2Healthy Body Weight National Institutes of Health More than 67% of American adults are overweightMore than 32% of American adults are obeseObesity has doubled since 1960At current rates, all American adults will be overweight by 2030
3Prevalence of Healthy Body Weight GenderWomen35%Men32%EthnicityWhiteLatino26%African American29%Age20–39 years40%40–59 years31%60+ years28%Health statusPeople with disabilitiesPeople with diabetes12%ALL ADULTS34%Source: National Center for Health Statistics
4Overweight and Obesity Overweight = characterized by a body weight that falls above the range associated with minimum mortality; weighing 10% or more over recommended weight or having a BMI over 25Obesity = severely overweight, with an excess of body fat; weighing 20% or more over recommended weight or having a BMI over 30
5Health Implications of Overweight and Obesity 33% rise in type 2 diabetes100,000+ premature deaths annuallyObesity is one of the six major controllable risk factors for heart diseaseWeight loss of 5-10% in obese individuals can reduce the risk of certain diseases
6Factors Contributing to Excess Body Fat: Genetic Factors Genetic factors influence body size and shape, body fat distribution, and metabolic rateGenetic contribution to obesity is estimated at 25–40%Hereditary influences must be balanced against contribution of environmental factorsGenetics is what can happen, our choices is what does happen!!
7PHYSICAL APPEARANCE Somatotype – Your physical appearance, body build. We are all products of heredity and environment. What we get from our parents and what we do with what we get!Somatotype – Your physical appearance, body build.Endomorph – A “pear-shaped” appearance. Short legs and arms, most of body weight centered around hips and abdomen.Mesomorph – Solid, muscular, large-boned physique. Most of body weight is away from the abdominal area. Wide shoulders, narrow hips, well-muscled.Ectomorph – Slender bodies and a slight build. Very little body fat. Light musculature, long arms and legs. Bony in appearance, narrow chest and hips and generally linear in appearance.Most people have some characteristics of each body type, but one will dominate.
8Fat Cell TheoryProponents of this theory believe that obese people have more fat cells and larger cells than the non-obese.Total number of fat cells increaseIt is believed that once we produce fat cells, they remain for life.Any weight reduction would involve a reduction in the size of the fat cell.Evidence seems to suggest that fat cells do reach a point where they can not get bigger, thus new cells are manufactured.
9Physiological Factors Metabolism – the sum of all the vital processes by which food energy and nutrients are made available to and used by the body.Resting Metabolic Rate (RMR) – The energy required to maintain vital body functions. (heart, lungs, body) Accounts for about 55-75% of the energy used by the body.Thermal Effect of Food (TEF) – The energy required to digest food. Accounts for additional 5-15% of daily energy expenditure.Effect of Physical Activity – Energy expended during physical activity. Accounts for 20-40% of expended energy.This is the component that is the most variable and the one we can do the most about.
10Factors That Affect Metabolic Rate RMR is higher inMenPeople with more muscle massPeople who exerciseRMR is lower inWomenPeople who are sedentaryPeople who have lost weight
12Factors Contributing to Excess Body Fat: Lifestyle Factors Eating—compared to the past, Americans nowConsume more caloriesConsume more refined and simple carbohydratesEat out more oftenPeople underestimate portion sizes
14Monster Thick Burger1,420 calories107 grams of fat2 – 1/3 slabs of beef4 strips of bacon3 slices of cheese
15CHEESEBURGER Today 20 Years Ago 333 calories How many calories are in today’s cheeseburger?
16CHEESEBURGER Today 20 Years Ago 333 calories 590 calories Calorie Difference: 257 calories
17Maintaining a Healthy Weight is a Balancing Act Calories In = Calories OutHow long will you have to lift weights in order to burn the extra 257 calories?**Based on 130-pound person
18Calories In = Calories Out If you lift weights for 1 hour and 30 minutes, you will burn approximately 257 calories.**Based on 130-pound person
19FRENCH FRIES 20 Years Ago Today 210 Calories 2.4 ounces How many calories are intoday’s portion of fries?
