Ch14 PP Dundalk 110910 Online lecture

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Weight management : 

Weight management Chapter 14 1

Introduction : 

Introduction National Institutes of Health 66% of American adults are overweight more than 33% of adult men and 35% of adult women are obese. 2015 75% of adults will be overweight and 41% will be obese 2030 Estimated that the entire American adult population will be overweight or obese 2

Figure 11-1 Obesity prevalence, by age and sex, of American adults : 

Figure 11-1 Obesity prevalence, by age and sex, of American adults 3

Basic Concepts of Weight Management : 

Basic Concepts of Weight Management 1 pound of fat = 3500 calories Body Composition Fat-free mass or Lean Body Mass Body Fat Subcutaneous fat 3-5% of total fat in men, 8-12% in women Visceral fat-(storage) –Located behind the abdominal wall Women: <8% at risk, Average 23%, > 32% at risk Men: < 5% at risk, Average 15%, > 25% at risk 4

Figure 1.2 The energy balance equation : 

Figure 1.2 The energy balance equation 5

Evaluating Body Weight and Body Composition : 

Evaluating Body Weight and Body Composition Overweight – total body weight above recommended range for good health Obesity – a more serious degree of overweight Body Mass Index (BMI) BMI = [Weight / Height in inches (squared)] X 703 6

Body Composition Analysis : 

Body Composition Analysis Hydrostatic (underwater) weighing and BOD POD Most accurate Skinfold measurements Thickness of fat under the skin Electrical Impedance Analysis Electricity prefers lean tissue Scanning procedures 7

Excess Body Fat and Wellness : 

Excess Body Fat and Wellness The Health Risks of Excess Body Fat Obese individuals have a mortality rate twice that of non-obese Reduces life expectancy by 10-20 years Associated with: Unhealthy cholesterol and triglycerides, impaired heart function, and death from cardiovascular disease Other health factors: hypertension, cancer, impaired immune function, gallbladder and kidney disease, skin problems, impotence, sleep disorder back pain, arthritis Strong association – Type II diabetes 8

Body Fat Distribution and Health : 

Body Fat Distribution and Health Apple shape Upper regions of their bodies Increase risk of high blood pressure, diabetes, early-onset heart disease, stroke, and cancer Pear shape Fat storage in the hips, buttocks and thighs Assessed by measuring waist circumference Risk if total waist measurement is more than 40 inches for men and 35 inches for women 9

Body Image : 

Body Image Collective picture of the body as seen through the mind’s eye. Perceptions Images Thoughts Attitudes Emotions 10

Problems Associated with Very Low Levels of Body Fat : 

Problems Associated with Very Low Levels of Body Fat Less than 8-12% for women and less than 3-5% for men. Extreme has been linked to problems with: Reproductive Circulatory Immune system disorders Female Athlete Triad Abnormal eating patterns Amenorrhea Decreased bone density 11

Factors Contributing To Excess Body Fat : 

Factors Contributing To Excess Body Fat Genetic Factors 25 to 40% of an individual’s body fat 600 genes have been linked to obesity Physiological Factors Metabolism (RMR) Hormones Fat Cells 12

Lifestyle Factors : 

Lifestyle Factors Eating Physical Activity Psychosocial factors Emotions Distraction from difficult feelings Helps regulate emotions Coping strategies Socioeconomic status Family and cultures 13

Approaches to Overcoming A Weight Problem : 

Approaches to Overcoming A Weight Problem Doing it yourself 0.5-2.0 pounds per week Initial weight loss from fluids. Very low calorie diets need to be avoided. Diet Books: Reject books with gimmicks or rotating levels of calories. Accept books that advocate a balanced approach. Diet Supplements and Diet Aids Formula drinks and food bars Herbal supplements Other supplements 14

Weight-Loss Programs : 

Weight-Loss Programs Noncommercial TOPS (Take Off Pounds Sensibly) OA (Overeaters Anonymous) 12-step program with spiritual orientation Commercial Weight Watchers Jenny Craig Online Clinical 15

Weight-Loss Programs : 

Weight-Loss Programs Prescription Drug Appetite Suppressants Produce a 5-15% weight reduction by controlling appetite. Once drugs are stopped most return to original heavy weight. Good option for very obese who need help getting started - permanent life style change. 16

Surgery : 

Surgery Severely obese – NIH recommends gastric bypass for individuals with a BMI of 40 or higher or are 100 pounds or more over recommended weight. Liposuction Weight loss from surgery generally ranges between 40% and 70% of total body weight over a years time. 17

Body Image : 

Body Image Severe body image problems Body dysmorphic disorder (BDD) Affects about 2% of Americans Usually before age 18 Knowing when the limits to healthy change have been reached. Knowing the unrealistic cultural ideal. Acceptance and change Knowing what is a healthy lifestyle change 18

Eating Disorders : 

Eating Disorders Problems with body weight and weight control. Characterized by severe disturbances in body image, eating patterns, and eating-related behaviors. Disordered eating affects an estimated 10 million American females and 1 million males. 19

Eating Disorders : 

Eating Disorders Anorexia Nervosa - Failure to eat enough food… Affects 3 million people – 95% are female Typically develops between the ages of 12 and 18 Characteristics Fear gaining weight. Distorted self-image. Compulsive behaviors and rituals. Excessive exercise Health Risks of Anorexia Nervosa Stop menstruation Intolerant of cold Low blood pressure and heart rate Dry skin Hands and feet may swell and take on a blue tinge Depression and suicide Medical complications Disorders of the cardiovascular, gastrointestinal, endocrine, and skeletal systems 20

Eating Disorders : 

Eating Disorders Bulimia Nervosa - recurring episodes of binge eating followed by purging. Begins in adolescence or young adulthood Increasingly younger (11-12 years) and older (40-60 years) ages. Characteristics: Rapidly consumes food, then purges. Done in secret. After a binge - feels ashamed, disgusted and physically and emotional drained. Health Risks: Erodes tooth enamel Deficient calorie intake Liver and kidney damage Cardiac arrhythmia Chronic hoarseness Esophageal tearing Rupture of the stomach Menstrual problems Increased depression 21

Eating Disorders : 

Eating Disorders Binge-Eating - Similar to Bulimia except no Purging behavior. Eating patterns - very rapid, eating until uncomfortably full. Often eat as a way of coping. Likely to be obese. High rates of depression and anxiety 22

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