Weight management 2

Chapter 10Chapter 10
Weight ManagementWeight Management

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
IntroductionIntroduction
•• 61% of Americans are overweight61% of Americans are overweight
– Overweight is defined as 1-19% above one’s idealOverweight is defined as 1-19% above one’s ideal
weightweight
– Obese is defined as above 19% one’s ideal weightObese is defined as above 19% one’s ideal weight
 Also can be defined in terms of total body fat contentAlso can be defined in terms of total body fat content

Many health risks associatedMany health risks associated
– DiabetesDiabetes
– Heart diseaseHeart disease
– Dyslipidemia (high blood cholesterol)Dyslipidemia (high blood cholesterol)
– Sleep apnea and breathing problemsSleep apnea and breathing problems
– CancerCancer
– DepressionDepression
– Hypertension (high blood pressure)Hypertension (high blood pressure)

Body ImageBody Image
•• Determining the Right Weight for YouDetermining the Right Weight for You
•• Reference Table 10.1 for Healthy Weight RangesReference Table 10.1 for Healthy Weight Ranges
••Based onBased on
– Body structureBody structure
– HeightHeight
– Distribution of weightDistribution of weight
– Ratio of lean tissue to body fatRatio of lean tissue to body fat

Assessing Fat LevelsAssessing Fat Levels
 Weight-for-HeightWeight-for-Height
ChartsCharts
Table 10.1: Healthy Weight Ranges.Table 10.1: Healthy Weight Ranges.
697-6777

 Weight tables give acceptable rangesWeight tables give acceptable ranges
– Low end of range for low ratio of lean mass toLow end of range for low ratio of lean mass to
fat massfat mass
– High end of range for more muscular bodyHigh end of range for more muscular body
 ““Ideal” body compositionIdeal” body composition
– Men’s range is 11-15%Men’s range is 11-15%
– Women’s range is 18-22%Women’s range is 18-22%

 Lean body mass consists of muscle,Lean body mass consists of muscle,
bone, body water, cellular elements andbone, body water, cellular elements and
organsorgans
 Body fats are essential or stored fatsBody fats are essential or stored fats
– Essential fats for physiological functionsEssential fats for physiological functions
 3-15% of total body weight3-15% of total body weight
 Storage fat is remainder of body fatStorage fat is remainder of body fat

 Body Mass IndexBody Mass Index
 Index of the relationship between height andIndex of the relationship between height and
weightweight
 BMI of 19-25 indicates healthy weightBMI of 19-25 indicates healthy weight
 Does have limitationsDoes have limitations
 Very muscular people may fall into overweight categoryVery muscular people may fall into overweight category
 ““Underweight” people may be in healthy weight categoryUnderweight” people may be in healthy weight category
yet too thinyet too thin

 Waist-to-Hip RatioWaist-to-Hip Ratio
– A measure of regional fat distributionA measure of regional fat distribution
– Excess fat in abdominals is health riskExcess fat in abdominals is health risk
 High blood pressureHigh blood pressure
 DiabetesDiabetes
 Heart diseaseHeart disease
 Certain cancersCertain cancers

 Waist-to-Hip Ratio (continued)Waist-to-Hip Ratio (continued)
– Men and postmenopausal women store fat inMen and postmenopausal women store fat in
upper region: abdominals, arms and chestupper region: abdominals, arms and chest
– Premenopausal women store fat in lower region:Premenopausal women store fat in lower region:
hips, buttocks and thighships, buttocks and thighs
– A waistline greater than 40 inches for men and 35A waistline greater than 40 inches for men and 35
inches for women may indicate health riskinches for women may indicate health risk

 Measures of Body FatMeasures of Body Fat
 Hydrostatic Weighing TechniqueHydrostatic Weighing Technique
 Pinch and Skinfold MeasurePinch and Skinfold Measure
 Girth and Circumference MeasureGirth and Circumference Measure
 Soft-Tissue RoentgenogramSoft-Tissue Roentgenogram
 Bioelectrical Impedance AnalysisBioelectrical Impedance Analysis
 Total Body Electrical ConductivityTotal Body Electrical Conductivity