20Calorie Difference: 400 Calories FRENCH FRIES20 Years AgoToday210 Calories2.4 ounces610 Calories6.9 ouncesCalorie Difference: 400 Calories
21Maintaining a Healthy Weight is a Balancing Act Calories In = Calories OutHow long will you have to walk leisurely in order to burn those extra 400 calories?**Based on 160-pound person
22Calories In = Calories Out If you walk leisurely for 1 hour and 10 minutes you will burn approximately 400 calories.**Based on 160-pound person
23Diet and Eating Habits 1 pound = 3500 calories If calorie intake = calorie output, weight remains the same.For weight loss, goal should be to losepounds/week
24Successful Weight Loss A successful, long-term weight control program involves three elements.Diet – the number of calories consumed should be reduced, along with the fat content of the diet. Watch portion sizes. Choose complex carbohydrates – fruits, vegetables and whole grains (Nutrient –dense foods) Or those foods which have a lower energy (calorie) density. An apple vs a pie of apple pie.Exercise – Goal is to expend calories/day with exercise.Behavior ModificationSelf-monitoring – Keep a food log, recording amounts and circumstances of eating.Food triggers – Identify those factors which trigger eating. Boredom, anxiety, stress, exhaustion.Develop techniques to control eating. Positive self-talk. Goals. Stay busy. Plan meals. Control social bingeing.Reinforce results with rewards.
25Physical Activity and Exercise Physical activity—increase daily physical activity to at least 30 minutes per day; to lose weight or maintain weight loss, 60–90 or more minutes per day is recommendedExerciseEndurance exercise burns caloriesStrength training builds muscle mass, which can increase metabolic rate
27Diet and Eating HabitsFat calories—keep total fat intake moderate, and limit intake of saturated and trans fatsCarbohydrate—emphasize whole grains, vegetables, fruits, and other high-fiber foods; limit consumption of foods high in refined carbohydrates, added sugars, and easily digestible starchProtein—meet recommended intake of 10–35% of total daily caloriesEating habits—eat meals and snacks on a regular schedule
28Doing It YourselfPhysical activity is a critical component of healthy weight managementSource: Ryan McVay/Getty Images (courtesy of McGraw-Hill Higher Education)
30Approaches to Overcoming a Weight Problem Doing it yourselfDiet booksDietary supplements and diet aidsWeight-loss programsPrescription drugsSurgeryPsychological help
31Diet Books Reject books that Advocate unbalanced ways of eatingClaim to be based on a secretUse gimmicksPromise quick weight lossLimit the selection of foodsAccept books that advocate a balanced diet plus exercise
32Popular Diet Plans Any diet that cuts calories causes weight loss Low-carbohydrate diets have not been proven safe over the long-termLow-fat diets should focus on nutrient dense foods, especially whole-grains, fruits, and vegetablesDiets with many restrictions have high drop-out ratesPeople who have been successful at long-term weight loss track food intake and engage in 60 or more minutes of physical activity per day
33Dietary Supplements and Diet Aids Dietary supplements are subject to fewer regulations than over-the-counter medications; they have not been proven safe and effectiveFTC: More than half of advertisements for weight-loss products make representations that are likely to be false
34SurgerySurgical intervention may be recommended for some people who have a BMI of 40 or higher or who are 100 or more pounds overweightGastric bypass surgery modifies the gastrointestinal tract by changing the size of the stomach or how the intestine drains, thereby restricting the amount of food that can be eatenSurgery has a high rate of complications
35Surgery Adjustable gastric banding Roux-en-Y gastric bypass Adjustable gastric banding: In this procedure, a hollow band made of silicone rubber is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the rest of the stomach. The band is then inflated with a salt solution through a tube that connects the band to an access port placed under the skin. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solutionRoux-en-Y gastric bypass (RGB). This operation is the most common and successful combined procedure in the United States. First, the surgeon creates a small stomach pouch to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This reduces the amount of calories and nutrients the body absorbs.Weight-Control Information Network Gastrointestinal Surgery for Severe Obesity. NIH Publication NoAdjustable gastric banding Roux-en-Y gastric bypassSource: National Institutes of Health
36Body ImageDissatisfaction with weight and shape is common in people with eating disordersSource: BananaStock/PunchStock (courtesy of McGraw-Hill Higher Education)
37Body ImageBody image = the mental representation a person holds about her or his bodyIt consists of perceptions, images, thoughts, attitudes, and emotionsMedia images are linked to negative body imageDifferent cultures have different ideas of the “ideal” body type
38BMI of Miss America Pageant Winners The data shows a steady decline in winners’ BMI from a range of 20–25 in the 1920s to below 18.5, considered undernutrition by WHO and represented by the horizontal line.SOURCE: Rubinstein, S., and B. Caballero Is Miss America an undernourished role model? Journal of American Medical Association 283(21): Used with permission from the American Medical Association.
