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Weight Management Chapter 9

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Page 1: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Weight Management

Chapter 9

Page 2: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Healthy Body Weight

• National Institutes of Health• More than 67% of American adults are

overweight• More than 32% of American adults are

obese• Obesity has doubled since 1960• At current rates, all American adults will

be overweight by 2030

Page 3: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Prevalence of Healthy Body Weight

Gender Women 35%

Men 32%

Ethnicity White 35%

Latino 26%

African American 29%

Age 20–39 years 40%

40–59 years 31%

60+ years 28%

Health status People with disabilities 29%

People with diabetes 12%

ALL ADULTS 34%Source: National Center for Health Statistics

Page 4: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Overweight and Obesity

• Overweight = characterized by a body weight that falls above the range associated with minimum mortality; weighing 10% or more over recommended weight or having a BMI over 25

• Obesity = severely overweight, with an excess of body fat; weighing 20% or more over recommended weight or having a BMI over 30

Page 5: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Health Implications of Overweight and Obesity

• 33% rise in type 2 diabetes• 100,000+ premature deaths annually• Obesity is one of the six major

controllable risk factors for heart disease

• Weight loss of 5-10% in obese individuals can reduce the risk of certain diseases

Page 6: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Factors Contributing to Excess Body Fat: Genetic

Factors• Genetic factors influence body size and

shape, body fat distribution, and metabolic rate

• Genetic contribution to obesity is estimated at 25–40%

• Hereditary influences must be balanced against contribution of environmental factors

• Genetics is what can happen, our choices is what does happen!!

Page 7: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

PHYSICAL APPEARANCE

• We are all products of heredity and environment. What we get from our parents and what we do with what we get!

• Somatotype – Your physical appearance, body build.• Endomorph – A “pear-shaped” appearance. Short legs and arms,

most of body weight centered around hips and abdomen.• Mesomorph – Solid, muscular, large-boned physique. Most of

body weight is away from the abdominal area. Wide shoulders, narrow hips, well-muscled.

• Ectomorph – Slender bodies and a slight build. Very little body fat. Light musculature, long arms and legs. Bony in appearance, narrow chest and hips and generally linear in appearance.

• Most people have some characteristics of each body type, but one will dominate.

Page 8: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Fat Cell Theory

• Proponents of this theory believe that obese people have more fat cells and larger cells than the non-obese.

• Total number of fat cells increase• It is believed that once we produce fat cells,

they remain for life.• Any weight reduction would involve a reduction

in the size of the fat cell.• Evidence seems to suggest that fat cells do

reach a point where they can not get bigger, thus new cells are manufactured.

Page 9: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Physiological Factors• Metabolism – the sum of all the vital

processes by which food energy and nutrients are made available to and used by the body.

• Resting Metabolic Rate (RMR) – The energy required to maintain vital body functions. (heart, lungs, body) Accounts for about 55-75% of the energy used by the body.

• Thermal Effect of Food (TEF) – The energy required to digest food. Accounts for additional 5-15% of daily energy expenditure.

• Effect of Physical Activity – Energy expended during physical activity. Accounts for 20-40% of expended energy.

• This is the component that is the most variable and the one we can do the most about.

Page 10: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Factors That Affect Metabolic Rate

• RMR is higher in• Men• People with more muscle mass• People who exercise

• RMR is lower in• Women• People who are sedentary• People who have lost weight

Page 11: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Energy-Balance Equation

Page 12: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Factors Contributing to Excess Body Fat: Lifestyle

Factors• Eating—compared to the

past, Americans now• Consume more calories• Consume more refined and

simple carbohydrates• Eat out more often

• People underestimate portion sizes

Page 13: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

National Geographic, August 2004

Page 14: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Monster Thick Burger• 1,420 calories• 107 grams of fat• 2 – 1/3 slabs of beef• 4 strips of bacon• 3 slices of cheese

Page 15: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

CHEESEBURGER

20 Years Ago Today

333 calories How many calories are in today’s cheeseburger?