Risk Factors for ObesityRisk Factors for Obesity
 Key Environmental FactorsKey Environmental Factors
 Most common nutritional disorder in the U.S.Most common nutritional disorder in the U.S.
 Increased energy intake:Increased energy intake:
 Bombarded with advertisingBombarded with advertising
 Changes in working familiesChanges in working families
 Bottle feedingBottle feeding
 Decreased energy expenditure:Decreased energy expenditure:
 Increased sedentary nature of many jobsIncreased sedentary nature of many jobs
 TV and video games, automated equipmentTV and video games, automated equipment

 HeredityHeredity
 Body type and genesBody type and genes
 Genes may set metabolic ratesGenes may set metabolic rates
 Obesity genesObesity genes
 Ob gene, leptin, GLP-1Ob gene, leptin, GLP-1
 Hunger, Appetite, and SatietyHunger, Appetite, and Satiety
 Hunger is physiological response to nutritional needHunger is physiological response to nutritional need
 Appetite is psychological response tied to emotionalAppetite is psychological response tied to emotional
reaction, not nutritional needreaction, not nutritional need

 DevelopmentalDevelopmental
FactorsFactors
 HyperplasiaHyperplasia
 ExcessiveExcessive
number of fatnumber of fat
cellscells
 HypertrophyHypertrophy
 Increased size ofIncreased size of
cellscells
Figure 10.2: One Person atFigure 10.2: One Person at
Various Stages of Weight Loss.Various Stages of Weight Loss.

•• Setpoint TheorySetpoint Theory
•• Body has a set weight and will attempt toBody has a set weight and will attempt to
maintain that weightmaintain that weight
•• Plateau when body sabotages dieting byPlateau when body sabotages dieting by
lowering metabolismlowering metabolism
• Possibility of changing setpoint?Possibility of changing setpoint?
• Exercise is most critical factorExercise is most critical factor
•• Psychosocial FactorsPsychosocial Factors
•• Eating as focal point of people’s livesEating as focal point of people’s lives

•• Metabolic ChangesMetabolic Changes
•• Basal Metabolic RateBasal Metabolic Rate
 60-70% of daily calories burned60-70% of daily calories burned
 Heartbeat, breathing, body temp…Heartbeat, breathing, body temp…
 Affected by muscle mass, ageAffected by muscle mass, age
 Can be resetCan be reset
– Change ratio of lean muscle massChange ratio of lean muscle mass
– Improve cardiorespiratory systemImprove cardiorespiratory system
– Extreme dieting can lower BMR!Extreme dieting can lower BMR!

•• Gender and ObesityGender and Obesity
•• Women more vulnerable to weight gainWomen more vulnerable to weight gain
 Have lower ratio of lean body mass to fat massHave lower ratio of lean body mass to fat mass
 Greater potential for weight fluctuation due toGreater potential for weight fluctuation due to
hormonal changes, pregnancy…hormonal changes, pregnancy…
•• Social physique anxiety (SPA)Social physique anxiety (SPA)
 Desire to “look good” disables one’s ability toDesire to “look good” disables one’s ability to
function sociallyfunction socially
 Susceptible to eating disordersSusceptible to eating disorders

Obesity Rates in USObesity Rates in US
 Women:Women:
 Men:Men:
 Children:Children:

Managing Your WeightManaging Your Weight
•• Keeping Weight Control inKeeping Weight Control in
PerspectivePerspective
•• Each person is differentEach person is different
•• Weight loss is not simpleWeight loss is not simple
 Requires supportRequires support
 Requires patienceRequires patience

Setting Realistic GoalsSetting Realistic Goals
 Establish enjoyable and stableEstablish enjoyable and stable
eating/exercise patternseating/exercise patterns
 Focus on small gains initially, later lookingFocus on small gains initially, later looking
toward long-term improvementstoward long-term improvements
 Establishing maintainable goalsEstablishing maintainable goals
 Making a lifetime commitment to exercise,Making a lifetime commitment to exercise,
food choices, and stress managementfood choices, and stress management
 Deemphasizing food as a central focusDeemphasizing food as a central focus

 What is a Calorie?What is a Calorie?
 The calorie, or gram calorie, is the quantity ofThe calorie, or gram calorie, is the quantity of
heat required to raise the temperature of 1heat required to raise the temperature of 1
gram of pure water 1°C.gram of pure water 1°C.
 Unit of measure of the amount of energyUnit of measure of the amount of energy
obtained from foodobtained from food
 One pound of fat = 3,500 caloriesOne pound of fat = 3,500 calories
 ExerciseExercise
 Resting Metabolic Rate-90% of caloriesResting Metabolic Rate-90% of calories
burnedburned
 Exercising Metabolic Rate-other 10%Exercising Metabolic Rate-other 10%

