Maintaining a Healthy Weight


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  • Maintaining a Healthy Weight

    1. 1. Chapter Six: Maintaining a Healthy Weight
    2. 2. Defining Overweight and Obesity <ul><li>Desirable weight = weight range deemed appropriate for people, taking into consideration gender, age, and frame size </li></ul><ul><li>Overweight = a person’s excess fat accumulation results in body weight that exceeds desirable weight by 1-19% </li></ul><ul><li>Obesity = a person’s body weight is 20% or more above desirable weight </li></ul>
    3. 3. Rates of Overweight and Obesity (Adult Americans)
    4. 4. Obesity and Disease <ul><li>Problems caused or complicated by obesity: </li></ul><ul><ul><li>Increased surgical risk </li></ul></ul><ul><ul><li>Hypertension </li></ul></ul><ul><ul><li>Heart disease </li></ul></ul><ul><ul><li>Arthritis </li></ul></ul><ul><ul><li>Stroke </li></ul></ul><ul><ul><li>Type 2 diabetes </li></ul></ul><ul><ul><li>Cancer </li></ul></ul><ul><ul><li>Joint deterioration </li></ul></ul><ul><li>Fat accumulation in the abdomen (“apple” shape) is associated with greater health risks than fat accumulation in the hips (“pear” shape) </li></ul>
    5. 5. Sociocultural Standards for Weight <ul><li>Body image: Subjective perception of how one’s body appears to oneself and others </li></ul><ul><li>What is today’s Western cultural standard of the ideal body? </li></ul><ul><ul><li>Hourglass shape? </li></ul></ul><ul><ul><li>Athletic? </li></ul></ul><ul><ul><li>How does it differ by gender? </li></ul></ul><ul><li>Body image dissatisfaction affects self-concept </li></ul><ul><ul><li>More women than men are dissatisfied with their weight </li></ul></ul>
    6. 6. Measuring and Assessing Weight and Body Fat Composition <ul><li>Body mass index (BMI) </li></ul><ul><li>Height/weight tables </li></ul><ul><li>Waist and hip measurement </li></ul><ul><li>Appearance </li></ul><ul><li>Home scale </li></ul><ul><li>Body fat measurement </li></ul><ul><ul><li>Electrical impedance </li></ul></ul><ul><ul><li>Bod Pod </li></ul></ul><ul><ul><li>Skinfold measurements </li></ul></ul><ul><ul><li>Hydrostatic weighing </li></ul></ul>
    7. 7. Body Mass Index (BMI) <ul><li>A mathematical calculation based on weight and height used to determine desirable body weight </li></ul><ul><ul><li>Weight (kg) ÷ [Height (m)] 2 </li></ul></ul><ul><li>Classification </li></ul><ul><ul><li>Normal: 18.5-24.9 </li></ul></ul><ul><ul><li>Overweight: 25.0-29.9 </li></ul></ul><ul><ul><li>Obese: ≥30 </li></ul></ul><ul><ul><li>Extreme obesity: ≥40 </li></ul></ul>
    8. 8. Body Fat Measurement <ul><li>Young adult men </li></ul><ul><ul><li>Normal = 10-15% </li></ul></ul><ul><ul><li>Obese = >25% </li></ul></ul><ul><li>Young adult women </li></ul><ul><ul><li>Normal = 22-25% </li></ul></ul><ul><ul><li>Obese = >30% </li></ul></ul>
    9. 9. Body Fat Measurement <ul><li>Electrical impedance: Use of a harmless electrical current to calculate percent body fat </li></ul><ul><li>Bod Pod: Measurement of air displacement to determine percent body fat </li></ul><ul><li>Skinfold measurements: Measurement of the thickness of the fat layer just below the skin; used to calculate percent body fat </li></ul><ul><li>Hydrostatic weighing: Weighing the body while it is submerged in water; used to calculate percent body fat </li></ul>
    10. 10. Causes of Obesity <ul><li>Calorie balance: Energy intake vs. energy output </li></ul><ul><ul><li>Intake = Output: Calorie balance </li></ul></ul><ul><ul><li>Intake > Output: Positive calorie balance </li></ul></ul><ul><ul><ul><li>Weight gain </li></ul></ul></ul><ul><ul><li>Output > Input: Negative calorie balance </li></ul></ul><ul><ul><ul><li>Weight loss </li></ul></ul></ul><ul><li>Energy needs: </li></ul><ul><ul><li>Basal metabolic rate (BMR) </li></ul></ul><ul><ul><li>Activity requirements </li></ul></ul><ul><ul><li>Thermic effect of food </li></ul></ul>
    11. 11. Causes of Obesity (cont.) <ul><li>Genetic factors </li></ul><ul><li>Physiological and hormonal factors </li></ul><ul><ul><li>Hypothyroidism </li></ul></ul><ul><ul><li>Hypercellular obesity </li></ul></ul><ul><ul><li>Hypertrophic obesity </li></ul></ul><ul><li>Metabolic factors </li></ul><ul><ul><li>Set point </li></ul></ul><ul><ul><li>Adaptive thermogenesis </li></ul></ul>
