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- 1. Weight Management: Overweight,WeightManagement: Overweight, Obesity, & UnderweightObesity, & Underweight
- 2. Overweight and ObesityOverweightand Obesity • Major health problem in the U.S. • Growing concern worldwide • Prevalence continues to increase • Women, poor, blacks, and Hispanics • Children • BMI of 25 or greater • Epidemic is worldwide • Not merely among industrialized countries
- 3. Increasing Prevalence ofIncreasingPrevalence of Obesity among US AdultsObesity among US Adults
- 4. Fat Cell DevelopmentFatCell Development • Energy in exceeds energy out • Stored in fat cells of adipose tissue • Body fat • Number and size of fat cells • Periods in life when fat cell numbers increase • Cell proliferation • Energy out exceeds energy in • Fat cell size decreases; no change in number
- 5. Fat Cell DevelopmentFatCell Development
- 6. Fat Cell MetabolismFatCell Metabolism • Lipoprotein lipase (LPL) activity • Storage of triglycerides • Obese people vs. lean people • Activity in varying body regions • Men vs. women • Enzyme activity releasing and breaking down fat • Fat oxidation is not efficient • Set point theory
- 7. Causes of Overweight& ObesityCauses of Overweight & Obesity – Genetics & Epigenetics– Genetics & Epigenetics • Causative role of genetics • Genetic influences do seem to be involved • Genetics may determine predisposition to obesity • Genes interact with: • Diet and physical activity • Satiety and energy balance • Human genome
- 8. Causes of Overweight& ObesityCauses of Overweight & Obesity – Genetics & Epigenetics– Genetics & Epigenetics • Obesity gene • Codes for the protein leptin • Acts as a hormone in hypothalamus • Promotes negative energy balance • Suppresses appetite • Increases energy expenditure • Locations of leptin secretion
- 9. Mice with andwithout Leptin Compared
- 10. Causes of Overweight& ObesityCauses of Overweight & Obesity – Genetics & Epigenetics– Genetics & Epigenetics • Obesity gene • Genetic deficiency of leptin or genetic mutation • Rare • Leptin resistance • Fructose consumption • Roles in the body • Energy regulation • Others
- 11. Causes of Overweight& ObesityCauses of Overweight & Obesity – Genetics & Epigenetics– Genetics & Epigenetics • Ghrelin • Promotes positive energy balance • Inverse correlation with body weight • Roles in the body beyond energy regulation • Uncoupling proteins • Types of body fat • Brown adipose tissue • White adipose tissue
- 12. Causes of Overweight&Causes of Overweight & Obesity – EnvironmentObesity – Environment • Encountered daily circumstances • Interaction between environment and genetics • Overeating • Present and past eating and activity patterns influence current body weight • Availability • Serving sizes • Restaurant food
- 13. Causes of Overweight&Causes of Overweight & Obesity – EnvironmentObesity – Environment • Physical inactivity • Life requires little exertion • Modern technology • Inactivity contributes to weight gain and poor health • Sedentary activities and weight gain • DRI for prevention of weight gain • 60 minutes of moderate activity every day
- 14. Problems of OverweightandProblems of Overweight and Obesity – Health RisksObesity – Health Risks • Three indicators • BMI • Waist circumference • Disease risk profile • Factors taken into account • Beneficial weight loss • Health status • Motivation
- 15. Problems of OverweightandProblems of Overweight and Obesity – Health RisksObesity – Health Risks • Overweight in good health • Sometimes health is not the motivation for weight loss • Obese or overweight with risk factors • Two or more risk factors • Obese or overweight with life-threatening condition • Recommendation to lose weight
- 16. Problems of Overweight& ObesityProblems of Overweight & Obesity – Perceptions & Prejudices– Perceptions & Prejudices • Most obese people do not successfully lose weight and maintain the loss • Social consequences • Jobs, school, and in social situations • Psychological problems • Embarrassment • Other feelings
