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Nu fsp chapters 10 and 11 weight control

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  • 1. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Chapter 10 Weight Control
  • 2. Obesity • United States – Rate of obesity increasing over past 30 years – 2 out of 3 adults are overweight or obese – Extreme obesity increasing at alarming rates • 1 in 200 in 1986 • 1 in 50 today – Overweight and obesity increasing rapidly in children • About 25% will be overweight or obese by 2015
  • 3. Body Mass Index • A height to weight ratio – Body weight in KG ÷ (Height in meters)² – Body weight in lbs x 705 ÷ (Height in inches)² • Normal BMI = 18.5 – 25.0
  • 4. What are the values and limitations of the BMI? • Value – A screening device for both underweight and obesity, both of which may be related to health problems – May be a useful guide to body weight for the average individual • Limitations – Does not evaluate body composition • Some classified as overweight may have low body fat • Some classified as normal weight may have excess fat
  • 5. Underwater weighing • Hydrodensitometry • Based on Archimedes’ principle – Buoyancy of water displacement • Previously was the gold standard • SEM is about 2.0 - 2.5%
  • 6. Air Displacement Plethysmography (APD) • Based on air displacement • Advantages over underwater weighing • Reliable method in testing same subject over time
  • 7. Skinfolds technique • Measure of subcutaneous fat – Skinfold calipers – Ultrasound • SEM about 3-4% • Use population-specific formulae • Good practical method • Used by NCAA for wrestlers
  • 8. Dual Energy X-ray Absorptiometry (DXA;DEXA) • Computerized X-ray • Concurrent measures – Bone mineral – Body mat – Fat-free mass • Some contend it is the criterion method • Others – Computed tomography – Magnetic resonance imaging
  • 9. Body composition • Other methods – Bioelectrical impedance analysis – Infrared interactance – Anthropometry • Regional fat distribution • Waist circumference – Multicomponent models • Use combination of methods • Some consider it the new gold standard
  • 10. Body mass index • Screening for health • Some classify a BMI of 35 or 40 as morbid obesity BMI Health Risks < 18.5 May signal malnutrition or serious disease 18.5-24.9 Healthy weight range that carries little health risk 25-25.9 Overweight; at increased risk for health problems, especially if you have one or two weight-related medical conditions Above 30 Obesity, more than 20 percent over healthy body weight; poses high risk to your health
  • 11. Body fat percentage • Recommendations for health /performance vary
  • 12. What is the cause of obesity? • The simple answer – Energy intake exceeds energy expenditure • The difficult answer – Involves a complex interplay of both genetic and environmental factors
  • 13. Possible health problems associated with overweight an obesity • Asthma • Cancer • Cardiovascular disease • Diabetes (type 2) • Dyslipidaemia • Gallstones • Gastrointestinal reflux • Gout • Hypertension • Insulin resistance • Low self-image and self-esteem • Osteoarthritis • Respiratory dysfunction • Sleep apnea • Social disabilities • Stroke • Vertebral disk herniation
  • 14. How does location of body fat affect health? • Regional fat distribution – Android-type obesity • Abdominal region • Visceral fat – Gynoid-type obesity • Gluteal-femoral region • Hips, buttocks, thighs
  • 15. Weight-loss Dietary Supplements • Numerous over-the-counter (OTC) products – Lose 30 Pounds in 30 Days • Most OTC weight-loss supplements do not appear to be effective • More research needed with some – Pyruvate and CLA • Some herbals may be dangerous – Ephedra – Others associated with liver damage
  • 16. Very-Low-Calorie Diets (VLCDs) • Modified fasts – < 800 Calories per day – May be successful under medical supervision – Used as a first step in weight-loss programs • Possible problems – Weakness Constipation – Loss of libido Decreased HDL – Decreased blood volume Cardiac arrhythmias • Best when coupled with lifestyle changes
  • 17. What are the major eating disorders? • Disordered eating – Less severe than full fledged Eating Disorders – American Psychiatric Association (APA) • Eating Disorders Not Otherwise Specified (EDNOS) – Purging disorders • Eating disorders (APA) – Anorexia nervosa (AN) – Bulimia nervosa (BN) – Binge eating disorder (BED)
  • 18. Anorexia nervosa (AN) • Compulsive personality disorder – Not completely understood • Strong genetic predisposition – Identical and fraternal twin studies – Genes may be linked to appetite control
  • 19. APA Criteria for Anorexia nervosa • Refusal to maintain body weight over a minimal normal weight for age and height • An intense fear of gaining weight or becoming fat, even though underweight • A disturbance in the way one’s body weight or shape is perceived • Amenorrhea, or the absence of at least three consecutive menstrual cycles in normally menstruating females.
