Transcript Wellness Workshop

Obesity Training
Jacques Courseault, M.D.
www.exercisemenu.com
Fitness and Wellness
• Weight Management
– Who is overweight?
– What is obesity?
– Why are we overweight?
– Negative effects of obesity
– Nutrition and Weight
– Adapt eating habits to New Orleans culture
– Exercise and Weight Management
Who is overweight?
• Facts:
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120 million U.S adults are overweight
60 million U.S adults are obese
9 million U.S adults are severely obese
64.5% are overweight
30.5% are obese
Overweight and obesity increases steadily with age
New Orleans is the 7th ranked city with the
highest overweight rates (2005)
– Many college students gain 10-15 lbs. freshman year
American Obesity Association
Health and Social Impact
• Too much fat increases the risk of illness from about 30
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serious medical conditions.
Obesity is associated with increases in deaths from allcauses.
Earlier onset of obesity-related diseases, such as type 2
diabetes, are being reported in children and adolescents
with obesity.
Individuals with obesity are at higher risk for impaired
mobility.
Overweight or obese individuals experience social
stigmatization and discrimination in employment and
academic situations.
Billions in healthcare expenditures
American Obesity Association
Is Obesity Considered a Disease?
• Disease - an interruption, cessation or disorder of a
bodily function, organ or system.
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3 Criteria of Disease:
Recognized causes
Identifiable signs and symptoms
Consistent Anatomic Alteration
Does obesity meet these criteria?
American Obesity Association
Is Obesity Considered a Disease?
• Recognized Causes include:
– Social- influence from friends, family, work, etc.
– Cultural- some favor certain unhealthy foods more
than others.
– Psychological- stress can have an effect on habits
– Behavioral- Behavior can be learned to eat when
angry or bored
– Metabolic – sugar is not cleared from the bloodstream
– Genetic factors – mutations in certain genes have
been shown to cause obesity
American Obesity Association
Is Obesity Considered a Disease?
• Signs and Symptoms include:
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Excess accumulation of fat
Increased size of fat cells
Insulin resistance
Increased blood sugar
Increased blood pressure
Elevated cholesterol and triglyceride levels
Shortness of breath
Back pain
American Obesity Association
Is Obesity Considered a Disease?
• Consistent Anatomic Alterations include:
– Increase in body mass
American Obesity Association
Why are we Overweight?
• Simply put: too much food, too little activity
• Today people are eating more food and exercising less
• Fatty convenience foods are more prevalent
– McDonald’s, Burger King, Taco Bell, etc.
• Many are working more sedentary jobs
American Obesity Association
Why are we Overweight?
• We drink anything but water
– Most soft drinks and “juices” have High
Fructose Corn Syrup which cause blood sugar
levels to spike.
– The body then produces high levels of insulin
which causes the body to store excess sugar
as fat.
Forbes.com
Why are we Overweight?
• We don’t walk
– We should:
• Walk to our destination
• Take the stairs
• Deliver messages by hand at work instead of email
or instant message
• Park in the back of the parking lot
• Walk the dog
• Play with kids
Forbes.com
Why are we Overweight?
• Genetics
– If our parents are overweight, chances are we
will be.
– However:
• Genes can be beat!
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Regular exercise
Healthy Diet
Plenty of Water
Ample Sleep
American Obesity Association
Why are we Overweight?
• We Grow Older
– Metabolism slows down as we age because of loss of
muscle mass
• We Eat Junk Food
– Potato Chips, Candy, Cookies, etc.
• These foods have little to no nutritional value!!
• Contains refined carbohydrates
• Is calorie dense
• Full of Fat!!!
Forbes.com
Why are we Overweight?
• We love Fried Food
– Fried Chicken, Shrimp, Beef, Crawfish, Fries,
etc.
– Fried Foods contain:
• High carbohydrates and calories
• Easy way to pack on pounds!
American Obesity Association
Why are we Overweight?
• Excessive Alcohol
– Alcoholic drinks have tons of calories
• Alcohol slows the body’s fat-burning power
• Produces acetate which is used as fuel instead of
fat
• Alcohol is an appetite stimulant
• Reduces testosterone levels, which slow fat burn
• But wine is good!
American Obesity Association
Why are we Overweight?
• Never read food labels
– Check labels for:
• Calories
• Refined Carbohydrates
• Total Fat
• Sugar
Forbes.com
Why are we Overweight?
• We don’t exercise!!