 Changing Your Eating HabitsChanging Your Eating Habits
 What triggers eating?What triggers eating?
 Changing Your Triggers, see Skills forChanging Your Triggers, see Skills for
Behavior Change, p. 271Behavior Change, p. 271
 Selecting a Nutritional PlanSelecting a Nutritional Plan
 Set realistic, attainable goalsSet realistic, attainable goals
 Seek help from reputable sourcesSeek help from reputable sources
 Successful plans allow good food choicesSuccessful plans allow good food choices
without sacrificing everythingwithout sacrificing everything

 Trying to Gain WeightTrying to Gain Weight
 Control exerciseControl exercise
 Eat more caloriesEat more calories
 Supplement your dietSupplement your diet
 RelaxRelax

Fad DietsFad Diets
 Fixed MenuFixed Menu
 Exchange-TypeExchange-Type
 Prepackaged-mealPrepackaged-meal
 FormulaFormula
 QuestionableQuestionable
 FlexibleFlexible
http://www.1is2fat.com/types_of_diets.htm

 South Beach DietSouth Beach Diet
 vinegar dietvinegar diet
 atkins dietatkins diet
 atkins diet menuatkins diet menu
 carbohydrate addicts dietcarbohydrate addicts diet
 fat flush dietfat flush diet
 cabbage soup dietcabbage soup diet
 macrobiotic dietmacrobiotic diet
 grapefruit dietgrapefruit diet
 sacred heart dietsacred heart diet
 the warrior dietthe warrior diet
 suzanne sommers dietsuzanne sommers diet
 dangers of diet pillsdangers of diet pills
 diet pillsdiet pills
 diet plandiet plan
 the atkins dietthe atkins diet
 adkins dietadkins diet
 low carb dietlow carb diet
 diabetic dietdiabetic diet
 low carbohydrate dietlow carbohydrate diet
 diabetes dietdiabetes diet
 dr atkins dietdr atkins diet
 fad dietsfad diets
 dr. atkins dietdr. atkins diet
 diet plansdiet plans
 diabetic diet recipesdiabetic diet recipes
 fad dietfad diet
 atkins diet recipesatkins diet recipes
 diabetic dietsdiabetic diets
 atkin's dietatkin's diet
 diet programsdiet programs
 dr atkins diet plandr atkins diet plan
 the adkins dietthe adkins diet
 cabbage soup diet recipecabbage soup diet recipe
 cabbage dietcabbage diet
 free adkins dietfree adkins diet
 dr. adkins dietdr. adkins diet
 suzanne somers dietsuzanne somers diet
 atkinson dietatkinson diet
 soup dietsoup diet
 atkins diet planatkins diet plan
 diet drugsdiet drugs
 diet tipsdiet tips
 diet softwarediet software
 copy of the atkins dietcopy of the atkins diet
 mayo dietmayo diet
 macrobiotic dietsmacrobiotic diets
 new mayo clinic dietnew mayo clinic diet
 dietdiet
no carb dietno carb diet
the cabbage soup dietthe cabbage soup diet
diet pills onlinediet pills online
american diabetes association dietamerican diabetes association diet
heart healthy dietheart healthy diet
diet pilldiet pill
high protien diethigh protien diet
robert atkins dietrobert atkins diet
low carb diets recipeslow carb diets recipes
the atkins diet pagethe atkins diet page
dr. atkins diet homepagedr. atkins diet homepage
diet free pillsdiet free pills
new mayo clinic diet copynew mayo clinic diet copy
diabetes dietsdiabetes diets
dr.atkins dietdr.atkins diet
diet gestational diabetesdiet gestational diabetes
cleveland clinic dietcleveland clinic diet
heart association dietheart association diet
adkin's dietadkin's diet
aitkins dietaitkins diet
atkins diet induction menuatkins diet induction menu
atkin dietatkin diet
best diet pillsbest diet pills
cabbage soup diet guidelinescabbage soup diet guidelines
the new atkins dietthe new atkins diet
akins dietakins diet
best low carb dietsbest low carb diets
no carbohydrate dietno carbohydrate diet
american diabetic association dietamerican diabetic association diet
grapefruit juice dietgrapefruit juice diet
sample low carbohydrate dietsample low carbohydrate diet
mayo clinic grapefruitmayo clinic grapefruit
gout dietgout diet
hollywood diethollywood diet
diabetic diet samplediabetic diet sample
vegetarian dietvegetarian diet
healthy diethealthy diet
3 day diet3 day diet
ulcerative colitis dietulcerative colitis diet
brat dietbrat diet
low cholesterol diet menuslow cholesterol diet menus
diet fooddiet food
fiber dietfiber diet
adhd dietsadhd diets
ice cream dietice cream diet
psoriasis dietpsoriasis diet
diet aidsdiet aids
low fat diet sheetlow fat diet sheet
caveman dietcaveman diet
free diet pills samplesfree diet pills samples
advocare dietadvocare diet
fruit dietfruit diet
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atkins diet menu planatkins diet menu plan
adkins diet recipesadkins diet recipes
new cabbage soup dietnew cabbage soup diet
carbohydrate dietcarbohydrate diet
apple cider vinegar dietapple cider vinegar diet
warrior dietwarrior diet
12day grapefruit diet12day grapefruit diet
microbiotic dietmicrobiotic diet
low calorie dietslow calorie diets
diet reviewsdiet reviews
3 day diets3 day diets
weight watchers dietweight watchers diet
slimfast dietslimfast diet
popular fad dietspopular fad diets
coumadin dietcoumadin diet
diet and nutritiondiet and nutrition
quick weight loss dietsquick weight loss diets
raw food dietraw food diet
subway dietsubway diet
mediterranean dietmediterranean diet
low cholesterol dietlow cholesterol diet
american diabetic dietamerican diabetic diet
the zone dietthe zone diet
zone dietzone diet
low carb dietslow carb diets
weight loss dietweight loss diet
protein dietprotein diet
blood type dietblood type diet
mayo clinic dietmayo clinic diet
dash dietdash diet
high protein diethigh protein diet
free diet planfree diet plan
diabeties dietdiabeties diet
low cholestrol dietlow cholestrol diet
the grapefruit dietthe grapefruit diet
gallbladder dietgallbladder diet
diet and exercisediet and exercise
diet patchesdiet patches
bodybuilding dietbodybuilding diet
free online dietsfree online diets
low fat dietlow fat diet
diverticulitis dietdiverticulitis diet

