chapter 7 Health 110 managing your weight

waist to hipe ratio men

.9 or less 1.0 is dangerous

waist to hip ratio for women

0.8

bariatric surgery complications

1. ruptured staples 2. bowel obstruction 3. infections, nausea, vomiting, dehydration 4. Dumping syndrome 5. Esophageal reflux 6. depression According to federal estimates, 4 in 10 patients suffer complications within six months. The mortality rate averages about 2 deaths in 1,000 operations. Even with excellent medical results, extreme weight loss creates drapes of excess skin that sag over the belly, buttocks, thighs, breasts, or upper arms.Footnote

anorexia nervosa peak ages

14.5- 18 years

overweight

A condition of having a BMI between 25.0 and 29.9.

Body Mass Index (BMI)

A mathematical formula that correlates with body fat; the ratio of weight to height squared.

2 types of anorexia

In the restricting type, individuals lose weight by avoiding any fatty foods and by dieting, fasting, and exercising. Some start smoking as a way of controlling their weight. Some college women may numb their pain by drinking alcohol, a problem the media have dubbed "drunkorexia." In the binge-eating/purging type, individuals engage in binge eating, purging (through self-induced vomiting, laxatives, diuretics, or enemas), or both. Obsessed with an intense fear of fatness, they may weigh themselves several times a day, measure various parts of their body, check mirrors to see if they look fat, and try on different items of clothing to see if they feel tight.

anorexia nervosa characteristics

Restriction of food intake, leading to a significantly low body weight for their age, health, and gender Intense fear of gaining weight or of becoming fat Disturbance in the way individuals experience their body weight or shapeFootnote

treatments for binge eating

Short-term talk treatment, such as cognitive-behavioral therapy, either individually or in a group setting, has proven most effective for binge eating

waist to hip ratio

The proportion of one's waist circumference to one's hip circumference.

binge eating

The rapid consumption of an abnormally large amount of food in a relatively short time.

prescription drug therapy for weight loss

Xenical (Orlistat, also available in a lower dose as the over-the-counter drug Alli) blocks fat absorption by the gut, and it also inhibits absorption of water and vitamins in some patients and may cause cramping and diarrhea. It produces a weight loss of 2 to 3 percent of initial weight beyond the weight lost by dieting over the course of a year. The FDA has approved two additional medications: Belviq (lorcaserin hydrochloride) and Qsymia (phentermine and topiramate extended-release). Both are meant for individuals with a BMI higher than 30 or a BMI higher than 27 with at least one weight-related health problem, such as hypertension or diabetes. Each should be taken only under a physician's care.

disordered eating

a pattern of atypical eating behaviors that is used to achieve or maintain a lower body weight ------------------- In a survey at a large, public, rural university in the mid-Atlantic states, 17 percent of the women were struggling with disordered eating. Younger women (ages 18 to 21) were more likely than older students to have an eating disorder. In this study, eating disorders equally affected women of different races (white, Asian, African American, Native American, and Hispanic), religions, athletic involvement, and living arrangements (on or off campus; with room -----------Women in sororities are at slightly increased risk of an eating disorder compared with those in dormitories. Loneliness also has emerged as a risk factor for eating disorders in college women.

gastric banding

a surgical means of producing weight loss by restricting stomach size with a constricting band

Binge-eating/purging type

a type of anorexia whereby the individual regularly engages in episodes of binge eating or purging or both Binge eating is probably the most common eating disorder. An estimated 8 to 19 percent of obese patients in weight loss programs are binge eaters.

Waist Circumference (WC)

a waist girth measurement to assess potential risk for disease based on intra-abdominal fat content

most common eating disorder

binge-eating disorder, anorexia nervosa, and bulimia nervosa

bariatric operation long term dangers

both physical and psychological—are unknown, particularly for adolescents. Following gastric bypass surgery, obese teenagers lose weight and no longer suffer from diabetes. The benefits extend beyond the physical, with many reporting better psychological health and social ease.

belviq adverse reactions

cognitive changes, neuromuscular symptoms, and digestive problems such as nausea, vomiting, and diarrhea.

