1. Weight Management
Chapter 14

2. Basic Concepts Body Composition Percent Body Fat - Lean Body Mass
Essential fat
Nonessential fat-(storage) - 3% of total fat in men, 12% in women
Percent Body Fat -
Women: <8% at risk, Average 23%, > 32% at risk
Men: < 5% at risk, Average 15%, > 25% at risk
Body composition – The human body can be divided into fat-free mass and body fat. Fat-free mass is composed of all the body’s non-fat tissue: bone, water, muscle, connective tissue, organ tissues, and teeth. Body fat includes both essential and nonessential fat. Essential fat includes lipids incorporated in the nerves, brain, heart, lungs, liver, and mammary glands. These fat deposits are crucial for normal body functioning and make-up approximately 3% of total body weight in men and 12% in women. The larger percentage in women is due to fat deposits in the breast, uterus, and other sites specific to females. Nonessential or storage fat exists primarily within fat cells (called adipose tissue) and are often located just below the skin (subcutaneous) and around major organs. The amount of storage fat varies from person to person based on many factors, including gender, age, heredity, metabolism, diet, and activity level.

3. Energy Balance
Crucial to keep a healthy ratio of fat and lean body mass
Energy
Consumption or expenditure of calories
Control over intake of calories
Energy balance – The key to keeping a healthy ratio of fat to fat-free mass is maintaining an energy balance. You take in energy (calories) from the food you eat. Your body uses energy (calories) to maintain vital body functions (resting metabolism), to digest food, and to fuel physical activity. When “energy in” equals “energy out,” you maintain you current weight. To change your weight and body composition, you must tip the energy balance equation in a particular direction. The two parts of the energy balance equation over which you have control are the “energy in” and the “energy out” portion in which you burn calories during physical activity.

5. Evaluating Body Weight and Body Composition
Percent body fat and distribution of body fat = weather a change on body composition would improve health.
Overweight
Obesity
Height-Weight charts
Body Mass Index (BMI)
Body Composition
Evaluating body weight and body composition – Many methods are available for measuring and evaluating body weight and percent body fat (body composition). The cutoff points (health standards) for defining overweight and obesity vary with the method chosen. Slides three and four provide more information on these areas.
Excess body fat and wellness – The amount of fat in the body can have profound effects on health. These include disease risks, fat distribution, weight cycling, body-image, and leanness. See slide five for more details.
What weight is right for you? For most of us, our body weight and percentage of body fat falls somewhere below the levels associated with significant health risks, if not we must first start there. However, the answer to the question, “How much you should you weigh?” is, it should be guided by your lifestyle. Don’t focus on a particular weight as your goal. Instead focus on living a lifestyle that includes eating moderate amounts of healthful foods, getting plenty of exercise, thinking positively, and learning to cope with stress. By letting a healthy lifestyle determine your weight, you can avoid developing unhealthy patterns of eating and a negative body image.

6. Assessment of Body Weight
Measurement.
Body Mass Index - BMI= (weight (kg)/Height (m)squared.
lbs. = kg [lbs./2.2] inch = m [inch / 39.4].
Healthy BMI =
BMI of 25or above is Overweight
BMI of 30 or above is Obese

8. BMI Results Elevated BMIs risks =.
BMIs between 23 and 25 double risk of High blood pressure in men. 26 triples the risk.
BMI of 24 increased the development of Type II diabetes by five times above that of a BMI of 21 in women.

