Chapter 16

1. Chapter 16 Diet and Weight Control

2. Objectives • Discuss causes and dangers of overweight • Discuss causes and dangers of underweight • Identify foods suitable for high-calorie diets and low-calorie diets

3. Rule of Thumb Method • Method for determining desired weight: • Males • Assume 106 pounds for first 5 feet (60 inches) • Add 6 pounds for each inch over 60 • Females • Assume 100 pounds for first 5 feet (60 inches) • Add 5 pounds for each inch over 60 (continues)

4. Rule of Thumb Method • Large-boned individuals of both sexes • Increase first sum by 10 percent • Small-boned individuals of both sexes • Decrease first sum by 10 percent (continues)

5. Rule of Thumb Method • Overweight • 10 to 20 percent above average • Obesity • 20 percent above average • Underweight • 10 to 15 percent below average

6. BMI • Medical standard used to define obesity • Determines whether person at health risk from excess weight • Obtained by dividing weight in kilograms by height in meters squared (continues)

7. BMI • Range of 19 to 25: • Normal weight • Few health risks • Greater than 25 • Overweight • Health risks • Above 30 • Obesity

8. Fat Distribution • Fat in abdominal cavity associated with greater health risks than fat in thigh, buttocks, and hip area • Person with pear-shaped body has lower risk for disease than someone with apple-shaped body (continues)

9. Fat Distribution • Waist-to-hip ratio • Health indicator • Caliper • Measures body fat

10. Overweight and Obesity • Overweight • Serious health hazard • Increases susceptibility to diabetes mellitus, hypertension, and other health problems • Significant cause: • Energy imbalance

11. Theories of Weight Loss • Fat cell theory • Obesity develops when size of fat cells increases • Set-point theory • Everyone has set point or natural weight at which body is so comfortable it does not allow for deviation

12. Healthy Weight • Not everyone can match healthy weight target • BMI of 19 to 25 • May mean weight at which individual: • Eats nutritiously • Exercises • Is free of health problems and disease

13. Dietary Treatment for Obesity • Reduce portion size • Reduce caloric intake • Counting fat grams may help • Base diet on MyPyramid • Use exchange lists to control calorie value (continues)

14. Dietary Treatment for Obesity • Lose no more than 1 to 2 pounds per week • Eat no less than 1,200 calories per day • Diet should consist of 10 to 35 percent protein, 45 to 65 percent carbohydrate, and 20 to 35 percent or less fat (continues)

15. Dietary Treatment for Obesity • Key: • Changing eating habits • Exercising for 90 minutes most days of week

16. Food Selection • Substitution foods: • Fat-free milk for evaporated milk • Evaporated fat-free milk for evaporated milk • Yogurt or low-fat sour cream for regular sour cream • Lemon juice and herbs for heavy salad dressings (continues)

17. Food Selection • Substitution foods: • Fat-free salad dressings for regular salad dressings • Fruit for rich appetizers or desserts • Bouillon for cream soups • Water-packed canned foods for those packed in oil or syrup

18. Cooking Methods • Broiling, grilling, baking, roasting, poaching, and boiling • Trim fat from meat before cooking • Skim fat from tops of soups and meat dishes • Avoid addition of extra butter or margarine • Replace with fat-free seasonings

19. Exercise • Excellent adjunct to any weight-loss program • Lowers set point • Aerobic exercise helps: • Tone muscles • Burn calories • Increase BMR • Lower set point (continues)

20. Exercise • To prevent chronic diseases: • 30 minutes most days • To prevent weight gain: • 60 to 90 minutes most days • To maintain weight loss: • More than 90 minutes most days • Children should be active for 60 minutes daily

21. Behavior Modification for Weight Loss • Change eating habits • Develop new and healthy eating plan and exercise program • Learn difference between hunger and appetite

22. Stop and Share • Consider the following scenario: • Your client would like to use behavior modification for weight loss. What recommendations could you give? (continues)

