Chapter 11: Weight Management

National Institute of Health
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

what percentage of American adults are overweight?
1 pound of fat is equal to…
3,500 calories
Body composition
fat-free mass (lean body mass) and body fat
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)
total body weight above recommended range
a more serious degree of overweight
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%

Evaluating body weight and percent body fat
1. body composition
2. body mass index (BMI)
3. body fat distribution
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
fat-free mass
fat-free mass
non-fat tissues
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)
Percent body fat
the proportion of the body’s total weight that is fat
Body Mass Index (BMI)
Body Mass Index (BMI)
measures the health risks of body weight for average people
-correlated with but does not directly measure body fat
BMI Scale
BMI Scale
< 18.5-underweight 18.5-24.9- healthy 29.9 ≥ 25 overweight ≥30- obese
Health risks of excess body fat
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
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
Diabetes Mellitus
Diabetes Mellitus
Apple Shape
Android Obesity
-upper regions of their bodies
-increase risk of HBP, diabetes, early-onset heart disease, stroke, cancer
Pear Shape
Gynoid Obesity
-fat storage in the hips, buttocks, and thighs
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
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
Physiological Factors
-Resting metabolic rate
-Fat cells
Psychosocial Factors
-coping strategy
-help regulate emotions
-distract from negative feelings
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
Diet and Eating Habits
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
Physical Activity & Exercise
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
Thinking and Emotions
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)
Coping Strategies
develop appropriate coping strategies to deal with stress
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))
*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
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
Body Image
collective picture of the body as seen through the mind’s eye
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”
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
Anorexia Nervosa
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
Bulimia Nervosa
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
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
Treating Eating Disorders
Treating Eating Disorders
Combination of psychotherapy and medical management
-Address eating disorder, misuse of food, and managing emotions