1. Chapter 11 Lecture Achieving and Maintaining a Healthful Body Weight, and Disordered Eating © 2015 Pearson Education, Inc.

2. Focus Points Achieve and Maintain Healthful Weight Diet plans to avoid Guidelines for successful weight loss Behavior Modification Underweight, Overweight, Obesity Disordered Eating, Eating disorders

3. Achieve and Maintain Healthful Weight Healthful weight change requires Gradual change in energy intake Regular and appropriate physical exercise Application of behavior modification techniques

4. Achieve and Maintain Healthful Weight Diet plans to avoid Fad diets—they do not result in long-term healthful weight change Promoters claim the program is based on some new discovery Rapid weight loss (>2 lb/week) with no exercise Special foods only available from promoter Rigid and limited menu Diets that over- or underemphasize specific, narrowly defined nutrients as the key to weight loss

5. Weight-Loss Strategies Guidelines for successful weight loss 1. Set realistic goals Specific, Reasonable, Measurable Monitor progress regularly 2. Eat smaller portions of lower-fat foods Reduce consumption of high-fat and high- energy foods Consume foods low in energy density 3. Participate in regular physical activity Critical for long-term maintenance of weight loss

6. Behavior Modification Successful weight loss requires behavior modification Eat only at set times in one location Keep a log of food consumed Avoid buying problem foods Eat small, regular meals throughout the day Chew slowly and stop eating when you feel full Share food with others Do not purchase foods from vending machines Shop for food only when you're not hungry

7. The Energy Density of Meals © 2015 Pearson Education, Inc.

8. Underweight BMI below 18.5 kg/m 2 Increases the risk of infections and illness Can be just as unhealthy as overweight

9. Underweight Effective weight gain should include Eating 500 to 1,000 extra kcal/day Eating frequently throughout the day Selecting healthful, energy-dense foods Avoiding tobacco products, which depress appetite and increase BMR Regular exercise with resistance training

10. Overweight, Obesity Overweight BMI between 25 and 29.9 kg/m 2 Can increase risk for high blood pressure and osteoarthritis Increases risk of obesity Obesity BMI between 30 and 39.9 kg/m 2 Morbid obesity Body weight exceeding 100% of normal BMI greater than or equal to 40 kg/m 2

11. Obesity Chronic diseases and complications linked to obesity include Hypertension Dislipidemia Type 2 diabetes Heart disease Stroke Gallbladder disease Osteoarthritis Sleep apnea

12. Obesity Chronic diseases and complications linked to obesity include Certain cancers Menstrual irregularities and infertility Gestational diabetes, premature fetal deaths, neural tube defects, and complications during labor and delivery Depression Alzheimer's disease, dementia, and cognitive decline

13. Abdominal Obesity, Metabolic Syndrome Abdominal obesity is one of the five risk factors of the metabolic syndrome People with metabolic syndrome are Twice as likely to develop heart disease Five times as likely to develop type 2 diabetes

14. Obesity Factors that can influence the chance of developing obesity include Genetics Physiology Physical factors such as thyroid levels, or use of certain prescription medications Overweight and obesity in childhood Social factors

15. Childhood and Adolescent Obesity © 2015 Pearson Education, Inc.

16. Obesity Treatments for obesity may include Low-energy diet and regular exercise Counseling or psychotherapy Prescription medications Surgery Sleeve gastrectomy Gastric bypass Gastric banding

17. Weight-Loss Surgery

18. Disordered Eating Disordered eating: general term describing a variety of abnormal or atypical eating behaviors used to achieve or maintain a lower body weight Usually doesn't make a person seriously ill Eating disorders are not the same as disordered eating Eating disorder: psychiatric condition involving extreme body dissatisfaction and long-term eating patterns harming the body

19. Disordered Eating Multiple factors contribute to the development of disordered eating behaviors Genetic and biological factors Family influences Unrealistic media images Social and cultural values Personality traits