- 17. The Psychology ofWeightThe Psychology of Weight CyclingCycling
- 18. Problems of OverweightandProblems of Overweight and Obesity – Dangerous InterventionsObesity – Dangerous Interventions • Intervention dangers • Diet books and weight-loss programs • Little success with weight loss maintenance • Fad diets • Weight-loss products • Herbal products • Laws for dietary supplements • Other gimmicks
- 19. Aggressive Treatments forAggressiveTreatments for Obesity – DrugsObesity – Drugs • Strategies for weight reduction depend on: • Degree of obesity • Risk of disease • Use drugs as part of long-term comprehensive weight-loss programs • Assist with modest weight loss • FDA approval
- 20. FDA Approved Drugsfor Weight Loss
- 21. Aggressive Treatments forAggressiveTreatments for Obesity – SurgeryObesity – Surgery • Clinically severe obesity • 200,000 surgeries performed each year • Reduces food capacity of stomach • Effectively limits food intake • Reduce production of ghrelin • Health-related benefits • Long-term safety and effectiveness • Liposuction
- 22. Gastric Surgery Usedin theGastric Surgery Used in the Treatment of Severe ObesityTreatment of Severe Obesity
- 23. Weight Loss StrategiesWeightLoss Strategies • Successful strategies • Small changes • Moderate losses • Reasonable goals • Reasonable rate of weight loss • Benefits of modest weight loss • Incorporation of healthy eating and physical activity
- 24. Reasonable Weight Goalsvs.Reasonable Weight Goals vs. Unrealistic ExpectationsUnrealistic Expectations
- 25. Weight Loss Strategies–Weight Loss Strategies – Eating PatternsEating Patterns • Be realistic about energy intake • Provide less energy than is needed • Avoid restrictive eating • Avoid rapid weight loss • Goal: nutritional adequacy without excess • Deficit of 500 to 1000 kcalories per day • Breakfast frequency • Inversely related to obesity
- 26. Weight Loss Strategies–Weight Loss Strategies – Eating PatternsEating Patterns • Nutritional adequacy • Minimum of 1200 kcalories a day • Eat small portions • Eat less food at each meal • Feel satisfied, not stuffed • Structured meal replacement plans • Lower energy density • Cost
- 27. Daily Amounts fromEach FoodDaily Amounts from Each Food GroupGroup
- 28. Weight Loss Strategies–Weight Loss Strategies – Eating PatternsEating Patterns • Remember water • Assistance with weight management • Focus on fiber • Low in energy and high in nutrients • Require effort to eat • Speed of food consumption • Choose fats sensibly • Energy density and satiation
- 29. Weight Loss Strategies–Weight Loss Strategies – Eating PatternsEating Patterns • Select carbohydrates carefully • Artificial sweeteners • Impact on energy intake • Watch for empty kcalories • Fat, sugar, and alcohol
- 30.
- 31. Weight Loss Strategies–Weight Loss Strategies – Physical ActivityPhysical Activity • Best approach to weight management • Moderate physical activity plus activities of daily life • Combination of diet and physical activity • Lose more fat • Retain more muscle • Regain less weight • Reduction of abdominal fat
- 32. Weight Loss Strategies–Weight Loss Strategies – Physical ActivityPhysical Activity • kCalorie expenditure • Body weight, intensity, and duration • Greater the energy deficit, greater the fat loss • Discretionary kcalorie allowance • Metabolism • Speeds up with activity • Immediate and long-term benefits
- 33. Influence of PhysicalActivityInfluence of Physical Activity on Discretionary kCalorieson Discretionary kCalories
- 34. Weight Loss Strategies–Weight Loss Strategies – Physical ActivityPhysical Activity • Body composition • Fat decreases and lean body mass increases • Strength-training exercises • Abdominal fat • Appetite control • Delayed appetite • Inappropriate appetite
- 35. Weight Loss Strategies–Weight Loss Strategies – Physical ActivityPhysical Activity • Psychological benefits • Self-esteem • Choosing activities • Ones you enjoy & are willing to do regularly • Low-to-moderate intensity • 2000 calories per week • Energy-expending daily activities • Spot reducing
