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Nutrition takes a very important part in our health, looks, body shape, and
feelings. And it is not only about eating vegetables or bread, or doing
sports or not. It is wider than that- it also has to do with the hours in which
we eat our food, the velocity we eat and much more. It is also important to
fit the diet to the person, and not the person to the diet. Different people
have different needs, therefore ones certain diet will not fit to another and
can even cause damage.
What is Obesity?
A. State of being over weight.
B. Condition resulting from excessive storage of fat in the body.
Obesity has been defined as a weight more than 20% above what
is considered normal according to standard age, height, and
weight tables, or by a complex formula known as the body mass
index. It has been estimated that 30% to 35% of Americans are
overweight or obese.
What are the symptoms of obesity?
The following are the most common symptoms that indicate an
adolescent is obese. However, each adolescent may experience
symptoms differently. Symptoms may include:
A. Facial features often appear disproportionate
B. Adiposity (fat cells) in the breast region in boys
C. Large abdomen (white or purple marks are sometimes present)
D. In males, external genitals may appear disproportionately small
E. Puberty may occur early
F. increased adiposity in the upper arms and thighs
G. “Genu Valgum” – “knock kneed” is common
H. Adolescents who are obese often experience significant social
pressure, stress, and difficulties accomplishing developmental tasks.
Psychological disturbances are also very common.
Treatment of Obesity
Treatment
The best way to significantly affect the prevalence of obesity is to prevent
it. Therefore, the issue of obesity should be addressed during every wellchild examination. Parents should be taught to respect their child's
appetite and to understand that it is not necessary for an infant to finish
every bottle. Breast feeding and delaying the introduction of solid foods
may decrease the risk of future weight problems.
Skim milk can safely replace whole milk after two years of age. Food
should not be used for non-nutritive purposes such as comfort or reward.
Children should not be offered sweets as a reward for finishing a meal, as
this teaches them to place a higher value on dessert foods and may
make desserts more desirable to them. Family meals should be oriented
toward a healthy diet with 30 percent or less of calories derived from fat.
Finally, parents should limit the amount of television that the child is
allowed to watch and should encourage active play in its place.
When a child does develop obesity, a serious attempt to treat it should be
undertaken.
Components of a Successful Weight Loss Plan Reasonable weightloss goal initially, 5 to 10 lb, or a rate of 1 to 4 lb per month. Dietary
management Provide dietary prescription specifying total number of
calories per day and recommended percentage of calories from fat,
protein and carbohydrates. Physical activity Begin according to
child's fitness level, with ultimate goal of 20 to 30 minutes per day (in
addition to any school activity). Behavior modification Selfmonitoring, nutritional education, stimulus control, modification of
eating habits, physical activity, attitude change, reinforcements and
rewards. Family involvement Review family activity and television
viewing patterns; involve parents in nutrition counseling.
A. Setting Goals for Weight Loss
Weight loss goals should be obtainable and should allow for normal
growth. Goals should initially be small, so that the child doesn't
become overwhelmed or discouraged. Five to 10 lb is a reasonable
first goal or, if preferred, a rate of 1 to 4 lb per month can be
established.
B. Dietary Management
The child should maintain a food record to aid in dietary assessment.
A straightforward dietary prescription should be offered. It is
necessary to provide parents with a specific calorie-per-day
recommendation that follows guidelines for percentages of fat,
protein and carbohydrates. Dietary fiber is also important, as it
increases satiety and displaces fat in the diet. The patient and family
should be referred to books that describe the nutritional contents of
foods and food exchange lists. Finally, the patient and his family
should be referred to a nutritional consultant, if this service is
available in the community.
C. Physical Activity
Exercise is necessary to maintain weight loss and to redistribute body fat
into muscle. It is, therefore, an essential part of any weight management
program. Initial exercise recommendations should be small and exercise
levels should be increased slowly, to avoid possible discouragement. A
reasonable goal is 20 to 30 minutes of moderate activity per day, in addition
to whatever exercise the child gets during the school day.
D. Family Involvement
It is important to involve the entire family when treating obesity in children.
Many studies have demonstrated a familial aggregation of risk factors for
obesity and the family provides the child's major social learning
environment. It has been demonstrated that the long-term (10-year)
effectiveness of a weight control program is significantly improved when
the intervention is directed at the parents as well as the child, rather than
aimed at the child alone.
