- 66% of American adults are overweight, including more than 32% who are obese. It is estimated that by 2030, the entire American adult population will be overweight or obese. - Body mass index (BMI) is used to evaluate body weight and composition. A BMI over 25 is considered overweight and over 30 is obese. Factors like gender, age, heredity, and metabolism impact body composition and fat distribution. - Excess body fat, especially around the waist, increases health risks like cardiovascular disease, diabetes, and some cancers. Very low body fat can also cause problems with reproductive, circulatory and immune systems. Genetics, lifestyle, and psychological factors all contribute to weight issues.

1. Weight Management Chapter 11

2. Introduction National Institutes of Health 66% of American adults are overweight Including more than 32% who are obese 2030 Estimated that the entire American adult population will be overweight or obese

3. Prevalence of overweight and obesity among Americans (Figure 11-1)

4. Basic Concepts 1 pound of fat = 3500 calories Body Composition Lean Body Mass Body Fat Essential fat 3-5% of total fat in men, 8-12% in women Nonessential fat-(storage) –Located just below the skin Depends on many factors: Gender Age Heredity Metabolism Diet activity level Women: < 8% at risk, Average 23%, > 32% at risk Men: < 5% at risk, Average 15%, > 25% at risk

5. Energy Balance Crucial to keep a healthy ratio of fat and lean body mass Energy Consumption and/or expenditure of calories Control over intake of calories Negative energy balance Positive energy balance Neutral energy balance

7. Evaluating Body Weight and Body Composition Percent body fat and distribution of body fat = weather a change on body composition would improve health. Overweight –above recommended range for good health Obesity – a more serious degree of overweight Height-Weight charts Body Mass Index (BMI) Weight in pounds X 703 / Height in inches (squared) Body Composition

8. Body Mass Index (BMI) National Institutes of Health Under 18.5 is classified underweight Between 18.5 and 24.9 is healthy Greater than 25 is overweight Greater than 30 is obese Measurement. Example: 5’6” tall, 150 pounds Multiply weight (in pounds) by 704 150 X 704 =105,600 Multiply height (in inches) by height (in inches) 66 X 66 = 4,356 Divide the answer in step 1 by the answer in step 2 to obtain a value for BMI BMI = 105,600 / 4,356 = 24.2

10. Body Composition Analysis Hydrostatic (underwater) weighing Most accurate Skinfold measurements Thickness of fat under the skin Electrical Impedance Analysis Electricity prefers lean tissue

11. The Health Risks of Excess Body Fat Obese individuals have a mortality rate twice that of non-obese Reduces life expectancy by 10-20 years Associated with : Unhealthy cholesterol and triglycerides, impaired heart function, and death from cardiovascular disease Other health factors : hypertension, cancer, impaired immune function, gallbladder and kidney disease, skin problems, impotence, sleep disorder back pain, arthritis Strong association – Type II diabetes

12. Body Fat Distribution and Health Apples Upper regions of their bodies Increase risk of high blood pressure, diabetes, early-onset heart disease, stroke, and cancer Pears Fat storage in the hips, buttocks and thighs Assessed by measuring waist circumference Risk if total waist measurement is more than 40 inches for men and 35 inches for women

13. Body Image Collective picture of the body as seen through the mind’s eye. Perceptions Images Thoughts Attitudes Emotions

14. Problems Associated with Very Low Levels of Body Fat Less than 8-12% for women and less than 3-5% for men. Extreme has been linked to problems with: Reproductive Circulatory Immune system disorders Female Athlete Triad Abnormal eating patterns Amenorrhea Decreased bone density

15. Factors Contributing To Excess Body Fat Genetic Factors 25 to 40% of an individual’s body fat 300 genes have been linked to obesity Physiological Factors Metabolism (RMR) Hormones Fat Cells Carbohydrate Craving