- 36. Weight Loss Strategies–Weight Loss Strategies – Environmental InfluencesEnvironmental Influences • Factors surrounding eating experience and the food itself • Atmosphere • Pleasant and comfortable equals more food • Accessibility • Less effort needed to obtain food, more food eaten
- 37. Weight Loss Strategies–Weight Loss Strategies – Environmental InfluencesEnvironmental Influences • Socializing • Duration of meal • Visual cues • Distraction • Distractions • Initiating eating • Interfering with internal controls • Extending duration of eating
- 38. Weight Loss Strategies–Weight Loss Strategies – Environmental InfluencesEnvironmental Influences • Multiple choice • Large assortments of foods increase consumption • Package and portion sizes • Serving containers
- 39. Weight Loss Strategies–Weight Loss Strategies – Behavior & AttitudeBehavior & Attitude • Behavior modification • Positive, matter-of-fact attitude • Become aware of behaviors • Keep record • Change behaviors • Set small, specific goals • Practice • Reward
- 40. Weight Loss Strategies–Weight Loss Strategies – Behavior & AttitudeBehavior & Attitude • Cognitive skills • Problem solving • Cognitive restructuring • Replace negative thoughts • Personal attitude • Understand personal relationship with food • Sound emotional health • Support groups
- 41. Weight Loss Strategies–Weight Loss Strategies – Weight MaintenanceWeight Maintenance • Successful weight loss • Plateau • Appropriate goal at this point • Prevalence of successful weight loss • Difficult to determine • Weight loss • Without formal program • Maintained for at least a year
- 42. Weight Loss Strategies–Weight Loss Strategies – Weight MaintenanceWeight Maintenance • Components of successful weight loss • Vigorous exercise regimens • Careful eating patterns • Frequent self-monitoring • Changes in metabolism • Takes more to prevent weight regain than to prevent weight gain
- 43. Preventing Weight GainPreventingWeight Gain • Preventing weight gain would benefit many people • Strategies are similar to losing weight • Start earlier
- 44. Community ProgramsCommunity Programs •Possibly change environment through public health law • Stretch beyond individual • Social networks • Community institutions • Government policies
- 45. Community Strategies toCommunityStrategies to Prevent ObesityPrevent Obesity
- 46. UnderweightUnderweight • Affects nomore than 2% of U.S. adults • Weight gain is a matter of health • Individual matter • Weight gain may be difficult • Physical conditioning combined with high energy intakes
- 47. Problems of UnderweightProblemsof Underweight • Demand for energy contributes to underweight • Physical activity • Growth and development • Difficult to gain weight • Adaptive thermogenesis • Learn new habits and like new foods • Underweight vs. anorexia nervosa
- 48. Weight-Gain StrategiesWeight-Gain Strategies •Key diet planning strategies • Adequacy and balance • Energy-dense foods • Regular meals daily • Large portions • Extra snacks • Juice and milk • Exercise to build muscles
- 49. The Latest andTheLatest and Greatest Weight-Greatest Weight- Loss Diet – AgainLoss Diet – Again Highlight 9Highlight 9
- 50. Fad DietsFad Diets •Outrageous claims • No requirements to prove the claims • Do not have to support with credible research • Distorted research • Numerous fad diet plans
- 51. Fad DietsFad Diets’Appeal’ Appeal • Market for weight-loss products is huge • Greatest appeal • Tend to ignore dietary recommendations • Sophisticated and often erroneous explanations • Tend to work for short time • Fail to produce long-lasting results
- 52. DonDon’t Count kCalories’tCount kCalories • Claim to disregard kcalories • Designed to have low energy intake • Tend to lack variety • Monotonous • Often recommend dietary supplement • Follow a plan • Most fad diets cannot support optimal health over time
- 53. The Real DealTheReal Deal • Fad diet “magical powers” • Tipping the energy balance equation to greater energy expenditure • Weight loss • Long-term lifestyle changes • Healthy plan • Flexibility and variety