Chapter 5 weight management
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Outline : Overweight vs. Obesity Diet Crazes Eating Disorders The Physiology of Weight Loss Diet and Metabolism Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Behavior Modification & Adherence to a Weight Management Program The Simple Truth.

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Chapter 5 Weight Management

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Chapter 5 weight management

Outline:

Overweight vs. Obesity

Diet Crazes

Eating Disorders

The Physiology of Weight Loss

Diet and Metabolism

Exercise: The Key to Weight Management

Losing Weight the Sound and Sensible Way

Behavior Modification & Adherence to a Weight Management Program

The Simple Truth

Chapter 5Weight Management


Weight management

Obesity has become an epidemic in most developed countries around the world

The WHO estimates 35% of the adult population in industrialized nations is obese

The obesity level is the point at which excess body fat can lead to serious health problems

Weight Management


Average weight of americans between 1963 1965 and 1999 2002

Average weight of Americans between 1963-1965 and 1999-2002

Obesity and overweight have dramatically increased as a direct result of physical inactivity and poor dietary habits

Average weight of American adults between ages 20 and 74 has increased by 25 lbs. or more since 1965


Percentage of the adult population that is overweight bmi 25 and obese bmi 30 in the united states

Percentage of the adult population that is overweight (BMI ≥ 25) and obese (BMI ≥ 30) in the United States

More than 66% of U.S. adults are over overweight and 32% are obese

Between 1960 and 2002, the prevalence of adult obesity increased from about 13% to 30%


Obesity trends in the united states 1985 2007 based on bmi 30 or 30 pounds overweight

Obesity trends in the United States 1985-2007 based on BMI ≥ 30 or 30 pounds overweight

Rates of obesity increased in the 1990s

No state reported an obesity rate above 15% before 1990

By 2007, only one state had a prevalence of less than 20%

Thirty states had a prevalence ≥ 25%

Three of these states had a rate above 30%


Weight management1

Weight Management

About 44% of all women and 29% of all men are on a diet at any given moment

People spend about $40 billion yearly attempting to lose weight

over $10 billion to weight reduction centers

$30 billion to diet food sales

About $100 billion spent yearly to treat obesity-related diseases


Weight management2

Weight Management

Excessive body weight and physical inactivity are the second leading cause of preventable death in the U.S. (over 112,000 deaths year)

Obesity is more prevalent than smoking, poverty, and problem drinking

Obesity and unhealthy lifestyles are the most critical public health problems of the 21st century

Health risks increase at a BMI over 25 and are enhanced at a BMI over 30


Health consequences of excessive body weight

Health Consequences of Excessive Body Weight


Overweight versus obesity

Overweight versus Obesity

Overweight: A chronic disease characterized by a body mass index (BMI) greater than 25 but less than 30

Obesity: A chronic disease characterized by a body mass index (BMI) 30 or higher


Tolerable weight

Tolerable Weight

The media has the greatest influence on people’s perception of what constitutes ideal body weight

Most people use fashion, fitness, and beauty magazines to determine what they should look like

The “ideal” body shapes, physiques, and proportions seen in these magazines are rare and essentially achieved only through airbrushing and medical reconstruction


The weight loss dilemma

The Weight Loss Dilemma

Yo-yo dieting carries as great a health risk as being and remaining overweight

Data show frequent fluctuations (up or down) in weight increase the risk of dying from cardiovascular disease

Quick-fix diets should be replaced by a slow, permanent weight loss program

Individuals gain the benefits of recommended body weight when they reach that weight and stay there throughout life


The weight loss dilemma1

The Weight Loss Dilemma

Only about 10% of people who begin a traditional weight loss program without exercise lose the desired weight

Only 5 in 100 keep the weight off because the body is highly resistant to permanent weight changes through calorie restrictions alone

Traditional diets fail because few of them incorporate permanent behavioral changes in food selection and overall increase in physical activity and exercise


Diet crazes

Diet Crazes

Fad diets continue to appeal to people of all shapes and sizes

These diets may work for a while but their success is usually short lived

Fad diets claim that dieters will lose weight by following all instructions

Very low calorie diets generate a metabolic imbalance by creating a nutritional deficiency

