Obesity- Weight Management

Objectives

Define obesity or overweight List health effects of obesity Explain possible causes of obesity Outline exercise recommendations Estimate calorie intake for weight loss List five possible components of a weight

loss program List and identify the stages of behavior

change

Status

Epidemic 2004- 66% of Americans overweight or obese Chronic disease Prevention

10 pound gain, 2” increase in waist

Obesity Related Health Issues

Hypertension Heart Disease Type 2 Diabetes Gallbladder Disease Pulmonary Disease

and Sleep Disorders Bone and Joint

Disorders Infections Liver damage

Cancer risk Surgical risk Accident risk Skin Disorders Pregnancy risk Menstrual

irregularities Infertility Psychological

Depression, low self-esteem, discrimination

Weight Loss Basics

CALORIES OUT Metabolism Physical Activity

CALORIES IN Food and beverages

Calories Out- Physical Activity

2010 Dietary Guidelines Adults 18-61 yo

2 hours and 30 minutes a week, moderate aerobic 1 hour and 15 minutes a week, vigorous aerobic Strengthening activities 2 days week

Children and Adolescents 6-17 yo 60 minutes or more of physical activity a day

Exercise Strong research No “news” story, no “best seller” Few people can lose and maintain w/out

Aerobic Activity

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

Calories In- Diet

Reduce portion sizes Cut “empty calories”

Fat Sugars Alcohol

Ben Franklin – “To lengthen thy life, lessen thy meals”

Calories In Decrease CHO, PRO and/or FAT calories Moderate distribution

20-25% fat, 20-35% lean protein Minimum 1200-1500 calories/day

Prevent decreased metabolic rate, hunger, fatigue Provide nutrients

Setting Calorie Goals

Determine current calorie intake; subtract 250-500 calories/day; (text 500-1000)

OR Decrease 250 calories a day from diet, 250

calories more physical activity

3500 calories in a pound of body fat

Obese Culture

Portion sizes Convenience foods Food accessibility, poverty Food marketing and advertising Inactive lifestyle

TV, computer, games Lack of sidewalks, public transportation, parks,

city design Safety concerns

Body Mass Index (BMI)

See text One way to determine healthy body weight Not perfect; men, athletes, genetically

muscular, short stature, health issues Healthy- 18.5-24.9 Overweight- 25.0-29.9 Obesity- 30- 39.0 Severely Obese- > 40

Other Thoughts….

BodPod (air displacement), DEXA, bioelectric impedence, caliper measures to determine body fat

Waist Circumference > 40” men, > 35” women Abdominal fat affects liver function

Healthy-Fit Weight Focus on fat weight vs muscle weight

Health benefits first 5-10% of weight lost 1-2 pounds per week weight loss average Easy to maintain Quality of life

National Weight Control Registry

Brown University, University of Colorado 6000 people, lost 30+ pounds (average 66),

stable 5.7 years 98% modified food intake somehow…

Lower calorie, lower fat 94% exercise, 1 hour/day, most walk 90% keep records, self-monitor 78% eat breakfast every day 45% lost on own, 55% with a program

National Weight Control Registry Findings

75% weight at least once a week 62% watch less than 10 hours tv a week 92% reported more energy and better

mobility, 95% better quality of life

Weight Loss Program Components

#1- Lower calorie, lower fat, sensible, long term dietary intake

#2- Exercise #3- Self Monitoring

Food, exercise, weight records Behavior modification

#4- Breakfast #5- Support

Stages of Change Pre-contemplation

Unaware Contemplantion

Realize need to make change Preparation

Gather information, make a plan Action

Implement plan Maintenance

Continue, revise plan Termination

New lifestyle