Insel10ebrup Ppt Ch11

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Weight Management

Chapter 11

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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

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

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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

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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

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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

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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 pounds1. Multiply weight (in pounds) by 704

– 150 X 704 =105,600

2. Multiply height (in inches) by height (in inches)– 66 X 66 = 4,356

3. 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

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Body Composition Analysis

• Hydrostatic (underwater) weighing– Most accurate

• Skinfold measurements– Thickness of fat under the skin

• Electrical Impedance Analysis– Electricity prefers lean tissue

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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

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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

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Body Image

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

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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 Triad1. Abnormal eating patterns

2. Amenorrhea

3. Decreased bone density

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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

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Lifestyle Factors

• Eating

• Physical Activity

• Psychosocial factors– Emotions– Coping strategies

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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

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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

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Physical Activity and Exercise

• 30 minutes or more of moderate-intensity physical activity, everyday– Walking– Gardening– Housework– Walking 1 mile in 15-20 minutes

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Thinking and Emotions

• What do you think of yourself?

• Self-esteem

• Negative emotions

• Ideal self

• Beliefs and attitudes you hold

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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

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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

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Weight-Loss Programs

• Noncommercial– TOPS, and OA

• Commercial

• Online

• Clinical

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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.

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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.

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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

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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

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Eating Disorders• Anorexia NervosaAnorexia 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

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Eating Disorders• Bulimia NervosaBulimia 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

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Eating Disorders

• Binge-EatingBinge-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

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Treating Eating Disorders• Address both eating disorder, misuse of

food and manage emotions– Anorexia Nervosa– Bulimia Nervosa– Binge-Eating

• Today’s Challenge


Weight Management

Chapter 11

Insel10ebrup Ppt Ch11

Education

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