Much of the weight lost is in the form of water and protein, not fat


Low carb diets

Low-Carb Diets

Low-carbohydrate/high-protein (LCHP) diets have been very popular

The intake of carbohydrate-rich foods--bread, potatoes, rice, pasta, cereals, crackers, juices, sodas, sweets (candy, cookies, cake), fruits and vegetables--is limited

Dieters can eat all they want of protein-rich foods including steak, ham, chicken, fish, bacon eggs, nuts, cheese, tofu, high-fat salad dressings, butter, and small amounts of a few fruits and vegetables

These diets are high in fat

Examples are the Atkins Diet, the Zone, Protein Power, the Carb Addict’s Diet, the South Beach Diet, Sugar Busters


Chapter 5 weight management

Low-carbohydrate/high-protein diets create nutritional deficiencies and contribute to the development of cardiovascular disease, cancer, and osteoporosis

Without fruits, vegetables, whole grains, high-protein diets lack many vitamins, minerals, antioxidants, phytonutrients, and fiber that protect against various ailments and diseases

Long-term adherence to a LCHP diet may increase one’s risk for heart disease, cancer, and osteoporosis


Low carb diets1

Low-Carb Diets

Side effects associated with LCHP diets include weakness, nausea, bad breath, constipation, irritability, lightheadedness, fatigue

Your doctor should know if you go on a LCHP diet for longer than a few weeks so that your blood lipids, bone density, and kidney function can be monitored


Low carb diets2

Low-Carb Diets

Adding extra protein (10-15 grams) to a weight loss program can suppress hunger

Dieters are less hungry when protein intake is increased to 30% of total calories, fat is 20%, and carbohydrates stay at 50% of total calories

10-15 grams of protein is equivalent to one and a half ounces of lean meat, two tablespoons of natural peanut butter, eight ounces of plain low-fat yogurt


Eating disorders

Eating Disorders

Medical illnesses that involve crucial disturbances in eating behaviors thought to stem from some combination of environmental pressures

Characterized by an intense fear of becoming fat even when the person is losing weight in extreme amounts

Three most common types are anorexia nervosa, bulimia, and binge-eating disorder

Emotional eating can also be listed as an eating disorder


Eating disorders1

Eating Disorders

People with eating disorders suffer from family and social problems

The eating disorder becomes the coping mechanism to avoid dealing with these problems

Controlling their body weight helps them believe they are restoring some control over their lives

Eating disorders are common in industrialized nations where society encourages low-calorie diets and thinness


Eating disorders2

Eating Disorders

Most prevalent among people between the ages of 25 and 50

40% of college-age women are struggling with an eating disorder

Every 1 in 10 cases occurs in men

These cases often go unreported because men’s role and body image are viewed differently in our society


Anorexia nervosa

Anorexia Nervosa

An eating disorder characterized by self-imposed starvation to achieve and maintain very low body weight

Affects 1% of the population in the U.S.

Anorexics fear weight gain more than death from starvation

They think of themselves as being fat even when they are emaciated because of their distorted body image

They are preoccupied with food, meal planning, grocery shopping, and have unusual eating habits

They will not stop the starvation

They refuse to consider the behavior abnormal


Anorexia nervosa1

Anorexia Nervosa

Physical changes from weight loss and malnutrition include:

amenorrhea (absence of menstruation)

digestive problems

sensitivity to cold

fluid and electrolyte imbalances (irregular heartbeat)

injuries to nerves and tendons

abnormalities of immune function

anemia

growth of fine body hair

dry skin

lowered skin/body temperature

hair and skin problems

mental confusion

inability to concentrate

lethargy and depression

osteoporosis


Anorexia nervosa2

Anorexia Nervosa

Diagnostic criteria for anorexia nervosa:

Refusal to maintain body weight over a minimal normal weight for age and height

Intense fear of gaining weight even though underweight

Disturbance in perception of one’s body weight, size, or shape; undue influences of body weight or shape on self-evaluation, and denial of seriousness of current low body weight

Amenorrhea


Anorexia nervosa3

Anorexia Nervosa

The disorder is 100% curable although it has the highest mortality rate of all psychosomatic illnesses--20% die as a result of their condition

Treatment usually requires professional help

Therapy is a combination of medical and psychological techniques to restore proper nutrition, prevent medical complications, and change the environment or events that triggered the disorder

