Managing a Healthy Weight: Facts and Myths

1. Chapter 6Managing a Healthy Weight

2. Managing a Healthy Weight • Learning Objectives • Describe the extent and causes of overweight in American society. • Describe the significance of body mass index (BMI) to health. • Describe the body’s energy-control system and factors affecting it. • Explain why calorie-restriction weight-loss regimes fail.

3. Managing a Healthy Weight • Learning Objectives (continued) • List the features of sensible weight management. • Discuss the advantages and disadvantages of medical treatments for overweight. • Describe common weight-loss fads and fallacies. • Define anorexia nervosa, bulimia, and binge eating disorder.

4. Managing a Healthy Weight • What Is Healthy Weight? • The Regulation of Body Fat • Diets Don't Work • Sensible Weight Management • Medical Management of Overweight • Weight-Control Fads and Fallacies • Body Image • Eating Disorders • It’s in Your Hands

5. Managing a Healthy Weight • 68% of the U.S. population is considered overweight. • This is a major problem because being overweight increases the risk for many illnesses, including heart disease and type 2 diabetes. • People who are overweight tend to live shorter lives than those who are not overweight.

6. Managing a Healthy Weight

7. Managing a Healthy Weight

8. Managing a Healthy Weight

9. Managing a Healthy Weight • Reasons for Increase in Overweight • Overconsumption of calorie-dense foods in relation to energy expenditure. • Abundance of inexpensive foods that contribute to weight gain. • Increase in portion sizes. • Reduction in jobs that require physical labor. • Decrease in leisure-time physical activity. • Increase in suburban living.

10. Managing a Healthy Weight • Reasons for Increase in Overweight (continued) • Reduction in school physical education and after-school physical activities. • An increase in time spent watching TV, using the computer, and playing video games. • Increase in the pace of life. • Increase in the stress of life.

11. Managing a Healthy Weight • What are the things that you have seen that are putting Americans at continued risk of being overweight?

12. Managing a Healthy Weight

13. What Is Healthy Weight? • Concerns about being overweight are most often concerns about being over fat. • Lean body mass includes: structural elements of cells, body water, muscles, and bone. • Body Fat • Essential fat • Storage fat

14. What Is Healthy Weight? • Body Fat (continued) • Essential fat: needed for normal physiological function. • Men—3% to 7% • Women—10% to 12% • Storage fat: energy stored as fat. • 5% to 25% of body weight of healthy weight individuals. • 1 lb = 3,500 calories.

15. What Is Healthy Weight? • Obesity: storage fat exceeding 30% of body weight. • Body mass index: a way of calculating body fatness. • Body weight (kg) / height (m)2 • Healthy: 19–25 • Above this recommendation, a person is at increased risk for disease.

16. What Is Healthy Weight?

17. What Is Healthy Weight? • Waist-hip ratio is another health-related index of body size. • Circumference of waist divided by circumference of hips. • Healthy: • Women, below 0.8 • Men, below 0.95 • It is healthier to be pear-shaped than apple-shaped and healthier not to have a beer belly.

18. What Is Healthy Weight? It is healthier to be pear-shaped

19. The Regulation of Body Fat • Calories In Versus Calories Out • If you take in more than you need, then you will gain body fat. • Energy balance—taking in only what you need so that your input equals output. • Excess calories will be stored; there are two principal calorie-storing mechanisms: • Glycogen, the storage form of carbohydrates • Triglyceride, the storage form of fat

20. The Regulation of Body Fat • The body is designed to store fat easily in case you ever have to go without food. Therefore if you allow weight gain to stay on for too long, it will be very hard to get it off and keep it off later. • The best weight loss efforts produce a 5% to 10% reduction in body weight over the first 6 months of trying and no more after that.

21. Diets Don’t Work • Going on a diet, or restricting calories, doesn’t work in the long run because the body turns on a mechanism that conserves body fat. • The focus is on food and not increasing physical activity. • Dieters become disillusioned and discouraged. • Dieters become bored with the same food. • Dieters become frustrated with not being able to eat what and how much they like.

22. Diets Don’t Work

23. Diets Don’t Work • Popular Weight-Loss Programs • Low-calorie: reduce portion size to limit calories consumed, e.g., Weight Watchers, LA Weight Loss, and Jenny Craig. • Low-carbohydrate: reduce intake of breads, rice, pasta, potatoes, sweets, and snacks, e.g., Atkins and South Beach. • Low-fat: recommend high complex carbohydrates and little fat, e.g., Ornish.

24. Sensible Weight Management • A wide variety of body sizes, shapes, and compositions is considered healthy. Striving for unattainable body weight and shape is unhealthy. • Calorie-restricting weight-loss programs have not proved to be effective. • Improved nutrition, regular exercise, and desire to feel good are the ways that people lose considerable amounts of weight and maintain healthful weights for many years.