Bod Pod

commercial name of the equipment used to assess body composition through the air displacement technique

basal metabolic rate

the body's resting rate of energy expenditure

Restricting Anorexia Nervosa

weight loss is achieved by severely limiting food intake, with no binge-eating/purging during the last three months

Weight loss programs

$2.5 billion per year Counseling plus calorie control (Weight Watchers and Jenny Craig). These are the only two programs backed by scientific evidence showing that their clients maintained weight loss for at least a year. Nutrisystem clients also lost weight but were followed for only three months. Very-low-calorie and low-calorie meal replacement programs (Medifast, Optifast, Health Management Resources). Consumers using these products initially reported greater weight loss than those given counseling alone, but attrition was high and the difference was not statistically significant by nine months. The very-low-calorie methods increased the risk of gallstones. Self-directed (Atkins, Slimfast). Individuals following the Atkins diet reported greater weight loss than those in education-counseling programs at 6 and 12 months. Adherence was not reported; the most common complication was constipation. Slimfast users lost more weight than a control group but had results similar to those who received counseling alone. Internet based programs (The Biggest Loser Club, eDiets, Lose it!). Results varied, with Biggest Loser Club members showing greater weight loss than a control group at three months but no difference between eDiets and LoseIt! participants and controls. Since so little solid research is available, the researchers' conclusion was inconclusive: "We still don't know whether a lot of these programs work."Footnote

what causes anorexia nervosa?

--associated with changes within the brain, including abnormalities in the stress hormone cortisol and the neurotransmitters dopamine, serotonin, and norepinephrine—all of which influence appetite and satiety. Brain chemistry returns to normal after treatment and recovery. -also may be a response to a personal loss or a sign of a driven, perfectionist personality. Often young anorexics have above-average grades and an unwarranted fear of failure. Girls who develop anorexia often have little insight into or awareness of their feelings, needs, and want -Sometimes illness, stress, or surgery triggers weight loss. Often the initial response to their weight loss—from parents, coaches, or friends—is positive. However, starvation seems to take on a life of its own, and anorexics cannot return to a healthy eating pattern. In time, they may place so much value on thinness that they cannot recognize the dangers to their health.

social consequences of obesity

-discrimination -judgement on appearance -laziness/ lack of self-control Heavy women are less likely to marry, earn less, and have lower rates of college graduation.

The individuals most likely to benefit from obesity surgery generally

1. Have a body mass index over 40 2. Have a BMI over 35 and a serious obesity-related problem, such as type 2 diabetes or severe sleep apnea (when breathing stops for brief periods during sleep) 3.Have made repeated unsuccessful attempts to lose weight 4 Do not have any significant or untreated psychological problems 5 Are well informed about the risks of the surgery 6 Recognize the need for lifestyle changes and daily vitamin and mineral supplements

ideal fat percentage for men and women

7 to 25 percent and for women from 16 to 35 percent

dual energy x-ray absorptiometry (DEXA)

A highly accurate method of measuring body composition and bone mass and density using multiple low-energy X rays.

why we overeat

A hormone called leptin, produced by fat cells, sends signals that regulate appetite to the brain. When leptin levels are normal, people eat just enough to maintain weight. When leptin is low, the brain responds as if fat stores had been depleted and slows down metabolism. This may be one reason why it is so difficult to lose weight by dieting alone. However, vigorous exercise can lower the hormone ghrelin, which is a natural appetite stimulant.

Bioelectrical Impedance Analysis (BIA)

A method of assessing body composition by running a low-level electrical current through the body.

skinfold measurements

A method to estimate body fat by measuring with calipers the thickness of a fold of skin and subcutaneous fat

fat talk

A process believed to be implicated in vulnerability to eating disorders that involves the tendency for friends, particularly female friends, to take turns criticizing and critiquing their bodies to each other men and women engage in fat talk. men comments are mostly as positive as negative

binge eating disorder

A psychiatric disorder characterized by binge-eating once a week or more for at least a three-month period.

anorexia nervosa

A psychological disorder in which refusal to eat and/or an extreme loss of appetite leads to malnutrition, severe weight loss, and possibly death. * food is an enemy * food is a threat to sense of self, autonomy, identity * affects 0.4 % of girls and young women * 10x more prevalent in females than males

how did so many get so fat?

