Analysis • Electricity prefers lean tissue

11. The Health Risks of Excess Body Fat • Obese individuals have a mortality rate twice that of non-obese • Reduces life expectancy by 10-20 years • Associated with: Unhealthy cholesterol and triglycerides, impaired heart function, and death from cardiovascular disease • Other health factors: hypertension, cancer, impaired immune function, gallbladder and kidney disease, skin problems, impotence, sleep disorder back pain, arthritis • Strong association – Type II diabetes

12. Body Fat Distribution and Health • Apples • Upper regions of their bodies • Increase risk of high blood pressure, diabetes, early-onset heart disease, stroke, and cancer • Pears • Fat storage in the hips, buttocks and thighs • Assessed by measuring waist circumference • Risk if total waist measurement is more than 40 inches for men and 35 inches for women

13. Body Image • Collective picture of the body as seen through the mind’s eye. • Perceptions • Images • Thoughts • Attitudes • Emotions

14. Problems Associated with Very Low Levels of Body Fat • Less than 8-12% for women and less than 3-5% for men. • Extreme has been linked to problems with: • Reproductive • Circulatory • Immune system disorders • Female Athlete Triad • Abnormal eating patterns • Amenorrhea • Decreased bone density

15. Factors Contributing To Excess Body Fat • Genetic Factors • 25 to 40% of an individual’s body fat • 300 genes have been linked to obesity • Physiological Factors • Metabolism (RMR) • Hormones • Fat Cells • Carbohydrate Craving

16. Lifestyle Factors • Eating • Physical Activity • Psychosocial factors • Emotions • Coping strategies

17. Adopting A Healthy Lifestyle For Successful Weight Management • Diet and Eating Habits • Total Calories • MyPyramid suggestions • Best approach for weight loss is combining an increase of exercise with moderate calorie restriction • Do not go on a crash diet

18. Adopting A Healthy Lifestyle For Successful Weight Management (Continued) • Portion Sizes • Energy (calorie) Density • Fat Calories • Carbohydrates • Simple Sugars and Refined Carbohydrates • Protein • Eating Habits

19. Physical Activity and Exercise • 30 minutes or more of moderate-intensity physical activity, everyday • Walking • Gardening • Housework • Walking 1 mile in 15-20 minutes

20. Thinking and Emotions • What do you think of yourself? • Self-esteem • Negative emotions • Ideal self • Beliefs and attitudes you hold

21. Coping Strategies • Adequate and appropriate strategies • Healthy lifestyles and proper stress management techniques will naturally and easily result in a reasonable body weight • Good nutrition • Good communication • Adequate exercise • Positive thinking and emotions • Effective coping strategies and behavior patterns

22. Approaches to Overcoming A Weight Problem • Doing it yourself • 0.5-2.0 pounds per week • Initial weight loss from fluids. • Very low calorie diets need to be avoided. • Diet Books: • Reject books with gimmicks or rotating levels of calories. • Diet Supplements and Diet Aids • Formula drinks and food bars • Herbal • Dietary supplements

23. Weight-Loss Programs • Noncommercial • TOPS, and OA • Commercial • Online • Clinical

24. Prescription Drug • Appetite Suppressants • Produce a 5-15% weight reduction by controlling appetite. • Once drugs are stopped most return to original heavy weight. • Good option for very obese who need help getting started - permanent life style change.

25. Surgery • Severely obese - BMI of 40 or higher or are 100 pounds or more over recommended weight. • Roux-en-Y-gastric bypass • Vertical banded gastroplasty (VBG) • Liposuction • Weight loss from surgery generally ranges between 40% and 70% of total body weight over a years time.

26. Body Image • Severe body image problems • Body dysmorphic disorder (BDD) • Knowing when the limits to healthy change have been reached. • Knowing the unrealistic cultural ideal. • Acceptance and change • Can-do attitude

27. Eating Disorders • Problems with body weight and weight control. • 0.5-2.0% of Americans suffer from anorexia and have bulimia • 10% of college-aged women • Binge eating disorder may affect 2-5%of all adults and 8% of those who are obese • Over 1 Million Americans develop anorexia or bulimia each year - 90% are female. • 60% of binge-eating are female

28. Eating Disorders • Anorexia Nervosa - Failure to eat enough food to maintain a reasonable body weight. • Affects 3 million people – 95% are female • Characteristics • Fear gaining weight. • Distorted self-image. • Compulsive behaviors and rituals. • Excessive exercise • Health Risks of Anorexia Nervosa • Stop menstruation • Intolerant of cold • Low blood pressure and heart rate • Dry skin • Hands and feet may swell and take on a blue tinge • Depression and suicide • Medical complications • Disorders of the cardiovascular, gastrointestinal, endocrine, and skeletal systems

29. Eating Disorders • Bulimia Nervosa - recurring episodes of binge eating followed by purging. • Begins in adolescence or young adulthood • Increasingly younger (11-12 years) and older (40-60 years) ages. • Characteristics: • Rapidly consumes food, then purges. • Done in secret. • After a binge - feels ashamed, disgusted and physically and emotional drained. • Health Risks: • Erodes tooth enamel • Deficient calorie intake • Liver and kidney damage • Cardiac arrhythmia • Chronic hoarseness • Esophageal tearing • Rupture of the stomach • Menstrual problems • Increased depression

30. Eating Disorders • Binge-Eating - Similar to Bulimia except no Purging behavior. • Eating patterns - very rapid, eating until uncomfortably full. • Often eat as a way of coping. • Likely to be obese. • High rates of depression and anxiety

31. Treating Eating Disorders • Address both eating disorder, misuse of food and manage emotions • Anorexia Nervosa • Bulimia Nervosa • Binge-Eating • Today’s Challenge

32. Weight Management Chapter 11