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Weight Management Chapter 11
Introduction <ul><li>National Institutes of Health </li></ul><ul><ul><li>66% of American adults are overweight </li></ul><...
Prevalence of overweight and obesity among Americans   (Figure 11-1)
Basic Concepts <ul><li>1 pound of fat = 3500 calories </li></ul><ul><li>Body Composition </li></ul><ul><ul><li>Lean Body M...
Energy Balance  <ul><li>Crucial to keep a healthy ratio of fat and lean body mass </li></ul><ul><ul><li>Energy  </li></ul>...
 
Evaluating Body Weight and Body Composition <ul><li>Percent body fat and distribution of body fat = weather a change on bo...
Body Mass Index (BMI) <ul><li>National Institutes of Health </li></ul><ul><ul><li>Under 18.5 is classified underweight </l...
 
Body Composition Analysis <ul><li>Hydrostatic (underwater) weighing </li></ul><ul><ul><li>Most accurate </li></ul></ul><ul...
The Health Risks of Excess Body Fat <ul><li>Obese individuals have a mortality rate twice that of non-obese </li></ul><ul>...
Body Fat Distribution and Health <ul><li>Apples </li></ul><ul><ul><li>Upper regions of their bodies </li></ul></ul><ul><ul...
Body Image <ul><li>Collective picture of the body as seen through the mind’s eye. </li></ul><ul><ul><li>Perceptions </li><...
Problems Associated with Very Low Levels of Body Fat <ul><li>Less than 8-12% for women and less than 3-5% for men. </li></...
Factors Contributing To Excess Body Fat <ul><li>Genetic Factors </li></ul><ul><ul><li>25 to 40% of an individual’s body fa...
Lifestyle Factors <ul><li>Eating </li></ul><ul><li>Physical Activity </li></ul><ul><li>Psychosocial factors </li></ul><ul>...
Adopting A Healthy Lifestyle For Successful Weight Management <ul><li>Diet and Eating Habits </li></ul><ul><ul><li>Total C...
Adopting A Healthy Lifestyle For Successful Weight Management (Continued) <ul><li>Portion Sizes </li></ul><ul><li>Energy (...
Physical Activity and Exercise <ul><li>30 minutes or more of moderate-intensity physical activity, everyday </li></ul><ul>...
Thinking and Emotions <ul><li>What do you think of yourself? </li></ul><ul><li>Self-esteem </li></ul><ul><li>Negative emot...
Coping Strategies <ul><li>Adequate and appropriate strategies </li></ul><ul><li>Healthy lifestyles and proper stress manag...
Approaches to Overcoming A Weight Problem <ul><li>Doing it yourself </li></ul><ul><ul><li>0.5-2.0 pounds per week </li></u...
Weight-Loss Programs <ul><li>Noncommercial </li></ul><ul><ul><li>TOPS, and OA </li></ul></ul><ul><li>Commercial </li></ul>...
Prescription Drug <ul><li>Appetite Suppressants </li></ul><ul><li>Produce a 5-15% weight reduction by controlling appetite...
Surgery <ul><li>Severely obese - BMI of 40 or higher or are 100 pounds or more over recommended weight . </li></ul><ul><ul...
Body Image <ul><li>Severe body image problems </li></ul><ul><ul><ul><li>Body dysmorphic disorder (BDD) </li></ul></ul></ul...
Eating Disorders <ul><li>Problems with body weight and weight control. </li></ul><ul><li>0.5-2.0% of Americans suffer from...
Eating Disorders <ul><li>Anorexia Nervosa  - Failure to eat enough food to maintain a reasonable body weight. </li></ul><u...
Eating Disorders <ul><li>Bulimia Nervosa  - recurring episodes of binge eating followed by purging. </li></ul><ul><li>Begi...
Eating Disorders <ul><li>Binge-Eating  - Similar to Bulimia except no Purging behavior. </li></ul><ul><ul><li>Eating patte...