SOUTH BEACH DIETSOUTH BEACH DIET
 Says…8-13 lbs weight loss in two weeks.Says…8-13 lbs weight loss in two weeks.
 Created by Dr. Arthur AgatstonCreated by Dr. Arthur Agatston
Recommendations:Recommendations:
 Drink a minimum of 8 glasses of water, decaffeinatedDrink a minimum of 8 glasses of water, decaffeinated
beverage, or sugar free soda every daybeverage, or sugar free soda every day
 Limit your intake of caffeine-containing beverage to 1 cupLimit your intake of caffeine-containing beverage to 1 cup
each dayeach day
 Take one multivitamin and mineral supplement dailyTake one multivitamin and mineral supplement daily
 Take 500 mg of calciumTake 500 mg of calcium
 Only eat foods out of the South Beach cookbook thatOnly eat foods out of the South Beach cookbook that
contain “healthy combinations of carbs, proteins and fats.”contain “healthy combinations of carbs, proteins and fats.”

ATKINS DIETATKINS DIET
 Substitute meat, eggs and cheese forSubstitute meat, eggs and cheese for
carbohydratescarbohydrates
 Tough to keep diet so stringentTough to keep diet so stringent
 Some studies show an all meat diet canSome studies show an all meat diet can
increase your LDL levels and raise yourincrease your LDL levels and raise your
cholesterolcholesterol
 American Heart Association issued asAmerican Heart Association issued as
statement… “To be safe, people on anstatement… “To be safe, people on an
Atkins-style diet should have their bloodAtkins-style diet should have their blood
lipids monitored regularly…”lipids monitored regularly…”http://www.1is2fat.com/types_of_diets.htm