A variety of factors, ranging from behavior to environment to genetics, played a role in the increase in overweight and obesity in the United States. They include the following: Bigger portions: As Table 7.1 shows, the size of many popular restaurant and packaged foods has increased two to five times during the past 20 years. According to studies of appetite and satiety, people presented with larger portions eat up to 30 percent more than they otherwise would. Consuming more calories than we burn: American adults have been eating steadily fewer calories for almost a decade, despite the continued increase in obesity rates, according to the Centers for Disease Control and Prevention (CDC). Among adults, average daily intake has fallen by about 75 calories. However, Americans may still not be getting enough exercise to burn the calories they do consume. Fast food: Young adults who eat frequently at fast-food restaurants gain more weight and develop metabolic abnormalities that increase their risk of diabetes in early middle age. (See the discussion of fast food in Chapter 6.) Physical inactivity: The heaviest individuals tend to move the least. Obese men and women log fewer hours of vigorous exercise than leaner individuals.Footnote Passive entertainment: Television viewing, a culprit in an estimated 30 percent of new cases of obesity, may increase weight in several ways: It takes up time that otherwise might be spent in physical activities. It increases food intake since people tend to eat more while watching TV. Compared with sewing, reading, driving, or other relatively sedentary pursuits, it lowers metabolic rate so viewers burn fewer calories. Emotional eating: College students who are prone to boredom and have difficulty coping with negative emotions are likely to eat when they have nothing else to do or are feeling upset.Footnote Genetics: Scientists have identified a particular variation in a gene associated with fat mass and obesity, called FTO, that increases the risk of excess weight by 20 to 30 percent. However, physical activity can counteract its effect. Social networks: Friends may have a significant effect on the risk of obesity. Young adults who are overweight or obese tend to befriend and date people who also have weight problems. Researchers are not sure if overweight people seek out other overweight people or whether normal-weight individuals become heavier as a result of their relationships with heavier partners. Marriage: Although marriage confers many health benefits, it also puts on pounds— particularly among the happily married. The reason may be that, having found a mate, spouses no longer try to stay slim to attract a partner. Table 7.1

racial differences in obesity

Asian Americans have the lowest obesity rates (11.6 percent). Obesity is significantly higher in American Indians and Alaska Natives (39.9 percent) and Native Hawaiians and Pacific Islanders (43.5 percent) than in other races. Among white people, 66.7 percent are overweight or obese, including 34.3 percent who are obese and 5.7 percent who are extremely obese. About 17 percent of children over age 5 and adolescents in the United States are obese, with higher rates among boys (18.6 percent) than girls (15 percent).

Hydrostatic (underwater) weighing

Based on Weight of body outside of water Weight of completely immersed body Density of water

disordered eating treatment

Brief interventions, such as four-hour Healthy Weight programs, have proven effective in preventing the onset of various forms of disordered eating.

A Practical Guide to a Healthy Weight

Drinking less soda Eating less junk food Drinking more water Increasing physical activity Weighing themselves regularly Adding more protein to their diets Watching less television Adding more fiber to their dietsFootnote

If You're Too Thin: How to Gain Weight

Eat more of a variety of foods rather than more high-fat, high-calorie foods. Get no more than 30 percent of your daily calories from fat. A higher percentage poses a threat to your heart and your health. If your appetite is small, eat more frequently. Try for five or six smaller meals rather than a big lunch and dinner. Choose some calorie-rich foods, such as dried fruits rather than fresh ones. Add nuts and cheese to salads and main dishes. Drink juice rather than regular or diet soda. Try adding a commercial liquid meal replacement as a snack. Exercise regularly to build up both appetite and muscle.

