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Weight Management

This chapter presents an overview of weight management, emphasizing the alarming prevalence of overweight and obesity in American adults, projected to reach 66% by 2030. It explores fundamental concepts such as body composition, energy balance, and the implications of excessive body fat on health. Tools like Body Mass Index (BMI) and body composition analysis are discussed to evaluate weight status. The chapter also covers the importance of diet, physical activity, and emotional health in effective weight management, highlighting strategies for adopting a healthier lifestyle.

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Weight Management

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  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

  6. 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

  7. 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

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

  9. 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

  10. 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

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

  12. 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

  13. 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

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

  15. 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

  16. 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

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

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

  19. 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

  20. 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

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

  22. 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.

  23. 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.

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

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

  30. Weight Management Chapter 11

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