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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