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  • Do the people you see at school and work meet this statistic? Do those in your family meet this statistic?Notice the number of children who are overweight or obese during this next week.
  • Notice the “overweight but not obese” line on the graph. What does this indicate has occurred since 1960?Obesity has risen dramatically over the last 50 years, but overweight has not changed.
  • Body composition considers muscle mass, body fat, water, and bones.Height/weight tables were developed by insurance companies and are not representative of the current population.Ideal weight is based on many factors.
  • Ask students to explain why these health problems are associated with obesity.
  • Discuss some of the environmental factors that can help contribute to obesity in a society.
  • Case Study:Maria is a 22-year-old Non-Hispanic African American female who has struggled with her weight for many years. She is 5 feet 6 inches tall and weighs 230 lbs.
  • There are many causes of weight extremes including an imbalance of energy intake with physical activity. Hormones such as leptin and ghrelin may play a role in obesity. Genetic and family factors can also contribute to weight. Non-Hispanic African American women have a disproportionately high level of obesity when compared with other racial and ethnic groups and the cause is not clearly defined but may be a combination of genetics and environmental factors. Studies also show that the greatest risk for being overweight is a history of being overweight. Physiologic factors that describe the amount of body fat a person carries is related to the number of and size of fat cells in the body. During periods of growth, once the body has added extra fat cells for more fuel storage, these cells remain and can store varying amounts of fat. Psychological factors including work, family, and social environments can cultivate emotional stress, which may result in eating more for comfort. In addition, easy access to fast foods and convenient foods, an increase in portion sizes, and an increase in screen time may all contribute to weight gain.
  • What are some current fad diets?Name some individual differences. Do you lose or gain weight differently than your friends?
  • All nutrients are poorly absorbed in the gut of a gastric bypass patient, including vitamins and minerals, warranting special supplementation.
  • Surgical procedures are usually reserved for severely obese patients who have not had success with other weight-loss methods.
  • Surgical intervention would not be appropriate for Maria.
  • Should focus on eating behaviors, increase in exercise, and emotional well-being.
  • The program’s goals must be realistic.The program must ensure nutritional adequacy.The program should focus on achieving lasting success. The program should take cultural appeal into account.Food caloric intake should be reduced and physical activity should be increased to be successful.
  • Energy intake = energy outputSeems like a simple equation, but individuality still exists. What works for one person will not necessarily work for another because of genetic and physiologic factors.
  • The best way to achieve weight loss is through combining decreased energy intake with increased energy output.Carbohydrates should make up the majority of calories.Eating simple snacks between meals can help prevent drops in glucose.
  • A sound weight program for Maria would consist of the following:Should focus on eating behaviors, increase in exercise, and emotional well-beingConsideration for behavior modificationDietary principles to include appropriate calories, protein, realistic goals, nutritional adequacy, and cultural appealKeeping away from fadsExercise to balance energyMonitoringPrinciples of self-management incorporated into the nutrition plan
  • Give examples of each.What food combinations have you heard about that claim weight loss?Food cures often are based on testimonials, not scientific data.“Natural” foods are more appealing because the term leads us to think foods we normally eat are not natural and therefore are dangerous to our health. Is this true?
  • Dangers include dangers to health, cost, lack of sound knowledge, and distrust of the food market.What is the answer?Use reliable sources.Recognize human needs.Remain alert to teaching opportunities.Think scientifically.Know responsible authorities.
  • Being underweight can be just as detrimental to health as being overweight.Increased risk for infection, decreased strength, and generally poorer health.
  • Beingunderweight often is seen in the elderly as their drive for eating decreases.Being underweight often is a side effect of depression.An exercise program should ideally be implemented along with an increase in calories to promote lean body mass.
  • These disorders are quite serious and can lead to death if not treated.Patients need extensive counseling.Most people with eating disorders are never “cured.”