– Sedentary lifestyles cause us to gain weight!
– Metabolism slows down
– Body stores extra weight because it isn’t
burning any
– Reduction of muscle slows metabolism
American Obesity Association
Why are we Overweight?
• Stress
– Heightened stress increases amount of
cortisol in the body
– Cortisol is a stress hormone that causes the
body to store fat
– Antidepressants cause weight gain
– When depressed we overeat because eating
“makes us happier”
Forbes.com
Negative Effects of being Overweight
• Obesity is the second leading cause of
unnecessary deaths, smoking is #1
• Obesity is more damaging to the body than
Smoking!!!
– Obesity affects all major body systems including the heart,
lungs, muscles and bones
American Obesity Association
Negative Effects of being Overweight
• Increases risks of 30 diseases including:
– Diabetes
– Cardiovascular Disease
– Certain Cancers
– Sleep apnea
– Osteoarthritis
American Obesity Association
Negative Effects of being Overweight
Table 1. Prevalence of Medical
Conditions by BMI for Men
Body Mass Index
18.5 - 24.9
25 - 29.9
30 - 34.9
> 40
Type 2 Diabetes
2.03
4.93
10.1
10.65
Coronary Heart Disease
8.84
9.6
16.01
13.97
High Blood Pressure
23.47
34.16
48.95
64.53
Osteoarthritis
2.59
4.55
4.66
10.04
Medical Condition
Source: NHANES III, 1988 - 1994.
American Obesity Association
Negative Effects of being Overweight
Table 1. Prevalence of Medical
Conditions by BMI for Women
Body Mass Index
18.5 - 24.9
25 - 29.9
30 - 34.9
> 40
Type 2 Diabetes
2.38
7.12
7.24
19.89
Coronary Heart Disease
6.67
11.13
12.56
19.22
High Blood Pressure
23.26
38.77
47.95
63.16
Osteoarthritis
5.22
8.51
9.94
17.19
Medical Condition
Source: NHANES III, 1988 - 1994.
American Obesity Association
Negative Effects of being Overweight
• Increased BMI increases risks of:
– Osteoarthritis (OA)
• Obesity is associated with the development of OA of the hand, hip, back and
especially the knee.
• Modest weight loss of 10 to 15 pounds is likely to relieve symptoms and
delay disease progression of knee OA.
– Rheumatoid Arthritis (RA)
– Deep Vein Thrombosis (DVT)
– Obesity increases the risk of DVT, a condition that disrupts the normal process of
blood clotting.
– Patients with obesity have an increased risk of DVT after surgery.
– Gallstones
– Obesity and rapid weight loss in obese persons are known risk factors for
gallstones.
– Gallstones are common among overweight and obese persons. Gallstones appear
in persons with obesity at a rate of 30% versus 10% in non-obese.
American Obesity Association
Negative Effects of being Overweight
– Birth Defects
– Maternal obesity (BMI > 29) has been associated with an
increased incidence of neural tube defects (NTD)
– Obesity is reportedly associated with the increased incidence of
overdue births, induced labor and longer labors.
– Women with maternal obesity have more Cesarean deliveries
and higher incidence of blood loss during delivery as well as
infection and wound complication after surgery.
– Complications after childbirth associated with obesity include an
increased risk of endometrial infection and inflammation, urinary
tract infection and urinary incontinence.
American Obesity Association
Negative Effects of being Overweight
– Breast Cancer
• Postmenopausal women with obesity have a higher risk of developing breast
cancer.
• Women who gain nearly 45 pounds or more after age 18 are twice as likely
to develop breast cancer after menopause than those who remain weight
stable.
• Premenopausal women diagnosed with breast cancer who are overweight
appear to have a shorter life span than women with lower BMI.
• The risk of breast cancer in men is also increased by obesity.
– Colorectal Cancer
• High BMI, high calorie intake, and low physical activity are independent risk
factors of colorectal cancer.
– Endometrial Cancer (EC)
• Women with obesity have three to four times the risk of EC than women
with lower BMI.
– Renal Cell Cancer
• Consistent evidence has been found to associate obesity with renal cell
cancer, especially in women.
American Obesity Association
Negative Effects of being Overweight
– Cardiovascular Disease (CVD)
– Obesity increases CVD risk due to its effect on blood lipid levels.
– Weight loss improves blood lipid levels by lowering triglycerides
and LDL (“bad”) cholesterol and increasing HDL (“good”)
cholesterol.