binge eaters experience at least three of the following:

Eating much more rapidly than usual Eating until they feel uncomfortably full Eating large amounts of food when not feeling physically hungry Eating large amounts of food throughout the day with no planned mealtimes Eating alone because they are embarrassed by how much they eat and by their eating habitsFootnote

bulimia nervosa

Episodic binge eating, often followed by forced vomiting or laxative abuse, and accompanied by a persistent preoccupation with body shape and weight. An estimated 1 to 2 percent of adolescent and young American women develop bulimia. Some experiment with bingeing and purging for a few months and then stop when they change their social or living situation. Others develop longer-term bulimia. Among males, this disorder is about one-tenth as common. The average age for developing bulimia is 18.

bariatric surgery types

Gastric bypass: Surgeons create an egg-sized pouch with staples and reroute food around part of the upper intestine to block absorption of calories and nutrients. About 75 percent of bypass patients lose 50 to 75 percent of their excess weight within two years. For the "super obese," a more extensive procedure that bypasses most of the small intestine can lead to a loss of 80 percent of excess weight. However, the latter procedure carries the highest risks of complications, including serious vitamin and mineral deficiencies. Banding: In this newer, less risky procedure, surgeons slip an inflatable silicon band around the stomach; it can be tightened or loosened at a doctor's office without the need for further surgery. Patients lose about 40 to 55 percent of excess weight but may be more likely to regain lost pounds. The band also may slip or erode. Duodenal switch: Duodenal switch or biliopancreatic diversion, a more extensive operation that removes a portion of the stomach and bypasses a large portion of the small intestine, may lead to greater long-term weight loss but carries a risk of more complications.Footnote Bariatric operations—particularly in the hands of poorly trained or inexperienced surgeons—pose serious risks, including potentially fatal leaks, infection, bleeding, hernias, and pneumonia. According to federal estimates, 4 in 10 patients suffer complications within six months. The mortality rate averages about 2 deaths in 1,000 operations. Even with excellent medical results, extreme weight loss creates drapes of excess skin that sag over the belly, buttocks, thighs, breasts, or upper arms.

Among the factors that increase the risk of an eating disorder are

Genetic predisposition Preoccupation with a thin body Social pressure Perfectionism and excessive cautiousness, which can reflect an obsessive-compulsive personality Lite transitions, such as puberty and the transition from adolescence to adulthood

home body fat analyzers

Handheld devices and stand-on monitors sold online and in specialty stores promise to make measuring your body fat percentage as easy as finding your weight. None has been extensively tested.

Limitations of BMI and just measuring body weight and height

However, some argue that fat distribution, not overall fatness, is a critical of the health risks of obesity. BMI has other limitations as an assessment tool: Muscular individuals, including athletes and body builders, may be miscategorized as overweight or obese because they have greater lean muscle mass. BMI does not reliably reflect body fat, an independent predictor of health risk. BMI is not useful for growing children, women who are pregnant or nursing, or elderly people. BMI, which was developed in Western nations, may not accurately indicate the risk of obesity-related diseases in Asian men and women.

weight on campus

In the last decade, the prevalence of overweight and obesity increased from 62.2 to 67.1 percent among young men and from 51.7 to 55.8 percent among young women ages 20 to 39. Here are some specifics about weight issues on campus: About six in ten undergraduates are overweight; about a third are obese.Footnote Students at two-year colleges may be twice as likely to be obese as those at four-year institutions.Footnote Bisexual and lesbian female undergraduates are more likely to be obese than heterosexual women and may be at greater risk for unhealthy dietary, exercise, and weight control behaviors.Footnote In addition to health-related risks, overweight and obesity in college are associated with significantly lower overall academic achievement and more depressive symptoms. Obese male undergraduates have significantly higher rates of lifetime trichotillomania (hair-pulling), while overweight and obese females report higher rates of panic disorder.Footnote Many factors contribute to weight gain in college. "Millennials," the young adults born between 1980 and 2000, report experiencing high levels of stress and engaging in unhealthy behaviors in response: They get little if any regular exercise; skip breakfast; eat more fast food; drink more sugary sodas, energy drinks, and alcohol; and get less sleep than older Americans. As a result, they're more likely to develop one or more risk factors for cardiovascular disease.