Treating Eating Disorders <ul><li>Address both eating disorder, misuse of food and manage emotions </li></ul><ul><ul><li>A...
Weight Management Chapter 11
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Insel10ebrup Ppt Ch11

  1. 1. Weight Management Chapter 11
  2. 2. Introduction <ul><li>National Institutes of Health </li></ul><ul><ul><li>66% of American adults are overweight </li></ul></ul><ul><ul><li>Including more than 32% who are obese </li></ul></ul><ul><ul><li>2030 </li></ul></ul><ul><ul><ul><li>Estimated that the entire American adult population will be overweight or obese </li></ul></ul></ul>
  3. 3. Prevalence of overweight and obesity among Americans (Figure 11-1)
  4. 4. Basic Concepts <ul><li>1 pound of fat = 3500 calories </li></ul><ul><li>Body Composition </li></ul><ul><ul><li>Lean Body Mass </li></ul></ul><ul><ul><li>Body Fat </li></ul></ul><ul><ul><ul><li>Essential fat 3-5% of total fat in men, 8-12% in women </li></ul></ul></ul><ul><ul><ul><li>Nonessential fat-(storage) –Located just below the skin </li></ul></ul></ul><ul><ul><ul><ul><li>Depends on many factors: </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Gender </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Age </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Heredity </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Metabolism </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Diet activity level </li></ul></ul></ul></ul></ul><ul><ul><li>Women: < 8% at risk, Average 23%, > 32% at risk </li></ul></ul><ul><ul><li>Men: < 5% at risk, Average 15%, > 25% at risk </li></ul></ul>
  5. 5. Energy Balance <ul><li>Crucial to keep a healthy ratio of fat and lean body mass </li></ul><ul><ul><li>Energy </li></ul></ul><ul><ul><li>Consumption and/or expenditure of calories </li></ul></ul><ul><ul><li>Control over intake of calories </li></ul></ul><ul><ul><li>Negative energy balance </li></ul></ul><ul><ul><li>Positive energy balance </li></ul></ul><ul><ul><li>Neutral energy balance </li></ul></ul>
  6. 7. Evaluating Body Weight and Body Composition <ul><li>Percent body fat and distribution of body fat = weather a change on body composition would improve health. </li></ul><ul><li>Overweight –above recommended range for good health </li></ul><ul><li>Obesity – a more serious degree of overweight </li></ul><ul><li>Height-Weight charts </li></ul><ul><li>Body Mass Index (BMI) </li></ul><ul><ul><li>Weight in pounds X 703 / Height in inches (squared) </li></ul></ul><ul><li>Body Composition </li></ul>
  7. 8. Body Mass Index (BMI) <ul><li>National Institutes of Health </li></ul><ul><ul><li>Under 18.5 is classified underweight </li></ul></ul><ul><ul><li>Between 18.5 and 24.9 is healthy </li></ul></ul><ul><ul><li>Greater than 25 is overweight </li></ul></ul><ul><ul><li>Greater than 30 is obese </li></ul></ul><ul><li>Measurement. Example: 5’6” tall, 150 pounds </li></ul><ul><ul><li>Multiply weight (in pounds) by 704 </li></ul></ul><ul><ul><ul><li>150 X 704 =105,600 </li></ul></ul></ul><ul><ul><li>Multiply height (in inches) by height (in inches) </li></ul></ul><ul><ul><ul><li>66 X 66 = 4,356 </li></ul></ul></ul><ul><ul><li>Divide the answer in step 1 by the answer in step 2 to obtain a value for BMI </li></ul></ul><ul><ul><ul><li>BMI = 105,600 / 4,356 = 24.2 </li></ul></ul></ul>
