Module 8 energy balance, weight management, and eating disorders notes

Components of a healthy weight loss plan pt. 2

4. Increase physical activity: Studies show that exercise does not help lose more pounds because most people do not consistently maintain the level of exercise needed to lose weight. However, exercise is the single most significant predictor of long-term weight management. In other words, if a person tries to lose weight by limiting calories and not exercising, the weight will inevitably be gained right back. For successful weight loss, aim for one hour of physical activity daily. MyPlate recommends that 150 minutes of exercise weekly is usually not enough for significant weight loss. A person should try to expend at least 2000 calories per week through exercise. Moderate-intensity exercises can be just as effective at burning calories as high-intensity activities, with aerobic exercise being best for burning calories. Resistance training (muscle building) activities are also very effective because they increase lean mass and improve BMR. A healthy weight loss plan includes both aerobic and resistance training exercises. Not only can exercise help improve body composition and help with weight loss, but it can also reduce the risk of obesity-related health problems such as Type 2 diabetes, hypertension, and cardiovascular disease. 5. Drink more water: Many studies show that people who drink adequate amounts of water have lower rates of obesity. There may be several mechanisms involved. First, thirst is often confused with hunger. When hunger is perceived, sometimes drinking a cup of water will help. Drinking water before a meal will help take up volume in the stomach and decrease solid food intake. Water is naturally calorie-free and can displace beverages that contribute empty calories to the diet. Additionally, water will provide the necessary hydration to exercise efficiently and improve long-term weight management.

Calculate calorie balance necessary for weight management pt. 3

Unexplained weight loss is a cause for concern and can indicate a severe health problem such as cancer. If the weight loss is unintentional, a person should see their doctor if they lose more than 5 percent of their weight in six months to a year. Rapid weight gain can also be concerning and related to medications, thyroid dysfunction, tumors, and other health problems. Any unexplained rapid weight loss and weight gain should be addressed by a physician. Does it matter if the extra calories are from carbohydrates, protein, or fat? Nope! A calorie is a calorie. While many diet plans restrict carbohydrates or fat, you would gain weight even if you consumed too much protein. Decreasing fat intake is generally thought to induce weight loss quickly because it contains more than twice as many calories as carbohydrates and protein. Thus, reducing your fat intake will more easily decrease your total calorie intake. However, many studies have demonstrated that people tend to have more challenges with losing weight on a low-fat diet. This is because fat is needed for satiety. The absence of adequate amounts of fat at meals may leave people hungry and more inclined to over-consume high-carbohydrate or sugary foods.

Orthorexia nervosa pt. 2

Warning Signs of Orthorexia 1. Obsession with avoiding foods that contain animal products, fats, sugar, salt, food coloring or dyes and pesticides 2. Obsessive concern with food and the development of health consequences such as medical illnesses including asthma, allergies, and gastrointestinal problems 3. Obsession with consuming supplements and vitamins 4. An extreme limitation on food groups which may result in only consuming less than a total of ten ingredients 5. An increased amount of time spent thinking about food 6. Allowing food to revolve around one's daily schedule 7. Obsession with meal prepping 8. Irrational concern about food preparation techniques and cleanliness of the kitchen 9. Avoidance of food prepared or brought by others 10. Extreme feelings of guilt or shame when consuming unhealthy foods 11. Feelings of power and satisfaction when consuming only healthy foods 12. Refusing to go out to eat or allowing oneself to be around other types of food 13. Isolating oneself from others because they do not share the same beliefs 14. Severe anxiety regarding how food is prepared 15. Avoidance of social events involving food for fear of being unable to comply with diet 16. Thinking critically of others who do not follow strict diets 17. Spending extreme amounts of time and money in meal planning and food choices 18. Feelings of guilt or shame when unable to adhere to diet standards 19. Feeling fulfilled or virtuous from eating "healthy" while losing interest in other activities once enjoyed

Causes of obesity: high amount of stress

When you are under stress, you may find it challenging to eat a healthy diet. Another hormone, cortisol, can also lead to weight gain over time. Cortisol is known as the "stress hormone." Because increased levels of cortisol cause high insulin levels, your blood sugar drops, and you are more likely to crave sugary, fatty foods. In addition to weight gain and increased abdominal fat storage, elevated cortisol levels can cause serious health problems over time. High levels are related to inflammation, decreased immunity, impaired digestion, reproduction, and growth processes. Cortisol can increase the risk for Type 2 diabetes and cardiovascular disease, which are also more likely to develop with obesity. Exercise is an effective way to help manage stress levels. It can increase levels of "feel good" endorphins in the body and improve mood. Exercise can help make better food choices, eliminate "stress eating," and lower the risk for obesity-related conditions such as Type 2 diabetes and cardiovascular diseases.

Health problems associated with very low body fat pt. 1

1. Amenorrhea: Amenorrhea refers to a lack of a menstrual cycle. Irregular or absent periods are often the first sign that a female's body fat is getting too low. 2. Infertility: Hormonal disruption in women and drops in sperm count in men can lead to infertility. 3. Poor bone density: Lack of body fat can interfere with the body's ability to properly absorb and use calcium and vitamin D. A decrease in bone density can eventually lead to full-blown osteoporosis. However, most young people suffering from poor bone density won't know it unless they get a DEXA scan or break a bone. 4. Heart Problems: The heart rate may become too low, which can cause dizziness, passing out, and heart attack. Electrolyte imbalances can also lead to heart problems. 5. Lack of Energy: Lack of energy (fat) reserves can cause fatigue and impair your ability to exercise. 6. Decrease in thyroid hormone production: This can further contribute to fatigue. 7. Impaired temperature regulation: You are always cold since there isn't enough fat for insulation.

Recommendations for weight gain

1. Eat regularly scheduled meals and snacks: The goal is to increase total energy intake. Underweight people often lack appetite, so trying to eat large meals may be unrealistic. It is usually more helpful to aim for smaller, more frequent portions throughout the day. 2. Consume high-calorie shakes in between meals: High-calorie shakes can be an easy way to boost extra calories. The key is to add the shakes to regular food intake, not replace meals with them. Many over-the-counter high-calorie shakes are convenient (Boost, Ensure, etc.). You can also make your own such as a smoothie with fresh fruit, protein powder, and oil. 3. Focus on consuming beverages with calories, such as juices and milk: Instead of drinking water throughout the day, try beverages that provide calories. Juices and milk are preferred since they contain nutrients and hydrate like water. Avoid unhealthy drinks such as soda. 4. Add healthy oils to food: Oils contain healthy unsaturated fat and provide a considerable boost in calories. Most oils have very little taste, so they can be added to most cooked foods without disrupting flavor. Adding oil to a shake or smoothie will also make it creamy. 5. Avoid drinking water and other beverages before meals: Filling up on fluids right before mealtime will decrease appetite and lead to eating less solid foods. 6. Engage in a resistance training exercise: Building muscle can help gain healthy weight. One cannot gain muscle mass without combining calorie surplus and resistance exercise. Healthy, energy-dense foods include nuts, peanuts, nut butter, whole dairy products, avocado, hummus, lean meats, dried fruits, and seeds. Try to avoid consuming high-calorie foods full of unhealthy fats and added sugars.

List potential causes of being underweight pt. 1

1. Genetics: Some people are naturally thinner than others. This can be as simple as inheriting a high metabolism or how the body regulates appetite and energy storage. 2. Undereating: Some people lack a good appetite to take in enough energy. This could be due to genes or emotional issues such as depression. Health problems can also cause a lack of appetite. Lack of senses such as taste and smell, common among the elderly, can also reduce the desire to eat. 3. Poverty: Not everyone undereats by choice. Lack of access to adequate food is a significant contributor to worldwide malnutrition and being underweight. Even the United States is not immune to this problem. 4. Drug Use: Substance abuse dramatically alters the diet and, in most cases, leads to irregular eating patterns and poor nutrition. The exception is marijuana, which tends to increase appetite. 5. Alcoholism: People with severe alcoholism usually lose weight, as alcohol eventually starts replacing food.