20. Disordered Eating Family influences Three traits run within families of people with eating disorders: Anxiety Compulsivity Abnormal eating behavior in one family member

21. Disordered Eating Personality traits It's difficult to tell if personality is the cause of or an effect of the eating disorder Personality traits associated with anorexia differ from those associated with bulimia nervosa Bulimia is associated with impulsiveness, low-self esteem, erratic personality, and seeking attention and admiration

22. Disordered Eating Anorexia nervosa: a serious, potentially deadly psychiatric disorder characterized by self-starvation, eventually leading to significant energy and nutrient deficiencies 85–95% of cases are young girls and women 0.5–3.7% of American females will develop anorexia nervosa 20% of women with anorexia nervosa will die prematurely from complications

23. Disordered Eating Signs and symptoms of anorexia nervosa Extremely restrictive eating practices that lead to self-starvation Amenorrhea: no menstrual periods for at least 3 months Criteria for diagnosis: Refusal to maintain body weight at or above a minimally normal weight for age and height Intense fear of weight gain Negative body image or denial of the seriousness of the current low body weight

24. Impact of Anorexia Nervosa on the Body

25. Disordered Eating Bulimia nervosa: a serious eating disorder characterized by repeated episodes of binge eating followed by purging Binge eating: eating a large amount of food in a short period of time Purging: an attempt to rid the body of unwanted food by vomiting, taking laxatives, fasting, excessive exercise, or other means 1–4% of women develop bulimia nervosa The mortality rate is approximately 4%

26. Disordered Eating Symptoms of bulimia nervosa Recurrent episodes of binge eating Recurrent inappropriate behavior to compensate for binge eating (vomiting, laxatives, diuretics, enemas, fasting, exercise) Binge eating occurs on average at least twice a week for 3 months Negative body image Occurrences can often be accompanied by anorexia

27. Disordered Eating Physical warning signs of bulimia nervosa Chronically inflamed and sore throat Swollen neck and jaw glands Worn tooth enamel, tooth sensitivity and erosion Gastrointestinal reflux disorder General intestinal distress and irritation Kidney problems Severe dehydration

28. Disordered Eating Health risks of bulimia nervosa Electrolyte imbalance (caused by dehydration and loss of sodium and potassium ions from vomiting) Gastrointestinal problems—inflammation, ulceration, rupture of esophagus and stomach Dental problems

29. Disordered Eating Binge-eating disorder: a disorder characterized by binge eating, on average, twice a week or more, usually without purging People with this disorder are often overweight Affects 2–5% of adult women Accounts for 8% of the obese population Often common in men as well as women Our food environment often makes it hard for people with this disorder to avoid food triggers

30. Disordered Eating Health risks of binge-eating disorder Increased risk of overweight or obesity Foods eaten during binging are often high in fat and sugar Stress leads to psychological effects, such as low self-esteem, avoidance of social contact, depression, negative thoughts

31. Disordered Eating Night-eating syndrome Most energy is consumed in the evenings and late at night Combination of three disorders: eating disorder, sleep disorder, and mood disorder (depression) Unlike with bulimia, purging does not occur Health risks include the increased risk of obesity and related impacts, and increased risk for sleep apnea

32. Disordered Eating Female athlete triad: serious medical syndrome frequently seen in female athletes that consists of Low energy availability with or without eating disorders Menstrual dysfunction such as amenorrhea Low bone density Seen particularly in sports that emphasize extreme leanness and that exert pressure to meet specific weight standards or body-size expectations

33. Female Athlete Triad © 2015 Pearson Education, Inc.

34. Disordered Eating Successful treatment for disordered eating usually involves a multidisciplinary approach, including Patient Physician Psychologist Nutritionist Coach and trainer for athletes Family members and friends

35. Disordered Eating Nutritional therapies and counseling Some patients may require immediate hospitalization Those who are stable may use outpatient programs Approach friends who may have eating disorders with sensitivity and locate specialized professional health resources