Page 16: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Calorie Difference: 257 calories

590 calories

CHEESEBURGER

20 Years Ago Today

333 calories

Page 17: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Maintaining a Healthy Weight is a Balancing ActCalories In = Calories Out

How long will you have to lift weights in order to burn the extra 257 calories?*

*Based on 130-pound person

Page 18: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

If you lift weights for 1 hour and 30 minutes,you will burn approximately 257 calories.*

*Based on 130-pound person

Calories In = Calories Out

Page 19: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

FRENCH FRIES 20 Years Ago Today

210 Calories

2.4 ounces How many calories are intoday’s portion of fries?

Page 20: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

610 Calories6.9 ounces

Calorie Difference: 400 Calories

FRENCH FRIES 20 Years Ago Today

210 Calories

2.4 ounces

Page 21: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

How long will you have to walk leisurely in order to burn those extra 400 calories?*

*Based on 160-pound person

Maintaining a Healthy Weight is a Balancing ActCalories In = Calories Out

Page 22: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

*Based on 160-pound person

If you walk leisurely for 1 hour and 10 minutes you will burn approximately 400 calories.*

Calories In = Calories Out

Page 23: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Diet and Eating Habits

• 1 pound = 3500 calories

• If calorie intake = calorie output, weight remains the same.

• For weight loss, goal should be to lose 0.5 -2 pounds/week

Page 24: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Successful Weight Loss• A successful, long-term weight control program

involves three elements.• Diet – the number of calories consumed should be

reduced, along with the fat content of the diet. Watch portion sizes. Choose complex carbohydrates – fruits, vegetables and whole grains (Nutrient –dense foods) Or those foods which have a lower energy (calorie) density. An apple vs a pie of apple pie.

• Exercise – Goal is to expend 200-400 calories/day with exercise.

• Behavior Modification• Self-monitoring – Keep a food log, recording amounts and

circumstances of eating.• Food triggers – Identify those factors which trigger eating.

Boredom, anxiety, stress, exhaustion.• Develop techniques to control eating. Positive self-talk.

Goals. Stay busy. Plan meals. Control social bingeing.• Reinforce results with rewards.

Page 25: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Physical Activity and Exercise

• Physical activity—increase daily physical activity to at least 30 minutes per day; to lose weight or maintain weight loss, 60–90 or more minutes per day is recommended

• Exercise• Endurance exercise burns calories• Strength training builds muscle mass,

which can increase metabolic rate

Page 26: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

National Geographic, August 2004

Page 27: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Diet and Eating Habits

• Fat calories—keep total fat intake moderate, and limit intake of saturated and trans fats

• Carbohydrate—emphasize whole grains, vegetables, fruits, and other high-fiber foods; limit consumption of foods high in refined carbohydrates, added sugars, and easily digestible starch

• Protein—meet recommended intake of 10–35% of total daily calories

• Eating habits—eat meals and snacks on a regular schedule

Page 28: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Doing It Yourself

• Physical activity is a critical component of healthy weight management

Page 29: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American
Page 30: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Approaches to Overcoming a Weight

Problem• Doing it yourself• Diet books• Dietary supplements and diet aids• Weight-loss programs• Prescription drugs• Surgery• Psychological help

Page 31: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Diet Books

• Reject books that• Advocate unbalanced ways of eating• Claim to be based on a secret• Use gimmicks• Promise quick weight loss • Limit the selection of foods

• Accept books that advocate a balanced diet plus exercise

Page 32: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Popular Diet Plans

• Any diet that cuts calories causes weight loss• Low-carbohydrate diets have not been proven safe

over the long-term• Low-fat diets should focus on nutrient dense foods,

especially whole-grains, fruits, and vegetables• Diets with many restrictions have high drop-out rates• People who have been successful at long-term weight

loss track food intake and engage in 60 or more minutes of physical activity per day

Page 33: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Dietary Supplements and Diet Aids

• Dietary supplements are subject to fewer regulations than over-the-counter medications; they have not been proven safe and effective

• FTC: More than half of advertisements for weight-loss products make representations that are likely to be false

Page 34: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Surgery • Surgical intervention may be

recommended for some people who have a BMI of 40 or higher or who are 100 or more pounds overweight

• Gastric bypass surgery modifies the gastrointestinal tract by changing the size of the stomach or how the intestine drains, thereby restricting the amount of food that can be eaten

• Surgery has a high rate of complications

Page 35: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Surgery

Adjustable gastric banding Roux-en-Y gastric bypass

Source: National Institutes of Health

Page 36: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Body Image

• Dissatisfaction with weight and shape is common in people with eating disorders

Page 37: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Body Image

• Body image = the mental representation a person holds about her or his body

• It consists of perceptions, images, thoughts, attitudes, and emotions

• Media images are linked to negative body image

• Different cultures have different ideas of the “ideal” body type

Page 38: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

BMI of Miss America Pageant Winners

The data shows a steady decline in winners’ BMI from a range of 20–25 in the 1920s to below 18.5, considered undernutrition by WHO and represented by the horizontal line.