39Acceptance and ChangeMost Americans are unhappy with some aspect of their appearanceRecognize the limits of changeSmall amounts of weight loss can significantly reduce health risks
40Eating DisordersSociety has created tremendous pressure for individuals to be thin.More than two-thirds of women between the ages of 12 and 23 have felt dissatisfied with their body image and feel pressure to conform to the “ideal” body size and shape.Weight reduction, often takes over thoughts and energies. Some feel weight loss makes them more attractive, accepted and successful.The pursuit of thinness can result in serious and sometimes life-threatening eating disorders.
41Eating DisordersAnorexia Nervosa – Condition is marked by suppression of appetite and intentional caloric deprivation or self-starvation.May have intense fear of becoming overweight and weight loss does not detensify that fear.There is a psychological distortion of body image, as the anorexic sees him/herself as fat, even if extremely underweight.Weight loss is pursued through extreme limitation of calories, fasting, strenuous exercise, use of laxatives and diuretics and sometimes self-induced vomiting.Disorder sometimes begins at the onset of puberty.Problems include CV problems, gastrointestinal problems, body can use organs for protein due to lack of fat, amenorrhea (suppression of menstrual cycle), anemia, calcium loss, brittle bones, swollen joints and light-headedness. Eventually heart failure can occur.
42Eating DisordersBulimia Nervosa – This is known as the binge-purge syndrome.It is marked by high amounts of food/calorie consumption (1,000-60,000 calories), followed by self-induced vomiting and/or use of laxatives and diuretics.Compulsive exercise also may be a characteristic of bulimia.Bulimia differs from anorexia in that the individual may maintain a normal body weight due to the binges experienced. This allows the bulimic to hide the problem, making it more difficult to identify.Eating disorders are mental disorders and must be treated as such.Causes and contributing factors are complex and professional help is necessary.
43Eating DisordersBinge-Eating Disorders – Individuals typically experience episodes of out of control eating.Common characteristics include:Eating much more rapidly than normalEating until uncomfortably fullEating large quantities of food even when not hungryEating alone to hide the quantity of food being ingestedFeeling disgusted, depressed, or guilty after overeatingThey do not purge their bodies after eating, thus different from bulimia.
44Who Is At Risk? Estimated 1 in every 100 teenage girls are anorexic Anorexia usually occurs in adolescent women (90% of all reported cases)Estimated 1 in every 5 college-bound females is bulimicCollege campuses have a higher incidence of people with eating disordersUpper middle class women who are extremely self-critical are also more likely to become anorexicActivities such as dance and dance team, gymnastics, figure skating, track and cheerleading tend to have higher incidences of eating disordersWrestlers and body builders are also at risk due to unsafe practices to “make weight” before competition.
45TREATMENT Be supportive. Provide information about eating disorders. Be a good listener.Encourage professional help. Person may need counseling, medical treatment or hospitalization.Be prepared for denial resistance and even hostility.Realize that the person’s responsibility is his/hers, not yours.Eating Disorders Therapy/ProgramsISU Counseling CenterISU Health ServicesISU Nutrition MissionAnorexia Nervosa and Related Eating Disorders, Inc. –