Food group strategies for weight gain

1. Grains: Choose whole grains more often than refined grains - they provide more nutrition with just as many calories. Focus on wheat or bran cereal, oats, whole grain bread, rice, and whole grain pasta. 2. Vegetables: While most vegetables are low in calories, you can boost energy by adding oils, butter, salad dressing, and other healthy fats. Choose potatoes, beans, and other starchy vegetables frequently 3. Fruits: Consume 100% fruit juices frequently Snack on dried fruits 4. Dairy: Consume at least 3 servings of dairy daily Choose whole milk products such as whole cows milk, cheese, and regular Greek yogurt Consume high calorie yogurt drinks such as kefir 5. Protein foods: Consume lean protein sources such as seafood, poultry, lean beef, and eggs Aim for 2 portions of oily fish per week, such as salmon or mackerel Consume nuts, seeds, and peanut butter frequently

Bulimia nervosa pt. 2

1. Physical signs include: Bloodshot eyes. Broken blood vessels in the face. Enlarged glands in the neck and under the jawline. Callused hands. Tooth decay. The smell of vomit. As with anorexia, serious complications or death is possible. In addition to mental stress, chronic binging and purging puts enormous strain on the body. 2. Complications that can occur with bulimia: Irritability Low sex drive Infertility Complications during pregnancy Chronic dehydration Gastric reflux Cracked, damaged lips Throat irritation Oral trauma Tooth damage Fainting Bloody vomit Hemorrhoids and/or rectal bleeding Facial swelling Dry skin Sore throat 3. Potentially severe or life-threatening complications include: Inflammation of the esophagitis Rupturing of the upper gastrointestinal tract Internal bleeding Peptic ulcers Electrolyte imbalances Cardiac arrhythmia Heart attack Kidney disorders Unfortunately, only about 43% of those suffering from bulimia nervosa ever receive treatment for it.

Anorexia nervosa pt. 2

1. Problems that can occur from anorexia nervosa: Fissures at the corner of the mouth Constipation Frequent night urination Fine hair growing over the body (lanugo) Thinning and loss of hair from the head Amenorrhea (loss of 3 consecutive periods or more) Inability to regulate body temperature Dry, Scaly skin Thinking is impaired Muscle wasting Degradation of fingernails Bone loss 2. Serious complications that can occur from anorexia nervosa: Dangerously low body fat Irregular pulse and heartbeat Growth failure in childhood and adolescence Severely low blood pressure Osteoporosis Brain damage Organ failure Death Treatment for anorexia involves intense psychiatric therapy, fluid and electrolyte replacement, and correction of other life-threatening symptoms. Weight should be regained gradually, focusing on developing a healthy relationship with food. In some cases, outpatient therapy may not be enough, and hospitalization may become necessary. Treatment often takes years.

Components of a healthy weight loss plan pt. 1

1. Reduce calorie intake: A moderate calorie deficit of 500-750 calories daily, through food restriction and physical activity, is usually adequate to help most people lose weight. It is important not to reduce calorie intake too much, or the weight loss efforts may backfire. Consuming too few calories, especially less than 1,200 daily, will significantly impair the basal metabolic rate. These low calories also make it very challenging to meet the RDA's for vitamins and minerals, and it will not support energy demands for exercise. A higher percentage of muscle is lost through very low-calorie diets as well. Most women should aim for 1,200 to 1,500 calories per day, while men should aim for 1,500 to 1,800 calories for weight loss. 2. Decrease intake of empty calories: Restricting calories for weight loss does not mean eliminating healthy foods. Evaluate the things you don't need in your diet when determining where to cut calories. Empty calorie foods such as sweetened beverages, desserts, added fats, and junk foods are not required for a healthy diet. 3. Consume more fruits and vegetables: You've heard this one before! Fruits and vegetables don't just provide healthy nutrients to improve nutrition. They are also high in water content, meaning that most fruits and vegetables can help with satiety without many calories. Eating plentiful amounts of fruits and vegetables makes it less likely that you will over-indulge in high-calorie foods.

Identify risk factors for the development of eating disorders pt. 2

2. Body image dissatisfaction. Body image encompasses how you feel both about and in your body. It's sadly not uncommon to dislike your appearance, but people who develop eating disorders are more likely to report higher levels of body image dissatisfaction and an internalization of the appearance ideal. This can also relate to transgender as well. 3. Personal history of an anxiety disorder. Research has shown that a significant subset of people with eating disorders, including 2/3's of those with anorexia, showed signs of an anxiety disorder (including generalized anxiety, social phobia, and obsessive-compulsive disorder) before the onset of their eating disorder. 4. Behavioral inflexibility. Many people with anorexia report that, as children, they always followed the rules and felt there was 1 "right way" to do things. SOCIAL 1. Weight stigma. The message that thinner is better is everywhere, & researchers have shown that exposure to this can increase body dissatisfaction, that can lead to eating disorders. It is discrimination or stereotyping based on a person's weight, & is damaging and pervasive in our society. 2. Teasing or bullying. Being teased or bullied - especially about weight - is emerging as a risk factor in many eating disorders. The harmful effects of bullying have received increased attention in recent years, starting an important national conversation. 60% of those affected by eating disorders said that bullying contributed to the development of their eating disorder. Weight shaming needs to be a significant part of anti-bullying discussions, particularly in the context of the widespread anti-obesity messaging.

Identify risk factors for the development of eating disorders pt. 3

3. Appearance ideal internalization. Buying into the message of the socially-defined "ideal body" may increase the risk of an eating disorder by increasing the likelihood of dieting and food restriction. 4. Acculturation. People from racial and ethnic minority groups, especially those who are undergoing rapid Westernization, may be at increased risk for developing an eating disorder due to complex interactions between stress, acculturation, and body image. Within three years after western television was introduced to Fiji, women, previously comfortable with their bodies and eating, developed serious problems: 74% felt "too fat;" 69% dieted to lose weight; 11% used self-induced vomiting; 29% were at risk for clinical eating disorders. 5. Limited social networks. Loneliness and isolation are some of the hallmarks of anorexia; many with the disorder report having fewer friends and social activities, and less social support. Whether this is an independent risk factor or linked to other potential causes (such as social anxiety) isn't clear. 6. Historical trauma, or intergenerational trauma, describes the "massive cumulative group trauma across generations," like with Jewish Holocaust survivors, Native American populations, and Indigenous groups that experienced European colonization. Research shows health consequences including "anxiety, intrusive trauma imagery, depression, elevated mortality rates from cardiovascular diseases as well as suicide and other forms of violent death, psychic numbing and poor affect tolerance, and unresolved grief" (Brave Heart, 1999). Similarities between the effects of eating disorders and historical trauma points to a need for more research and information that addresses these systems of oppression.

List potential causes of being underweight pt. 2

6. Excess physical activity: This is a common problem among athletes. It is often difficult for athletes to take in enough food to compensate for their enormous energy expenditure. 7. Hyperthyroidism: An overactive thyroid will significantly increase the BMR, and weight loss usually results. 8. Disease: Serious medical problems are one of the leading causes of rapid weight loss. In addition to losing appetite, metabolic stress can significantly increase the basal metabolic rate and potentially cause malabsorption. Psychological problems: Depression, anxiety, stress, sadness, and dementia can all affect food intake and lead to weight loss over time. 9. Dental problems: Tooth pain and tooth loss can affect the ability to chew food and usually results in insufficient food intake. Inability to swallow properly can also decrease food intake, which is a common problem among the elderly. 10. Eating disorders: Eating disorders such as anorexia nervous can result in serious weight loss. If weight loss cannot be explained, it is essential to see a doctor to determine if a health problem is a cause. If there is no medical explanation, take the time to assess your dietary intake, see if you are getting proper nutrition, and meet the goals for each food group. It's not uncommon for underweight people to think they are eating a lot when in reality, they are not.

Components of a healthy weight loss plan pt. 3

6. Increase fiber intake: Although fiber is a carbohydrate, we do not have enzymes to break it down. So, we do not obtain the same calories as other carbohydrates. It also helps slow the digestion of other carbohydrates to prevent excess insulin response. Soluble fiber, in particular, can provide the feeling of fullness after a meal and keep you full for an extended period. Therefore, you are less likely to overeat on a high-fiber diet. Focus on consuming plentiful amounts of foods such as beans, oats, fruits, and vegetables. 7. Eat slowly: Eating slowly usually means that you will eat less, and research shows that slow eaters tend to have lower rates of obesity. It takes time for your body to sense fullness. On average, your brain and stomach register a feeling of fullness after about 20 minutes. Think about how much food you can devour in 20 minutes if you eat quickly! Try putting your fork down after every bite. Chew and swallow that bite of food before picking your fork back up. This tactic will help you to eat more slowly. 8. Follow a good eating schedule: Another way to decrease appetite and eat more slowly is to eat regularly. Going too long between meals will often cause you to build a ravenous appetite, resulting in rapid eating to satisfy those annoying hunger pangs. The odds are that you will overeat at the next meal. If you know there will be many hours between meals, it's OK to include healthy snacks to "bridge" the gap. Skipping meals typically decreases the basal metabolic rate. Studies show that regularly skipping breakfast, in particular, usually results in weight gain over time. Despite claims to the contrary, there is no evidence that eating after a specific time in the evening will result in weight gain.