Benefits of exercise

Increasing energy expenditure Building up muscle tissue Burning off fat stores Stimulating the immune system Possibly reprogramming metabolism so that more calories are burned during and after a workout

herbal supplements for weight loss

Medicinal plant extracts, some traditionally used to prevent or treat disease, are being touted—often with misleading labels—as "natural" fat fighters. They include green tea from the leaves of C. sinensis, dehydrated fruit rind (Garcinia cambogia) used as a cooking ingredient in southern India, and the milkweed H. gordonii. Although widely advertised, the researchers concluded that "the evidence in support of their effectiveness is either non-existent or points to a negligible effect.

health dangers of anorexia nervosa

Menstrual periods stop in women; testosterone levels decline in men. Adolescents with this disorder do not undergo normal sexual maturation, such as breast development, and may not reach their anticipated height. Even individuals who look and feel reasonably healthy may have subtle or hidden abnormalities, including heart irregularities and arrhythmias that can increase their risk of sudden death. Women who do not menstruate for six months or more may develop osteoporosis and suffer irreversible weakening and thinning of their bones as a result.

NEAT (nonexercise activity thermogenesis)

Nonvolitional movement that can be an effective way of burning calories.

common diet traps

OTC pills, Diet foods, Artificial sweetners, fake fats,

Weight in America

Over the past 30 years, the proportion of Americans considered overweight (with a body mass index [BMI] of 25 or higher) or obese (with a BMI of 30 or higher) has steadily increased. (BMI is discussed later in this chapter.) However, health experts have reported an encouraging change: a significant decline in obesity among children aged 2 to 5 years, which has dropped from 14 percent a decade ago to about 8 percent. Obesity levels among other age groups seem to be leveling off. Although this trend was initially attributed to hard economic times, health experts now see it as a result of better eating habits that Americans began to adopt about 10 years ago. According to a recent report, long-term efforts to educate Americans about healthy eating habits and food choices are paying off, and people are consuming fewer calories. However, excess weight continues to be a problem for many Americans (see Figure 7.1): More than 2 in 3 adults are overweight or obese. More than 1 in 3 adults—some 78 million individuals—are obese. More than 1 in 20 adults have extreme obesity. More than 1 in 6 children and adolescents ages 6 to 19 are obese.

bulimia nervosa characteristics

Repeated binge eating A feeling of lack of control over eating behavior Regular reliance on self-induced vomiting, laxatives, or diuretics Strict dieting or fasting, or vigorous exercise, to prevent weight gain A minimum average of one bingeing episode a week for at least three months A preoccupation with body shape and weight.Footnote,

unhealthy eating on campus

Researchers estimate that only about one-third of college women maintain healthy eating patterns

Method of Measurement for body fat

Skinfold Measurement Skinfold measurement is determined using a caliper to measure the amount of skinfold. The usual sites include the chest, abdomen, and thigh for men and the tricep, hip, and thigh for women. Various equations determine body fat percentage, including calculations that take into account age, gender, race, and other factors. This relatively simple and low-cost method requires considerable technical skill for an accurate reading. Home Body Fat Analyzers Handheld devices and stand-on monitors sold online and in specialty stores promise to make measuring your body fat percentage as easy as finding your weight. None has been extensively tested. Laboratory Methods Bioelectrical Impedance Analysis (BIA). This noninvasive method is based on the principle that electrical current applied to the body meets greater resistance with different types of tissue. Lean tissue, which contains large amounts of water and electrolytes, is a good electrical conductor; fat, which does not, is a poor conductor. In theory, the easier the electrical conduction, the greater an individual's lean body mass. Hydrostatic (underwater) weighing. According to the Archimedes Principle, a body immersed in a fluid is buoyed by a force equal to the weight of the displaced fluid. Since muscle has a higher density than water and fat has a lower density, fat people tend to displace less water than lean people. Dual-energy X-ray absorptiometry (DXA). X-rays are used to quantify the skeletal and soft tissue components of body mass. The test requires just 10 to 20 minutes, and radiation dosage is low (800 to 2,000 times lower than a typical chest X-ray). Some researchers believe that DXA will supplant hydrostatic testing as the standard for body composition assessment. The Bod Pod ® . This large, egg-shaped fiberglass chamber uses an approach based on air displacement plethysmography—that is, the calculation of the relationship between pressure and volume—to derive body volume.