9. Methods of Determining Percent Body Fat
Hydrostatic (underwater)
Skinfold
Electrical Impedance Analysis
Waist-To-Hip ratio
Waist and the widest part of the hips
Ratio or higher for men
0.8 or higher for women
Indicate elevated risk
Here are the most accurate and reliable methods for analyzing body composition:
Hydrostatic (underwater) weighing – This is one of the most accurate methods of measuring percent body fat. In the technique, a person is submerged an weighed under water. Percent body fat can be calculated from body density. Muscle has a higher density and fat a lower density than water, so people with more fat tend to flat, while lean people tend to sink and weigh relatively more under water.
Skinfold measurements – The skinfold thickness technique measures the thickness of fat under the skin. A technician grasps a fold of skin (this is also sometimes called the “pinch technique”) at a predetermined location (landmark) and measures it using an instrument called a caliper. Measurements are taken at several sites and plugged into formulas that predict body fat percentages
Electrical impedance analysis (Bioelectrical impedance analysis – BIA) – In this method, electrodes are attached to the body and a harmless electrical current is transmitted from electrode to electrode. The electrical conduction through the body favors the path of fat-free tissues over the fat tissues. Therefore, the more lean a person is, the faster the current will travel through the body. A computer can calculate fat percentages from current measurements.
Scanning procedures – High-tech scanning procedures are highly accurate means of assessing body composition, but they require expensive equipment. These procedures include computed tomography (CT), magnetic resonance imaging (MRI), dual-energy X ray absorptiometry, and dual-photon absorptiometry.

10. Excess Body Fat and Wellness
The amount of fat in the body - and its location- can have profound effects on health.

11. The Health Risks of Excess Body Fat
Obese individuals have a mortality rate twice that of non-obese
Associated with: diabetes, elevated cholesterol levels, impaired heart function, hypertension and cancer
Psychological health: depression, body dissatisfaction and eating disorders
Body Fat distribution and Health
Apples
Pears
The health risks of excess body fat – Obese people have an overall mortality rate almost twice that of non-obese people. Obesity is associated with unhealthy cholesterol and triglyceride levels, impaired heart function, and death from cardiovascular disease. It is estimated that if all Americans had a health body composition, the incidence of coronary heart disease would drop by more than 25%. Other health risks associated with obesity include diabetes, hypertension, many kinds of cancer, impaired immune function, gallbladder and kidney diseases, skin problems, sleep disorders, arthritis, and other bone and joint disorders. Of particular note is the strong association between excess body fat and diabetes mellitus. Excess body fat is a major risk factor for the most common form of diabetes (Type 2 diabetes). Obese people are more than three times as likely to develop diabetes, and the incidence among Americans has increased dramatically as the rate of obesity has climbed. Diabetes is currently the seventh leading cause of death in the U.S. Obesity can affect psychological, as well as physical well-being. Being perceived as fat can be a source of ridicule,ostracism, and sometimes discrimination from others. It can contribute to psychological problems such as depression, anxiety, and low self-esteem (often caused by repeated failures at losing weight). For some, the stigma associated with obesity can give rise to a negative body image, body dissatisfaction, and eating disorders. It is important to note, that many people who are overweight do have at least some of the risk factors associated with obesity.
Body fat distribution and health – The distribution of body fat is also an important indicator of health. Men and postmenopausal women tend to store fat in the upper regions of their body, particularly in the abdominal area (“apples”). Premenopausal women usually store fat in their hips, buttocks, and thighs (“pears”). Excess fat in the abdominal area increases the risk of high blood pressure, diabetes, early-onset heart disease, and certain types of cancer. The reasons for this are unclear at this time. The risks from body fat distribution are usually assessed by measuring waist circumference or by calculating waist-to-hip ratio (the relative circumference of the waist and hips). A total waist measurement of more than 40 inches for men and 35 for women and a waist-to-hip ratio above 0.94 for young men and 0.82 for young women are associated with a significantly increased risk for disease. More research is needed to determine the precise degree of risk related to specific values.
Weight cycling – It has been hypothesized that repeatedly losing and regaining weight, known as weight cycling or “yo-yo dieting,” might be harmful to both overall health and to efforts at weight loss. However, most studies have not supported this idea. Losing even a few pounds brings substantial health benefits that appear to exceed any potential risks that might be incurred from weight loss or weight cycling.
Body image – The collective picture of the body as seen through the mind’s eye is called body image. It consists of perceptions, images, thoughts, attitudes, and emotions. A negative body image is characterized by dissatisfactions with the body in general or some part of the body in particular. This dissatisfaction can cause significant psychological distress.
Is it possible to be too lean? Experts have generally viewed very low levels of body fat – less than 8% for women and 5% for men – as a threat to wellness. Extreme leanness has been linked with reproductive, circulatory, and immune system disorders.

