Transcript Weight Management - McGraw Hill Higher Education

Weight Management
Chapter 9
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
Healthy Body Weight
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National Institutes of Health
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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
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Prevalence of Healthy Body Weight
Gender
Ethnicity
Age
Health status
Women
35%
Men
32%
White
35%
Latino
26%
African American
29%
20–39 years
40%
40–59 years
31%
60+ years
28%
People with disabilities
29%
People with diabetes
12%
ALL ADULTS
34%
Source: National Center for Health Statistics
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Overweight and Obesity
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Overweight = 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
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Health Implications of Overweight
and Obesity
33% rise in type 2 diabetes
n 100,000+ premature deaths annually
n Obesity is one of the six major controllable
risk factors for heart disease
n Weight loss of 5-10% in obese individuals
can reduce the risk of certain diseases
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Factors Contributing to Excess Body
Fat: Genetic Factors
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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
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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
n Resting metabolic rate (RMR) = energy
required to maintain vital body functions;
the largest component of metabolism
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Factors That Affect Metabolic Rate
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RMR is higher in
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Men
People with more muscle mass
People who exercise
RMR is lower in
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Women
People who are sedentary
People who have lost weight
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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
n Weight cycling, or yo-yo dieting
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Factors Contributing to Excess Body
Fat: Lifestyle Factors
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Eating—compared to the past, Americans
now
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Consume more calories
Consume more refined and simple
carbohydrates
Eat out more often
People underestimate portion sizes
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Factors Contributing to Excess Body
Fat: Lifestyle Factors
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Physical activity levels have declined; on
average, Americans spend
15 minutes per day exercising
n 170 minutes per day watching television and movies
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Psychosocial factors include eating as a
means of coping and cultural and family
influences
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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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.
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Adopting a Healthy Lifestyle for
Successful Weight Management
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Diet and eating habits
Physical activity and exercise
Thoughts and emotions
Coping strategies
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Diet and Eating Habits
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Total calories—choose an appropriate energy
intake for your activity level
Portion 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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Diet and Eating Habits
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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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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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
n Exercise
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Endurance exercise burns calories
Strength training builds muscle mass, which
can increase metabolic rate
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Thoughts and Emotions
How you think about yourself and your
environment
n Realistic self-talk, beliefs, and goals can
be positively motivating
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Coping Strategies
Some people cope with stress by
overeating
n Analyze your eating habits to determine if
you are using food appropriately
n Develop adequate and appropriate
strategies for dealing with stress
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Approaches to Overcoming a Weight
Problem
Doing it yourself
n Diet books
n Dietary supplements and diet aids
n Weight-loss programs
n Prescription drugs
n Surgery
n Psychological help
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Doing It Yourself
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Don’t try to lose more than 0.5–2 pounds per
week
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3500 calories corresponds to 1 pound of body weight
A daily negative energy balance of 250–1000 calories
corresponds to 0.5–2 pounds per week of weight loss
Combine any cuts in calorie intake with physical
activity
Choose lifestyle strategies that you can maintain
over the long term
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Diet Books
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Reject books that
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Advocate unbalanced ways of eating
Claim to be based on a secret
Use gimmicks
Promise quick weight loss
Limit the selection of foods
Accept books that advocate a balanced
diet plus exercise
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
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Popular Diet Plans
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Any diet that cuts calories causes weight loss
Low-carbohydrate diets have not been proven safe
over the long-term
Low-fat diets should focus on nutrient dense foods,
especially whole-grains, fruits, and vegetables
Diets with many restrictions have high drop-out rates
People who have been successful at long-term
weight loss track food intake and engage in 60 or
more minutes of physical activity per day
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
Dietary Supplements and Diet Aids
Dietary supplements are subject to fewer
regulations than over-the-counter
medications; they have not been proven
safe and effective
n FTC: More than half of advertisements for
weight-loss products make
representations that are likely to be false
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Weight-Loss Programs
Noncommercial weight-loss programs
n Commercial weight-loss programs
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Partnership for Healthy Weight Management
Online weight-loss programs
n Clinical weight-loss programs
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Prescription Drugs
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Appetite suppressants include phentermine,
diethylpropion, and sibutramine
Orlistat is a drug that blocks fat absorption
Prescription weight-loss drugs cause moderate
weight loss, but all have risks and side effects
Prescription weight-loss drugs are recommended
only for people who have a BMI over 30 and who
have been unable to lose weight with lifestyle
changes
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
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Surgery
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Surgical intervention may be recommended for
some people who have a BMI of 40 or higher or
who are 100 or more pounds overweight
Gastric bypass surgery modifies the
gastrointestinal tract by changing the size of the
stomach or how the intestine drains, thereby
restricting the amount of food that can be eaten
Surgery has a high rate of complications
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Psychological Help
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When concerns about body weight and
shape become severe, professional help is
recommended
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Body Image
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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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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BMI of Miss America Pageant Winners
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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.
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
Severe Body Image Problems
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Poor body image can cause psychological
distress
Body dysmorphic disorder (BDD)
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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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Acceptance and Change
Most Americans are unhappy with some
aspect of their appearance
n Recognize the limits of change
n Small amounts of weight loss can
significantly reduce health risks
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Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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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
n Major types
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Anorexia nervosa
Bulimia nervosa
Binge-eating disorder
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Eating Disorders
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Anorexia nervosa = an eating disorder
characterized by a refusal to maintain body
weight at a minimally healthy level and an
intense fear of gaining weight or becoming fat
n Affects 1–3 million Americans, 95% female
n Distorted body image
n Severe medical complications, including
death
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Eating Disorders
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Bulimia nervosa = an eating disorder characterized
by recurrent episodes of binge eating and purging:
overeating and then using compensatory behaviors
such as vomiting and excessive exercise to
prevent weight gain
n Begins in adolescence or young adulthood
n During a binge, a person may consume 1,000 to
60,000 calories
n Binge-purge cycle places tremendous stress on
the body
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Eating Disorders
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Binge-eating disorder = an eating disorder
characterized by binge eating and a lack of
control over eating behavior in general
Eating patterns:
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Eating very rapidly
Eating until uncomfortably full
Eating when not hungry
Eating alone
Feelings of guilt, shame, and depression
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Treating Eating Disorders
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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
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Creating an Individual WeightManagement Plan
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Assess your motivation and commitment
Set reasonable goals
Assess your current energy balance
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To lose one pound, you must create a negative
energy balance of 3500 calories
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To lose 1/2 pound per week requires a negative daily energy
balance of 250 calories
To lose 2 pounds per week requires a negative daily energy
balance of 1000 calories
Energy balance is affected by food intake and energy
output
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Energy
Balance
Neutral Calorie Balance
Calories consumed = calories used
no change in weight
Positive Calorie Balance
calories consumed > calories used
weight gain
Negative Calorie Balance
calories consumed < calories used
weight loss
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Creating an Individual WeightManagement Plan
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Increase your level of physical activity—exercise
habits are critical for long-term success
Make changes in your diet and eating habits
Put your plan into action
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Write daily
Get others to help
Think positively
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
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Weight Management
Chapter 9
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education