Download Chapter 9 – Weight Management: Overweight and Underweight

Chapter 9 – Weight Management: Overweight and Underweight
OVERWEIGHT / OBESE:
More than 50% of adults in the U.S. are overweight or obese
15% of children 6-19 years are obese
FAT CELL DEVELOPMENT
 Obesity develops when a person's fat cells increase in size, number, or both
 The number of fat cells increases rapidly during the growth years (childhood,
puberty)
 People with a large number of fat cells are more likely to regain lost weight
rapidly
 Obese people have more LPL (lipoprotein lipase) activity in their fat cells than
lean people
SET POINT THEORY
 Body weight may be physiologically regulated
 Even after dieting, the body strives to be at a certain weight because the body
adjusts its metabolism
CAUSES OF OBESITY:
1. GENETICS
 When both parents are obese, there is a high likelihood that the children will
be obese too
 Twins separated at birth are likely to be of similar weight as adults
 Leptin (Obesity gene) – suppresses appetite and increases energy expenditure
 Ghrelin – stimulates appetite and promotes efficient energy storage. Ghrelin
levels are high in underweight people and people with eating disorders.
Levels are also high while on low calorie diets.
2. ENVIRONMENT
 Overeating – There is an abundance of high-calorie, high-fat, inexpensive
foods in the United States.
 Physical Inactivity – The main cause of obesity! 60 minutes of moderately
intense physical activity per day is recommended.
DANGEROUS INTERVENTIONS FOR OBESITY
1. FAD DIETS
 Most people do not maintain weight loss for very long
 Promise a “quick” weight loss
 May be harmful
 Do not encourage healthy long-term lifestyle changes
1
2. OVER THE COUNTER DRUGS
 Majority of users are women
 10% of users are of normal weight
 Most are not approved by the FDA
3. HERBAL PRODUCTS AND DIETARY SUPPLEMENTS
 Few have proved to be effective
 St. John’s Wort – inhibits the uptake of serotonin and suppresses appetite
 Ephedrine – implicated in several deaths
4. OTHER GIMMICKS
 Hot baths, steam and sauna baths
 Cellulite treatments
AGGRESSIVE TREATMENTS OF OBESITY:
1. MEDICATIONS
 Most have potential side-effects
 Weight usually returns when person quits taking the medication
 Sibutramine – suppresses appetite
 Orlistat – blocks dietary fat digestion and absorption by 30%
2. GASTRIC SURGERY
 Limits food intake by reducing the size of the stomach and suppressing hunger by
reducing production of
.
 Most people achieve lasting weight loss of more than 50% of excess body weight
 Effectiveness depends on compliance with dietary instructions
 High risk of complications
ESSENTIAL COMPONENTS OF A WEIGHT LOSS PLAN:
1. Balanced Diet
 Eat a variety of foods, including all food groups
2. Realistic Calorie Intake
 At least 1,200 calories per day
 Most weight loss plans provide 1,200-1,800 calories per day
* It takes
calories to make a pound
To lose 1 pound a week, subtract 500 calories from daily intake
To lose 2 pounds a week, subtract 1,000 calories from daily intake
2
3. Small Portions
 Even low-fat foods can contribute to weight gain
 The amount eaten at meals should leave you satisfied, not full
 Focus on foods with low energy density
4. Balance of carbohydrates, protein, and fats
5. Limit “empty calorie” foods such as sugar and alcohol
6. Adequate Water Intake
 Water can help satisfy thirst
 Dilutes metabolic wastes generated by the breakdown of fat
7. Regular Physical Activity
 Daily exercise is best for weight loss (try to burn at least 2,000 calories per week)
 Speeds up the BMR
 Helps with appetite control
 Psychological Benefits (which may control eating)
8. Behavior Modification
 Some people may require psychological counseling
 Repeat visits for diet counseling are usually needed
 Support groups are helpful
 Recording eating and exercise behaviors are helpful
UNDERWEIGHT
Affects no more than 5% of U.S. adults
STRATEGIES FOR WEIGHT GAIN:
 Consume energy-dense foods
 Exercises that build muscle
 At least three meals a day
 Large Portions
 High calorie snacks
 Juice and milk (beverages that contain calories)
EATING DISORDERS:
Eating disorders are psychological problems, best treated with the help of a licensed
mental health counselor (preferably someone specializing in eating disorders). Eating
disorders are not classified as nutritional problems.
3
1. ANOREXIA NERVOSA
 Self-induced starvation
 Can be life-threatening
 Weight becomes severely low
 Often affects young female athletes
2. BULIMIA
 Combination of bingeing and purging
 May be combined with anorexia
 May also abuse laxatives
 Can affect as many as 20% of college-age women
 Usually are of normal weight
3. BINGE-EATING DISORDER
 The most common type of eating disorder
 Not followed by purging or laxative use
 Usually associated with guilt after a binge
 Can consume large quantities of food (thousands of calories) at one sitting
4