13. Diets Weight cycling or YO-YO effect of dieting
Some feel that it may be harmful to both overall health and to efforts at weight lost.
Studies have not yet conclusively shown weight cycling be harmful.
Weight cycling – It has been hypothesized that repeatedly losing and regaining weight, known as weight cycling or “yo-yo dieting,” might be harmful to both overall health and to efforts at weight loss. However, most studies have not supported this idea. Losing even a few pounds brings substantial health benefits that appear to exceed any potential risks that might be incurred from weight loss or weight cycling.

14. Body Image
Collective picture of the body as seen through the mind’s eye.
Perceptions
Images
Thoughts
Attitudes
Emotions
Body image – The collective picture of the body as seen through the mind’s eye is called body image. It consists of perceptions, images, thoughts, attitudes, and emotions. A negative body image is characterized by dissatisfactions with the body in general or some part of the body in particular. This dissatisfaction can cause significant psychological distress.

15. Is It Possible to Be Too Lean?
Less than 8% for women and less than 5% for men.
Extreme has been linked to problems with:
Reproductive
Circulatory
Immune system disorders
Female Athlete Triad
Amenorrhea
Is it possible to be too lean? Experts have generally viewed very low levels of body fat – less than 8% for women and 5% for men – as a threat to wellness. Extreme leanness has been linked with reproductive, circulatory, and immune system disorders.

16. Factors Contributing To Excess Body Fat
Genetic Factors
Physiological Factors
Metabolism (RMR)
Hormones
Fat Cells
Carbohydrate Craving
Much research has been conducted in an effort to pinpoint the cause of being overweight and obese. It appears, however, that body weight and body composition are determined by multiple factors that may vary with each individual. Here are the major factors:
Genetic factors – Estimates of genetic contribution to obesity vary widely, from about 5% to 40%. More than 20 genes have been linked to obesity, but their actions are still under investigation. Research suggests a genetic component to the determination of body fat. However, hereditary influences must be balanced against the contribution of environment. Thus, the tendency to develop obesity may be inherited, but the expression of this tendency is affected by other factors. The message you should understand for research is that genes are not destiny. It is true that some people have a harder time losing weight and maintaining weight loss than others. However, with increased exercise and attention to diet, even those with a genetic tendency toward obesity can maintain a health body weight. And regardless of genetic factors, lifestyle choices remain the cornerstone of successful weight management.
Physiological factors – Metabolism is a key physiological factor in the regulation of body fat and body weight; hormones also play a role. Other proposed physiological factors in contributing to obesity include fat cell biology and carbohydrate craving. Slide seven provides more details.

17. Factors Contributing To Excess Body Fat
Lifestyle Factors
Eating
Physical Activity
Psychosocial
Lifestyle factors – Research clearly indicates a variety of factors involve in weight gain and weight management. Particular lifestyle factors, such as eating and physical activity play key roles. See slide 8.
Psychosocial factors – Many people have learned to use food as a means of coping with stress and negative emotions. When food and eating become the primary means of regulating emotion, unhealthy patterns of eating occur. Obesity is strongly associated with socioeconomic status. The prevalence of obesity goes down as income level goes up. More women are obese at lower income levels than men, but men are somewhat more obese at higher levels. In some families and cultures, food is used as a symbol of love and caring. It is an integral part of social gatherings and celebrations. In such cases, it may be difficult to change established eating patterns because they are linked to cultural and family values.