  8. 10. Body Composition Analysis <ul><li>Hydrostatic (underwater) weighing </li></ul><ul><ul><li>Most accurate </li></ul></ul><ul><li>Skinfold measurements </li></ul><ul><ul><li>Thickness of fat under the skin </li></ul></ul><ul><li>Electrical Impedance Analysis </li></ul><ul><ul><li>Electricity prefers lean tissue </li></ul></ul>
  9. 11. The Health Risks of Excess Body Fat <ul><li>Obese individuals have a mortality rate twice that of non-obese </li></ul><ul><ul><li>Reduces life expectancy by 10-20 years </li></ul></ul><ul><ul><li>Associated with : Unhealthy cholesterol and triglycerides, impaired heart function, and death from cardiovascular disease </li></ul></ul><ul><ul><li>Other health factors : hypertension, cancer, impaired immune function, gallbladder and kidney disease, skin problems, impotence, sleep disorder back pain, arthritis </li></ul></ul><ul><ul><li>Strong association – Type II diabetes </li></ul></ul>
  10. 12. Body Fat Distribution and Health <ul><li>Apples </li></ul><ul><ul><li>Upper regions of their bodies </li></ul></ul><ul><ul><li>Increase risk of high blood pressure, diabetes, early-onset heart disease, stroke, and cancer </li></ul></ul><ul><li>Pears </li></ul><ul><ul><li>Fat storage in the hips, buttocks and thighs </li></ul></ul><ul><li>Assessed by measuring waist circumference </li></ul><ul><ul><li>Risk if total waist measurement is more than 40 inches for men and 35 inches for women </li></ul></ul>
  11. 13. Body Image <ul><li>Collective picture of the body as seen through the mind’s eye. </li></ul><ul><ul><li>Perceptions </li></ul></ul><ul><ul><li>Images </li></ul></ul><ul><ul><li>Thoughts </li></ul></ul><ul><ul><li>Attitudes </li></ul></ul><ul><ul><li>Emotions </li></ul></ul>
  12. 14. Problems Associated with Very Low Levels of Body Fat <ul><li>Less than 8-12% for women and less than 3-5% for men. </li></ul><ul><li>Extreme has been linked to problems with: </li></ul><ul><ul><li>Reproductive </li></ul></ul><ul><ul><li>Circulatory </li></ul></ul><ul><ul><li>Immune system disorders </li></ul></ul><ul><li>Female Athlete Triad </li></ul><ul><ul><li>Abnormal eating patterns </li></ul></ul><ul><ul><li>Amenorrhea </li></ul></ul><ul><ul><li>Decreased bone density </li></ul></ul>
  13. 15. Factors Contributing To Excess Body Fat <ul><li>Genetic Factors </li></ul><ul><ul><li>25 to 40% of an individual’s body fat </li></ul></ul><ul><ul><li>300 genes have been linked to obesity </li></ul></ul><ul><li>Physiological Factors </li></ul><ul><ul><li>Metabolism (RMR) </li></ul></ul><ul><ul><li>Hormones </li></ul></ul><ul><ul><li>Fat Cells </li></ul></ul><ul><ul><li>Carbohydrate Craving </li></ul></ul>
  14. 16. Lifestyle Factors <ul><li>Eating </li></ul><ul><li>Physical Activity </li></ul><ul><li>Psychosocial factors </li></ul><ul><ul><li>Emotions </li></ul></ul><ul><ul><li>Coping strategies </li></ul></ul>
  15. 17. Adopting A Healthy Lifestyle For Successful Weight Management <ul><li>Diet and Eating Habits </li></ul><ul><ul><li>Total Calories </li></ul></ul><ul><ul><li>MyPyramid suggestions </li></ul></ul><ul><ul><li>Best approach for weight loss is combining an increase of exercise with moderate calorie restriction </li></ul></ul><ul><ul><li>Do not go on a crash diet </li></ul></ul>