Partial syndrome eating disorders

Syndromes that don't meet the full criteria for anorexia nervosa or bulimia nervosa

obesity

The excessive accumulation of fat in the body; class 1 obesity is defined by a BMI between 30.0 and 34.9; class 2 obesity is a BMI between 35.0 and 39.9; class 3, or severe obesity, is a BMI of 40 or higher.

hunger

The physiological drive to consume food.

adult obesity in the us

The prevalence of obesity among women has remained relatively stable, at about 35 percent, since 2000, but the prevalence among men has increased from 27.5 percent to 35.5 percent. Americans of all races carry excess pounds, but there are racial differences. Asian Americans have the lowest obesity rates (11.6 percent). Obesity is significantly higher in American Indians and Alaska Natives (39.9 percent) and Native Hawaiians and Pacific Islanders (43.5 percent) than in other races. Among white people, 66.7 percent are overweight or obese, including 34.3 percent who are obese and 5.7 percent who are extremely obese. About 17 percent of children over age 5 and adolescents in the United States are obese, with higher rates among boys (18.6 percent) than girls (15 percent).

satiety

The sensation of feeling full after eating.

Major diseases linked to obesity include

Type 2 diabetes-More than 80 percent of people with type 2 diabetes are overweight. ,Heart disease and stroke-: People who are overweight are more likely to suffer from high blood pressure, high levels of triglycerides (blood fats) and harmful low-density lipoprotein (LDL) cholesterol, and low levels of beneficial high-density lipoprotein (HDL) cholesterol. Even relatively small amounts of excess fat—as little as 5 pounds—can add to the dangers in those already at risk for hypertension. People with more body fat have higher blood levels of substances that cause inflammation, which may raise heart disease risk. Obese men face a much greater risk of dying from a heart attack, regardless of whether they have other risk factors. Losing 5 to 15 percent of your weight can lower your chances for developing heart disease or having a stroke. cancer,--Obesity contributes to more than 100,000 cases of cancer—among them cancers of the endometrium, esophagus, pancreas, gallbladder, kidney, breast, ovaries, and colon—in the United States every year. Excess weight may account for 14 percent of all cancer deaths in men and 20 percent of those in women. Obesity quadruples the risk of prostate cancer in black men.Footnote Women who were overweight as children or teens may have a greater risk of colon cancer as adults.Footnote Losing weight, researchers estimate, could prevent as many as one in every six cancer deaths. other health problems such as: Other health problems: Overweight men and women are also more likely to develop Knee injuries that require surgery to repair. Spinal disc degeneration, a common cause of low back pain. Alterations in various measures of immune function. Greater risk of gall stones, kidney stones, and kidney disease. Less responsiveness to flu vaccination. Cognitive problems and dementia. Worsened symptoms of fibromyalgia, a musculoskeletal disorder. Poor sleep, which could add to the risk of medical problems. (See Chapter 2 for a discussion of sleep.) Health professionals describe the "plague of obesity" as an epidemic that claims 2.8 million lives around the world every year.Footnote Premature death: Obese American adults die an average of almost four years earlier than those with normal weight, and middle-aged obese adults face the highest risk of early death. According to recent research, obesity is associated with at least a 20 percent increased risk of death from all causes or from heart disease. Overall, obese adults died 3.7 years earlier from all causes and 1.7 years earlier from heart disease, compared with normal-weight adults.Footnote

eating disorders

Unusual, often dangerous patterns of food consumption, including anorexia nervosa and bulimia nervosa affect an estimated 5 to 10 million women and 1 million men. Despite evidence that 5 to 10 percent of those with eating disorders are male, many college students believe mainly young white women develop eating disorders.