Health problems associated with very low body fat pt. 2

8. Muscles don't recover from exercise: Lack of body fat usually results in a lack of glycogen (glucose) storage. Glycogen is needed to help your muscles recover by refueling them. 9. Excessive hunger: Levels of leptin decrease. 10. Testosterone levels drop: Low leptin levels can lead to low testosterone levels. 11. Muscles become weaker: Muscle gain is virtually impossible when body fat becomes very low. 12. Sexual dysfunction: Low leptin and testosterone levels tell a man's body to shut down the reproductive system, and impotence may occur. 13. Impaired immunity: Very low body fat may cause an increase in cortisol levels and therefore weaken immunity. 14. Impaired mood: Essential fatty acid deficiency can cause irritability and mood swings. 15. Brain fog: Essential fatty acid deficiency can cause mental fatigue and trouble concentrating. 16. Bad skin: Lack of glycogen stores can lead to dehydration and dry and pasty skin.

Components of a healthy weight loss plan pt. 4

9. Address psychological problems: If you suffer from emotional issues such as depression or anxiety, this can sabotage your weight. It is hard to treat obesity without treating underlying depression first. Many people know the healthy ways to lose weight but do not have the power to enact those changes. Emotional issues can lead to chronic overeating, especially with comfort foods such as sweets and salty snacks. Seek medical attention if you think your weight problem may be psychologically related. 10. Find a support system: Losing weight is a considerable challenge, and your weight loss efforts will likely fail without encouragement from the people around you. If you don't have any supportive persons at home, consider joining a weight loss support group. Many people have an easier time achieving a healthy diet and exercise goals when doing it with others with the same goals. Often corporate weight loss programs and support groups within the workplace can also be very effective.

Identify factors that influence the basal metabolic rate pt. 2

9. Illness: The BMR will significantly increase during fever or chronic illness, often leading to extreme weight loss. 10. Smoking: Nicotine temporarily increases your BMR. Smoking should NOT be used as a method of weight control, however. 11. Caffeine: Caffeine temporarily increases your BMR. Sleep: Your BMR is the lowest when you sleep. However, sleep deprivation over time will only lead to weight gain, not weight loss. 12. Weight loss: When you lose weight, your BMR will naturally slow down since it takes less energy to support a smaller body. To estimate BMR, you can use the following calculations: Men: 1 kcal/kg/hour Women: 0.9 kcal/kg/hour Example: For a woman who weighs 138 pounds, you would divide the pounds by 2.2 to get her weight in kilograms, and then multiply the weight in kg by 0.9, then by 24 (24 hours in a day). 138/2.2 = 62.7 x 0.9 = 56.45 x 24 = 1354 calories Her estimated BMR would be 1,354 calories Many overweight people complain about having a "sluggish" metabolism and use it to excuse their lack of ability to lose weight. While it is likely that a person's metabolism may be impaired, it is essential to ask why. Quite often, the person's bad habits have impaired their metabolism over time. As mentioned above, chronic dieting, skipping meals, not getting enough sleep, and low physical activity can slow the basal metabolic rate. The following section's weight loss tips will address ways to increase the basal metabolic rate.

Building muscle

A healthy diet with nutrient dense foods that support all the processes of the body is the start to building muscle. A person must be in + calorie and nitrogen balance to make extra muscle. If you are in - calorie balance (fewer calories consumed than you are excreting), the body will break down tissue. One must consume more calories than they expend if anabolism (building tissue) is desired. A slightly higher amount of protein can help get to a + nitrogen balance that is needed for muscle gain. Neither extra calories nor extra protein will build extra muscle without resistance exercise. It is through the breaking down of muscle tissue that is replaced with the extra calories and protein that muscle can be expanded. Resistance training is crucial for muscle building. Through these exercises, muscle is torn down and must be replaced. By having more calories, a little more protein, and adequate vitamins and minerals, the body has all the components necessary to replace the muscle. The more routinely the body does this exercise, the better it gets at making muscle and building more. Resistance training is needed for overall health, not just muscle building. Muscle is harder to build and maintain as we age. Most of us start losing muscle around age 30 due to declining testosterone levels in men and lower estrogen levels in women, both of which help build muscle. The body experiences changes in nerves and blood cells. The body also does not effectively convert amino acids to muscle tissue with age. Over the years, this can result in weakness, lack of coordination, and overall lower quality of life. On average, inactive adults experience a 3% to 8% loss of muscle mass per decade, along with resting metabolic rate reduction and fat accumulation. One of the best ways to combat these effects is with exercise.

Binge eating disorder

A prevalent type of eating disorder among all age groups, Binge Eating Disorder, is the most difficult to diagnose. People suffering from this type of eating disorder are almost always overweight or obese because they consume mass amounts of food at one time but do NOT purge it afterward. The binge-eating disorder has much of the same characteristics as bulimia but without purging. Doctors often don't recognize the signs and simply diagnose the person with obesity. However, losing weight is a considerable challenge without addressing the psychological factors causing overeating behaviors. Individuals with BED often feel that they don't have control over their food intake. After binging on food, they have feelings of guilt and disgust. Binge eating disorder may be genetic in at least half of those suffering from it. Binge eating disorder usually results in the same health risk associated with clinical obesity, such as hypertension, high cholesterol, heart disease, Type 2 diabetes, and gallbladder disease.

Identify how weight influences health risks pt. 2

A thin person might think they can eat unhealthy foods and avoid exercising because they are underweight, but that is not the case. An underweight person can still clog arteries and develop chronic disease due to unhealthy food choices. In addition, while a thin person might not have the apparent extra fat around the abdomen, they may carry fat around internal organs, putting them at higher risk of disease. Just like a person won't lose weight overnight, a person won't gain weight overnight either. Those wishing to gain weight should aim for about one pound per week. This means consuming about 500 additional calories per day above normal needs. Gradually gaining weight will allow the addition of lean muscle and bone mass rather than unhealthy fat weight. First and foremost, focus on getting proper nutrition. If a person consumes enough nutrient-dense foods throughout the day, their calorie intake will likely be sufficient. Choosing healthy, energy-dense foods from all food groups is best, focusing on complex carbohydrates, lean protein, and healthy fats.

Fat distribution pt. 2

Because abdominal fat is independent of BMI, having a waist circumference greater than this increases the health risk of your BMI. For example, if we identify someone with a 29 BMI, we would classify them as overweight with an increased risk of disease. But, if the individual is a woman with a 37-inch waist circumference, her disease risk is now high instead of increased. Having a high waist circumference is called central obesity. Where you store your body fat is mainly genetic, although inactivity, alcohol, and stress are also contributing factors. Despite popular headlines, there is no evidence that specific foods can "blast belly fat." Even spot training exercises like sit-ups will not reduce abdominal fat. Sit-ups will only strengthen the muscles in the abdomen. However, an overall calorie-controlled healthy diet combined with regular physical activity can help to reduce the risk of central obesity.

Anorexia nervosa pt. 1

Anorexia nervosa is characterized by a refusal to maintain weight and a distorted body image. Those who suffer from it have an intense fear of gaining weight. Anorexia Nervosa is potentially life-threatening. Approximately 1 out of 10 persons with anorexia will die from their condition eventually. Anorexia is most likely to occur among young females. It is a condition in which they will starve their bodies in an extreme attempt to lose weight. While the primary characteristic is restricting food intake, some may also use purging, including vomiting, laxatives, or excess exercise. With anorexia, the person will lose weight rapidly and become grossly underweight, which will be evident to those around them. Anorexia nervosa is a psychological disorder characterized by a distorted body image. In other words, when someone with anorexia looks in the mirror, she will see a "fat" person. About 90% of those suffering from anorexia are female. Furthermore, close to 1% of American women suffer from anorexia in their lifetime. An estimated 10% of those suffering from anorexia are male, although many cases may be under-reported. Anorexia is typically thought of as a female disease, so males are more likely to suffer from anxiety and shame with their condition and are less likely to seek treatment. Anorexia is life-threatening. A review of nearly fifty years of research confirms that anorexia has the highest mortality rate of any psychiatric disorder, with one out of five deaths by suicide. About 5-10% of those suffering from the disease die within ten years, and 18-20% will die after 20 years. Symptoms to look for include extreme weight loss, fixation on weight, lack of food intake or refusal to eat in front of others, inability to concentrate, depression, hair loss, thin and brittle hair, always cold, and fainting.

