1) Many Americans are overweight due to an increase in fat cell size and number over time with periods of excess calorie intake and weight cycling from repeated dieting. 2) Weight cycling is problematic because it resets the body's "set point" to a higher weight each time, making further weight gain more likely even after dieting. 3) Eating disorders like anorexia nervosa, bulimia nervosa, and binge eating disorder can form a vicious cycle where unhealthy behaviors are used due to unrealistic perceptions of body weight and shape.

1. Weight Management: Overweight and Underweight

2. Distribution of Body Weights in American Adults

4. How Does US Stand? ADD Stat% of US Adults were overweight in 1998

5. Fat Cell Development During periods of growth in late childhood/early puberty, # on fat cells increase During periods of excess intake, fats cell size increases When fat cells have reached their maximum size, the cell number increases Even with fat loss, the cells may shrink but not the number

6. LPL Levels and Set Point Theory LPL (Lipoprotein Lipase) -- located on adipose cell membranes and promote fat storage -- higher the activity level of LPL, the more efficient storage of fat is -- after weight lose, LPL increases, increasing fat deposition

7. The Weight-Cycling Effect of Repeated Dieting Each period of dieting results in a resetting of your “homeostatic set point”. Therefore, each loss is followed by a gain even larger than the loss

8. The ob Protein: Leptin

9. Leptin’s Action in the Body: Negative Energy Balance

10. Leptin’s Action in the Body: Positive Energy Balance

11. The Psychology Weight Cycling Where does this “I’m not happy with my appearance” come from?

12. Comparison of Average Women, Barbie and Store Mannequins “ Average” Women Barbie Store M annequin s Height Weight Dress size Bust Waist Hips BMI 5 ’ 4” 145 lbs. 11 -14 36 - 37 ” 29 - 31 ” 40 - 42 ” 24.97 6 ’ 0 ” 101 lbs 4 39 ” 19 ” 33 ” 13.7 6 ’ 0 ” Not available 6 34” 23” 34”

13. BMI of Miss America Winners

14. Jamie Lee Curtis Interview on Dateline following her Cover Story in More Magazine Add link to video

15. Aggressive Methods of Weight Control Drugs: Sibutramine - suppresses appetite by inhibiting uptake of serotonin Orlistat - inhibits pancreatic lipase activity lowering the efficiency of fat digestion and absorption Over the counter: Benzocaine, Acutrim, Dex-A-Diet, Phenyldrine, Phenoxine,

16. Aggressive Methods of Weight Control Herbal: St. John’s Wort Ma Huang - Ephedrine (Nature’s Own Fat Burner!!) CLA (Conjugated Linoleic Acid)

17. Aggressive Methods of Weight Control Surgery: Suction lipectomy - Liposuction Stomach restriction - Gastric Bypass Surgery

18. Surgical Methods of Weight Control Gastric Bypass

19. More Reasonable Methods for Weight Loss Weight Loss Eating Plans: - emphasize Adequacy - smaller portions (e.g. grazing) - emphasize Complex Carbs - select Fats wisely - emphasize Nutitional Density - drink lots of water - increase Physical Activity

20. More Reasonable Methods for Weight Gain Weight Gain Eating Plans: - Energy Dense Foods - Regular Meals - Add Extra Snacks - Juice & Milk - Physical Activity builds Muscle

21. Athlete Eating Disorders – Female Athlete Triad Add video

22. Anorexia Nervosa Bulimia Nervosa Binge Eating Disorders The Vicious Cycle:

23. Anorexia Nervosa - refusal to maintain healthy body weight ( Usually < 85% of healthy body weight ) - intense fear of gaining body weight - see themselves in unrealistic way - restrictive and binge-and-purge types

24. Bulimia Nervosa - relatively normal body weight - see themselves in unrealistic way - purge and non-purging types

25. Binge Eating Disorder - normal and obese body weight - see themselves in unrealistic way - rarely purge - behavioral disorder