25. Sensible Weight Management • Sensible weight losers can live healthier lives while allowing their body to find ideal weight by adopting these goals: • Forget slim, go for health. • Set realistic goals. • Eat only when hungry and don’t overeat. • Eat healthy foods. • Exercise.

26. Sensible Weight Management • Weight-loss goals (continued): 6. Limit mindless snacking. 7. Consume little or no alcohol. 8. Be aware of eating triggers. 9. Don’t feed your feelings.

27. Sensible Weight Management • Quick Suggestions • Keep a diary of your weight-loss activities. • Keep faith with your intention to attain a healthful weight. • Don’t count calories or constantly weigh yourself; focus on developing healthy behaviors and feeling good. • Ignore weight-loss and exercise-machine advertising.

28. Medical Management of Overweight • Medical techniques for managing overweight: • Counseling and hypnosis • Psychological counseling • Medications—appetite suppressants are medications to produce weight loss; they diminish the sense of hunger • Surgery—small bowel bypass, gastroplasty, gastric bypass, and liposuction

29. Weight-Control Fads and Fallacies • Most claims made for weight-control products and plans are exaggerated and misleading. • Two major weight-control fads: • Body wraps • Weight lost is water, not fat. • Chemicals and supplements—“natural,” amphetamines, phenylpropanolamine, benzocaine, bulk-producing agents, hormones, vitamins, minerals, and amino acid supplements

30. Body Image • Body image: a person’s mental picture of her or his own body. • Body esteem: judgment a person makes about his or her body image. • Society creates a definition of the “perfect” body, which is unrealistic or unattainable for most people.

31. Body Image • Body Dysmorphic Disordera preoccupation with an imagined defect in one or more of your body parts • For males – height/muscles/genitals/hair thinning • For females – body size & shape(s)/facial/features/body hair • Over concern about body image leads to health problem

32. Body Image • Being overly concerned about body image and weight can have adverse health consequences: • Low body esteem and low self-worth • Poor nutrition from extensive dieting • Inadequate calcium and iron intake from undernutrition • Anorexia and bulimia

33. Body Image • Health consequences (continued): • Musculoskeletal injuries from overexercising • Risks associated with cosmetic surgery • Cigarette smoking to reduce body weight

34. Eating Disorders • Slimness is considered a sign of health and attractiveness. • Three most common eating disorders are anorexia nervosa, bulimia, and binge eating. • Athletes are at risk for orthorexia, a rigid fixation with righteous and healthy eating whereby one prepares proper meals but carries guilt and anxiety, self-punishing through excessive exercise when they do not follow their desired eating regimen.

35. Watch Dying to be thin 53 min • Watch Eating Disorders from the Inside Out: Laura Hill at TEDx19 min

36. Eating Disorders • Anorexia Nervosa • Voluntary refusal to eat that leads to severe underweight and disturbances in metabolism. • Characterized by: • Occurrence usually in young women (but can and does occur at all ages and in men) • An overprotective family unable to deal with interfamilial conflict • Disturbances in body image • Preoccupation with food • Not eating in the presence of others

37. Eating Disorders • Anorexia Nervosa (continued) • Possible causes: • Avoidance of adolescence by trying to remain a dependent, asexual child • Attempt to establish identity by controlling the environment • Avoidance of family conflicts

38. Eating Disorders • Anorexia Nervosa (continued) • Treatment includes: • Weight gain • Change in attitude toward eating and food • Resolution of personal and family conflicts • Psychological counseling

39. Eating Disorders • Bulimia • Voluntary restriction of food intake followed by extreme overeating and self-induced vomiting or use of laxatives. • Binge eating disorder is an uncontrollable consumption of large quantities of food in a short period of time, even if the person is not hungry. • Possible causes: response to psychological stress or manifestation of a drive to become an “ideal.”

40. Eating Disorders • Bulimia (continued) • Treatment goals: • Stopping binge-purge cycles • Establishing appropriate ways to handle unpleasant feelings • Improving self-esteem • Receiving the help of psychological counseling

41. Eating Disorders • Binge Eating Disorder • Uncontrolled consumption of large quantities of food in a short time, even if the person is not hungry. • Binge episodes followed by feelings of disgust, depression, and guilt. • Needs help keeping track of and changing unhealthy eating behaviors, identifying social factors that contribute to the problem, counseling, and medication.

42. It’s in Your Hands • Successful weight control involves reducing calorie intake and increasing the level of physical activity. • What are specific things that you can do right now to achieve or maintain a healthy lifestyle? • Are there things that you need to change? • How do you eat healthily while on the go and/or eating in cafeterias? What are simple things that can help?