  16. 18. Adopting A Healthy Lifestyle For Successful Weight Management (Continued) <ul><li>Portion Sizes </li></ul><ul><li>Energy (calorie) Density </li></ul><ul><li>Fat Calories </li></ul><ul><li>Carbohydrates </li></ul><ul><ul><li>Simple Sugars and Refined Carbohydrates </li></ul></ul><ul><li>Protein </li></ul><ul><li>Eating Habits </li></ul>
  17. 19. Physical Activity and Exercise <ul><li>30 minutes or more of moderate-intensity physical activity, everyday </li></ul><ul><ul><li>Walking </li></ul></ul><ul><ul><li>Gardening </li></ul></ul><ul><ul><li>Housework </li></ul></ul><ul><ul><li>Walking 1 mile in 15-20 minutes </li></ul></ul>
  18. 20. Thinking and Emotions <ul><li>What do you think of yourself? </li></ul><ul><li>Self-esteem </li></ul><ul><li>Negative emotions </li></ul><ul><li>Ideal self </li></ul><ul><li>Beliefs and attitudes you hold </li></ul>
  19. 21. Coping Strategies <ul><li>Adequate and appropriate strategies </li></ul><ul><li>Healthy lifestyles and proper stress management techniques will naturally and easily result in a reasonable body weight </li></ul><ul><ul><li>Good nutrition </li></ul></ul><ul><ul><li>Good communication </li></ul></ul><ul><ul><li>Adequate exercise </li></ul></ul><ul><ul><li>Positive thinking and emotions </li></ul></ul><ul><ul><li>Effective coping strategies and behavior patterns </li></ul></ul>
  20. 22. Approaches to Overcoming A Weight Problem <ul><li>Doing it yourself </li></ul><ul><ul><li>0.5-2.0 pounds per week </li></ul></ul><ul><ul><li>Initial weight loss from fluids. </li></ul></ul><ul><ul><li>Very low calorie diets need to be avoided. </li></ul></ul><ul><ul><li>Diet Books: </li></ul></ul><ul><ul><ul><li>Reject books with gimmicks or rotating levels of calories . </li></ul></ul></ul><ul><ul><li>Diet Supplements and Diet Aids </li></ul></ul><ul><ul><ul><li>Formula drinks and food bars </li></ul></ul></ul><ul><ul><ul><li>Herbal </li></ul></ul></ul><ul><ul><ul><li>Dietary supplements </li></ul></ul></ul>
  21. 23. Weight-Loss Programs <ul><li>Noncommercial </li></ul><ul><ul><li>TOPS, and OA </li></ul></ul><ul><li>Commercial </li></ul><ul><li>Online </li></ul><ul><li>Clinical </li></ul>
  22. 24. Prescription Drug <ul><li>Appetite Suppressants </li></ul><ul><li>Produce a 5-15% weight reduction by controlling appetite. </li></ul><ul><li>Once drugs are stopped most return to original heavy weight. </li></ul><ul><li>Good option for very obese who need help getting started - permanent life style change. </li></ul>
  23. 25. Surgery <ul><li>Severely obese - BMI of 40 or higher or are 100 pounds or more over recommended weight . </li></ul><ul><ul><li>Roux-en-Y-gastric bypass </li></ul></ul><ul><ul><li>Vertical banded gastroplasty (VBG) </li></ul></ul><ul><ul><li>Liposuction </li></ul></ul><ul><li>Weight loss from surgery generally ranges between 40% and 70% of total body weight over a years time. </li></ul>
  24. 26. Body Image <ul><li>Severe body image problems </li></ul><ul><ul><ul><li>Body dysmorphic disorder (BDD) </li></ul></ul></ul><ul><ul><li>Knowing when the limits to healthy change have been reached. </li></ul></ul><ul><ul><li>Knowing the unrealistic cultural ideal. </li></ul></ul><ul><li>Acceptance and change </li></ul><ul><ul><li>Can-do attitude </li></ul></ul>