18. Adopting A Healthy Lifestyle For Successful Weight Management
“Normal” body weight
Diet and Eating Habits
Total Calories
1600 calories - Sedentary women and older adults
2200 calories - Children, teenage girls, active women, and sedentary men
2800 calories - Teenage boys, active men, and very active women.
When all the research has been assessed, it is clear that most weight problems are lifestyle problems. A good time to develop a lifestyle for successful weight management is during early adulthood, when healthy behavior patterns have a better chance of taking a firm hold. Permanent weight loss is not something you start and stop. You need to adopt healthy behaviors that you can maintain throughout your life. Lifestyle factors that are critical for successful long-term weight management include eating habits, level of physical activity, an ability to think positively and manage your emotions effectively and the coping strategies you use to deal with the stresses and challenges in your life.
Diet and eating habits – In contrast to “dieting,” which involves some form of food restriction, “diet” refers to your daily food choices. Everyone has a diet, but not everyone is dieting. You need to develop a diet that you enjoy and that enables you to maintain a healthy body composition. Use the Food Guide Pyramid as the basis for planning a healthy diet (see chapter 12). For weight management, you may need to pay special attention to total calories, portion sizes, energy density, fat and sugar intake and eating habits. These are discussed on the next slide.

19. Adopting A Healthy Lifestyle For Successful Weight Management
Portion Sizes
Energy (calorie) Density
Fat Calories
Complex Carbohydrates
Simple Sugars and Refined Carbohydrates
Protein
Eating Habits

20. Physical Activity and Exercise
Muscles needing energy.
Not anaerobic only burns simple sugars.
Aerobic burns more of the fat.
Must last minutes.
Use all major muscle groups.
Gradually increase time of
endurance activities.
Physical activity and exercise – Regular physical activity is another important lifestyle factor in weight management. Physical activity and exercise burn calories and keep the metabolism geared to use food for energy instead of storing it as fat. Making significant cuts in food intake in order to lose weight is a difficult strategy to maintain. Increasing your physical activity is a much better approach. The message is clear. Regular exercise, maintained throughout life, makes weight management easier and improves quality of life (see chapter 13 for more details on physical activity and exercise programs).

21. Adopting a Healthy Lifestyle
Thinking and Emotions
Coping strategies
Thinking and emotions – What goes on in your head is another factor in a healthy lifestyle and successful weight management. The way you think about yourself and the world around you, influences and is influenced by how you feel and how you act. Certain kinds of thinking produce negative emotions, which can undermine a healthy lifestyle. Research on people who have a weight problems indicates that low self-esteem and the negative emotions that accompany it are significant problems. Some of these problems include negative self-talk, anxiety, and depression. Your beliefs and attitudes influence how you interpret what happens to you and what you can expect in the future, as well as how you feel and react. A healthy lifestyle is supported by having realistic beliefs and goals and by engaging in positive self-talk and problem-solving efforts (see chapter 3 for more on psychological heath).
Coping strategies – Adequate and appropriate coping strategies for dealing with the stresses and challenges of life are another lifestyle factor in weight management. One strategy that some people adopt for coping is eating (others use alcohol or other drugs, smoking, spending, gambling, etc.). When boredom occurs, eating can provide entertainment. Food may be used to alleviate loneliness or as a pickup for fatigue. Eating provides distraction from difficult problems and is a means of punishing the self or others for real or imagined transgressions. People with a healthy lifestyle have more effective ways to get their needs met. Having learned to communicate assertively and to manage interpersonal conflict effectively, they don’t shrink from problems or overreact. The person with a healthy lifestyle knows how to create and maintain relationships with others and has a solid network of friends and loved ones. Food is used appropriately – to fuel life’s activities and gain personal satisfaction, not to manage stress (see chapter 2 for more on stress management and positive coping skills).

22. Creating an Individual Weight Management Program
Assess your motivation and commitment.
Set a weight loss goal that is healthy and reasonable.
Create a negative energy balance.
Increase your level of physical activity.
Make changes in your diet and eating habits.
Keep records of your weight and behavior change progress.