Intermittent fasting

Another method used to reduce weight and improve body composition is intermittent fasting. This is a fairly broad term that refers to various methods of short-term fasting. Some standard methods are alternate day fasting, limited time fasting (5-20 hours at a time), and whole day fasts (1-2 times per week). There is inadequate science-based research in this area. Of the research available, there is a positive correlation with improved body composition. In other words, there may be a relationship between an intermittent fast lowering body fat. However, it is vital to understand how to correctly use the techniques. If not done correctly, restrictive calories can inhibit exercise performance, decrease concentration at school and work, and break down lean tissue. It would be wise for anyone considering intermittent fasting to consult a physician first. Some individuals also use this method of eating to increase body mass (muscle). However, this type of eating pattern is more challenging to use for weight gain. Most individuals who follow a restricted time frame for eating end up eating fewer calories. One needs to consume more calories (more than energy expenditure) to gain muscle. It also must be accompanied by resistance training to gain muscle.

Diet pills and medications

As with diet plans, if it sounds too good to be true, it probably is. There are many over-the-counter weight loss pills on the market. How effective they are is debatable. There is also a safety concern, as many of these over-the-counter supplements and pills are poorly regulated. Side effects and serious harm are very possible. If there was a magic pill out there for losing weight that was safe and effective, most of us would be taking it. There are also some prescription weight loss medications that doctors can prescribe to treat clinically obese people, such as Orlistat, Belviq, Contrave, Saxenda, Phentermine, and Qsymia. Most of these medications decrease appetite through various mechanisms, while Orlistat blocks the absorption of fat. While these medications may assist with weight loss, they are intended to be used in combination with a healthy diet and exercise. Weight loss medications often cause side effects, some of which may be serious. Unfortunately, many studies show that weight usually returns once weight loss medications are discontinued.

Identify risk factors for the development of eating disorders pt. 1

BIOLOGICAL 1. Having a close relative with an eating disorder. Studies of families have found that having a first-degree relative (like a parent or sibling) with an eating disorder increases a person's risk of developing an eating disorder. 2. Having a close relative with a mental health condition. Issues like anxiety, depression, and addiction can also run in families, and have also been found to increase the chances that a person will develop an eating disorder. 3. History of dieting. A history of dieting and other weight-control methods is associated with developing binge eating. 4. Negative energy balance. Burning off more calories than you take in leads to a state of negative energy balance. Many people report that their disorder began with deliberate efforts to diet or restrict the amount and/or type of food they were eating in the form of dieting, other causes can include growth spurts, illness, and intense athletic training. 5. Type 1 (insulin-dependent) diabetes. Recent research has found that approximately 1/4 of women diagnosed with type 1 diabetes will develop an eating disorder. The most common pattern is skipping insulin injections, known as diabulimia, which can be deadly. PSYCHOLOGICAL 1. Perfectionism. One of the strongest risk factors for an eating disorder is perfectionism, especially a type of perfectionism called self-oriented perfectionism, which involves setting unrealistically high expectations for yourself.

Bariatric surgery

Bariatric surgery (gastric bypass, Roux-en-Y, sleeve gastrectomy, gastroplasty, etc.) is currently the only medical therapy for obesity that results in long-term, sustained weight loss. However, this is significant surgery, and the pros and cons must be evaluated before a drastic measure such as this. Any surgery can have severe risks such as infection, excessive bleeding, blood clots, and potentially death. Bariatric surgery can also cause malnutrition, dehydration, and other long-term problems. However, for severely obese individuals in which other weight loss methods have failed, gastric bypass may be their last hope. Bariatric surgery should only be done on obese people with a BMI of 40 or higher or those with a BMI of 35 who have additional obesity-related health problems. Studies show that most people who undergo surgery will lose quite a bit of their excess body weight. Bariatric surgery helps alter the stomach's usable part, resulting in less space for food and a decrease in energy intake. Intestinal hormones may also be changed to reduce hunger and appetite and increase feelings of fullness. For example, ghrelin production decreases after bariatric surgery. However, a person must be evaluated psychologically before undergoing a life-changing procedure, and underlying issues such as depression should be addressed. The person's dietary habits will never be the same again, and realistic expectations must be discussed before the procedure.

Causes of obesity: early onset obesity

Being overweight during the pre-adolescent years can also increase the likelihood of adult obesity. Many studies show that the number of fat cells in both thin and obese people is more or less set during childhood and adolescence. While you can shrink these fat cells with weight loss, they are not eliminated. Once they are there, it is easy to plump them back up again with an energy excess. Interestingly, about 75% of obese children grow up to be obese adults, while only 10% of those with a healthy weight do the same. This fact helps explain the importance of preventing weight problems early in life.

Underweight

Being underweight affects about 5% of the adults in the United States. You cannot always assume that an underweight person does not eat much or has an eating disorder. A person can be underweight if they have a wasting or malabsorption disease or have a hormonal problem such as hyperthyroidism. People can also be underweight because they exercise too much or have a very high metabolism compared to what they eat. While underweight rates are relatively low in the United States, it remains a significant health problem worldwide, especially among children. The primary cause of this is chronic malnutrition, and it disproportionally affects those in developing countries. The World Health Organization estimates that about 10% of adults are underweight. At the same time, nearly a quarter of the World's children are seriously underweight. However, more people worldwide are now obese than underweight, but this is primarily among adults. As with losing weight, gaining weight can be a considerable challenge for some individuals. Insensitive comments from others don't help either. While everyone knows that it would not be appropriate to say "you are fat" to an obese person, an underweight person may be just as offended by people saying "you are skinny." Being underweight is not usually a choice, and several health problems can contribute to a lack of a healthy weight.

Benefits of resistance training

Benefits of Resistance Training: Increases lean body mass (muscle) Improves muscle strength, size, power, and endurance Decreases visceral fat Increases strength and coordination Decreases lower back pain Increases bone mineral density (helps prevent osteoporosis) Improves glucose metabolism and insulin sensitivity Decreases risk of Type 2 diabetes Decreases blood triglycerides Increases HDL cholesterol and decreases LDL cholesterol Decreases risk of cardiovascular diseases Reduces blood pressure Improves cognition and self-esteem Eases discomfort with arthritis and fibromyalgia Enhances quality of life in older adults

Snacking

Contrary to popular belief, snacking is not bad. It is usually what people snack on that causes weight gain. It is easy to grab tasty and convenient snack foods high in fat and sugar. As mentioned above, snacking can help control appetite, prevent overeating at mealtime, and fuel fitness regimen throughout the day. Choose snacks that contain protein and heart-healthy fat in combination with healthy carbohydrates. Protein and fat digest more slowly than carbohydrates and can contribute to satiety. On the other hand, snacks that are primarily carbohydrates tend to make you hungry much sooner. Portion control is essential. Snacks should contain between 100 and 200 calories. Unfortunately, popular low-calorie snacks marketed for weight management are often just junk foods in disguise, pre-portioned in small amounts. Focus on nutrition, not necessarily calories. Good snack ideas include nuts, cheese, Greek yogurt, milk, and whole fruit. Here are some good snack combinations: Fresh fruit with nuts Apple slices with peanut butter Fruit smoothie with a scoop of protein power Trail mix with nuts and dried fruit Whole grain bread with peanut butter Cucumber slices with hummus Carrot sticks and broccoli with yogurt-based dip

Fad diets

Dieting is a multi-billion dollar industry in the United States. There are thousands of diet plans out there. Unfortunately, the overwhelming majority are not based on credible scientific evidence and may not be developed by health professionals. Anyone can develop a diet plan, write a book, and market it. Sure, many diet plans work, and the odds are you know people who have success stories. You may also encounter two people who followed the same diet with very different results. A Fad diet promises rapid weight loss, often with an unhealthy balance of macronutrients. Exercise is usually not emphasized. Most fad diets tend to be very restrictive and lack proper nutrition. At the same time, some may even cause serious health problems if followed long-term. Most people do lose weight while following fad diets, but often it is water weight and loss of muscle that contribute to the rapid weight loss. Another problem is that most people do not maintain weight loss after discontinuing a fad diet. Fad diets tend to be very popular for a certain period of time and then will gradually fade away. Before engaging in any specific diet plan, ask yourself the following questions: Is the diet healthy to follow long-term? Does it restrict many foods that you enjoy? Are healthy foods demonized and restricted? How will you feel while following the diet? Does it promise weight loss too rapidly - more than one or two pounds per week? Are their common health problems associated with the diet? Do your research! A reliable weight loss plan is safe and effective, provides adequate nutrition, includes foods you like, accommodates cultural foods and special occasions, encourages physical activity, allows for slow and steady weight loss, and can be followed for a lifetime.

