weight management: overweight, obesity, and underweight

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Weight Management: Overweight, Obesity, and Underweight. Chapter 9. Overweight and Obesity. Major health problem in the U.S. Prevalence continues to increase Defined by BMI of 25 or greater Epidemic is worldwide. Fat Cell Development. Energy in exceeds energy out - PowerPoint PPT Presentation

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  • Chapter 9Weight Management: Overweight, Obesity, and Underweight

  • Overweight and ObesityMajor health problem in the U.S.Prevalence continues to increaseDefined by BMI of 25 or greaterEpidemic is worldwide

  • Fat Cell DevelopmentEnergy in exceeds energy outStored in fat cells of adipose tissueBody fatNumber and size of fat cellsEnergy out exceeds energy inFat cell size decreases; no change in number

  • Fat Cell MetabolismLipoprotein lipase (LPL) activityStorage of triglyceridesObese people vs. lean peopleActivity in varying body regionsEnzyme activity releasing and breaking down fatFat oxidation is not efficient

  • Causes of Overweight & Obesity Genetics & EpigeneticsCausative role of geneticsGenetic influences do seem to be involvedGenetics may determine predisposition to obesityHuman genomeObesity geneCodes for the protein leptinLocations of leptin secretion

  • Causes of Overweight & Obesity Genetics & EpigeneticsObesity geneGenetic deficiency of leptin or genetic mutationLeptin resistance Roles in the bodyEnergy regulationOthers

  • Causes of Overweight & Obesity Genetics & EpigeneticsAdiponectinSecreted by adipose tissueInverse correlation with body fatBenefits

    GhrelinPromotes positive energy balanceInverse correlation with body weightRoles in the body beyond energy regulation

  • Causes of Overweight & Obesity Genetics & EpigeneticsPYYGI cells secrete in proportion to kcalories consumedSignals satiety and decreases food intake

    Ideal dietMaintain satiating hormonesMinimize appetite stimulating hormonesLow in fat and rich in fiber

  • Causes of Overweight & Obesity Genetics & EpigeneticsUncoupling proteinsProteins involved in energy metabolismTwo types of fatWhite adipose tissueBrown adipose tissue

    Uncoupling proteins found in both types of fatInfluence basal metabolic rate (BMR)

  • Causes of Overweight & Obesity EnvironmentEncountered daily circumstancesInteraction between environment and geneticsOvereatingPresent and past eating and activity patterns influence current body weightAvailabilityServing sizes Physical inactivityLife requires little exertionInactivity contributes to weight gain and poor healthDRI for prevention of weight gain

  • Problems of Overweight and Obesity Health RisksThree indicatorsBMIWaist circumferenceDisease risk profileFactors taken into accountBeneficial weight lossHealth statusMotivation

  • Problems of Overweight and Obesity Health RisksOverweight in good healthSometimes health is not the motivation for weight lossObese or overweight with risk factorsTwo or more risk factorsObese or overweight with life-threatening conditionRecommendation to lose weight

  • Problems of Overweight and Obesity Perceptions & PrejudicesMost obese people do not successfully lose weight and maintain the lossSocial consequencesJobs, school, and in social situationsPsychological problems

  • Problems of Overweight and Obesity Dangerous InterventionsIntervention dangersDiet books and weight-loss programsLittle success with weight loss maintenanceFad dietsWeight-loss productsHerbal productsLaws for dietary supplementsOther gimmicks

  • Aggressive Treatments for Obesity Drugs Strategies for weight reduction depend on:Degree of obesityRisk of diseaseUse drugs as part of long-term comprehensive weight-loss programsAssist with modest weight lossDrugs approved by FDA for obesitySibutramine OrlistatPhentermine and diethylpropionOther drugs

  • Aggressive Treatments for Obesity SurgeryClinically severe obesity200,000 surgeries performed each year Reduces food capacity of stomachEffectively limits food intakeReduce production of ghrelinHealth-related benefitsLong-term safety and effectivenessLiposuction

  • Weight Loss StrategiesSuccessful strategiesSmall changesModerate lossesReasonable goalsReasonable rate of weight lossBenefits of modest weight lossIncorporation of healthy eating and physical activity

  • Wt Loss Strategies Eating PlansBe realistic about energy intakeProvide less energy than is neededGoal: nutritional adequacy without excessBreakfast frequency

    Nutritional adequacyMinimum of 1200 kcalories a dayEat small portionsEat less food at each meal; structured meal replacement plansFeel satisfied, not stuffedLower energy density

  • Wt Loss Strategies Eating PlansRemember waterAssistance with weight managementFocus on fiberLow in energy and high in nutrients; require effort to eatChoose fats sensiblyEnergy density and satiation Select carbohydrates carefully Artificial sweetenersWatch for empty kcaloriesFat, sugar, and alcohol

  • Wt Loss Strategies Physical ActivityBest approach to weight managementModerate physical activity plus activities of daily lifeCombination of diet and physical activityLose more fatRetain more muscleRegain less weightReduction of abdominal fat

  • Wt Loss Strategies Physical ActivitykCalorie expenditureBody weight, intensity, and durationGreater the energy deficit, greater the fat lossDiscretionary kcalorie allowanceMetabolismSpeeds up with activityImmediate and long-term benefits

  • Wt Loss Strategies Physical Activity

  • Wt Loss Strategies Physical ActivityBody compositionFat decreases and lean body mass increasesStrength-training exercisesAppetite controlDelayed appetiteInappropriate appetite Psychological benefitsSelf-esteemChoosing activitiesSpot reducing

  • Wt Loss Strategies Environmental Influences Factors surrounding eating experience and the food itselfAtmospherePleasant and comfortable equals more foodAccessibilityLess effort needed to obtain food, more food eaten SocializingDistractions

  • Wt Loss Strategies Environmental Influences PresenceSight, smell, or thought of food can prompt eatingMultiple choiceLarge assortments of foods increase consumptionPackage and portion sizesServing containers

  • Weight Loss Strategies Behavior & AttitudeBehavior modificationPositive, matter-of-fact attitudeBecome aware of behaviorsKeep recordChange behaviors

  • Weight Loss Strategies Behavior & AttitudeCognitive skillsProblem solvingCognitive restructuringPersonal attitudeUnderstand personal relationship with foodSound emotional healthSupport groups

  • Weight Loss Strategies Weight MaintenanceSuccessful weight lossPlateau Prevalence of successful weight lossDifficult to determineWeight lossComponents of successful weight lossChanges in metabolismTakes more to prevent weight regain than to prevent weight gain

  • Preventing Weight GainPreventing weight gain would benefit many peopleStrategies are similar to losing weightStart earlier

  • Public Health ProgramsPossibly change environment through public health lawStretch beyond individual

  • UnderweightAffects no more than 5% of U.S. adultsWeight gain is a matter of healthWeight gain may be difficult

    Demand for energy contributes to underweightDifficult to gain weightLearn new habits and like new foodsUnderweight vs. anorexia nervosa

  • Weight-Gain StrategiesKey diet planning strategiesEnergy-dense foods Exercise

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