1. Weight Management Overweight and Underweight
Chapter 9
Weight Management
Overweight
and
Underweight

2. Objectives of Chapter 9 Identify how fat cells develop
Identify causes of overweight and obesity
Health risks associated with overweight and obesity
Aggressive treatments of obesity
Weight loss strategies

3. Fat Cell Development Hyperplastic obesity Hypertrophic obesity
Increase in number of fat cells
Hypertrophic obesity
Increase in size of fat cells
Lipotoxicity
Accumulation of fat in non adipose tissue. For example, heart or liver increase risk of heart failure and fatty liver

4. Fat Cell Development

5. Fat Cell Metabolism Lipoprotein lipase (LPL) Promotes fat stores
Activity of LPL increase in obese people than lean people
LPL activity is different among male and female
Fat breakdown is slower in women than men
Release of fat in various body parts is different for both sexes
LPL activities increase after weight loss contributing to more weight gain and “set point theory”

6. Fat Cell Metabolism “Set point” (your internal thermostat)
theory holds that body opposes weight loss and works to maintain a set weight
Provide an explanation that some inner mechanism seems to set a person’s weight or body composition at a fixed point.
The body readjust after a weight loss to restore that set point.

9. Prevalence of Obesity Among U.S. Adults (BMI > 30)
1991: Only 4 states had obesity rates greater than 15%
1995: Over ½ of the states had obesity rates greater than 15%
2000: Only 1 state had an obesity rate below 15%, most had obesity rates greater than 20%, and one had obesity rate greater than 25%
2005: All states have at least 15% obesity rate, only 4 states has obesity rate < 20%, 1/3rd of the states have obesity rate > 25%, 3 states have rates > 30%
U.S. Obesity Trends 1985–2006
Adapted from:

10. Overweight
Overweight (BMI ) and obesity (≥ 30) are widespread health problems that are continuing to increase.
Many refer to overweight and obesity as an epidemic.
For good health, weight management is important.

11. Body Weight, Body Composition, and Health
Health Risks of Overweight
Diabetes
Hypertension
Cardiovascular disease Sleep apnea
Osteoarthritis (bone disease)
Some cancers
Gallbladder disease
Kidney disease
Respiratory problems
Complications in pregnancy and surgery

12. What Factors Are Likely to Affect Body Weight?
What and how often you eat,
Hunger and appetite affect what you eat.
Appetite is psychological desire for food
Hunger is physiological need for food, subsides as feeling of satiation sets in
Satiety determines length of time between eating episodes
environment 12

13. What Factors Are Likely to Affect Body Weight?
Physiological feedback mechanisms
involving mouth, stomach, intestines, and brain increase or decrease hunger
Many hormones play role:
Ghrelin:
produced in stomach
increases hunger and appetite
positive energy balance
High in obese people as well as people with eating disorder
Leptin:
in fat tissue signals brain to decrease hunger and food intake.
Promote negative energy balance
May be deficient or defective in obese individuals, but very rare
Cholecystokinin: released when stomach is distended, increasing feelings of satiation, decreasing hunger 13

15. What Factors Are Likely to Affect Body Weight?
Genetics play a role in determining body weight
Risk of becoming obese doubles if parents are overweight, triples if obese, five times greater if severely obese
Genetic differences in level or function of hormones, such as high ghrelin or low leptin levels, increase obesity.
Many obese have adequate leptin but brain has developed resistance to it 15

16. What Factors Are Likely to Affect Body Weight?
Environmental factors can increase appetite and decrease physical activity.
cheap and easily obtainable energy-dense foods stimulate appetite
We work more and cook less.
About 1/3 calories come from ready-to-eat foods prepared outside of home
Frequent dining out associated with higher BMI
Inadequate physical activities
Americans eating about 300 calories/day more than in 1985 16

17. What Is a Reasonable Rate of Weight Loss?
National Institutes of Health: overweight individuals should aim to lose about 10% of body weight over 6-month period
Example: 180-lb person should lose 18 pounds/6 months = 3 lbs/month, ¾ lb/week
To lose 1 lb of body fat, need 3,500 calorie deficit
Weight loss of ½-1 lb/week, need to decrease daily calories by calories
Diet Meals video Overweight Children approach to weight loss 17