CABBAGE SOUP DIETCABBAGE SOUP DIET
 Cabbage soup has fat burning qualities.Cabbage soup has fat burning qualities.
 Claims you can loose 10 lbs in a weekClaims you can loose 10 lbs in a week
 HOW? As much water as you want!HOW? As much water as you want!
Day 1: Cabbage soup plus as much fruit as you would like.Day 1: Cabbage soup plus as much fruit as you would like.
Day 2: Cabbage soup plus vegetables including 2 jacket potato with aDay 2: Cabbage soup plus vegetables including 2 jacket potato with a
little butter.little butter.
Day 3: Cabbage soup plus fruit and veggies excluding potatoes andDay 3: Cabbage soup plus fruit and veggies excluding potatoes and
bananasbananas
Day 4: Cabbage soup plus up to eight bananas and as much skimmedDay 4: Cabbage soup plus up to eight bananas and as much skimmed
milk as you likemilk as you like
Day 5: Cabbage soup plus up to 20 ounces of beef and up to 6Day 5: Cabbage soup plus up to 20 ounces of beef and up to 6
tomatoestomatoes
Day 6: Cabbage soup plus as much beef and vegetables (excludingDay 6: Cabbage soup plus as much beef and vegetables (excluding
potatoes) as you like.potatoes) as you like.
Day 7: Cabbage soup plus brown rice, vegetables and unsweetenedDay 7: Cabbage soup plus brown rice, vegetables and unsweetened
fruit juice.fruit juice.
 Short Term weight loss. (Weight loss from water, muscle tissue notShort Term weight loss. (Weight loss from water, muscle tissue not
fat reserves.)fat reserves.)
 Starvation diet…Starvation diet…

GRAPEFRUIT DIETGRAPEFRUIT DIET
 2 ½ Months you should lose 52 lbs2 ½ Months you should lose 52 lbs
 Diet planDiet plan
 How?How?
1.1. Drink 8- 8 oz glasses of water dailyDrink 8- 8 oz glasses of water daily
2.2. Eat until you are full at every mealEat until you are full at every meal
3.3. Eat the minimum listed at every mealEat the minimum listed at every meal
4.4. Do not eliminate anything from your diet.Do not eliminate anything from your diet.
5.5. Don’t add or reduce amounts of grapefruit juice.Don’t add or reduce amounts of grapefruit juice.
6.6. Cut down on coffee.Cut down on coffee.
7.7. Don’t eat between meals.Don’t eat between meals.
8.8. Use butter generously on vegetablesUse butter generously on vegetables
9.9. Don’t eat desserts, breads and white vegetablesDon’t eat desserts, breads and white vegetables
10.10. Double and triple helpings of meat, salad and veggies.Double and triple helpings of meat, salad and veggies.
11.11. Eat until you are stuffed. “The more you eat the more you will lose”Eat until you are stuffed. “The more you eat the more you will lose”
12.12. Stay on the diet for 12 days, then stop for 2. And repeat.Stay on the diet for 12 days, then stop for 2. And repeat.

Eating DisordersEating Disorders
 Anorexia NervosaAnorexia Nervosa
 Self-starvationSelf-starvation
 Intense fear of fatIntense fear of fat
 Bulimia NervosaBulimia Nervosa
 Binge and then take inappropriate measuresBinge and then take inappropriate measures
to lose caloriesto lose calories
 3% of adolescent and young females3% of adolescent and young females

 Bulimia Nervosa (continued)Bulimia Nervosa (continued)
 Males 1 for every 10 femalesMales 1 for every 10 females
 Often at normal weightOften at normal weight
 Binge Eating DisorderBinge Eating Disorder
 Often clinically obeseOften clinically obese
 Eat excessive amounts without purgingEat excessive amounts without purging

 Who is at Risk?Who is at Risk?
 Most often young peopleMost often young people
 Obsessive-compulsiveObsessive-compulsive
disorder/Depression/Anxiety all play a roledisorder/Depression/Anxiety all play a role
 Tend to be women from middle to upper classTend to be women from middle to upper class
familiesfamilies
 Male sufferers are increasingMale sufferers are increasing

 Treatments for Eating DisordersTreatments for Eating Disorders
 Goal is to stabilize the patient’s lifeGoal is to stabilize the patient’s life
 Long-term therapyLong-term therapy
 Multidimensional approachMultidimensional approach
 Psychological, social, environmental, andPsychological, social, environmental, and
physiological factorsphysiological factors

Next weekNext week
 Wear shorts and a t-shirtWear shorts and a t-shirt
 Tennis shoesTennis shoes

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