23. Overcoming a Weight Problem
Self- Help programs.
Initial weight loss from fluids.
Very low calorie diets need to be avoided.
Diet Books:
Reject books with gimmicks or rotating levels of calories.
Diet Supplements and Diet Aids
Here are a variety of options available to you if you want to overcome a weight problem:
Doing it yourself – Research indicates that people are far more successful than was previously thought at losing weight and keeping it off. One study found that about 64% of the subjects achieved long-term success without joining a formal program or getting special help . Supporting these findings, U.S. Public Health Service survey indicated that about 50% of the general population succeed with long-term weight management. A key characteristic for success was making exercise a permanent part of their lifestyle. If you need to lose weight, focus on adopting the healthy lifestyle described throughout the book. The “right” weight for you will naturally develop, and you won’t have to diet. However, if you must diet, do so in combination with exercise, and avoid very-low-calorie diets. Don’t try to lose more than ½ -2 pounds per week. Realize that low-calorie diets cause a rapid loss of body water at first. When this phase passes, weight loss declines. As a result, dieters are often misled into believing that their efforts are not working. Then, they tend to give up.
Diet books – Many people who try to lose weight by themselves fall prey to one or more of the dozens of diet books on the market. Although a very few of these do contain useful advice and tips for motivation, most make empty promises. Beware of their claims. A recent crop of popular books has advocated diets high in protein, low in carbohydrates, and relatively high in fat. The American College of Sports Medicine, the American Dietetic Association, the Cooper Institute for Aerobics Research, and the Women’s Sports Foundation released a joint statement saying such diets are not a good weight-loss strategy, will not improve athletic performance, and can be harmful to your health in some cases. The only reason such plans help some people lose weight is that the diets they advocate provide so few calories; but as with all such plans, they are difficult to maintain over any extended period of time.
Dietary supplements and diet aids – The number of dietary supplements and other weight loss aids on the market has also increased in recent years. Promoted in a variety of media, these products typically promise a quick and easy path to weight loss. Most of these products are marketed as dietary supplements and so they are subject to fewer regulations than OTC medications. Be a wise consumer, think critically, and do your homework when considering using one of these products.

24. Overcoming a Weight Problem
Legitimate programs provide;
Nutritional Education
Emphasis on exercise and change in lifestyle
Individual and Group counseling
Self-Help groups
Registered dietitians
Physician monitored program
Weight-loss programs - Weight-loss programs come in a variety of types, including noncommercial, commercial, on-line Web sites, and medically supervised programs.
Noncommercial weight-loss programs – Noncommercial programs such as TOPS (Take Off Pounds Sensibly) and Overeater Anonymous (OA) mainly provide group support. They do not advocate any particular diet, but they do recommend seeking professional advice for creating an individualized diet and exercise plan. Like Alcoholics Anonymous, OA is a 12 step program with a spiritual orientation that promotes “abstinence” from compulsive overeating. These types of programs are generally free. Your physician or a registered dietitian can also provide information and support for weight loss.
Commercial weight-loss programs – Commercial programs such as Weight Watchers, Jenny Craig, Diet Workshop, and Richard Simmons Slimmons typically provide group support, nutrition education, physical activity recommendations, and behavior modification advice for changing habits. Some also make available packaged foods to assist in following dietary advise. Many commercial programs voluntarily belong to the Partnership for Healthy Weight Management established by the Federal Trade Commission in By doing so, they agree to provide clients with information on staff training and education, the risks associated with overweight and obesity, risks related with each program or product, the costs of the program, and the expected outcomes of the program, including success rate. A commercial program can work, but only if you are motivated to decrease caloric intake and increase physical activity. A strong commitment and a plan for maintenance are specially important because studies indicate that only about 10-15% of program participants maintain their weight loss – the rest gain back all or more than they had lost. One study of participants found that regular exercise was the best predictor to maintaining weight loss, whereas frequent television viewing was the best predictor of weight gain.
On-line weight-loss programs – A recent addition to the weight-loss program scene is the Internet-based program. Most such Web sites include a cross between self-help and group support through chat rooms, bulletin boards, and e-newsletters. Many offer on-line self-assessments for diet and exercise, as well as help for meal planning. Many are free, but some charge a small weekly or monthly fee. Preliminary research suggests that this type of program provides an alternative to in-person diet counseling and can lead to weight loss for some people.
Clinical weight-loss programs – Medically supervised clinical programs are usually located in a hospital or other medical settings. Designed to help those who are severely obese, these programs typically involve a closely monitored very-low-calorie diet. The cost of a clinical program is usually high, but insurance will often cover part of the fee.