Thermic Effect of Food (TEF)

Every time you eat, you will burn calories. The TEF is the increase in energy expenditure (above your resting metabolic rate) that occurs after eating due to your body digesting and processing nutrients. The TEF is often referred to as diet-induced thermogenesis (DIT), accounting for about 5-15% of the energy expended daily in a mixed diet of carbohydrates, protein, and fat. Protein appears to have the highest thermic effect, which is why many diet plans tend to be higher in protein. Will this make a significant difference in weight over time? Probably not, but eating regularly scheduled meals and snacks may help you burn a few more calories throughout the day, which could potentially affect your weight over long periods. The increased metabolism is part of the rationale for the expression "you need to eat to lose". BMR x TEF = x 1354 x 0.10 (10%) = 135 kcals burned with diet-induced thermogenesis. Often this number is excluded from the consideration of total calories since it is a minimal amount.

Fat cell development

Fat cells increase most rapidly during early adolescence. As children, the extra calories are stored in new adipose cells. In other words, the number of fat cells increases when excess calories are consumed. As growing ceases, the existing adipose cells will be expanded upon when excess calories are consumed. Therefore, a child who overconsumes calories has more fat cells. As adults, excess energy expenditure stored as fat increases the size of the fat cells. When a person is in a calorie deficit, fat is removed from adipose cells to use as an energy source. But, the cell remains intact, ready to accept more fat as calories increase. This process may be part of why obesity continues to be a problem for overweight children as they enter adulthood, even when they try to lose weight.

Differentiate between hunger, appetite, and satiety.

Food intake is controlled by hunger, appetite, satiation and satiety, cravings, emotions, advertising, body image, dieting, health, hormones, income, availability, and habit. These things affect how much we eat and when we eat as well. Hunger is the physiological urge to eat. In other words, hunger results in physical discomfort and weakness in the absence of food. Hunger is controlled by chemical messengers originating in the hypothalamus of the brain. Dozens of chemicals in the brain participate in appetite control and energy balance. Sometimes people who are sick, have a chronic disease (cancer, etc.), or are suffering from emotional problems such as depression, lack hunger. Chronic hunger usually refers to malnutrition and the absence of enough healthy and safe food by a person who wants to eat, such as poverty, famine, and war. One out of nine people worldwide suffers from chronic hunger. Appetite is the desire to eat. Appetite can be stimulated by the sight and smell of food and emotional state. You can have hunger without appetite (those who "eat to live"), just as you can have appetite without real hunger (those who "live to eat"). The odds are that you know people in both categories. In general, people who have large appetites are more likely to be overweight or obese. Therefore, it is essential to assess whether a person who says they are hungry is really experiencing boredom or stress that affects appetite rather than hunger. A healthy person will usually have a balance between hunger and appetite. Most people eat to the point of achieving satiety, the feeling of being satisfied.

Identify the role of hormones in weight management.

Hormones such as ghrelin and leptin play a role in weight management. Ghrelin is a hormone released by the stomach that increases appetite and energy storage in the body, and amounts increase in response to a lack of food intake. This could explain why people on low-calorie diets complain of being hungry all the time. Leptin is a hormone made by fat cells that decreases your appetite. Typically, leptin levels are lower when you are thin and higher when you are overweight. However, experts believe that many obese people have built up leptin resistance. In leptin-resistant people, the reward system doesn't tell a person to stop eating when leptin levels increase. Therefore, for most obese people, providing leptin treatment will not work, nor is leptin approved as a medical treatment for weight loss.

Fat distribution pt. 1

If excess fat is identified on an individual, where he/she carries it also makes a difference in health risk. There are 2 types of fat specified: visceral fat obesity, subcutaneous fat obesity. Most of the health problems related to obesity are associated with excess fat stored in the abdominal area (apple shape). This visceral fat is located around the internal organs and raises blood pressure, blood sugar levels, and cardiac disease risk. In comparison, excess fat stored in the hips, buttocks, and thighs (pear shape) is not associated as much with increased health problems. Excess body fat in the lower regions is referred to as gynoid obesity and is more common in women. Excess amounts of abdominal fat are referred to as central obesity or android obesity. It's more common in men than women, although a woman's risk increases with age. Measuring waist circumference is the simplest way to determine if central obesity is a problem. For example, a man with a waist circumference above 40 inches or a woman with a waist circumference above 35 inches has central obesity.

Body composition

If the goal is weight loss, you should aim to lose fat, not muscle, bone mass, or water weight. The more slowly you lose weight, the more likely you will lose fat. Body weight is comprised of weight from water, lean tissue, and fat. Body fat percentage refers to the total body weight composed of fat compared to water, bone, muscle, and other lean body tissue. As we learned in the previous section, fat is found in various body parts, and some are worse. Percent body fat gives us an idea of total fat in the body, but not necessarily where the fat is located. Healthy goals aim to improve the ratio of lean tissue to fat. Increasing muscle mass would improve the ratio of fat tissue to lean tissue, decreasing the percentage of bodyweight coming from fat. Therefore, one of the most effective ways to improve body composition would be through exercise and nutrition. A combination of both aerobic and resistance exercise is key to improving body composition. Aerobic exercise will help burn more calories by increasing energy expenditure to lose body weight and fat. Resistance or weight training exercises will improve muscle mass tissue. The ultimate goal should be to lose body fat while preserving and increasing muscle mass.

Identify how mindful eating promotes overall health pt. 1

Intuitive (or mindful) eating is a practice that has individuals listen to their bodies. There are 4 principles to eating intuitively: 1. Reject the diet mentality and challenge the food police: Reject the negative messages about food. Become aware of your instant self-talk when it comes to food. Some common misperceptions are listed below. THESE ARE NOT ACCURATE, but they are common: Fat is bad, Carbohydrates are bad, It is bad to eat after 7:00 pm, Eggs are bad, Ice cream is bad, All of the things that I like to eat are bad, I am overweight, I must fit in a size smaller before the wedding. You may believe some of these things with all your heart and soul. But remember, simply because you think something is true doesn't make it so. Food is inherently nutritious. Even what some may deem the worst of the worst foods, has nutritional value because all food has nutrients. Yet, we have found a way to demonize food and make ourselves feel bad. Food should not generate emotions. These thoughts are called cognitive distortions, and we call the voices that speak these distortions the Food Police. 2. Listen to your body: Pay attention to hunger signals and fullness. Learning your body's signals for hunger may be difficult, especially if you have been turning those signals off by consuming caffeine, smoking cigarettes, fasting or chewing gum. There are many non-diet approaches to weight loss. They all seem to tell you to only eat when you're hungry. The problem is that they don't mention how to do that. You have often been suppressing or ignoring those internal signals for so long that you have no idea when you should eat. After World War II, a group of scientists wanted to figure out the best way to feed concentration camp survivors.

