Chapter 11: Weight Management

Surgery

*Patient must be severely obese (BMI greater than 40) 1. Roux-en-Y gastric bypass 2. Vertical Band Gastroplasty (VBG) 3. Lap Band- adjustable band (variaton of VBG) 4. Liposuction

Physical Activity & Exercise

-30 mins/day (5 days) -burns calories -positive effect on metabolism -improves cardiovascular + respiratory health -enhances mood, sleep, self-esteem, & sense of accomplishment

Diet and Eating Habits

-Energy balance- combine exercise w/ moderate calories + my plate suggestions - Portion size -eat regular balanced meals -replace energy dense w nutrient dense foods

Physiological Factors

-Resting metabolic rate -Hormones -Fat cells

Problems Associated with Low Levels of Body Fat

-less than 8-12% for women & 3-5% for men -linked to problems: reproductive, circulatory, & immune system disorders -female athlete triad: abnormal eating patterns, amenorrhea- losing your period, decreased bone density

Eating Disorders

-problems with body weight and weight control -severe disturbances in body image, eating patterns, and eating-related behaviors -affects an estimated 10 million American females and 1 million males -central feature- dissatisfaction with body image and body weight created by distorted thinking

Thinking and Emotions

-weight problems are correlated with low self-esteem + negative emotions -"ideal self" -self talk can be self-deprecating (bad) or positively motivating (good)

Adopting a Healthy Lifestyle for Successful Weight Management

1. Diet and eating habits 2. Physical activity and exercise 3. Thinking and emotions 4. Coping Strategies

Factors Contributing to Excess Body Fat

1. Genetic Factors 2. Physiological Factors 3. Eating 4. Physical Activity 5. Socioeconomic status 6. Family and cultures 7. Psychosocial Factors

Weight Loss Programs

1. Noncommercial (TOPS, OA) 2. Commercial (Jenny Craig, Weight Watchers) 3. Online (Self assessments, chat rooms) 4. Clinical (medically supervised) 5. Prescription drugs (appetite suppressants to control appetite, i.e. Sibutramine & Orlistat (Xenical))

Evaluating body weight and percent body fat

1. body composition 2. body mass index (BMI) 3. body fat distribution

1 pound of fat is equal to...

3,500 calories

Essential fat

3-5% of total body weight in men and 8-12% in women (amount of fat stored depends on: Gender, Age, Hereditary, Metabolism, Diet, and Activity Level)

what percentage of American adults are overweight?

68%

National Institute of Health

68.8% of American adults are overweight & 35.7% of American adults are obese 35.5% of adult men and 35.8% of adult women are obese

BMI Scale

< 18.5-underweight 18.5-24.9- healthy 29.9 ≥ 25 overweight ≥30- obese

Severe body image problems

Body Dysmorphic Disorder (BDD) - affects 2% of Americans -constant preoccupation with body imperfections -related to OCD -usually before age 18 Muscle Dysmorphia -body builders -never satisfied with muscle growth, always see themselves as scrawny no matter how large they are -"megarexia" or "bigarexia"

Treating Eating Disorders

Combination of psychotherapy and medical management -Address eating disorder, misuse of food, and managing emotions

The energy balance

Crucial to keep a healthy ratio of fat to fat-free mass energy in- calories from food energy out- physical health activity 20-30% Food digestion +/- 10% Resting Metabolism 65-70%

Borderline Disordered Eating

Eating habits and body image run along a continuum from healthy to seriously disordered -Some have symptoms of disorder -Do not meet full diagnostic criteria for disorder -Excessive dieting -Occasional binging and purging -Inability to control eating

Psychosocial Factors

Emotions -coping strategy -help regulate emotions -distract from negative feelings

Genetic Factors

Nutrigenomics-study of how nutrients and genes are interact -25-40% of individual's body fat -600 genes have been linked to obesity

Health risks of excess body fat

Obese individuals have a mortality rate 2x that of non-obese -reduces life expectancy by 10-20 yrs -Associated with: unhealthy cholesterol and triglycerides, impaired heart function, death from CVD -Strong association : Type 2 diabetes

Body Image

collective picture of the body as seen through the mind's eye -Perceptions -Images -Thoughts -Attitudes -Emotions

Coping Strategies

develop appropriate coping strategies to deal with stress

Body fat

essential fat, fat stored in fat called (apidose tissue), and fat located in subcutaneous fat (under the skin) and around major organs (visceral fat)

Anorexia Nervosa

failure to eat enough food to maintain a reasonable body weight -Affects 3 million people (95% are female) -Typically develops between 12-18 years old

Body composition

fat-free mass (lean body mass) and body fat

body composition

fat-free mass and body fat (determine percent body fat) 1. hydrostatic weighing (underwater) & Bod Pod 2. skin fold measurements-thickness of fat under the skin 3. bioelectrical impedance analysis- electricity prefers fat-free tissue 4. Scanning procedures- CT scan, MRI, dual-energy X-ray, dual-photon absorptiometry, infrared reactance, total body electrical conductivity

Bulimia Nervosa

recurring episodes of binge eating followed by purging -Begins in adolescence or young adulthood *Increasingly younger (11-12 years) and older (40-60 years) ages

Binge-Eating Disorder (BED)

similar to bulimia, except no purging behavior -Uncontrollable eating, usually followed by guilt and shame -Affects about 2% of American adults -Often eat as a way of coping

Percent body fat

the proportion of the body's total weight that is fat

Overweight

total body weight above recommended range

fat-free mass

non-fat tissues

Apple Shape

Android Obesity -upper regions of their bodies -increase risk of HBP, diabetes, early-onset heart disease, stroke, cancer (MALE BODY TYPE)

Pear Shape

Gynoid Obesity -fat storage in the hips, buttocks, and thighs (FEMALE BODY TYPE)

Type 1 Diabetes Mellitus

The immune system destroys insulin-producing cells in the pancreas -not related to obesity

Type 2 Diabetes Mellitus

The pancreas does not produce enough insulin, body cells have become resistant, or both -strongly associated with excess body fat

Obesity

a more serious degree of overweight

Body Mass Index (BMI)

measures the health risks of body weight for average people -correlated with but does not directly measure body fat