E. Behavior Modification
Self-monitoring is accomplished by food and activity logs, which force
the child to become more aware of his or her eating and exercise
patterns. Nutritional education should be aimed at both the child and the
family. Stimulus control includes limiting the amount of fattening foods in
the house, eating all meals at the dinner table and at designated times,
and serving food only once before putting it away. Parents should not
verbally encourage the child to eat, and the child should not be forced to
finish the entire meal. Activity patterns are an important target for
behavior modification. The child should help set a weekly activity goal,
sign a contract to perform the activity and help determine the reward for
reaching the goal. Family television-viewing patterns should be reviewed
and modified accordingly. Attitude change involves teaching the child to
turn negative self-statements into positive ones, and helping him or her
cope with the negative remarks of others. Finally, reinforcements and
rewards include verbal praise from the physician and family members, as
well as tangible rewards for achieving dietary, activity and weight-loss
goals. Rewards should be determined with input from the child, and they
should encourage further physical activity.
F. Alternative Therapies
Another kind of treatment is Alternative Therapies. Today, you can find all
sorts of treatments, which can deal with all kinds of medical problems,
including obesity. Behind those treatments usually stands a theory,
which have lasted for thousands of years. Usually, those treatments treat
the problem naturally, and sometimes solve other problems additionally
to the problem that you wished to solve.
Dangers of Obesity
• Obese children are at risk of type 2 diabetes (non-insulin
dependent) and developing risk factors for disease, like elevated
cholesterol and high blood pressure.
• Obese children are exposed to negative labelling, discrimination,
social rejection and isolation, and can develop a distorted body
image as early as six years of age.
• By adolescence, obesity can result in lower self esteem, and
increased rates of sadness, loneliness and nervousness.
• Adverse social, educational and economic consequences of
childhood obesity may be lifelong.
• Overweight children and adolescents are at increased risk of
becoming overweight adults and of experiencing the chronic health
problems associated with adult obesity such as cardiovascular
disease and premature death.
• Historically, there has been little information on the health of
overweight/obese children.
• Serious physical and psychosocial health problems are
associated.
What causes obesity?
The causes of obesity are complex and include genetic, biological,
behavioral and cultural factors. Basically, obesity occurs when a person
eats more calories than the body burns up. If one parent is obese, there is
a 50 percent chance that the children will also be obese. However, when
both parents are obese, the children have an 80 percent chance of being
obese. Although certain medical disorders can cause obesity, less than 1
percent of all obesity is caused by physical problems. Obesity in
childhood and adolescence can be related to:
• Poor eating habits
• Overeating or binging
• Lack of exercise (i.e., couch potato kids)
• Family history of obesity
• Medical illnesses (endocrine, neurological problems)
• Medications (steroids, some psychiatric medications)
• Stressful life events or changes (separations, divorce, moves, deaths,
abuse)
• Family and peer problems
• Low self-esteem
• Depression or other emotional problems
What are Eating Disorders?
Eating disorders are real illnesses that can affect how we eat and how we feel about food.
They can be treated to help people who have them have healthy and full lives. From time to
time, we all change our eating habits. Sometimes we reduce the amount of food we eat or go
on a diet to drop off some pounds, or we eat more to gain weight. These can be healthy
ways to control or reach our ideal body weight. But, people who have eating disorders have
unhealthy ways of eating. They may eat too much and become overweight, or way too little
and become very thin. Sometimes a person can eat so little, or nothing at all, they actually
begin to starve (called anorexia nervosa). A person can also eat an extreme amount of food
all at once and then do things like vomit to rid the body of food (called bulimia nervosa).
And, a person may not be able to control the need to overeat, often keeping it a secret
(called binge eating disorder). People can also have wrong ideas, or misperceptions, of their
body weight. People with eating disorders can feel certain they weigh too much, even though
they may be well under the ideal body weight for a person their size.
Eating disorders affect people of all ages, race, and income levels. But, these disorders affect
women much more than they do men. Women make up more than 90 percent of people
with these disorders. Without treatment, an eating disorder can take over a person's life and
cause serious illness and death. These disorders can increase risk for osteoporosis (thinning
of the bones) and heart problems. People who have eating disorders can also have
depression and anxiety, and may turn to alcohol and drugs for relief.