Calculate calorie balance necessary for weight management pt. 2

It is important not to consume too few calories when trying to lose weight. While weight may come off in the beginning on a very low calorie diet, consuming too little can reduce basal metabolism and make it more difficult to keep the weight off after it is lost. Consume very little food also makes it very difficult, if not impossible, to meet nutritional needs. An ideal calorie intake for most women who want to lose weight is 1,200 to 1,500 calories daily, and an ideal intake for most men who want to lose is 1,500-1,800 calories daily. Weight is not lost overnight, just as gaining is not overnight either. Sometimes people gain weight gradually over time without realizing it, especially those who don't weigh themselves frequently. Consuming only 100 extra calories daily more than expended would result in approximately 1 lb of weight gain per month, or every 35 days. That is about 10 pounds per year! It doesn't take much to consume 100 extra calories. This could be that extra cup of juice, half a can of soda, the small bag of chips, or those two cookies after dinner. For people who don't want to gain weight, the hope is to have a slight energy deficit on some days to balance out the days when too much is consumed. Weight will usually vary by a few pounds throughout the day due to fluid fluctuations. If your weight fluctuates by more than 3 to 5 pounds throughout the day, it can indicate edema. Edema is often associated with severe health problems such as kidney disease, liver disease, vascular disease, and congestive heart failure. However, it may also be related to pregnancy, medications, PMS, and a high sodium diet.

Calculate calorie balance necessary for weight management pt. 1

It's generally thought that 1 lb of body fat is approximately 3,500 calories. Studies show that there can be some variability in how 3,500 calories affect different people. However, the concept is concrete, so let's go with the 3,500 calories = 1 lb rule. This would mean that to lose 1 pound, a person would need a deficit of approximately 3,500 calories. Conversely, consuming 3,500 calories more than expended would cause one pound of weight gain. It is doubtful that individuals would consume 3,500 extra calories in 1 day! Nor could a person have a deficit of that many calories daily. Therefore, diet advertisements promising "lose one pound daily" or "lose 5-10 pounds this week" should always be viewed with skepticism. However, it would be pretty easy to gain (or lose) 1 lb per week or a few pounds per month. To lose 1 lb per week, one would need a deficit of 500 calories per day (3,500 / 7), while to lose 2 lbs per week 1,000 calorie deficit daily is necessary. This deficit could either come from eating less or exercising more. A combo of both seems to be the most beneficial. For many people, a realistic goal for weight loss is 1 lb per week. This is especially true for smaller women who don't have as many calories to cut from their diet. A larger person can more easily create a calorie deficit and lose body fat more quickly. Not only does a larger person burn more calories at rest, but they also expend more calories through physical activity. Unfortunately, the more rapidly weight comes off, the more muscle and water weight is lost. Therefore, slow weight loss should always be the goal. People who lose weight slowly are more likely to keep the weight off long term. Health care professionals set goals for patients to lose 10% body weight in 6 months which usually equates to about 1-2 pounds per week.

Problems with low body fat

Many of the health problems that can occur with being underweight occur with too little fat on the body. Body fat is essential for cardiovascular, endocrine, reproductive, skeletal, and central nervous systems working correctly. Fat helps support the skin and keep it lubricated, cushions feet, sheaths neurons, stores vitamins, and is the building block of hormones. Athletes and those with severe eating disorders are most prone to having a very low-fat percentage. But how low is too low? It depends. ALL individuals need a minimum of "essential" fat to function normally. You would eventually die without the essential fat needed to sustain life. Death from low body fat is most common with anorexia nervosa.

Other specified feeding or eating disorder (OSFED)

Many people have severe eating disorders yet don't meet the specific criteria for anorexia, bulimia, or binge-eating disorder. OSFED, formerly known as Eating Disorder not Otherwise Specified (EDNOS), includes these disorders. There is significant distress or impairment involved, but often people suffering from OSFED fall through the cracks because of a lack of definite diagnosis. Examples of OSFED include: Anorexia nervosa eating behaviors, yet weight is not below normal Bulimia nervosa, with less frequent behaviors Binge-eating disorder, with less frequent binge eating Purging disorder without binge eating Night eating syndrome (excessive nighttime food consumption) There is often severe emotional and psychological suffering and relationship problems. Work and school may also suffer. Without treatment, a significant number of those suffering from OSFED will go on to meet the full criteria for anorexia, bulimia, or BED at some point.

Causes of obesity: Inadequate sleep

Many studies have identified a high BMI in people who do not get enough sleep. The higher body weight may be due to decreased BMR and hormones that increase hunger and energy storage. Lack of sleep may also indirectly cause weight gain due to decreased physical activity and the likelihood of making poor food choices when tired.

Causes of obesity: overeating

Many theories have been established over the years to explain the growing epidemic of obesity in this country. Genetics will always play a role in obesity. We will likely learn more about this genetic role as technology advances. The question is whether or not increased genetic problems have caused the growing number of obese individuals. Most health care professionals look to our environment rather than DNA to explain the ever-increasing numbers. Over time, taking in more calories than your body needs will undoubtedly lead to obesity. Obviously, many people overeat. Our environment is ravished with an abundance of high-calorie, high-fat, inexpensive foods in the United States. Individuals in this country lead a fast pace, 'immediate gratification' lifestyle. We can obtain and eat food without ever having to leave our vehicles. In fact, lack of activity is probably the most important factor linked to obesity! As we look at other countries comparing obesity factors, the nations that rely less on their vehicles and more on walking have a much lower incidence of obesity. Overeating: Obviously, a consistently high-calorie diet will lead to weight gain over time, especially if not combined with adequate physical activity. Eating the wrong foods: Consuming large amounts of added sugars and solid fats can significantly increase calorie intake, including beverages.

Identify how the distribution of fat on the body influences disease risk.

Measuring body fat percentage is a more accurate way of determining health risks. Body fat percentage calculates the total weight from fat tissue (not including muscle, water, bones, and organs). Women naturally have more body fat than men. It is essential for women not to have body fat that is too low because it is necessary for reproduction. Often, a woman will experience amenorrhea, or absence of menstrual periods, if her body fat is below 15%. Having too little or too much body fat increases the risk of health problems. Ideal body fat percentages 1. Women (non-athletic): Recommended range for body fat %: 20-31% Increased risk of health problems: 32%+ for women under 40, 35%+ for women over 40 2. Women (athletic): Recommended range for body fat %: 15-20% 3. Men (non-athletic): Recommended range for body fat %: 11-21% Increased risk of health problems: 22%+ for men under 40, 25%+ for men over 40 4. Men (athletic): Recommended range for body fat %: 5-10%

Differentiate between healthy and unhealthy components of weight management plans. pt. 1

Often, "losing fat" is confused with losing weight. There are endless ads, websites, and supplements promoting fat loss. In reality, weight loss with these gimmicks doesn't significantly reduce body fat %. Measuring your waist circumference is an effective way to tell if you are losing actual fat. The first place that fat usually comes off is the waist, which is good news for disease risk reduction. While it may seem that losing weight would be the leading way to decrease body fat, that is often not the case. Weight gain and loss are primarily fat tissue, but a certain % of the weight lost is muscle. Faster weight loss results in more muscle loss because it requires more restrictive calorie intake. The lower the calorie intake, the more the body holds onto fat. When the person regains the lost weight, they usually regain the weight in the form of fat. Ultimately, people who frequently lose weight and regain it (yo-yo dieters) tend to increase their body fat percentage over time. This change in body composition will only make it harder to lose or maintain a healthy weight in the future. There is much controversy about food and fat loss. Many ads claim that certain foods reduce body fat, but there is no real scientific evidence of this. However, the distribution of macronutrients in your diet may affect your likelihood of decreasing fat. A recent study showed that restricting dietary fat led to body fat loss at a rate of 68% higher than cutting the same number of carbohydrate calories among adults. The results counteract the common belief that restricting carbohydrates may be more effective. While low carbohydrate diets are very effective with overall weight loss, much of this is from water loss. Losing fat without losing some protein (muscle) is challenging, especially when not eating adequate carbohydrates.

Bulimia nervosa pt. 1

One of the most common eating disorders among college-aged women is bulimia. The condition is characterized by binging on large amounts of food and then "purging" calories by vomiting, fasting, and/or abusing laxatives. Compulsive exercise may also be a form of purging calories. Some even restrict food intake after a purge. Like people with anorexia, they often fear gaining weight, want desperately to lose weight, and are intensely unhappy with their body size and shape. Since some calories are being absorbed, most often, the person with bulimia is at or near an ideal body weight, making it difficult for others to detect. Rapid weight fluctuations are common. Sometimes the person may have a combination of anorexia and bulimia. They may go days without eating and then eat mass amounts of food at one sitting while purging it afterward. According to the National Institute of Health, approximately 1.5% of American women suffer from bulimia nervosa in their lifetime, with the average age of onset being around 20 years. However, as many as 25% of college-age women report engaging in bingeing and purging as a method of weight management. There appear to be certain personality traits associated with bulimia. People with bulimia tend to be impulsive, emotional, self-destructive, and suffer from low self-esteem and anxiety. They are also more likely to abuse substances, especially alcohol. There are signs to look for if you think someone is bulimic, although they may not be obvious. Binge eating is usually done in private, as are the purging behaviors, so it is often well hidden from others for some time. When living with someone, you may notice large amounts of food disappearing. The person may frequently use the bathroom after meals.

