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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
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
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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Obesity prevalence, by age and sex, of American adults
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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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
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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Health Implications of Overweight and Obesity
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More than 30% 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
© 2007 McGraw-Hill Higher Education
Factors Contributing to Excess Body
Fat: Genetic Factors
Genetic factors influence body size and
shape, body fat distribution, and metabolic
rate
n Genetic contribution to obesity is
estimated at 25–40%
n Hereditary influences must be balanced
against contribution of environmental
factors
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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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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
© 2007 McGraw-Hill Higher Education
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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
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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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
© 2007 McGraw-Hill Higher Education
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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
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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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
© 2007 McGraw-Hill Higher Education
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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.
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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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
© 2007 McGraw-Hill Higher Education
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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
© 2007 McGraw-Hill Higher Education
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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
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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Approaches to Overcoming a Weight Problem
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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
© 2007 McGraw-Hill Higher Education
Surgery
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Adjustable gastric banding
Roux-en-Y gastric bypass
Source: National Institutes of Health
http://www.videojug.com/interview/adjustable-gastricbanding-3
http://www.videojug.com/interview/roux-en-y-gastric-bypass-2
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
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
© 2007 McGraw-Hill Higher Education
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Different Body Builds
ENDOMORPHY
MESOMORPHY
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ECTOMORPHY
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education
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
© 2007 McGraw-Hill Higher Education
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Body Image
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Knowing when the limits to
healthy change have been
reached.
Knowing the unrealistic
cultural ideal.
Acceptance and change
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Knowing what is a healthy
lifestyle change
http://www.videojug.com/interview/understanding-bodydysmorphic-disorder-2
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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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
© 2007 McGraw-Hill Higher Education
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Body Image
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Dissatisfaction
with weight
and shape is
common in
people with
eating
disorders
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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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
© 2007 McGraw-Hill Higher Education
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Eating Disorders
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Anorexia Nervosa - Failure to eat enough
food…
Affects 3 million people – 95% are female
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Characteristics
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Fear gaining weight.
Distorted self-image.
Compulsive behaviors and rituals.
Excessive exercise
Health Risks of Anorexia Nervosa
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Typically develops between the ages of 12 and 18
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
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Disorders of the cardiovascular, gastrointestinal,
endocrine, and skeletal systems
http://www.videojug.com/interview/dangers-of-anorexia-2
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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Eating Disorders
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Bulimia Nervosa - recurring episodes of binge eating
followed by purging.
Begins in adolescence or young adulthood
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Characteristics:
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Increasingly younger (11-12 years) and older (40-60 years) ages.
Rapidly consumes food, then purges.
Done in secret.
After a binge - feels ashamed, disgusted and physically and emotional
drained.
Health Risks:
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Erodes tooth enamel
Deficient calorie intake
Liver and kidney damage
Cardiac arrhythmia
Chronic hoarseness
Esophageal tearing
Rupture of the stomach
Menstrual problems
Increased depression
http://www.videojug.com/interview/physical-dangers-of-bulimia-2
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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Eating Disorders
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Binge-Eating - Similar to
Bulimia except no Purging
behavior.
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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
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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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
© 2007 McGraw-Hill Higher Education
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Energy
Balance
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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Wellness Worksheet Assignment
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Wellness Worksheets can be accessed online at
www.mhhe.com/fahey8e
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From the website above, click on “student edition” at the bottom
left column.
Click on “wellness worksheets”
Click on “126 Wellness Worksheets are available online” in the
middle of the page.
Click on “76: Body Image” and complete the worksheet.
Print out the completed worksheet and submit on Wednesday,
March 30th
Fahey/Insel/Roth, Fit & Well: Core Concepts and Labs in Physical Fitness and Wellness, Chapter 9
© 2007 McGraw-Hill Higher Education