What is Binge Eating Disorder?
Binge Eating Disorder is an illness which resembles bulimia nervosa. Like bulimics,
Binge eaters have episodes of uncontrolled eating or bingeing. However, Binge
Eating Disorder differs from bulimia because its sufferers do not purge their bodies
of excess food.
Individuals with Binge Eating Disorders feel that they lose control of themselves
when eating. They eat large quantities of food and do not stop until they are
uncomfortably full. Usually, they have more difficulty losing weight and keeping it off
than do people with other serious weight problems. Most people with the disorder
are obese and have a history of weight fluctuations.
What causes Binge Eating Disorder?
The causes of Binge Eating Disorder are still unknown. Up to half of all people
with Binge Eating Disorder have a history of depression. Still, whether depression is
a cause or effect of Binge Eating is unclear. Many people report that anger, sadness,
boredom, anxiety or other negative emotions can trigger a binge episode. Impulsive
behavior and certain other psychological problems may be more common in people
with Binge Eating Disorder. The effect of dieting on Binge Eating Disorder is also
unclear. While findings vary, early research suggests that about half of all people
with Binge Eating Disorder had binge episodes before they started to diet. Still, strict
dieting may worsen Binge Eating in some people.
How is Binge Eating treated?
Several studies have found that people with Binge Eating Disorder may find it
harder than other people to stay in weight loss treatment. Binge eaters also may
be more likely to regain weight quickly. For these reasons, people with the
disorder may require treatment that focuses on their Binge Eating before they
try to lose weight. Even those who are not overweight are frequently distressed
by their Binge eating, and may benefit from treatment.
Several methods are being used to treat Binge Eating Disorder. Like all eating
disorders, Binge Eating should be treated on both a physical and psychological
level. Physicians and nutritionists can help monitor weight gain/loss. Therapy
can help modify behavior and attitude. Cognitive-behavioral therapy teaches
patients techniques to monitor and change their eating habits as well as to
change the way they respond to difficult situations. Interpersonal psychotherapy
helps people examine their relationships with friends and family and to make
changes in problem areas. Treatment with medications such as antidepressants
may be helpful for some individuals. Self-help groups also may be a source of
support. Researchers are still trying to determine which method or combination
of methods is the most effective in controlling Binge Eating Disorder.
The type of treatment that is best for an individual is a matter for discussion
between the patient and her health care provider.
What should you do if you or someone you
know has an eating disorder?
Support is important when you or someone you know has an eating
disorder. Tell someone you trust about your problem. It may be a
family member, friend, counselor, religious or community leader, or
doctor. Talking to a school counselor or mental health professional
is a good place to start. Seeing a health care provider as soon as you
can is important too. Your doctor can help you get the help you
need for your eating disorder. You can also learn about healthier
ways to eat. Don't put off seeing a doctor, thinking you will get
better on your own. Keep in mind, an eating disorder can cause
serious harm to your body and to your emotional health.
Anorexia nervosa is an illness that usually occurs in
teenage girls, but it can also occur in teenage boys,
and adult women and men. People with anorexia
are obsessed with being thin. They lose a lot of
weight and are terrified of gaining weight. They
believe they are fat even though they are very thin.
Anorexia isn't just a problem with food or weight. It's
an attempt to use food and weight to deal with
.emotional problems
The reason some people get anorexia isn't known. People with anorexia may believe
they would be happier and more successful if they were thin. They want everything in
their lives to be perfect. People who have this disorder are usually good students. They
are involved in many school and community activities. They blame themselves if they
.don't get perfect grades, or if other things in life are not perfect
Girls with anorexia usually stop having menstrual periods. People with anorexia have
dry skin and thinning hair on the head. They may feel cold all the time, and they may
get sick often. People with anorexia are often in a bad mood. They have a hard time
concentrating and are always thinking about food. It is not true that anorexics are never
hungry. Actually, they are always hungry. Feeling hunger gives them a feeling of control
over their lives and their bodies. It makes them feel like they are good at something-they are good at losing weight. People with severe anorexia may be at risk of death
from starvation.
What is the treatment for anorexia?
