Chapter 5

1. CHAPTER OUTLINE Chapter 5 Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Weight Management

2. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Health Consequences of Obesity • Obesity is a risk factor for • Type 2 diabetes • Osteoarthritis • Gallbladder disease • Sleep apnea • Ruptured intervertebral disks • Arthritis • Cancer (breast, colon, and prostate)

3. Why are We Fat? • Psychological, social, and cultural • Using food as a way of coping with stress • Obesity is associated with socioeconomic status—income goes up and obesity goes down • Why? – cheap means of fighting boredom • In some families and cultures, food is used as a symbol of love and caring • Social aspect • Dating and hanging out with friends

4. Why are We Fat? • Historical changes • Americans eat more fats and sugars and fewer complex carbs than ancestors • More readily available • Less exercise—about 200 kcals/day less • Don’t have to hunt our food

5. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • Many people want to lose weight so they will look better—that’s a noteworthy goal • The problem, however, is that they have a distorted image of what they would really look like if they reduce to what they think is their ideal weight • __________ factors play a big role and only a small fraction of the population have the genes for a “_____________”

6. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management 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

7. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • The “ideal” body shapes, physiques, and proportions seen in these magazines are rare and essentially achieved only through airbrushing and medical reconstruction

8. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • Many individuals, and primarily young women, go to extremes in an attempt to achieve these unrealistic figures • Failure to attain a “perfect body” may lead to eating disorders in some individuals

9. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • As people set their own target weight, they should be realistic • Attaining an excellent body-fat value is extremely difficult for some

10. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • An excellent body fat value is extremely difficult to maintain, unless people are willing to make a commitment to a VIGOROUS LIFETIME EXERCISE PROGRAM AND TO PERMANENT DIETARY CHANGES • Few people are willing to do that – thus, the moderate percent body fat category may be more realistic for many people

11. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • A question you should ask yourself is: Are you happy with your weight? • Part of enjoying a higher quality of life is being happy with yourself • If you are not, you either need to do something about it or learn to live with it!

12. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • If you are above the moderate percent body fat category, you should try to come down and stay in this category, for health reasons: this is the category in which there appears to be no detriment to health

13. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Tolerable Weight • If you are in the moderate category but would like to be lower, you need to ask yourself a second question: How bad do I want it? • Do you want it bad enough to implement lifetime exercise and dietary changes? • If you are not willing to change, you should stop worrying about your weight and deem the moderate category as “tolerable” for you

14. 5.3 Differences Between Self-Reported and Actual Energy Intake and Physical Activity in Overweight People

15. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Ideal vs. RecommendedBody Weight • No such thing as “ideal” weight • “Recommended” weight is a better term • Recommended weight varies among people • Two overweight individuals at the same weight—if one has risk factors due to genetics or dietary habits, this individual is at higher risk for disease and a lower weight may be recommended

16. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management 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 • “When I get the latest fad diet, I imagine a trick birthday cake candle that keeps lighting up and we have to keep blowing it out” -Kelly Brownell (foremost weight management researcher) • Prescription weight loss drugs?

19. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Carb/High-Protein (LCHP) DietsA few studies suggest that, short-term, LCHP diets are more effective for weight loss than carbohydrate-based diets. These results are preliminary and controversial.In LCHP diets: • A large amount of weight loss is _______ and ______________, not body ______. Some of this weight is quickly regained when regular dietary habits are resumed

20. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Carb/High-Protein (LCHP) Diets • Few people are able to stay with LCHP diets for more than a few weeks at a time; the majority stop dieting before the targeted program completion • LCHP dieters are rarely found in a national weight-loss registry of people who have lost 30 pounds and kept them off for a minimum of six years • Food choices are severely restricted in LCHP diets; with less variety, individuals tend to eat less (____ to _____ calories/day) and thus lose more weight

21. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Carb/High-Protein (LCHP) Diets • LCHP diets may promote heart disease, cancer, and increase the risk for osteoporosis • LCHP diets are fundamentally high in fat (about ____ fat calories) • LCHP diets are not recommended for people with diabetes, high blood pressure, heart disease, or kidney disease • LCHP diets do not promote long-term healthy eating patterns

22. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Eating Disorders • Anorexia nervosa, bulimia nervosa, binge-eating disorder: physical and emotional conditions thought to stem from individual, family, and social pressures • Eating disorders are increasing steadily in most industrialized nations where society encourages low-calorie diets and thinness

23. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Eating Disorders • Intense fear of becoming fat does not disappear even when losing extreme weight • Individuals clip images from magazines to use as their ideal body goal • Articles on dangers of eating disorders fail to deter behavior in these individuals; instead, they look for ideas in these articles to use in their search for a "perfect body"

24. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Key Term • _____________: An eating disorder characterized by self-imposed starvation to achieve and maintain very low body weight

25. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Anorexia Nervosa • Individuals suffering from anorexia nervosa: • Refuse to maintain body weight over a minimal normal weight • Perceive themselves as overweight even when emaciated • Deny their condition • Have an intense fear of gaining weight even though underweight • May fear weight gain more than death by starvation

26. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Key Term • ______________: An eating disorder characterized by a pattern of binge eating and purging in an attempt to lose weight and maintain low body weight

27. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Bulimia Nervosa • Bulimics usually are healthy-looking, well-educated, and near recommended body weight • They seem to enjoy food and often socialize around it • They have emotional challenges, rely on others, lack self-confidence • For them, recommended weight and food are abnormally important

28. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Bulimia Nervosa • People suffering from bulimia nervosa: • Fear gaining weight • Have recurrent episodes of binge eating • Feel stress after binge eating • Practice self-induced vomiting, fasting, and excessive exercise and misuse laxatives and medications • Evaluate themselves based on body shape and weight

29. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Key Term • ____________disorder: An eating disorder characterized by uncontrollable episodes of eating excessive amounts of food within a relatively short time

30. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Binge-Eating Disorder • 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

31. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Energy-Balancing Equation • Weight maintenance: Calories in ___ calories out • Weight gain: Calories in ___ calories out • Weight loss: Calories in ___ calories out

32. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management 1 pound of fat = ______ calories

33. Why can’t you lose 10lbs in 10 days? • Probably could in water (dehydration ) plus fat, etc., but not all fat and fat is what we want to lose • 3500 kcal/lb of fat • Let’s say a person can take in 2000 kcal/day and maintain • If fasted for 10 days that would only be a reduction of ____lbs • Would lose more because of muscle loss and dehydration • Would still have to burn about ______ kcal • That = _____ kcal/day that have to be burned by exercise

34. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Setpoint Theory • A weight-regulating mechanism, located in the hypothalamus of the brain, regulates how much the body should weigh • Setpoint sets the amount of body fat it considers necessary and works tirelessly to maintain it • Setpoint functions like a thermostat: it detects fluctuations in weight and makes adjustments in energy metabolism and appetite

35. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Setpoint Theory • The setpoint has a profound effect on amount of food you eat • As you lose weight, it signals _______ • As you gain weight, it _______ appetite • As you overeat, triggers body to “waste” • As you don’t eat enough, triggers body to “conserve”

36. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Setpoint Theory • Two most common obstacles to weight loss 1. 2. • Setpoint illustrates how genetics and lifestyle overlap • The setpoint range is determined by ________ • Where the individual ends up in the range is a result of ________ • The tendency to obesity may be inherited… but the expression of obesity is affected by environment

37. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Research and Setpoint • The body resists maintenance of altered weight • Obese and lifetime non-obese individuals were used • Following a 10% weight loss, body attempted to regain the lost weight, burning up to 15% fewer calories • Following a 10% weight gain, the body attempted to lose weight, burning 10–15% more calories than expected • Results imply that after a 10% weight loss, a person would have to eat less or exercise more to account for the estimated deficit of 200 to 300 daily calories

38. Setpoint increases with Constant ______ Excessive ___ intake High _____ intake _________ and ____ composition changes associated with aging Setpoint decreases with _______ exercise ___________ (more detrimental than the extra weight) Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Factors That May Influence the Setpoint

39. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Weight Gain and Body Composition Changes • Starting at age 25, the typical American gains ____ pound of weight per year • By age 65, the average adult will have gained ___ pounds of weight • Because of the typical reduction in activity as we age, each year people also lose half a pound of ______ tissue • Therefore, over this span of 40 years, there is an actual fat gain of ____ pounds accompanied by a ____-pound loss of lean body mass

40. 5.5 Effects of Types of Diet and Exercise on Weight Loss

41. 5.6 Body Composition Changes as a Result of Frequent Dieting without Exercise

42. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Intensity vs. High-Intensity • Some individuals promote low-intensity exercise over high-intensity for weight loss purposes • Compared with high intensity, a greater proportion of calories burned during low-intensity exercise are derived from ____ • The lower the intensity of exercise, the higher the _________ of fat utilization as an energy source

43. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Intensity vs. High-Intensity • In theory, if you are trying to lose fat, this principle makes sense, but in reality it is misleading • The bottom line when you are trying to lose weight is to burn more _______ — when your daily caloric expenditure exceeds your intake, weight is lost • The more calories you burn, the more ____ is lost

44. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Intensity vs. High-Intensity • During low-intensity exercise, up to ___% of the calories burned may be derived from fat, the other ___% from glucose (carbohydrates) • With intense exercise, only ___ to ___% of the caloric expenditure comes from fat • Overall, however, you can burn ________ as many calories during high-intensity exercise and, subsequently, more fat as well

45. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Intensity vs. High-Intensity • For example:If you exercise for 30 to 40 minutes at moderate intensity and burn ___ calories, about ____ of those calories (50%) would come from fat • If you exercise at high intensity during those same 30 to 40 minutes, you can burn ____ calories—with ____ to ____ of the calories (30 to 40%) coming from ___

47. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Low-Intensity vs. High-Intensity • 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

48. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management “ Quote Physical inactivity is certainly a major, if not the primary, cause of obesity in the United States today. A certain minimal level of activity might be necessary for us to accurately balance our caloric intake to our caloric expenditure. With too little activity, we appear to lose the fine control we normally have to maintain this incredible balance. This fine balance amounts to less than 10 calories per day, or the equivalent of one potato chip.” Dr. Jack Wilmore

49. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Increase Physical Activity • Accumulate 60 minutes of activity every day of your life • To increase daily physical activity • Walk, don’t drive; avoid escalators, remote controls • Commit to a lifetime aerobic exercise program • 45–60 minutes/session, 5–6 times/week during weight loss period • 30 minutes/session, 3–5 times/week for weight maintenance • Strength train 2–3 times per week • Select 10–12 exercises and do 3 sets of 10–12 reps

50. Overweight vs. Obesity Tolerable Weight The Weight Loss Dilemma Eating Disorders Physiology of Weight Loss Exercise: The Key to Weight Management Losing Weight the Sound and Sensible Way Daily Food Logs Behavior Modification & Weight Management Role of Aerobic Exercisein Weight Management • A 45-minute exercise session = ____ calories • 5 sessions per week: 300 x 5 = ____ calories • 52 weeks per year: 1500 x 52 = ______ calories • 1 lb of fat = _____ calories • 78,000 calories ÷ 3,500 = ____ pounds of fat