Orthorexia nervosa pt. 1

Orthorexia Nervosa is not an officially recognized eating disorder. However, it is similar to other eating disorders as a significant mental health disorder with multiple complications. No doubt, there is disordered eating. Unlike eating disorders in which the person is focused on weight, those suffering from orthorexia have an unhealthy obsession with eating healthy. Usually, the individual has an extreme fear of eating anything they have heard negative things about or believe might harm them. Those with orthorexia usually become socially isolated and distance themselves from family and friends who do not share similar views on food. Eating at restaurants or in others' homes becomes a challenge. Often there is a "self-righteous" belief about their eating habits, and guilt sets in if they deviate from their own strict dietary rules. Usually, orthorexia starts with "clean eating," which in itself can be pretty healthy. However, those with orthorexia take it to the extremes. As the disease progresses, eventually, there will be very little that the person will allow themselves to eat. Entire food groups will usually be excluded, including foods with pesticides, GMOs, fat, sugar, and salt. Eventually, extreme malnutrition and severe weight loss will occur if not treated like anorexia nervosa. Death may even occur. As with other eating disorders, psychological therapy is needed to treat orthorexia.1

Problems with high body fat

Regardless of BMI, excessive body fat can increase a person's mortality risk. The BMI does not consider a person's leanness due to unhealthy behaviors, such as extreme dieting and drug use. Body composition doesn't always align with the BMI. Lifestyle behaviors matter more than numbers on a scale regarding health. A healthy, active individual with a higher BMI will have better cardiovascular fitness than someone with a normal BMI with an unhealthy lifestyle managed through extreme measures. Excess body fat can be a problem if it is stored in the wrong place. Gynoid (pear) shaped bodies do not carry the same health risk as central obesity (android or apple-shaped). The % body fat only provides an overall amount of fat, not a breakdown of where the fat is located on the body. Independent of the BMI, a high waist circumference causes an increased risk of dyslipidemia (high cholesterol, high triglycerides), hypertension, heart disease, and type 2 diabetes mellitus. These diseases are primarily due to the excess abdominal fat causing insulin resistance, excessive insulin production, glucose intolerance, inflammation, and endothelial dysfunction. Higher body fat slows down your metabolism, so you don't burn as many calories. Lean tissue (muscle) is much more metabolically active. A higher body fat % means your metabolism or BMR (basal metabolic rate) is lower than if you had more muscle mass. Therefore, body weight will easily increase since your body burns fewer calories than you eat. One of the greatest benefits of improved body composition with higher lean tissue is that you are more likely to maintain or lose weight over time due to the higher BMR. Changing body composition is not an easy task. To lose body fat, one must be in a negative calorie balance. However, to preserve lean tissue, calories cannot be too low.

Identify weight classification based on body mass index (BMI).

The BMI measures the relationship between your height and weight. BMI is calculated by dividing your weight in kg by your height in meters squared. BMI classification and disease risk: 1. under 18.5: underweight/high risk 2. 18.5-25: normal/very low risk 3. 25-30: overweight/increased risk or high risk 4. 30-35: class I obesity/high risk or very high risk 5. 35-40: class II obesity/very high risk 6. above 40: class III obesity/extreme risk There are some disadvantages of using BMI to determine health risks. It does not account for body composition, gender, or frame size. A person might fall within an ideal BMI but not necessarily have a perfect distribution of fat and muscle on their body. Let's take an athlete as an example. Danielle Hunter is considered the most "jacked" football players in the NFL. He is a defensive end for the Minnesota Vikings who is not only impressively strong but also fast and agile. At 6'6" and 240 pounds, his BMI is 28.5, making him overweight. What do you think? Is Danielle Hunter overweight? BMI does not take into account body composition. It does not work for athletes or pregnant women. However, it does give health care professionals red flags that can be further assessed with body composition measurements.

Identify factors that influence the basal metabolic rate pt. 1

The Basal Metabolic Rate (BMR) is the rate at which the body expends energy for metabolic maintenance activities. Quite simply, it is the calories your body burns at rest. The BMR is about two-thirds of the calories you expend daily. You burn calories every minute of the day, even if you don't do anything. The amount of calories you burn at rest varies from person to person. Many factors influence your BMR, some of which you cannot control. 1. Gender: Men typically have higher BMRs than women due to the more significant lean muscle percent. 2. Age: The older you get, the more your BMR is likely to decrease, primarily due to a decline in muscle mass. 3. Body Composition: Muscle is more metabolically active than fat. Therefore, the more muscular the person is, the more calories they will burn. 4. Body Size: The larger the person, the more calories they will burn. 5. Extreme Temperature: Both extreme cold and extremely hot climates will speed up the BMR temporarily. 6. Growth: During periods of development, the BMR increases. 7. Hormones: Menstrual hormones secreted just before menstruation in women will increase the BMR. Thyroid hormones can also greatly influence BMR. 8. Starvation and Food Deprivation: Although a person may initially lose weight under these circumstances, the body will eventually try to adapt by lowering the BMR.

The food police

The Food Police is your inner judge and jury that determines if you are doing "good" or "bad" It gets strengthened through new food rules that you may read about on social media or messages you hear from friends and family. The Food Police does not help you. It merely makes you feel bad. Who else works with the Food Police? The Nutrition Informant, or the Tattletale. It says it's looking out for your health, but it is just tallying all of your "sins." It is the voice that says, "If you want a snack, it should only be fruits or vegetables." The Nutrition Informant is tricky because most of us D.O. want to eat a healthy diet, so it seems silly that we would want to fight against that good advice. But is it good advice? When it comes to having an apple as a snack, that's OK, right? Sure, but know that a 75-calorie snack will put a little something in your belly, but you will probably be hungry again soon, wanting to eat. The Nutrition Informant will insist that "you can't possibly be hungry after eating that apple for a snack." What the Nutrition Informant doesn't tell you is that a peanut butter sandwich or cheese and crackers or some bean dip with crackers are all healthy foods too, and they will actually satisfy you. To get the voices of our Food Police to quiet down and reject that diet mentality, you must challenge that voice inside your head. You must say, "I know what hungry feels like, and even though I just ate breakfast, I am hungry now," or, "Avocados are good for me, taste delicious and make me feel satisfied," or, "Chocolate is not going to make me fat; 1 food does not have the power to make or break my health." As you turn those negative thoughts into positive ones, your whole outlook on food will change.

Thermic Effect of Exercise (TEE)

The calories expended through physical activity. These are the calories you have the most control over and usually account for about 20% of energy burned daily. However, with a very active person or an athlete, 30% or more of energy expended daily can be through the TEE. Conversely, a sedentary person will expend less than 20% of their calories through activity. Not everyone burns the same amount of calories through activity. Since lean tissue such as muscle burns calories at a faster rate than fat, body composition plays a role in overall energy burned. In general, a larger person will expend more calories through exercise than a smaller person. However, some studies show that there could be an absence of exercise-induced thermogenesis in some obese people, which could help explain their difficulty with weight reduction. In other words, exercise does not increase metabolism much, if at all. Calories burned through activity vary from person to person. Regardless, increasing your physical activity should always be a goal if you are trying to lose weight. Non-exercise activity thermogenesis (NEAT) is the energy expended for everything we do that is not sleeping, eating, or structured exercise. This would include energy expended to walk and move around during the day and even fidgeting, or other subconscious activity is included as part of NEAT. NEAT explains most of an individual's non-resting energy needs. It could be a critical component in maintaining our body weight over time. The mechanism that regulates NEAT is unknown but is mainly determined by your genes. BMR x TEE = y 1354 x 0.2 (20%) = 270 kcals burned with physical activity BMR + TEF + TEE = total energy expenditure for the day 1354 + 135 + 270 = 1759 kcals For this woman to maintain her weight, she should consume 1,759 kcals per day

Differentiate between healthy and unhealthy components of weight management plans. pt. 2