Treatment of anorexia is difficult, because people with
anorexia believe there is nothing wrong with them. Patients in
the early stages of anorexia (less than 6 months or with just a
small amount of weight loss) may be successfully treated
without having to be admitted to the hospital. But for
successful treatment, patients must want to change and must
.have family and friends to help them
People with more serious anorexia need care in the hospital,
usually in a special unit for people with anorexia and bulimia.
Treatment involves more than changing the person's eating
habits. Anorexic patients often need counseling for a year or
more so they can work on changing the feelings that are
causing their eating problems. These feelings may be about
their weight, their family problems or their problems with selfesteem. Some anorexic patients are helped by taking
medicine that makes them feel less depressed. These
medicines are prescribed by a doctor and are used along with
counseling
Warning signs of anorexia
•Deliberate self-starvation with weight loss
•Fear of gaining weight
•Refusal to eat
•Denial of hunger
•Constant exercising
•Greater amounts of hair on the body or the face
•Sensitivity to cold temperatures
•Absent or irregular periods
•Loss of scalp hair
•A self-perception of being fat when the person is really too thin
Bulimia, also called bulimia nervosa, is a psychological
eating disorder.
Bulimia is characterized by episodes of binge-eating
followed by inappropriate methods of weight control,
including vomiting, fasting,enemas, excessive use of
laxaitives and diuretics, or compulsive exercising.
Excessive shape and weight concerns are also
characteristics of bulimia. A binge is an episode where an
individual eats a much larger amount of food than most
people would in a similar situation. Binge eating is not a
response to intense hunger. It is usually a response to
depression, stress, or self esteem issues.
During the binge episode, the individual experiences a
loss of control.
However, the sense of a loss of control is also
followed by a short-lived calmness.
The calmness is often followed by self-loathing.
The cycle of overeating and purging usually becomes
an obsession and is repeated often.
Interesting facts about bulimia:
•
Bulimia was only diagnosed as its own eating disorder in the 1980s.
•
People with bulimia can look perfectly normal. Most of them are of
normal weight, and some may be overweight. Women with bulimia
tend to be high achievers.
•
It is often difficult to determine whether a person is suffering
from Bulimia. This occurs because binging and purging is often done
in secret. Also, individuals suffering from Bulimia often deny their
condition.
•
Sufferers consume huge quantities of food. Sometimes up to
20,000 calories at a time. The foods on which they binge tend to be
foods labeled as "comfort foods" -- sweet foods, high in calories, or
smooth, soft foods like ice cream, cake, and pastry. An individual
may binge anywhere from twice a day to several times daily
•Bulimia nervosa: the diet-binge-purge disorder
1. Person binge eats.
2. Feels out of control while eating.
3. Vomits, misuses laxatives, exercises, or fasts to get rid
of the calories.
4. Diets when not bingeing. Becomes hungry and binges
again.
5. Believes self-worth requires being thin. (It does not.)
6. May shoplift, be promiscuous, and abuse alcohol,
drugs, and credit cards.
7. Weight may be normal or near normal unless anorexia
is also present.
8. Like anorexia, bulimia can kill. Even though bulimics put
up a brave front, they are often depressed, lonely,
ashamed, and empty inside. Friends may describe them
as competent and fun to be with, but underneath,
where they hide their guilty secrets, they are hurting.
Feeling unworthy, they have great difficulty talking
about their feelings, which almost always include
anxiety, depression, self-doubt, and deeply buried
anger. Impulse control may be a problem; e.g.,
shoplifting, sexual adventurousness, alcohol and drug
abuse, and other kinds of risk-taking behavior. Person
acts with little consideration of consequences.
What is the difference between anorexia
and bulimia?
People with anorexia starve themselves, avoid highcalorie foods and exercise constantly. People with
bulimia eat huge amounts of food, but they throw up
soon after eating, or take water pills to keep from
gaining weight. People with bulimia don't usually lose as
much weight as people with anorexia.
People in different ages need different diets:
Babies, teenagers and elderlings need to get a different amount of different vitamins &
minerals:
During pregnancy the fetus obtains nutrients from its mother via the placenta. Once the
baby is born, energy and nutrients are supplied by breast milk or formula milk.