16. Lifestyle Factors Eating Physical Activity Psychosocial factors Emotions Coping strategies

17. Adopting A Healthy Lifestyle For Successful Weight Management Diet and Eating Habits Total Calories MyPyramid suggestions Best approach for weight loss is combining an increase of exercise with moderate calorie restriction Do not go on a crash diet

18. Adopting A Healthy Lifestyle For Successful Weight Management (Continued) Portion Sizes Energy (calorie) Density Fat Calories Carbohydrates Simple Sugars and Refined Carbohydrates Protein Eating Habits

19. Physical Activity and Exercise 30 minutes or more of moderate-intensity physical activity, everyday Walking Gardening Housework Walking 1 mile in 15-20 minutes

20. Thinking and Emotions What do you think of yourself? Self-esteem Negative emotions Ideal self Beliefs and attitudes you hold

21. Coping Strategies Adequate and appropriate strategies Healthy lifestyles and proper stress management techniques will naturally and easily result in a reasonable body weight Good nutrition Good communication Adequate exercise Positive thinking and emotions Effective coping strategies and behavior patterns

22. Approaches to Overcoming A Weight Problem Doing it yourself 0.5-2.0 pounds per week Initial weight loss from fluids. Very low calorie diets need to be avoided. Diet Books: Reject books with gimmicks or rotating levels of calories . Diet Supplements and Diet Aids Formula drinks and food bars Herbal Dietary supplements

23. Weight-Loss Programs Noncommercial TOPS, and OA Commercial Online Clinical

24. Prescription Drug Appetite Suppressants Produce a 5-15% weight reduction by controlling appetite. Once drugs are stopped most return to original heavy weight. Good option for very obese who need help getting started - permanent life style change.

25. Surgery Severely obese - BMI of 40 or higher or are 100 pounds or more over recommended weight . Roux-en-Y-gastric bypass Vertical banded gastroplasty (VBG) Liposuction Weight loss from surgery generally ranges between 40% and 70% of total body weight over a years time.

26. Body Image Severe body image problems Body dysmorphic disorder (BDD) Knowing when the limits to healthy change have been reached. Knowing the unrealistic cultural ideal. Acceptance and change Can-do attitude

27. Eating Disorders Problems with body weight and weight control. 0.5-2.0% of Americans suffer from anorexia and have bulimia 10% of college-aged women Binge eating disorder may affect 2-5%of all adults and 8% of those who are obese Over 1 Million Americans develop anorexia or bulimia each year - 90% are female. 60% of binge-eating are female

28. Eating Disorders Anorexia Nervosa - Failure to eat enough food to maintain a reasonable body weight. Affects 3 million people – 95% are female Characteristics Fear gaining weight. Distorted self-image. Compulsive behaviors and rituals. Excessive exercise Health Risks of Anorexia Nervosa Stop menstruation Intolerant of cold Low blood pressure and heart rate Dry skin Hands and feet may swell and take on a blue tinge Depression and suicide Medical complications Disorders of the cardiovascular, gastrointestinal, endocrine, and skeletal systems

29. Eating Disorders Bulimia Nervosa - recurring episodes of binge eating followed by purging. Begins in adolescence or young adulthood Increasingly younger (11-12 years) and older (40-60 years) ages. Characteristics: Rapidly consumes food, then purges. Done in secret. After a binge - feels ashamed, disgusted and physically and emotional drained. Health Risks: Erodes tooth enamel Deficient calorie intake Liver and kidney damage Cardiac arrhythmia Chronic hoarseness Esophageal tearing Rupture of the stomach Menstrual problems Increased depression

30. Eating Disorders Binge-Eating - Similar to Bulimia except no Purging behavior. Eating patterns - very rapid, eating until uncomfortably full. Often eat as a way of coping. Likely to be obese. High rates of depression and anxiety

31. Treating Eating Disorders Address both eating disorder, misuse of food and manage emotions Anorexia Nervosa Bulimia Nervosa Binge-Eating Today’s Challenge

32. Weight Management Chapter 11