The effect of protein intake on body composition has been researched quite a bit over the years. One of the main theories emerging from this research is that when calories are restricted to lose weight, higher amounts of protein in the diet are necessary to build muscle or prevent the loss of lean tissue. When higher protein diets are combined with intense resistance exercise, body fat decreases, and muscle increases. Research shows that protein should be distributed throughout the day rather than focused at once. Adjusting the intensity of exercise to alter the type of fuel source burned during physical activity does not matter regarding losing body fat. As mentioned in previous sections, a person doesn't need to be in the "fat-burning zone" during an activity to lose body fat. This is a myth. The calorie deficit reduces stored body fat, not whether carbohydrate (glucose), fat, or protein fueling your body during physical activity. A combination of diet and exercise is by far the best way to reduce body fat. Cardiovascular activity significantly helps reduce total fat on the body, weight-bearing activity improves bone density, and resistance training builds muscle. The higher amount of muscle, the lower the body fat %. Resistance training is increasingly important with age to preserve lean body mass and in overweight or obese individuals to improve the basal metabolic rate. To keep your body safe and healthy, you should only lose about one percent of your body fat per month. Reducing body fat alone is often not enough to reach a healthy body weight. For many, they may also need to increase their lean tissue. Others may desire more muscle for competition or body image. Two key aspects are critical to increasing muscle, one is through diet and the other is exercise.

Fat cell metabolism

The enzyme lipoprotein lipase (LPL) promotes fat storage in the body. Obese individuals have higher levels of LPL in their system. Even with moderate elevations of calories in their diet, fat is very easily deposited with this high level of LPL. Gender and genetic differences in LPL dictate why certain body areas are more susceptible to fat storage than others. This theory helps explain why some individuals are "apple-shaped," and others are "pear-shaped." Another aspect of LPL is that after weight loss, LPL activity rises, increasing the most in individuals who were obese before weight loss. This certainly explains why the formerly obese have the most difficulty maintaining weight loss.

Causes of obesity: gut bacteria

There are many other theories about what can contribute to obesity. One emerging theory is the relationship between gut bacteria and weight management. New evidence indicates that gut bacteria alter how we store fat, balance glucose levels in the blood, and respond to hormones that make us feel hungry or full. After accounting for all factors, obese people seem to have slightly less diverse gut bacteria than lean people. Since the bacteria in our gastrointestinal tract are primarily determined by the foods we eat, the relationship between diet, obesity, and gut bacteria is a promising study area. However, more research must be conducted before probiotic supplements, or specific diet changes can be recommended for all overweight people.

Differentiate between the different types of eating disorders.

There are several types of eating disorders, with anorexia, bulimia, and binge eating being the most well-known. However, many people suffer from Other Specified Feeding and Eating Disorder (OSFED). These people may not meet the specific criteria for other eating disorders. Still, their condition can be severe and potentially life-threatening. Psychological disorders affecting people's eating are not always about weight, such as orthorexia nervosa. Different types of eating disorders can also overlap. Eating disorders typically begin with disordered eating and a disordered relationship with the body.

Identify how mindful eating promotes overall health pt. 3

There is no need to say, "OK, I can have this cake now, but tomorrow I will diet or run two miles." Many studies show by restricting food, people start to obsess about food, dream about food, and ultimately overeat when finally allowed to eat what they want. Enjoy food. Avoid mindlessly eating at the computer desk or in front of the television. Eat slowly, and think about every delicious bite. 4. Consider gentle nutrition: You may be wondering where the nutrition is in these recommendations. The message we want to give is to make food choices that honor both your health & taste buds while making you feel good. Progress, not perfection, is what counts. Remove yourself from the idea that you are just one bite away from dying of heart disease or diabetes. As reported in the media, medical nutrition easily creates the impression that food will kill you or heal you. If you are that worried about food, then you are not enjoying food. No one food has the power to do either. You can make more healthy food choices. If you listen to how your body feels, you will probably find out that while that greasy, fried food tastes good, it makes you feel weighed down, bloated, or uncomfortable. You will begin to inherently make healthier food choices most of the time when you listen to your body. Even if you consume something formerly on your "bad food" list, it will be OK because if you listen to your hunger/fullness cues, you will not overindulge. There is no medical diet that cannot work in a chocolate kiss once in a while. Once you can put the enjoyment of food and how your body feels as the priority, you start to focus your choices on healthier options. Use your hunger/fullness scale to guide when and how much to eat.

Identify how mindful eating promotes overall health pt. 2

They took a group of American men and decreased their food intake to what they guessed was daily intake for holocaust survivors, reducing calories from 3,500 to 1,500. Guess what happened to these men on a restricted diet? Among other results, the men became obsessed with food (reading recipes continuously...yes army men), their metabolic rates decreased by 40%, their personalities changed and they became irritable, depressed, and moody. Sounds like being on a diet, right? These men went on weekend eating binges of 8,000 to 10,000 calories. After the restricted eating period, it took most men an average of 5 months to normalize their eating. It's typical of what our bodies and minds do when we restrict food by being on a diet. Eating is primal. We need food to survive, and when it is withheld, it is frightening. When you restrict foods, you crave them more, obsess more, and binge more. Not only that, but it changes our body's physiology. The more you restrict food, the more your body conserves energy (lowers metabolism) and hangs onto fat. Again, the more you restrict food, the more your body hangs onto fat. The fewer your calories, the less weight you lose. We have seen this in study after study. Between the psychological and physiological changes, you may begin to understand why diets fail so often. 3. Aim for peace and satisfaction: Food should not make you feel guilty or shameful, nor should your happiness depend on what you eat. Food, dieting, and weight loss are neither moral nor immoral. Try to embrace the concept that no foods are off limits, and allow yourself to believe that eating what you want is just fine. It's the way to have a healthy relationship with food. Give yourself unconditional permission to eat. No one food has the power to make you fat or help you become slim. Eat without obligatory penance.

Identify the components of metabolic rate.

To determine how many calories a person needs to consume, one must consider how energy is used in the body. There are three main ways we can expend calories: basal metabolic rate (BMR), thermic effect of food (TEF), and thermic effect of exercise (TEE). The number of calories expended from each of these varies from person to person

Identify how weight influences health risks pt. 1

While some underweight people can be healthy, being underweight can put you at high risk for specific health problems. Weighing too little can cause: Nutrient Deficiencies, Weakened immune system, Poor bone density, Lack of menstruation (women), Infertility (women), Pregnancy Problems (women), Poor temperature regulation, Sexual dysfunction (men), Anemia. Women seem to have more health problems associated with being underweight compared to men. The top health risk for underweight women is reproductive problems. Being underweight causes hormonal imbalances that may disrupt the menstrual cycle and lead to infertility. If an underweight woman does conceive, she is much more likely to have a miscarriage in the first trimester. Also, these women are at a much greater risk of delivering premature and underweight babies. Although much of the focus on infertility is on women, men are not immune to reproductive problems if they are underweight. For example, underweight men are more likely to have sexual problems, including erectile dysfunction, difficulty ejaculating, and painful intercourse. The health of sperm may also be diminished in underweight men. Being too thin can work against a person's immune system. If a person doesn't eat very much, they are more likely to lack critical nutrients to boost their immune system. This would decrease their ability to fight colds, infections, and everyday illnesses. Cancer cells are also more likely to grow. Underweight people should have their doctor check for any nutritional deficiencies. Underweight adults are as much at risk of death as those who are overweight. People with low BMI are 1.8 times more likely to die than those with a normal BMI. When a person needs to gain weight, they must be in calorie surplus. Whether a person is underweight or normal weight trying to gain muscle m

Healthy body fat

Women need more fat on their bodies to allow for regular menstruation and reproduction. According to the American Council on Exercise, the average woman should strive for a body fat percentage of 25 to 31 percent -- although lower numbers may be more ideal for a fit or athletic woman. The average man should have a body fat percentage of 18-24%. However, like women, athletic or very fit individuals may have lower numbers. A man with a body fat percentage of 25% or above or a woman with a body fat percentage of 32 or above is classified as obese and is at high risk of obesity-related problems. The average body fat in the U.S. is 32% for women and 22% for men - too high by most standards. 1. Essential fat Women: 10-13% Men: 2-4% 2. Athletes Women: 14-20% Men: 6-13% 3. Fitness Women: 21-24% Men: 14-17% 4. Average Women: 25-31% Men: 18-24% 5. Obese Women: 32% and higher Men: 25% and higher