Download DIET AND WEIGHT CONTROL

DIET AND
WEIGHT CONTROL
Dr Reham Khresheh
OBJECTIVES
After studying this chapter, you should be able to:
 Discuss the causes and dangers of overweight
 Discuss the causes and dangers of underweight
 Identify foods suitable for high-calorie diets and those
suitable for low calorie diets
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Introduction
- Normal weight is that which is appropriate for the
maintenance of good health for a particular individual
at a particular time.
- Overweight can be defined as weight 10% to 20%
above average.
- Obesity can be defined as excessive body fat, with weight
20% above average.
- Underweight is weight 10% to 15% below average.
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Introduction ..
 The medical standard used to define obesity is the body mass
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index (BMI).
It is used to determine whether a person is at health risk from
excess weight.
The BMI is obtained by dividing weight in kilograms by height in
meters squared.
Fewer health risks are associated with a BMI range of 19 to 25
than with BMI above or below that range.
A BMI between 25 and 30 indicates overweight, whereas a BMI
over 30 indicates obesity.
Introduction…
 Body weight is composed of fluids, organs, fat, muscle, and
bones, so large variation exists among people.
 In addition to height, one needs to consider age, physical
condition, heredity, gender, and general frame size (small,
medium, or large) in determining desired weight.
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Introduction…
 Body fat is measured with a caliper. Using a caliper
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correctly requires practice and skill.
Because the fat under the skin on the stomach and on
the upper arm is representative of the percentage of
overall body fat, it is usually measured when
knowledge of the percentage of body fat is required.
If it is more than 11⁄2 inches, one is considered
overweight.
If it is under 1⁄2 inch, one is considered underweight .
A moderate amount of fat is a necessary component of
the body. It protects organs from injury and acts as
insulation. The final determination of desirable weight
depends on common sense.
OVERWEIGHT AND OBESITY
 BMI measures weight in relation to height.
 Healthy Weight BMI from 18.5 up to 25 refers to
healthy weight.
 Overweight BMI from 25 up to 30 refers to
overweight.
 Obese BMI 30 or higher refers to obesity. Obese
persons are also overweight.
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Causes
 There is no one cause for excess weight, but poor diet and inactivity
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appear to be leading factors
Genetic, physiological, metabolic, biochemical, and psychological
factors can also contribute to it.
Energy imbalance is a significant cause of overweight.
People eat more than they need.
Excess weight can accumulate during and after middle age because
people reduce their level of activity and metabolism slows with age.
Consequently, weight accumulates unless calorie intake is reduced.
Hypothyroidism is a possible, but rare, cause of obesity. In this
condition, the basal metabolic rate (BMR) is low, thereby reducing the
number of calories needed for energy. Unless corrected with
medication, this condition can result in excess weight.
Healthy Weight
 Not everyone fits the “healthy weight target,” which is a BMI
of 18.5 to 25.
 For anyone with a BMI of 25 or higher, a more realistic
approach would be a reduction of one or two BMI points to
reduce health problems and disease risks.
 After this loss has been maintained for 6 months, further
lowering of the BMI needs to be attempted.
 A “healthy weight” may be the weight at which one is eating
nutritiously, is exercising, has no health problems, and is free
from disease.
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DIETARY TREATMENT OF OVERWEIGHT
AND OBESITY
 if a significant cause of overweight is overeating, the solution is to reduce portion size
and caloric intake. This is seldom easy. To accomplish it, one must undertake a weight
reduction (low-calorie) diet. For the diet to be effective, one must have a genuine desire
to lose weight.
1. Food Selection
- Some foods are good choices on weight loss diets because of their low calorie and lowfat-gram values, and some foods should be used in moderation because of their highcalorie and high-fat-gram values ). The low calorie, low-fat-gram foods should be used
during weight loss and thereafter. The following are examples:
- Fat-free milk for whole milk
- Evaporated fat-free milk for evaporated milk
- Yogurt or low-fat sour cream for regular sour cream
- Lemon juice and herbs for heavy salad dressings
- Fat-free salad dressings for regular salad dressings
- Fruit for rich appetizers or desserts
- Water-packed canned foods rather than those packed in oil or syrup
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2. Cooking Methods
 Broiling, grilling, baking, roasting, poaching, or boiling are
the preferred methods because no additional fat is added,
unlike frying.