non invasive body contouring

Various methods using ultrasound, laser, and radio frequency may produce modest reductions in fat deposits at specific sites, such as the waist or upper arm, in normal-weight individuals but offer little, if any benefits, to the obese.Footnote

Mindfulness and eating disorders

Weight loss programs that incorporate mindfulness (discussed in Chapter 4) along with diet and exercise have proven effective in helping participants shed pounds, but the impact of mindfulness alone is not clear.Footnote

reactions to qsymia

altered mood and thought processes, suicidal thoughts and behaviors, dizziness, drowsiness, and birth defects if taken during the first trimester of pregnancy.

weight loss maintainers

are more active, have fewer TVs in their homes, and don't keep high-fat foods in their pantries

obesity surgery

bariatric, surgery is becoming the most popular weight loss approach for the estimated 15 million men and women who qualify as "morbidly obese" (100 or more pounds overweight) because of their increased health risks. --This year as many as 200,000 Americans will undergo obesity surgery—four times the number who did so in 2000. Eight in 10 are women. --A growing number are teenagers. Bariatric surgery seems to offer the same benefits for obese teens as for older patients, but its long-term health consequences are unknown.

duodenal switch

biliopancreatic diversion, a more extensive operation that removes a portion of the stomach and bypasses a large portion of the small intestine, may lead to greater long-term weight loss but carries a risk of more complications

compulsive overeating

binge eating disorder *eat fast and alot *eat even when full Turning to food when depressed or lonely, when feeling rejected, or as a reward A history of failed diets and anxiety when dieting Thinking about food throughout the day Eating quickly and without pleasure Continuing to eat even when no longer hungry Frequently talking about food or refusing to talk about food Fear of not being able to stop eating after starting

appetite

desire for food, stimulated by anticipated hunger, physiological changes within the brain and body, the availability of food, and other environmental and psychological factors.

extreme dieting

diet and weight loss become an obsession They become preoccupied with what they eat and weigh. Although their weight never falls below 85 percent of normal, their weight loss is severe enough to cause uncomfortable physical consequences, such as weakness and sensitivity to cold. Technically, these dieters do not have anorexia nervosa (discussed later in this chapter), but they are at increased risk for it. Extreme dieters may think they know a great deal about nutrition, yet many of their beliefs about food and weight are misconceptions or myths

weight in america

excess weight continues to be a problem for many Americans (see Figure 7.1): More than 2 in 3 adults are overweight or obese. More than 1 in 3 adults—some 78 million individuals—are obese. More than 1 in 20 adults have extreme obesity. More than 1 in 6 children and adolescents ages 6 to 19 are obese.Footnote

Complementary and Alternative Medicine (CAM) for Obesity

herbal supplements, acupuncture, non invasive body contouring, mindfulness,

pear shaped versus apple shaped bodies

pear- fat stores around hips and predominate apple-fat stores around waist predominate

habit reversal

replace your bingeing with a competing behavior. For example, every time you're tempted to binge, immediately do something—text-message a friend, play solitaire, check your e-mail—that keeps food out of your mouth.

Benefits of bariatric surgery

surgery patients lose 50 to 75 percent of their excess weight within two years and keep it off. Among its other potential benefits are the following: Improvement in or elimination of diabetes in some people. Alleviation of high cholesterol, hypertension, and sleep apnea. Reduction of odds of dying by nearly half. Reduction of cardiovascular disorder, such as heart attack or stroke, and heart-related deaths.Footnote Lower risk of gestational (pregnancy) diabetesFootnote

gastric bypass

surgical treatment for obesity; portion of stomach is stapled off and bypassed so that it holds less food; also called stomach stapling