  • 20. Anorexia nervosa • Prevalence is relatively low – Primarily females under the age of 25 – 1% or less of the general population – As high as 2% in college students • Strong genetic predisposition – Identical and fraternal twin studies • Chronic low self-esteem • Serious medical consequences – Anemia – Decreased heart mass – High risk for suicide
  • 21. Anorexia nervosa • Therapy for AN may require hospitalization and intensive psychiatric treatment for both the patient and family • The outcome for females with AN has changed little over the past 50 years • Mortality is high – AN with lowest body weight at highest risk
  • 22. APA Criteria for Bulimia nervosa (BN) • Recurrent episodes of binge eating, at least two per week for 3 months. • Lack of control over eating during the binge. • Regular use of self-induced vomiting, laxatives, diuretics, fasting, or excessive exercise to control body weight. • Persistent concern with body weight and body shape. Diagnostic and statistical manual of mental disorders (Fourth edition) 
  • 23. Bulimia nervosa • Bulimia nervosa means morbid hunger – Loss of control over the impulse to binge – Binge-purge syndrome • BN is more common than AN – 2-3% of the general population – One estimate suggests up to 10% of college students • Medical consequences of vomiting and laxatives – Erosion of tooth enamel – Tears in esophagus – Electrolyte imbalances • Psychological counseling may help; Prozac use has been approved
  • 24. APA Criteria for Binge Eating Disorder (BED) • Eat more quickly than usual during binge episodes • Eat until they are uncomfortably full • Eat when they are not hungry • Eat alone because of embarrassment • Feel disgusted, depressed, or guilty after eating
  • 25. Binge Eating Disorder (BED) • Individuals with BED have behaviors common to BN, but do not purge • Health consequences include – Weight gain and obesity – Increased risk of CHD and cancer • Treatment is similar to BN
  • 26. What eating problems are associated with sports? • Eating Disorders Not Otherwise Specified • Anorexia Athletica • Weight loss as an ergogenic aid – Wrestling – Gymnastics – Cheerleading – Bodybuilding – Lightweight football and rowing – Distance running
  • 27. Anorexia Athletica Five set criteria • Excessive fear of becoming obese • Restriction of caloric intake • Weight loss • No medical disorder to explain leanness • Gastrointestinal complaints Additional criteria (1 or more) • Disturbance in body image • Compulsive exercising • Binge eating • Use of purging methods • Delayed puberty • Menstrual dysfunction
  • 28. Eating disorders in sports • Estimates of prevalence vary – NCAA study • 20-40 % of female college athletes may exhibit criteria of eating disorders • 50-70 % in certain sports, such as gymnastics – One study of NCAA Division I athletes • 10% with symptoms of bulimia nervosa • 3% with symptoms of anorexia nervosa • Symptoms of eating disorders may abate at the end of the competitive season
  • 29. The Female Athlete Triad
  • 30. The Female Athlete Triad • Disordered eating – Low energy availability • Amenorrhea – Disturbance of hypothalamus-pituitary-ovary axis – Primary or secondary • 3-6 months or more between periods • Osteoporosis – Decreased estrogen from the ovaries – Low body fat so less conversion of androgens to estrogen – Estrogen is involved in bone metabolism
  • 31. The Female Athlete Triad • Prevention involves education of those involved sports – Coaches, athletic trainers, administrator, parents • What to look for – Unexplained weight losses – Frequent weight fluctuations – Sudden increases in training volume – Excessive concern with body weight – Appearance, and evidence of bizarre eating practices
  • 32. The Female Athlete Triad • Treatment – Counsel with the athlete – Increase dietary energy intake – Decrease exercise-associated energy expenditure • Mental health practitioners may be needed for athletes with eating disorders

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