 Skimming fat from the tops of soups and meat dishes will
reduce their fat content, as will trimming fat from meats
before cooking.
 The addition of extra butter or margarine to foods should be
avoided and should be replaced with fat-free seasonings such
as fruit juice, vinegar, and herbs and spices.
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3. Exercise
 Exercise, particularly aerobic exercise, is an excellent adjunct to any
weight loss program.
 Examples are dancing, jogging, bicycling, skiing, rowing, and power
walking. Such exercise helps tone the muscles, burns calories, increases
the BMR so food is burned faster, lowers the set point, and is fun for the
participant
 Exercise alone can only rarely replace the actual diet, however. The
dieter should be made aware of the number of calories burned by
specific exercises so as to avoid overeating after the workout.
 General daily guidelines for exercise are 30 minutes to prevent chronic
diseases, 60 to 90 minutes to prevent weight gain, and over 90 minutes
to maintain weight loss.
 Children should exercise or be active 60 minutes every day.
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4. Behavior Modification for Weight Loss
 Behavior modification means change in habits. The fundamental
behavior modifications for a weight loss program are the
development of a new and healthy eating plan and an exercise
program that can be used over the long term.
 It is important that one learn the difference between hunger and
appetite.
 Hunger is the physiological need for food that is felt 4 to
6 hours after eating a full meal. Appetite is a learned
psychological reaction to food caused by pleasant
memories of eating it.
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Additional behavior modifications are given below.
1. Weigh regularly (for example, once a week), but do not weigh
yourself daily.
2. Don’t wait too long between meals.
3. Join a support group and go to meetings during and after the
weight loss.
4. Eat slowly.
5. Use a small plate and fill it two-thirds with fruits, vegetables,
and
whole-grain products and just one-third with meat products.
6. Use low-calorie garnishes.
7. Eat whole, fresh foods that are low-calorie and nutrientdense. Avoid processed foods.
8. Treat yourself with something other than food.
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5. Surgical Treatment of Obesity
 When obesity becomes morbid (damaging to health)
and dieting and exercising are not working, surgery
could be indicated.
 Two of the surgical procedures used are the gastric bypass
and stomach banding. Both procedures reduce the
size of the stomach
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GASTRIC
BYPASS
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STOMACH
BANDING
6. Pharmaceutical Treatment of Obesity
 The use of any weight loss medication, whether by
prescription or over the counter, should be considered very
carefully. Amphetamines (pep pills) have been
prescribed for the treatment of obesity because they
depress the appetite
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UNDERWEIGHT
 Dangers
- Underweight can cause complications in pregnancy and cause various nutritional
deficiencies. It may lower one’s resistance to infections and, if carried to the extreme,
can cause death.
 Causes
- inadequate consumption of nutritious food because of depression, disease, anorexia
nervosa, bulimia, or poverty, or it can be genetically determined.
excessive activity, the
- tissue wasting of certain diseases,
- poor absorption of nutrients,
- infection, or hyperthyroidism.
 Treatment : Underweight is treated by
- a high-calorie diet or by a high-calorie diet combined with psychological counseling if the
condition is psychological in origin as, for example, in depression or anorexia nervosa.
In many cases, a high-calorie diet will be met with resistance. It can be as difficult for an
underweight person to gain weight as it is for an overweight person to lose it.
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CONSIDERATIONS FOR THE HEALTH
CARE PROFESSIONAL
 Even for the most determined clients, a successful weight
loss program will be charged with anxiety. There will be
days of disappointment. It will take a long time to reach the
ultimate goal.
 The health care professional will need to supply
psychological support and nutritional advice when
disappointing results create the need for emotional support.
 It is essential that the health care professional see the
problems, support the client, and then effectively lead her or
him back to the diet. The key words for the health care
professional are support and encouragement.
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9. Anticipate problems ( holidays). “Undereat” slightly before and
after.
10. “Save” some calories for snacks and treats.
11. If something goes wrong, don’t punish yourself by eating.
12. If there is no weight loss for 1 week, realize that lean muscle
mass is being produced from exercising or there may be retention of
water.
14. Adapt family meals to suit your needs. Don’t make a
production of your diet. Avoid the heavy-calorie items. Limit yourself
to a spoonful of something too rich for a weight loss diet. Substitute
something you like that is low in calories.
15. Take small portions.
16. Eat vegetables and bread without butter or margarine.
17. Include daily exercise. Park further from work and walk.
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