The feeding mother needs a special diet too
A mother who is breast feeding needs extra energy and nutrients. Some of this
requirement is supplied by the diet. Only a small amount of extra food is needed,
although the extra energy needed is about 1,900kJ (450kcal) per day during the
first month and rises slightly as the baby gets older. Using energy from stores
laid down in pregnancy can help mothers return to the weight they were before
pregnancy.
Growth and development are rapid during the teenage years, and the
demand for energy and most nutrients is relatively high. This demand
different between boys and girls: boys need more protein and energy
than girls due to their greater growth spurt.
The growth spurt usually begins around the age of
10 inyears girls and in boys. years12
of In both sexes, an average
23cm is added to height and 20-26 kg to weight.
Before adolescence,both girls and boys have an average of 15%
body fat.
During adolescence this increases to about 20% in girls and
decreases to about 10% in boys.
One way to obtain sufficient energy is by the consumption of frequent
snacks as well as meals. However, some adolescents eat more than they
need and may become overweight, especially if they are inactive. It is
better to try to prevent obesity than to encourage strict dieting in this
age group. Encouraging a healthy lifestyle is therefore of prime
importance during these years. Good habits practiced now will be likely
to benefit their health for the rest of their lives.
There is an increasing tendency for teenagers, particularly girls, to control their
weight by unsuitable methods such as smoking or adopting very low energy
diets. Restriction of many food items can lead to nutrient deficiencies and
problems in later life. During adolescence iron requirements increase to help
.with growth and muscle development
After menstruation begins, girls need more iron than boys to replace menstrual
losses. It is difficult to estimate the number of teenagers who are anemic but
the National Diet and Nutrition Survey published in 2000 of young people found
1% of boys aged 15-18 had a hemoglobin level lower than the limit for men and
9% of girls had a hemoglobin level lower than the limit for women.The survey
also found many teenage girls had a low intake of iron, with 45% of 11-14 year
and 50% of 15-18 year olds having intakes below the lower reference nutrient
intake (LRNI), implying that their intakes were likely to be inadequate.Those
who start a poorly planned vegetarian diet or are slimming may be particularly
at risk. Bread flour is fortified with iron by law and iron is also added to most
breakfast cereals.This makes breakfast an important means of acquiring iron. .
But many adolescents do not eat breakfast, so these foods could be encouraged
as snacks instead together with food or drink containing vitamin C, e.g. fruit
.juice
The rapid increase in bone mass in adolescents means that they
require more calcium than adults. Boys should aim for 1000mg
per day and girls for 800mg. (link to section on minerals –
calcium).
Old people:
Older people is the term generally used to refer to people over the age of 65.
Energy requirements continue to fall with advancing age because people
tend to be less active, but it is important that older people continue to enjoy
their food and that they keep active in order to maintain a good appetite,
.prevent obesity and maintain mobility
A person may eat less as they get older for many reasons. Some elderly
people have difficulty chewing and swallowing. People with arthritis, for
example, have difficulty shopping, preparing and cooking food. Other people
may simply lose interest in food, because they live alone or are unwell, and
others limit what they buy because they have financial problems. It is
therefore not uncommon for intake of certain nutrients to be lower than
recommended. Intakes of some of the B vitamins and vitamin C may be low
due to a reduction in the amount of fresh foods eaten, and therefore
consumption of fruit juice and canned fruits should be encouraged.
Osteoporosis is a major problem in elderly people, especially women. It occurs
when bones have become so fragile that they fracture easily. It affects 1 in 3
women and 1 in 12 men and costs the NHS 942 million pounds per year.The
best way to prevent this condition is to build a strong skeleton during
childhood by eating a good diet rich in calcium and being physically active.
These habits should then be maintained as an adult. An adequate calcium
intake during the later years is also important as it may help to reduce bone
loss.Vitamin D, which is necessary for calcium absorption, is mainly obtained
from the action of sunlight on the skin. So people who are housebound or live
in institutions may be at risk of deficiency. It is recommended that everyone
over 65 years of age takes a supplement of vitamin D, and dietary sources such
as oily fish, cod liver oil and margarine should be eaten regularly.
It is also important that the intake of fluids is kept up in old age to avoid
dehydration which may cause mental confusion.