  • Considerations for Maria Since she is young and struggles with her weight, she could be at risk if she starts to lose too much weight or starts to bingeBehavior modification is importantSupport systemsMonitoring weight lossCultural considerations

Transcript

  • 1. Williams' Basic Nutrition & Diet Therapy Chapter 15 Weight Management Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 1 14th Edition
  • 2. Lesson 15.1: Causes of Obesity and Risks of Food Fads  Underlying causes of obesity include a host of various genetic, environmental, and psychological factors.  Short-term food patterns, or fads, often stem from food misinformation that appeals to some human psychological need but does not necessarily meet physiologic needs. 2Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 3. Introduction (p. 280)  Currently in the United States  34.2% of adults are overweight  33.8% are obese  5.7% are extremely obese  16.9% of children and adolescents are obese 3Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 4. Introduction (cont’d) (p. 280)  Overweight and obesity, by age: United States, 1960- 2004 4Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 5. Obesity and Weight Control (p. 280)  Body weight and body fat  Definitions  Body composition  Measures of weight maintenance goals  Standard height/weight tables  Healthy weight range • Individual variation • Necessity of body fat 5Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 6. Obesity and Health (p. 286)  Weight extremes: clinically severe obesity is health hazard  Overweight and health problems: hypertension, diabetes, heart disease, arthritis, cancer 6Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 7. Causes of Obesity (p. 286)  Basic energy balance  Hormonal control: leptin and ghrelin  Genetic and family factors  Genetic control: obesity highly associated with genetics  Family reinforcement: teach food habits and exert social pressure  Physiologic factors: number of fat cells in the body  Other environmental factors: availability of energy- dense, fast foods, convenient foods 7Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 8. Case Study  Maria is a 22-year-old Non-Hispanic African American female who has struggled with her weight for many years. She is 5 feet 6 inches tall and weighs 230 lbs. 8Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 9. Case Study (cont’d)  Discuss factors that can contribute to Maria’s weight. 9Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 10. Individual Differences and Extreme Practices (p. 288)  Individual energy balance levels  Extreme practices  Fad diets  Scientific inaccuracies and misinformation  Failure to address the necessity of changing long- term habits 10Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 11. Extreme Practices (p. 289)  Fasting: negative health effects, rebound effect  Specific macronutrient restrictions: no evidence to support, carry health risks  Clothing and body wraps: cause temporary water loss  Drugs: FDA regulates, should be combined with lifestyle changes  Surgery: gastric restriction, malabsorptive procedures, lipectomy 11Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 12. Surgical Treatments for Obesity (p. 293) 12Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 13. Case Study (cont’d)  Would surgical intervention be appropriate for Maria? 13Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 14. Lesson 15.2: Weight Management Tools and Risks of Being Underweight  Realistic weight management focuses on individual needs and health promotion, including meal pattern planning and regular physical activity.  Severe underweight carries physiologic and psychological risk to the body. 14Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 15. A Sound Weight Management Program (p. 294)  Essential characteristics: food and exercise behaviors  Behavior modification  Basic principles  Basic strategies and actions • Defining problem behavior • Recording and analyzing baseline behavior • Planning behavior management strategy 15Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 16. Dietary Principles (p. 294)  Dietary principles  Realistic goals: ½ to 1 lb per week loss  Negative energy balance: 500 to 1000 kcal/day  Nutritional adequacy: choose nutrient-dense foods  Cultural appeal: to allow permanent change in habits  Energy readjustment to maintain weight: when desired weight is reached 16Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 17. Basic Energy Balance Components (p. 295)  Energy input: food behaviors  Energy output: exercise behaviors 17Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 18. Principles of a Sound Food Plan (p. 296)  Energy balance: modifications to energy intake and output  Nutrient balance: carbohydrate, protein, fat proportions  Distribution balance: spread food throughout the day  Food guide: American Dietetic Association  Preventive approach: overweight children become obese adults 18Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 19. Case Study (cont’d)  Outline considerations for a sound weight management program for Maria. 19Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 20. Food Misinformation and Fads (p. 300)  Types of claims  Food cures: certain foods cure specific conditions  Harmful foods: certain foods are harmful  Food combinations: specific combinations restore health  “Natural” foods: only “natural” foods can meet body needs 20Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 21. Food Misinformation and Fads (cont’d) (p. 301)  Erroneous claims  Dangers  To health  Often expensive  Perpetuates superstitions  Distrust of modern food market  Vulnerable groups  Elderly, young persons, obese persons, athletes and coaches, entertainers 21Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 22. Underweight (p. 302)  General causes  Wasting disease  Poor food intake  Malabsorption  Hormonal imbalance  Energy imbalance  Poor living situation 22Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 23. Dietary Treatment (p. 303)  High-calorie diet  High protein  High carbohydrate  Moderate fat  Adequate sources of vitamins and minerals 23Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 24. Disordered Eating (p. 303)  Definition of normal eating  Disordered eating  Anorexia nervosa: results in self-imposed starvation  Bulimia nervosa: binge-and-purge cycle  Binge eating disorder: often follows stress or anxiety  Significant mortality rates, slow recovery  Treatment 24Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.
  • 25. Case Study (cont’d)  List some considerations for Maria so that she would not fall into these eating disorders. 25Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.