25. 1 Lb. Of Fat Is About 3,500 Calories.
Weight Loss
Most Experts Recommend a Gradual Weight Loss of ½ to 2 Pounds Per Week!!
1 Lb. Of Fat Is About 3,500 Calories.
How? Reduce Diet by 250 Calories/day and Expend 250 Additional Calories/day

26. Prescription Drug Appetite Suppressants
Produce a 5-15% weight reduction by controlling appetite.
Once drugs are stopped most return to original heavy weight.
Good option for very obese who need help getting started - permanent life style change.
Prescription drugs – The medications most often prescribe for weight loss are appetite suppressants that reduce feelings of hunger or increase feelings of fullness. All prescription weight-loss drugs have potential side effects and risks. Studies have generally found that appetite suppressants produce modest weight loss (about 5-22 pounds) above what’s expected with non-drug obesity treatments. Unfortunately, weight loss tends to level off or reverse after about 4-6 months on medication, and many people regain the weight they’ve lost if they stop taking the drugs. Since most weight-loss medications are approved for only short-term use, regaining weight is a serious problem. Prescription weight-loss drugs are not for people who want to lose a few pounds to wear a smaller size of jeans. The latest federal guidelines advise people to try lifestyle modification for at least 6 months before trying drug therapy. Prescription drugs are only recommended – in conjunction with lifestyle changes – in certain cases.

27. Surgery
Severely obese - BMI of 40 or higher or are 100 pounds or more over recommended weight.
Roux-en-Y-gastric bypass
Liposuction
Surgery – Surgical intervention may be necessary as a treatment of last resort for those who have not been successful in permanently reducing weight through other methods. In addition, liposuction is a cosmetic procedure, not a weight-loss method and is not recommended for removing large amounts of fat.

28. Psychological Help Acceptance and change Can-do attitude Body Image
Knowing when the limits to healthy change have been reached.
Knowing the unrealistic cultural ideal.
Psychological help – Many people can lose weight just by increasing their physical activity and moderately restricting total calories, especially fat calories. Qualified professional help should be sought when signs of eating disorders are present.
Acceptance and change – Most Americans, young and old, are unhappy with some aspect of their appearance and often their weight. There are limits to the changes that can be made to body weight and body shape, both of which are influenced by heredity. The changes that can and should be made are lifestyle changes – engaging in regular physical activity, obtaining adequate nutrition, and maintaining healthy eating habits. With these lifestyle changes, the body weight and shape that develop will be natural and appropriate for an individual’s particular genetic makeup. Knowing when the limits to healthy change have reached – and learning those limits – is crucial for overall wellness. A reasonable body weight must take into account a person’s weight history, social circumstances, metabolic profile, psychological well-being and lifestyle.

29. Eating Disorders Problems with body weight and weight control.
1 Million Americans develop anorexia or bulimia each year - 90% are female.
Factors in developing an eating disorder
Problems with body weight and weight control are not limited to excessive body fat. A growing number of people, especially adolescent girls and young women, experience eating disorders, characterized by severe disturbances in eating patterns and eating-related behaviors. Eating disorders are associated with depression, anxiety, low self-esteem, and increased health risks, including, in some cases, increased risk of premature death. Many factors are probably involved in the development of an eating disorder. Although many widely different explanations have been proposed, they share one central feature: a dissatisfaction with body image and body weight. Heredity appears to play a role in the development of eating disorders, accounting for about 30-50% of the risk. But as with other conditions, only the tendency to develop an eating disorder is explained by heredity. The expression of this tendency is affected by other factors. Some of these factors include unhealthy behaviors, unhealthy coping strategies, home and family influences, and the impact of cultural messages.