– Weight loss of 5% to 10% can reduce total blood cholesterol.
– The effects of obesity on cardiovascular health can begin in
childhood, which increases the risk of developing CVD as an
adult.
– Overweight and obesity increase the risk of illness and death
associated with coronary heart disease.
– Obesity is a major risk factor for heart attack, and is now
recognized as such by the American Heart Association.
American Obesity Association
Negative Effects of being Overweight
– Carpal Tunnel Syndrome (CTS)
– Obesity has been established as a risk factor for CTS.
– The odds of an obese patient having CTS were found in one
study to be almost four times greater than that of a non-obese
patient.
– Seventy percent of persons in a recent CTS study were
overweight or obese.
– Chronic Venous Insufficiency (CVI)
– Patients with CVI, an inadequate blood flow through the veins,
tend to be older, male, and have obesity.
– Daytime Sleepiness
– People with obesity frequently complain of daytime sleepiness
and fatigue, two probable causes of mass transportation
accidents.
American Obesity Association
Negative Effects of being Overweight
– Diabetes (Type 2)
– As many as 90% of individuals with type 2 diabetes
are reported to be overweight or obese.
– Obesity has been found to be the largest
environmental influence on the prevalence of diabetes
in a population.
– Obesity complicates the management of type 2
diabetes by increasing insulin resistance and glucose
intolerance, which makes drug treatment for type 2
diabetes less effective.
– A weight loss of as little as 5% can reduce high blood
sugar.
American Obesity Association
Negative Effects of being Overweight
– Gout
– Obesity contributes to the cause of gout -- the deposit of uric
acid crystals in joints and tissue.
– Heat Disorders
– Obesity has been found to be a risk factor for heat injury and
heat disorders.
– Hypertension
– Over 75% of hypertension cases are reported to be directly
attributed to obesity.
– Weight or BMI in association with age is the strongest indicator
of blood pressure in humans.
– The risk of developing hypertension is five to six times greater in
obese adult Americans, age 20 to 45, compared to non-obese
individuals of the same age.
American Obesity Association
Negative Effects of being Overweight
– Impaired Immune Response
– Obesity has been found to decrease the body’s resistance to harmful
organisms.
– A decrease in the activity of scavenger cells, that destroy bacteria and
foreign organisms in the body, has been observed in patients with
obesity.
– Impaired Respiratory Function
– Obesity is associated with impairment in respiratory function.
– Obesity has been found to increase respiratory resistance, which in turn
may cause breathlessness.
– Decreases in lung volume with increasing obesity have been reported.
– Infections Following Wounds
– Obesity is associated with the increased incidence of wound infection.
– Burn patients with obesity are reported to develop pneumonia and
wound infection with twice the frequency of non-obese.
American Obesity Association
Negative Effects of being Overweight
– Infertility
– Obesity increases the risk for several reproductive disorders, negatively
affecting normal menstrual function and fertility.
– Weight loss of about 10% of initial weight is effective in improving
menstrual regularity, ovulation, hormonal profiles and pregnancy rates.
– Liver Disease
– Excess weight is reported to be an independent risk factor for the
development of alcohol related liver diseases including cirrhosis and
acute hepatitis.
– Low Back Pain
– Obesity may play a part in aggravating a simple low back problem, and
contribute to a long-lasting or recurring condition.
– Women who are overweight or have a large waist size are reported to
be particularly at risk for low back pain.
American Obesity Association
Negative Effects of being Overweight
– Pain
– Bodily pain is a prevalent problem among persons with obesity.
– Greater disability, due to bodily pain, has been reported by persons with obesity
compared to persons with other chronic medical conditions.
– Obesity is known to be associated with musculoskeletal or joint-related pain.
– Foot pain located at the heel, known as Sever’s disease, is commonly associated
with obesity.
– Pancreatitis
– Obesity is a predictive factor of outcome in acute pancreatitis. Obese patients
with acute pancreatitis are reported to develop significantly more complications,
including respiratory failure, than non-obese.
– Sleep Apnea
– Obesity, particularly upper body obesity, is the most significant risk factor for
obstructive sleep apnea.
– There is a 12 to 30-fold higher incidence of obstructive sleep apnea among
morbidly obese patients compared to the general population.
– Among patients with obstructive sleep apnea, at least 60% to 70% are obese.
American Obesity Association
Negative Effects of being Overweight
– Stroke
– Elevated BMI is reported to increase the risk of ischemic stroke independent of
other risk factors including age and systolic blood pressure.