It can go undetected because thinness and dieting are socially acceptable


Bulimia nervosa

Bulimia Nervosa

An eating disorder characterized by a pattern of binge eating and purging in an attempt to lose weight and maintain low body weight

More prevalent than anorexia nervosa

1 in every 5 women on college campuses may be bulimic

More prevalent than anorexia in males

Bulimics are usually healthy looking, well educated, near recommended body weight

Bulimics enjoy food and often socialize around it

They are emotionally insecure, rely on others, lack self-confidence and self-esteem

Recommended weight and food are important to them


Bulimia nervosa1

Bulimia Nervosa

The binge-purge cycle can be caused by stress or the compulsion to eat

Bulimics periodically engage in binge eating that may last an hour or longer during which time they may eat several thousand calories

up to 10,000 calories (in extreme cases)

After a short period of relief and satisfaction, feelings of deep guilt, shame, an intense fear of gaining weight emerge

Purging seems to be the easiest answer


Bulimia nervosa2

Bulimia Nervosa

Diagnostic criteria for bulimia nervosa

Recurrent episodes of binge eating characterized by eating in a discrete period of time an amount of food more than most people would eat during a similar period under similar circumstances

A sense of a lack of control over eating during the episode

Practice self-induced vomiting, fasting, excessive exercise and misuse laxatives and medications to prevent weight gain

Binge-purge cycle occurs on average at least twice a week for 3 months

Self-evaluation influenced by body shape and weight


Bulimia nervosa3

Bulimia Nervosa

Medical problems associated with bulimia include:

cardiac arrhythmias

amenorrhea

kidney and bladder damage

ulcers

colitis

tearing of esophagus or stomach

tooth erosion, gum damage

general muscular weakness

Bulimics know their behavior is abnormal and they are ashamed so they practice in secrecy

A change in attitude can prevent damage or death


Binge eating disorder

Binge-Eating Disorder

An eating disorder characterized by uncontrollable episodes of eating excessive amounts of food within a relatively short time

Most common of the 3 main eating disorders

About 2% of U.S. adults have binge-eating disorder in any 6-month period

More common in women than in men, 3 women for every 2 men have it

Depression, anger, sadness, boredom, worry can trigger an episode

Bingers are usually overweight or obese as bingers do not purge


Binge eating disorder1

Binge-Eating Disorder

Typical symptoms include:

Eating an unusually large amount of food

Eating until uncomfortably full

Eating out of control

Eating much faster than usual during binge episodes

Eating alone due to embarrassment by how much food is consumed

Feeling disgusted, depressed, or guilty after overeating


Emotional eating

Emotional Eating

The consumption of large quantities of food to suppress negative emotions

Emotions include stress, anxiety, uncertainty, guilt, anger, pain, depression, loneliness, sadness, boredom

People eat for comfort when they are at their weakest point emotionally

Comfort foods often include calorie-dense, sweet, salty, and fatty foods

Some foods such as chocolate help to offset negative emotions by causing the body to release mood-elevating opiates


Emotional eating1

Emotional Eating

Eating is a temporary distraction

The following list of suggestions may help:

Learn to differentiate between emotional and physical hunger

Avoid storing and snacking on unhealthy foods

Keep healthy snacks handy

Use countering techniques (go for a walk instead of eating ice cream, listen to music instead of eating a candy bar)

Keep a “trigger” log and know what triggers your emotional food consumption

Work it out with exercise instead of food


Treatment

Treatment

Treatment for eating disorders is available through many schools’ counseling or health center, at local hospitals, community support groups offering confidential help led by professional personnel free of charge


Energy balancing equation

Energy Balancing Equation

One pound of fat is the equivalent of 3,500 calories

In theory, if a person requiring 3,500 calories a day decreased intake by 500 calories per day, the person should lose 1 pound of fat in 7 days (500 x 7 = 3,500)

When dieters balance caloric input against caloric output, weight loss does not always result as predicted


Recommendation

Recommendation

Daily caloric intakes of 1,200-1,500 calories provide the necessary nutrients if they are properly distributed over the basic food groups

Weight loss should be gradual and not abrupt

Under no circumstances should a person go on a diet that calls for a level of 1,200 calories or less for women or 1,500 calories or less for men