30. Eating Disorders
Anorexia Nervosa - Failure to eat enough food to maintain a reasonable body weight.
Characteristics
Fear gaining weight.
Distorted self-image.
Compulsive behaviors and rituals.
Health Risks
Anorexia nervosa – A person suffering from anorexia nervosa does not eat enough food to maintain a reasonable body weight. Anorexia affects 1-3 million Americans, 95% of them are females. Although it can occur later in life, anorexia typically develops between the ages of 12 and 18. People suffering from anorexia have an intense fear of gaining weight or becoming fat. Their body image is distorted, so that even when emaciated, they think they are fat. People with anorexia may engage in compulsive behaviors or rituals that help keep them from eating and some binge and purge. Anorexic people are typically introverted, emotionally reserved, and socially insecure. They are often “model children” and are anxious to please others and win their approval. Anorexia nervosa has been linked to a variety of medical complications, including disorders of the cardiovascular, gastrointestinal, and endocrine systems. Depression is also a serious risk, and about half the fatalities related to anorexia are suicides.

31. Eating Disorders
Bulimia Nervosa - recurring episodes of binge eating followed by purging.
Characteristics
Rapidly consumes food, then purges.
Done in secret.
After a binge - feels ashamed, disgusted and physically and emotional drained.
Health Risks
Bulimia nervosa – A person suffering from bulimia nervosa engages in recurrent episodes of binge eating followed by purging. Bulimia is often difficult to recognize because sufferers conceal their eating habits and usually maintain a normal weight, although they may experience weight fluctuations of pounds. Although bulimia usually begins in adolescence or young adulthood, it has recently begun to emerge at increasingly younger (11-12 years) and older (40-60years) ages. During a binge, a bulimic person may rapidly consume anywhere from ,000 calories. This is followed by an attempt to get rid of the food by purging, usually by vomiting or using laxatives or diuretics. Some individuals only binge and purge occasionally, while others do so many times a day. The binge-purge cycle places a tremendous strain on the body and can have serious health effects including: liver, kidney, and intestinal tract damage, heart arrhythmia, and dental problems.

32. Eating Disorders
Binge-Eating - Similar to Bulimia except no Purging behavior.
Eating patterns - very rapid, eating until uncomfortably full.
Often eat as a way of coping.
Likely to be obese.
Binge-eating disorder – This disorder is characterized by uncontrollable eating, usually followed by feelings of guilt and shame and weight gain. Common eating patterns are eating more rapidly than normal, eating until uncomfortably full, eating when not hungry, and preferring to eat alone. Binge eaters may eat large amount of food throughout the day, with no planned mealtimes. Compulsive eaters rarely eat because of hunger. Instead, food is used as a means of coping with stress, conflict, and other difficult emotions or to provide solace and entertainment. Binge eaters are almost always obese, so they face all the health risks associated with obesity. In addition, binge eaters may have higher rates of depression and anxiety.

33. Anorexia Bulimia Health Risk
CHRONIC HOARSENESS
ESOPHAGEAL TEARS
TOOTH DECAY
CARDIA ARRHYTHMIA
ABNORMAL MENSE
AMENORRHEA
LOW BLOOD PRESURE AND HEART RATE
DRY SKIN AND FINE BODY HAIR
DISORDERS OF THE CARDIO, GASTRO,AND ENDOCRINE

34. Treatment
Address both eating disorder, misuse of food and manage emotions
Anorexia Nervosa
Bulimia Nervosa
Binge-Eating
Today’s Challenge
Treating eating disorders – The treatment of eating disorders must address both problematic eating behaviors and the misuse of food to manage stress and emotions. Treatment usually involves a combination of psychotherapy and medical management and may last from a few months to several years depending on the severity of the condition.

35. Correct Weight
The “right” weight for any individual should be the result of a healthy lifestyle.

36. Thank You