– Abdominal obesity appears to predict the risk of stroke in men.
– Obesity and weight gain are risk factors for ischemic and total stroke in women.
– Surgical Complications
– Obesity is a risk factor for complications after a surgery.
– Surgical patients with obesity demonstrate a higher number and incidence of
hospital acquired infections compared to normal weight patients.
– Urinary Stress Incontinence
– Obesity is a well-documented risk factor for urinary stress incontinence,
involuntary urine loss, as well as urge incontinence and urgency among women.
– Obesity is reported to be a strong risk factor for several urinary symptoms after
pregnancy and delivery, continuing as much as 6 to 18 months after childbirth.
American Obesity Association
Negative Effects of being Overweight
– Several other obesity-related conditions have been
reported by various researchers including:
• abdominal hernias, acanthosis nigricans, endocrine
abnormalities, chronic hypoxia and hypercapnia,
dermatological effects, depression, elephantitis,
gastroesophageal reflux, heel spurs, hirsutism, lower
extremity edema, mammegaly (causing considerable
problems such as bra strap pain, skin damage, cervical pain,
chronic odors and infections in the skin folds under the
breasts, etc.), large anterior abdominal wall masses
(abdominal paniculitis with frequent panniculitis, impeding
walking, causing frequent infections, odors, clothing
difficulties, low back pain), musculoskeletal disease, prostate
cancer, pseudo tumor cerebri (or benign intracranial
hypertension), and sliding hiatil hernia.
American Obesity Association
Calories In – Calories Out =
Weight Loss
• Weight loss can be achieved either by eating fewer calories or by
burning more calories with physical activity, preferably both.
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A healthy weight loss program consists of:
A reasonable, realistic weight loss goal – 2.5 lbs/week
A reduced calorie, nutritionally-balanced eating plan
Regular physical activity
A behavior change plan to help you stay on track with your goals
American Obesity Association
Keep in Mind
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Calories count
Portions count
Nutrition counts
Even a small amount of weight loss can lead to big health benefits
Strive to develop good habits to last a lifetime
• Feel free to discuss your weight loss plans with us!
• To lose about 1 pound per week, subtract 500 calories each day
from the daily amount. To lose about 2 pounds per week, subtract
1000 calories daily.
• DO NOT LET A SLIP TURN INTO A SUBSTANTIAL WEIGHT GAIN!
American Obesity Association
New Orleans Diet
• Red Beans and Rice- Use brown rice-
Helps Lower LDL
• Grill or Bake fish instead of Frying it
• Boil Seafood instead of Frying it- DO NOT
FRY ANYTHING!
• Add a Salads to your meals
• Avoid anything with High Fructose Corn
Syrup
American Obesity Association
New Orleans Diet
• Drink More Water- 8 Glasses
• Eat more Fiber- Whole Weat, Use Whole
Grain Wheat Bread instead of
White/French Bread
• Add vegetables to every meal
• If you must drink alcohol, choose light
beer, wine
American Obesity Association
New Orleans Diet
• By Lean Meats
• Eat smaller portions throughout the day
• Avoid Trans-Fat
• Boost Fiber to lose weight/prevent cancer
– All Bran Cereal
– Fruit/Vegetables
– Eat skin on Fruits/Potatoes
American Obesity Association
The Key to Weight Loss!
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It’s like putting gas in a car!
Join a gym, and hire a personal trainer
Find a friend and go walk/jog/run
Buy light weights and exercise at home
Take stairs at work
Park far away from work or store (ensure
safety)
Use a pedometer and aim for 5,000/steps/day
American Obesity Association
Exercise
• Dance
• Improve posture
• Play with your kids/ grandkids
• Resistance Bands
• Yoga/Pilates Class
American Obesity Association
Goal
• Gradual Change of Lifestyle
• Slip ups are okay, just bounce back
• Small changes exponentially add years to
your life!
American Obesity Association
Cardio
• 5 days/week
• 30 min/day
• Anything that gets you moving!
American Obesity Association
Weight lifting tips
• Endurance training- 12-15 reps
• Toning training 8-10 reps
• Strength training 3-6 reps
• Burnouts!! To Lose Weight!
• Warmup
• Stretch
• Muscle is 70% water!
American Obesity Association
Weight Lifting Tips
• 3x per week, but if can just do once a
week that’s okay
• Work out entire body/workout
• One exercise per muscle group is enough
• Stay hydrated
American Obesity Association