1. Obesity- Weight Management

2. Objectives Define obesity or overweight List health effects of obesity Explain possible causes of obesity Outline exercise recommendations Estimate calorie intake for weight loss List five possible components of a weight loss program List and identify the stages of behavior change

3. Status Epidemic 2004- 66% of Americans overweight or obese Chronic disease Prevention 10 pound gain, 2” increase in waist

4. Obesity Related Health Issues Hypertension Heart Disease Type 2 Diabetes Gallbladder Disease Pulmonary Disease and Sleep Disorders Bone and Joint Disorders Infections Liver damage Cancer risk Surgical risk Accident risk Skin Disorders Pregnancy risk Menstrual irregularities Infertility Psychological Depression, low self- esteem, discrimination

5. Weight Loss Basics CALORIES OUT Metabolism Physical Activity CALORIES IN Food and beverages

6. Calories Out- Physical Activity 2010 Dietary Guidelines Adults 18-61 yo 2 hours and 30 minutes a week, moderate aerobic 1 hour and 15 minutes a week, vigorous aerobic Strengthening activities 2 days week Children and Adolescents 6-17 yo 60 minutes or more of physical activity a day Exercise Strong research No “news” story, no “best seller” Few people can lose and maintain w/out

7. Aerobic Activity Duration/regular more important than intensity 10,000 steps a day Increase activities of daily living Any better than none!

8. Calories In- Diet Reduce portion sizes Cut “empty calories” Fat Sugars Alcohol Ben Franklin – “To lengthen thy life, lessen thy meals”

9. Calories In Decrease CHO, PRO and/or FAT calories Moderate distribution 20-25% fat, 20-35% lean protein Minimum 1200-1500 calories/day Prevent decreased metabolic rate, hunger, fatigue Provide nutrients

10. Setting Calorie Goals Determine current calorie intake; subtract 250-500 calories/day; (text 500-1000) OR Decrease 250 calories a day from diet, 250 calories more physical activity 3500 calories in a pound of body fat

11. Obese Culture Portion sizes Convenience foods Food accessibility, poverty Food marketing and advertising Inactive lifestyle TV, computer, games Lack of sidewalks, public transportation, parks, city design Safety concerns

12. Body Mass Index (BMI) See text One way to determine healthy body weight Not perfect; men, athletes, genetically muscular, short stature, health issues Healthy- 18.5-24.9 Overweight- 25.0-29.9 Obesity- 30- 39.0 Severely Obese- > 40

14. Other Thoughts…. BodPod (air displacement), DEXA, bioelectric impedence, caliper measures to determine body fat Waist Circumference > 40” men, > 35” women Abdominal fat affects liver function Healthy-Fit Weight Focus on fat weight vs muscle weight Health benefits first 5-10% of weight lost 1-2 pounds per week weight loss average Easy to maintain Quality of life

15. National Weight Control Registry Brown University, University of Colorado 6000 people, lost 30+ pounds (average 66), stable 5.7 years 98% modified food intake somehow… Lower calorie, lower fat 94% exercise, 1 hour/day, most walk 90% keep records, self-monitor 78% eat breakfast every day 45% lost on own, 55% with a program

16. National Weight Control Registry Findings 75% weight at least once a week 62% watch less than 10 hours tv a week 92% reported more energy and better mobility, 95% better quality of life

17. Weight Loss Program Components #1- Lower calorie, lower fat, sensible, long term dietary intake #2- Exercise #3- Self Monitoring Food, exercise, weight records Behavior modification #4- Breakfast #5- Support

18. Stages of Change Pre-contemplation Unaware Contemplantion Realize need to make change Preparation Gather information, make a plan Action Implement plan Maintenance Continue, revise plan Termination New lifestyle