Weight ManagementChapter 9

Healthy Body Weight National Institutes of Health

More than 60% of American adults are overweight More than 30% of American adults are obese Obesity has doubled since 1960 At current rates, all American adults will be

overweight by 2030

Overweight and ObesityOverweight = 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

Health Implications of Overweight and Obesity

More than 30% 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

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

Factors Contributing to Excess Body Fat: Physiological Factors

Metabolism = sum of all vital processes by which food energy and nutrients are made available to and used by the body

Resting metabolic rate (RMR) = energy required to maintain vital body functions; the largest component of metabolism

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

Factors Contributing to Excess Body Fat: Physiological Factors

Hormones play a role in the accumulation of body fat; the hormone leptin is involved in the regulation of appetite and metabolic rate

Weight cycling, or yo-yo dieting

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

Factors Contributing to Excess Body Fat: Lifestyle Factors

Physical activity levels have declined; on average, Americans spend

15 minutes per day exercising 170 minutes per day watching television and movies

Psychosocial factors include eating as a means of coping and cultural and family influences

Activity Level and Risk of Obesity

Data from Hu, F. B., et al. 2003. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. Journal of the American Medical Association 289(14): 1785–1791.

Diet and Eating HabitsTotal calories—choose an appropriate

energy intake for your activity levelPortion sizes—limit portions to those

recommended by My Pyramid to help keep energy intake moderate; measure portions at home and read food labels

Energy (calorie) density—choose foods with a low energy density, meaning those that are relatively heavy but have few calories

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

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

Approaches to Overcoming a Weight Problem

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

Surgery

Adjustable gastric banding Roux-en-Y gastric bypassSource: National Institutes of Health

http://www.videojug.com/interview/roux-en-y-gastric-bypass-2http://www.videojug.com/interview/adjustable-gastric-banding-3

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

Different Body BuildsENDOMORPHY MESOMORPHY

ECTOMORPHY

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.

Severe Body Image ProblemsPoor body image can cause psychological distress

Body dysmorphic disorder (BDD) Related to obsessive-compulsive disorder Can lead to depression, social phobia, and suicide Treated with medication and psychotherapy

Muscle dysmorphia = a disorder characterized by distorted body image; affected people inaccurately perceive themselves as small, with underdeveloped muscles

Body Image 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

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http://www.videojug.com/interview/understanding-body-dysmorphic-disorder-2

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

Body Image

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

Eating Disorders Eating disorder = a serious disturbance in eating pattern or behavior, characterized by a negative body image and concerns about body weight or body fat

Major types Anorexia nervosa Bulimia nervosa Binge-eating disorder

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

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http://www.videojug.com/interview/dangers-of-anorexia-2

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

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http://www.videojug.com/interview/physical-dangers-of-bulimia-2

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

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Treating Eating Disorders

Must address both problematic eating behaviors and the misuse of food to manage stress and emotions

Averting a medical crisis Dealing with psychological aspects Stabilizing eating habits Changing behavior patterns and thoughts Possibly involving medication and/or

hospitalization

Energy Balance

Wellness Worksheet Assignment

Wellness Worksheets can be accessed online at www.mhhe.com/fahey8e

1. From the website above, click on “student edition” at the bottom left column.

2. Click on “wellness worksheets”3. Click on “126 Wellness Worksheets are available online”

in the middle of the page.4. Click on “76: Body Image” and complete the worksheet.5. Print out the completed worksheet and submit on

Wednesday, October 26th