18. Three Pieces of the Long-Term Weight Loss Puzzle18

19. How Can You Lose Weight Healthfully?
Successful long-term weight loss requires changes in three areas: diet, physical activity, and behavior
Eat smart, because calories count: add satiation to low- calorie meals by including higher-volume foods
Eat more vegetables, fruit, and fiber
Include some protein and fat in your meals
Protein increases satiety most
Fat slows movement of food from stomach into intestines
Choose lean meat, skinless chicken, fish, nuts, and unsaturated oils. 19

20. The Energy Density of Foods20

21. Add high-volume fruits and vegetables to displace higher calorie foods.21

22. The Volume of Food You Eat22

23. How Can You Lose Weight Healthfully?
Use MyPyramid as a weight-loss guide:
High volume of fruits, vegetables, whole grains, some lean protein, modest amounts of fat
Diet should contain variety of foods from all food groups
Replace higher-calorie foods with lower-calorie options from each food group.
Example: replace full-fat dairy with nonfat products
Replace sodas with water 23

24. How Can You Lose Weight Healthfully?
Move to lose
60 minutes/day of moderate-intensity activities can prevent becoming overweight and aid in weight loss
10,000 steps/day can reduce risk of becoming overweight
Spot Reducing
Regular aerobic exercise and weight loss will help trouble spots.
Strength training can improve muscle tone.
Stretching can help flexibility
Exercise may help to curb appetite.
Activity can reduce stress and improve self-esteem
Break bad habits
Behavior modification: change behaviors that contribute to weight gain or impede weight loss 24

25. Fad Diets Are the Latest Fad
Research shows that reduction of calories, not the composition of the diet, is effective in weight loss.
People who adhere the longest to weight-loss diets lose the most weight.
High drop-out rates for most extreme diets (Atkins and Ornish diets)
Beware of fad diet sensational claims and hype:
“It’s the carbs, not calories, that make you fat!”
Celebrity-endorsed miracle weight-loss products
“Natural” substances help lose weight without risk
How to get fat without really trying 25

26. What’s in the Fad Diets? 26

27. How Can You Maintain Weight Loss?
Weight cycling is a common result of fad diets.
Weight loss can be maintained if keep healthy habits used during weight loss
New, lower weight requires less calories to maintain weight
Physical activity can close the “energy gap”, easier than further reducing caloric intake
60-90 minutes/day of moderate-intensity physical activity recommended to maintain weight loss 27

28. Aggressive Treatments of Obesity
bariatric surgery – Gastric bypass and gastric banding
Results in dramatic weight loss and reduction of hypertension, diabetes, high blood cholesterol, and sleep apnea
Risks include ulcers, gallstone, bleeding in stomach and intestines
for individuals with clinically severe obesity and major medical problems.
Changing and improving eating and exercise habits offer the greatest benefit.

29. Aggressive Treatments of Obesity
bariatric surgery
Over 100,000 is performed annually and numbers continue to grow
Limit food intake by reducing the capacity of the stomach
To qualify, a person must be at least 100lbs over their ideal body weight or BMI > 40
Must comply with prescribed diet
At risk of iron, b12, folate, calcium and vit D deficiencies
Infections, nausea, vomiting, and dehydration is a very real possibility after surgery
Lifelong medical supervision is necessary

30. Gastric bypass surgery video

31. Aggressive Treatments of Obesity
Drugs
Sibutramine (meridia) suppresses the appetite and is most effective when used with a reduced kcalorie diet and increased physical activity. There are many side effects.
Orlistat (Xenical) blocks fat digestion and absorption. There are many side effects. You can now get a low dose over the counter under the brand name, Alli.
Other drugs are still under study
Liposuction is a popular procedure that is primarily cosmetic but poses risk. Provides no health benefit

32. How Much Should you Weigh?
Ideal Body Weight (IBW)
Men
106 pound for the first 5 feet, + 6 pounds for every inch over 5 feet. For example, a man who is 6’1” have IBW of 184 pounds
Women
100 pound for the fist 5 feet, + 5 pounds for every inch over 5 feet. For example, a woman who is 4’11” have IBW of 95 pounds

33. Extra Credit
10 points
Use worksheet for chapter 9 to evaluate a poplar weight loss program
Must be typed
No more than 1 page
One word answer will not be accepted