Vegetarians also need a special diet, taken from a special food pyramid:
Good nutrition leads to good health, good life and a good feeling. It is also
recommended to combine the healthy diet with exercising which will keep
you strong and in shape.
It is important to remember that one who wishes to start eating and living
healthy, should ask an expert, and only the turn to the dieting.
The basic food pyramid:
Bulimia and anorexia
Anorexia and Bulimia
www.ANRED.com
www.mamashealth.com
www.nami. -
www.itspeed.com
www.priory-hospital.co.uk
Healthy eating
Eating disorder
www.healtyeating.net
http://navigator.tufts.edu
http://default.asp
Healthy eating
Eating Disorder
www.nutrition.gov
http://www.edneferral.com
www.nutrition.org
www.mirrir.org
www.aedweb.org
‫נוירולוגי‪ ,‬של מערכת העצבים – ‪Neurological‬‬
‫מכוון‪ ,‬מונחה ‪Oriented -‬‬
‫הערכת יתר– ‪Overeat‬‬
‫שכיחות – ‪Prevalence‬‬
‫חיזוק‪ ,‬תגבורת – ‪Reinforcements‬‬
‫שובע‪ ,‬תחושת שובע – ‪Satiety‬‬
‫ברור – ‪Straightforward‬‬
‫לחלק שנית – ‪Redistribute‬‬
‫פרישה ‪Requirements -‬‬
‫מוחשי‪ ,‬ברור – ‪Tangible‬‬
‫מילולי – ‪Verbal‬‬
‫בעל פה – ‪Verbally‬‬
‫הקאות ‪Vomits -‬‬
‫שומן‪ ,‬שמנוניות – ‪Adiposity‬‬
‫מצבור – ‪Aggregation‬‬
‫חרדה ‪Anxiety -‬‬
‫פחמימות ‪Carbohydrates -‬‬
‫מחלת לב וכלי דם – ‪Cardiovascular disease‬‬
‫מאופיין ‪Characterized -‬‬
‫רכיבים – ‪Components‬‬
‫להתמודד‪ ,‬להתגבר על – ‪Cope‬‬
‫להרפות ידיים‪ ,‬להרתיע – ‪Discourage‬‬
‫מעוות – ‪Distorted‬‬
‫אנדוקרין‪ ,‬הפרשה הורמונאלית פנימית – ‪Endocrine‬‬
‫תנודות – ‪fluctuations‬‬
‫מבוצר \ מחוזק \ מוגבר \ מועשר ‪Fortified -‬‬
‫בתחילה‪ ,‬בהתחלה – ‪Initially‬‬
‫יומן‪ ,‬שיחה שנשמרה – ‪Log‬‬
‫שימוש לרעה בחומרים משלשלים –‪misuses laxatives‬‬
‫מחזור ‪Menstruation -‬‬
‫שינוי‪ ,‬התאמה – ‪Modification‬‬
‫השגחה – ‪Monitoring‬‬
1. does a person' that sick in bulimia look:.
Normal .a
to fat .b
to thin .c
2. what is the difference between
anorexia and bulimia?
a.bulimia is when a person stave
him self and in anorexia he cant
stop eating
b. there is no difference.
c. anorexia is when the person
starve himself and bulimia is when
he cant stop eating and then throw
up.
3. anorexia nervosa usually
occurs in: a. teenage girls
b. grown up weman
c. old ladeys
1.what effects the eating disorders:
a.the way we eat or feel about food
b. what people think about us
c. nothing
2. what causes eating disorders:
un known yet .a
the Barby model .b
the parents of the sick child .c
3. what should you do if you will know someone
with eating disorders:
Nothing .a
tell some on you trust .b
support the person. .c
b and c are the right answer .d
1. how does the nutririon effects us:
a. look,bodey shape and feeling
b. dont effect at all
c. hair color and eyes
2. does all the people have the same diet:
Yes .a
no .b
3. how does the diets division:
babies have the same diet as old people .a
babies elders and grownup- each on have his .b
own diet
elders have the same diet as teenage girls .c
Nir schayer & Naama Zilber - Nutrition &
Diets
Keren Eisen & Yael Schechner –
Anorexia & Bulimia
Bar River & Lotem Galili – Obesty &
Binge Eating Disorder
Nitzan Zamir – Computer Woman