SOURCE: Rubinstein, S., and B. Caballero. 2000. Is Miss America an undernourished role model? Journal of American Medical Association 283(21):

1569. Used with permission from the American Medical Association.

Page 39: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Acceptance and Change

• Most Americans are unhappy with some aspect of their appearance

• Recognize the limits of change• Small amounts of weight loss can

significantly reduce health risks

Page 40: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Eating Disorders

• Society has created tremendous pressure for individuals to be thin.

• More than two-thirds of women between the ages of 12 and 23 have felt dissatisfied with their body image and feel pressure to conform to the “ideal” body size and shape.

• Weight reduction, often takes over thoughts and energies. Some feel weight loss makes them more attractive, accepted and successful.

• The pursuit of thinness can result in serious and sometimes life-threatening eating disorders.

Page 41: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Eating Disorders

• Anorexia Nervosa – Condition is marked by suppression of appetite and intentional caloric deprivation or self-starvation.

• May have intense fear of becoming overweight and weight loss does not detensify that fear.

• There is a psychological distortion of body image, as the anorexic sees him/herself as fat, even if extremely underweight.

• Weight loss is pursued through extreme limitation of calories, fasting, strenuous exercise, use of laxatives and diuretics and sometimes self-induced vomiting.

• Disorder sometimes begins at the onset of puberty.• Problems include CV problems, gastrointestinal problems, body can

use organs for protein due to lack of fat, amenorrhea (suppression of menstrual cycle), anemia, calcium loss, brittle bones, swollen joints and light-headedness. Eventually heart failure can occur.

Page 42: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Eating Disorders• Bulimia Nervosa – This is known as the binge-purge

syndrome.• It is marked by high amounts of food/calorie

consumption (1,000-60,000 calories), followed by self-induced vomiting and/or use of laxatives and diuretics.

• Compulsive exercise also may be a characteristic of bulimia.

• Bulimia differs from anorexia in that the individual may maintain a normal body weight due to the binges experienced. This allows the bulimic to hide the problem, making it more difficult to identify.

• Eating disorders are mental disorders and must be treated as such.

• Causes and contributing factors are complex and professional help is necessary.

Page 43: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Eating Disorders

• Binge-Eating Disorders – Individuals typically experience episodes of out of control eating.

• Common characteristics include:• Eating much more rapidly than normal• Eating until uncomfortably full• Eating large quantities of food even when not hungry• Eating alone to hide the quantity of food being

ingested• Feeling disgusted, depressed, or guilty after

overeating• They do not purge their bodies after eating, thus

different from bulimia.

Page 44: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

Who Is At Risk?

• Estimated 1 in every 100 teenage girls are anorexic• Anorexia usually occurs in adolescent women (90% of all

reported cases)• Estimated 1 in every 5 college-bound females is bulimic• College campuses have a higher incidence of people with

eating disorders• Upper middle class women who are extremely self-critical

are also more likely to become anorexic• Activities such as dance and dance team, gymnastics,

figure skating, track and cheerleading tend to have higher incidences of eating disorders

• Wrestlers and body builders are also at risk due to unsafe practices to “make weight” before competition.

Page 45: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American

TREATMENT

• Be supportive. Provide information about eating disorders.• Be a good listener.• Encourage professional help. Person may need counseling,

medical treatment or hospitalization.• Be prepared for denial resistance and even hostility.• Realize that the person’s responsibility is his/hers, not yours.

Eating Disorders Therapy/ProgramsISU Counseling CenterISU Health ServicesISU Nutrition Mission

Anorexia Nervosa and Related Eating Disorders, Inc. – www.anred.com

Page 46: Weight Management Chapter 9. Healthy Body Weight National Institutes of Health More than 67% of American adults are overweight More than 32% of American