Body composition changes as a result of frequent dieting without exercise

Body composition changes as a result of frequent dieting without exercise


Exercise the key to weight management

Exercise: The Key to Weight Management

A person that jogs 3 miles per exercise session 3 times a week burns 900 calories a week; 3,600 calories per month; 46,800 calories per year

This minimal amount of exercise represents about 13.5 pounds of fat in one year

Many of the health benefits that people seek by losing weight are reaped through exercise alone

Exercise offers protection against premature morbidity and mortality for everyone, including people who already have risk factors for disease


Low intensity vs vigorous intensity exercise for weight loss

Low-Intensity vs. Vigorous-Intensity Exercise for Weight Loss

A greater proportion of calories burned during low-intensity exercise are derived from fat

The lower the intensity of exercise, the higher the percentage of fat used as an energy source

During low-intensity exercise, up to 50% of the calories burned may be from fat with the other 50% from glucose

With intense exercise, only 30%-40% of the caloric expenditure comes from fat

Overall, twice as many calories can be burned during vigorous-intensity activity, and more fat


Low intensity vs vigorous intensity exercise for weight loss1

Low-Intensity vs. Vigorous-Intensity Exercise for Weight Loss

If you exercised for 30-40 minutes at moderate intensity and burned 200 calories, 50% (100 calories) would come from fat

If you exercised at a vigorous intensity for 30-40 minutes and burned 400 calories, 120-160 calories would come from fat

Whereas it is true that the percentage of fat used is greater during low-intensity exercise, the overall amount of fat used is still less during low-intensity exercise

If you exercise at a low intensity, you would have to do so twice as long to burn the same number of calories

Metabolic rate remains at a slightly higher level longer after vigorous-intensity exercise, so you continue to burn calories after exercise


Comparison of energy expenditure between 30 40 minutes of low intensity vs high intensity exercise

Comparison of Energy Expenditure between 30-40 Minutes of Low-Intensity vs. High-Intensity Exercise


Weight loss myths

Weight Loss Myths

Wearing rubberized sweat suits hastens the rate of body fluid that is lost and raises core temperature at the same time

This combination puts a person in danger of dehydration, which impairs cellular function and can cause death

Mechanical vibrators like vibrating belts and turning rollers are worthless in a weight control program as fat cannot be shaken off


Losing weight the sound and sensible way

Losing Weight the Sound and Sensible Way

Research finds that a negative caloric balance is required to lose weight because:

People often underestimate their intake

People have trouble changing and adjusting to new eating habits

Many people take a long time to increase their activity level enough to offset the setpoint and burn enough calories to lose body fat

Most successful dieters monitor their daily caloric intake

A few people will not alter their food selection, so they must either increase physical activity, have a negative caloric balance, or both


Caloric expenditure of selected physical activities

Caloric Expenditure of Selected Physical Activities


Losing weight the sound and sensible way1

Losing Weight the Sound and Sensible Way

Breakfast is a critical meal while you are on a weight loss program

People who skip breakfast are hungrier later in the day and end up consuming more total daily calories than those who eat breakfast

Regular breakfast eaters have less of a weight problem, lose weight more effectively, and have less difficulty maintaining weight loss


Losing weight the sound and sensible way2

Losing Weight the Sound and Sensible Way

If most of the calories are consumed during one meal, the body may slow the metabolism to store more calories in the form of fat

Eating most of the calories during one meal causes a person to go hungry the rest of the day, making it difficult to stick to the diet


Behavior modification adherence to a weight maintenance program

Behavior Modification & Adherence to a Weight Maintenance Program

Make a commitment to change

Surround yourself with people who have the same weight loss goals you do as data indicate that obesity can spread through “social networks”

Gender plays a role in social networks

A male’s weight has a greater effect on the weight of male friends and brothers

A woman’s weight has a greater effect on sisters and girlfriends

If you are trying to lose weight choose your friendships carefully


The simple truth

The Simple Truth

There is no quick and easy way to achieve and maintain excess body fat loss

People have to decrease their caloric intake moderately, be physically active, and implement strategies to modify unhealthy eating behaviors

Three most common reasons for relapse:

Stress-related factors

Social reasons

Self-enticing behaviors

Making mistakes is human and does not mean failure


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