23. Stop and Share • Weigh regularly • But not daily • Avoid waiting too long between meals • Join support group • Go to meetings during and after weight loss • Eat slowly • Use small plate (continues)

24. Stop and Share • Use low-calorie garnishes • Eat whole, fresh foods • Avoid processed foods • Treat yourself with something other than food • Anticipate problems and under-eat slightly before and after • E.g., banquets, holidays (continues)

25. Stop and Share • Save some calories for snacks and treats • If something goes wrong, avoid punishing yourself by eating • If weight not lost for one week, may be from exercising (production of lean muscle) or water retention (continues)

26. Stop and Share • If bingeing occurs, avoid punishing yourself • Go for a walk, attend a movie or museum, or call a friend • Adapt family meals to suit your needs • Avoid making a production of your diet • Avoid heavy-calorie items (continues)

27. Stop and Share • Limit yourself to spoonful of something too rich for weight-loss diet • Substitute something you like low in calories • Take small portions (continues)

28. Stop and Share • Eat vegetables and bread without butter or margarine • Include daily exercise • Park farther from work and walk

29. Crash Diet • Intended to cause very rapid rate of weight reduction • Results in initial rapid weight loss (continues)

30. Crash Diet • Weight loss caused by loss of body water and lean muscle mass • Rather than body fat • Plateau period follows • Weight does not decrease

31. Fad Diets • Many are crash diets • Usually rapid weight loss followed by plateau period • Disillusionment occurs • May lead to binge • Can result in regaining weight • Causes dieter to try another weight-loss diet • Creating yo-yo effect

32. Surgical Treatment of Obesity • May be used when obesity becomes morbid • Damaging to health • Requires psychological evaluation and counseling • Two types: • Gastric bypass • Stomach banding

33. Gastric Bypass • Most of stomach stapled off • Creating pouch in upper part • Pouch attached directly to jejunum

34. Stomach Banding • Stomach stapled, but to slightly less degree than gastric bypass • Food moves to duodenum • But outlet from upper stomach somewhat restricted

35. Surgical Treatment of Obesity • Complications: • Bleeding, infections, gastritis, gallstones, and vitamin and mineral deficiencies • Dumping syndrome • Nausea, vomiting, diarrhea, bloating, and dizziness

36. Pharmaceutical Treatment of Obesity • Amphetamines depress appetite • Pep pills • Effectiveness reduced within short time • Causes nervousness and insomnia • Can become habit-forming

37. Over-the-Counter Diet Pills • Intended to reduce appetite • Not considered effective • Contain caffeine, artificial sweeteners, and phenylpropanolamine • Can damage blood vessels • Should be avoided

38. Diuretics and Laxatives • Do not cause reduction of body fat • Only water • Excess can result in fluid and electrolyte imbalance • Laxatives can become habit-forming

39. Sibutramine (Meridia) • FDA-approved for weight loss • Suppresses appetite • Used in conjunction with reduced calorie diet • Indicated for those with BMI of at least 30

40. Orlistat (Xenical) • FDA-approved for weight loss • Blocks one-third of fat in food from being digested • Follow reduced-calorie diet with no more than 30 percent fat

41. Underweight • Possible causes: • Poor nutrition, psychological or physical conditions, or genetics • Treated with high-calorie diet • Combined with counseling if cause psychological • Can be as difficult for underweight person to gain weight as overweight person to lose it (continues)

42. Underweight • Base diet on MyPyramid • 3,500 calories added to normal weekly intake leads to gain of 1 pound per week • Must introduce extra calories progressively • Recommend easily digested food • Avoid fried and bulky foods

43. Conclusion • Health care professional must support and encourage client regarding weight control • Excessive weight endangers health and should be lost using restricted-calorie diet based on MyPyramid • Excess weight caused by energy imbalance (continues)

44. Conclusion • Underweight also dangerous to health • Psychological counseling and high-calorie diet may be required • Behavior modification • Essential component of any weight-loss or weight-gain regimen