  25. 27. Eating Disorders <ul><li>Problems with body weight and weight control. </li></ul><ul><li>0.5-2.0% of Americans suffer from anorexia and have bulimia </li></ul><ul><li>10% of college-aged women </li></ul><ul><li>Binge eating disorder may affect 2-5%of all adults and 8% of those who are obese </li></ul><ul><li>Over 1 Million Americans develop anorexia or bulimia each year - 90% are female. </li></ul><ul><li>60% of binge-eating are female </li></ul>
  26. 28. Eating Disorders <ul><li>Anorexia Nervosa - Failure to eat enough food to maintain a reasonable body weight. </li></ul><ul><li>Affects 3 million people – 95% are female </li></ul><ul><ul><li>Characteristics </li></ul></ul><ul><ul><ul><li>Fear gaining weight. </li></ul></ul></ul><ul><ul><ul><li>Distorted self-image. </li></ul></ul></ul><ul><ul><ul><li>Compulsive behaviors and rituals. </li></ul></ul></ul><ul><ul><ul><li>Excessive exercise </li></ul></ul></ul><ul><ul><li>Health Risks of Anorexia Nervosa </li></ul></ul><ul><ul><ul><li>Stop menstruation </li></ul></ul></ul><ul><ul><ul><li>Intolerant of cold </li></ul></ul></ul><ul><ul><ul><li>Low blood pressure and heart rate </li></ul></ul></ul><ul><ul><ul><li>Dry skin </li></ul></ul></ul><ul><ul><ul><li>Hands and feet may swell and take on a blue tinge </li></ul></ul></ul><ul><ul><ul><li>Depression and suicide </li></ul></ul></ul><ul><ul><li>Medical complications </li></ul></ul><ul><ul><ul><li>Disorders of the cardiovascular, gastrointestinal, endocrine, and skeletal systems </li></ul></ul></ul>
  27. 29. Eating Disorders <ul><li>Bulimia Nervosa - recurring episodes of binge eating followed by purging. </li></ul><ul><li>Begins in adolescence or young adulthood </li></ul><ul><ul><li>Increasingly younger (11-12 years) and older (40-60 years) ages. </li></ul></ul><ul><li>Characteristics: </li></ul><ul><ul><ul><li>Rapidly consumes food, then purges. </li></ul></ul></ul><ul><ul><ul><li>Done in secret. </li></ul></ul></ul><ul><ul><ul><li>After a binge - feels ashamed, disgusted and physically and emotional drained. </li></ul></ul></ul><ul><li>Health Risks: </li></ul><ul><ul><li>Erodes tooth enamel </li></ul></ul><ul><ul><li>Deficient calorie intake </li></ul></ul><ul><ul><li>Liver and kidney damage </li></ul></ul><ul><ul><li>Cardiac arrhythmia </li></ul></ul><ul><ul><li>Chronic hoarseness </li></ul></ul><ul><ul><li>Esophageal tearing </li></ul></ul><ul><ul><li>Rupture of the stomach </li></ul></ul><ul><ul><li>Menstrual problems </li></ul></ul><ul><ul><li>Increased depression </li></ul></ul>
  28. 30. Eating Disorders <ul><li>Binge-Eating - Similar to Bulimia except no Purging behavior. </li></ul><ul><ul><li>Eating patterns - very rapid, eating until uncomfortably full. </li></ul></ul><ul><ul><li>Often eat as a way of coping. </li></ul></ul><ul><ul><li>Likely to be obese. </li></ul></ul><ul><ul><li>High rates of depression and anxiety </li></ul></ul>
  29. 31. Treating Eating Disorders <ul><li>Address both eating disorder, misuse of food and manage emotions </li></ul><ul><ul><li>Anorexia Nervosa </li></ul></ul><ul><ul><li>Bulimia Nervosa </li></ul></ul><ul><ul><li>Binge-Eating </li></ul></ul><ul><li>Today’s Challenge </li></ul>
  30. 32. Weight Management Chapter 11

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