    12. 12. Causes of Obesity (cont.) <ul><li>Family, social, and cultural factors </li></ul><ul><li>Environmental factors </li></ul><ul><ul><li>Local environment </li></ul></ul><ul><ul><li>Packaging and price </li></ul></ul><ul><ul><li>Unit bias </li></ul></ul><ul><li>Psychological factors </li></ul>
    13. 13. Facts About Weight Loss
    14. 14. Weight Management Strategies: Lifestyle Approaches <ul><li>Balanced diet supported by portion control </li></ul><ul><li>Moderate physical activity </li></ul><ul><ul><li>60 minutes/day for weight maintenance </li></ul></ul><ul><ul><li>90 minutes/day for weight loss and maintenance </li></ul></ul><ul><li>Sleep </li></ul><ul><li>Lifestyle support and problem solving </li></ul>
    15. 15. Weight Management Strategies: Specific Dietary Approaches <ul><li>Temporary calorie restriction (“dieting”) </li></ul><ul><li>Low-calorie foods and controlled serving sizes </li></ul><ul><li>Controlled fasting </li></ul><ul><ul><li>For extreme obesity </li></ul></ul><ul><ul><li>Often in a hospital setting </li></ul></ul><ul><li>Formal or commercial weight reduction programs </li></ul>
    16. 16. Weight Management Strategies: Weight Loss Drugs <ul><li>OTC drugs and herbal supplements </li></ul><ul><ul><li>Ephedrine, phenylpropanolamine (now banned) </li></ul></ul><ul><ul><li>Caffeine, laxatives </li></ul></ul><ul><li>Prescription weight loss drugs </li></ul><ul><ul><li>Phentermine </li></ul></ul><ul><ul><li>Sibutramine </li></ul></ul><ul><li>Fat-blocking drugs </li></ul><ul><ul><li>Orlistat </li></ul></ul><ul><ul><ul><li>Prescription Xenical </li></ul></ul></ul><ul><ul><ul><li>OTC Alli </li></ul></ul></ul>
    17. 17. Weight Management Strategies: Surgical Interventions <ul><li>Gastric bypass </li></ul><ul><li>Gastric band </li></ul><ul><li>Cosmetic </li></ul><ul><ul><li>Liposuction </li></ul></ul><ul><ul><li>Abdominoplasty </li></ul></ul><ul><ul><li>Body wrapping </li></ul></ul>
    18. 18. Eating Disorders <ul><li>Most eating disorders involve psychological issues as well as inappropriate food choices or eating patterns </li></ul><ul><li>Types/categories </li></ul><ul><ul><li>Anorexia nervosa </li></ul></ul><ul><ul><li>Bulimia nervosa </li></ul></ul><ul><ul><li>Binge eating disorder </li></ul></ul><ul><ul><li>Chewing, spitting out food syndrome </li></ul></ul><ul><ul><li>Night eating syndrome </li></ul></ul><ul><ul><li>Body dysmorphic disorder </li></ul></ul><ul><ul><li>Bigorexia </li></ul></ul>
    19. 19. Anorexia Nervosa <ul><li>Diagnostic criteria: </li></ul><ul><ul><li>Body weight 15% or more below desirable weight </li></ul></ul><ul><ul><li>Fear of weight gain </li></ul></ul><ul><ul><li>Distorted body image </li></ul></ul><ul><ul><li>In women, absence or three of more menstrual periods </li></ul></ul><ul><ul><li>In men, decreased sex hormone </li></ul></ul><ul><li>Serious medical complications, including death </li></ul><ul><li>Treatment: Medical and dietary interventions, psychological treatment </li></ul>
    20. 20. Bulimia Nervosa <ul><li>Diagnostic criteria: </li></ul><ul><ul><li>Binge eating two or more times/week for at least 3 months </li></ul></ul><ul><ul><li>Lack of control over bingeing </li></ul></ul><ul><ul><li>Inappropriate compensatory behaviors (purging) </li></ul></ul><ul><ul><ul><li>Vomiting or use of laxatives, diuretics, or other medications </li></ul></ul></ul><ul><ul><ul><li>Excessive exercise </li></ul></ul></ul><ul><ul><ul><li>Fasting </li></ul></ul></ul><ul><ul><li>Overconcern with body image </li></ul></ul><ul><li>Serious medical complications </li></ul><ul><li>Treatment: nutritional and psychological counseling, medical consultation </li></ul>
    21. 21. Other Eating Disorders <ul><li>Binge eating disorder </li></ul><ul><ul><li>Bingeing without compensatory purging </li></ul></ul><ul><ul><li>Use food to cope; feel out of control during binge </li></ul></ul><ul><li>Chewing and spitting out food syndrome </li></ul><ul><li>Night eating syndrome </li></ul><ul><li>Body dysmorphic disorder </li></ul><ul><ul><li>Preoccupation with an imagined or slight flaw in one’s appearance </li></ul></ul><ul><li>Bigorexia </li></ul><ul><ul><li>Muscle dysmorphia, “Adonis complex” </li></ul></ul><ul><ul><li>An obsession with getting bigger and more muscular </li></ul></ul><ul><ul><li>Thinking that your body is never muscular enough </li></ul></ul>
    22. 22. Chapter Six: Maintaining a Healthy Weight