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
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
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.
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
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* 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
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