Chapter 12 Achieving a Healthy Weight A Wellness Way of Life Ninth Edition Robbins/Powers/Burgess ©...

Chapter 12Achieving a Healthy Weight

A Wellness Way of LifeNinth EditionRobbins/Powers/Burgess

© 2011 McGraw-Hill Higher Education. All rights reserved.

Chapter 12 ObjectivesAfter reading this chapter, you will be able to:1. Differentiate between overweight and obesity.2. Identify the percentages of adults over age 20 who are overweight and the

percentage who are obese.3. Explain the purpose of the body mass index (BMI) and identify a BMI

associated with health problems.4. List six health conditions associated with obesity.5. Explain how the location of fat on the body is liked to health risks and

calculate waist-to-hip ratios.6. Identify a risky waist-to-hip ratio and a high-risk waist circumference for both

men and women.7. Describe how each of the following factors contributes to obesity: energy

balance, heredity, fat cells, set point, and metabolism.8. Define basal metabolic rate (BMR), and identify five factors that affect it.9. Distinguish a healthy weight loss program from a fad/diet program.10. Identify and explain the three major components of effective lifetime weight

management.11. Explain how exercise helps in weight management.12. Compare and contrast the eating disorders bulimia nervosa, anorexia

nervosa, binge eating disorders, and disordered eating.


Weight and Health

67% of American adults are overweight or obese (40% are obese).

$59 billion a year is spent on weight loss. Obesity rates continue to climb. Obesity is

considered by many health professionals as the most serious health threat to Americans.


Body Composition Fat-free mass includes muscles, bone,

body fluids, and organs. Lean mass is muscle. Body fat can be either essential fat or

storage fat.– Essential fat is required for body functions.

– Storage fat is extra fat that accumulates around organs and beneath the skin for padding, insulation, and for functioning. Some storage fat is okay.


Overweight Versus Obese

Overweight refers to a body weight in excess of a recommended range for good health.

Obesity refers specifically to having an excessive accumulation of body fat.

Body Mass Index (BMI): weight in pounds divided by height in inches squared multiplied by 703 (this measure is not appropriate for athletes or body builders).

A BMI of 25 to 30 is considered overweight. A BMI over 30 is considered obese.


Risks Associated with Obesity

Risk factor in four of the ten leading causes of death.

Heart disease, cancer, stroke, diabetes, and atherosclerosis.

Aggravates liver disorders and osteoarthritis and is a factor in gallbladder disease.

Complicates surgery and pregnancy. Also becoming a big problem for children.


Location of Fat Fat distributed primarily in the abdominal area is linked

to increased risk for heart disease, hypertension, high cholesterol, type 2 diabetes, and cancer.

Abdominal fat causes more fatty acids to be in the bloodstream versus lower body fats.

Waist-to-hip ratio might be a better predictor of fat-related health problems.

Waist-to-hip ratio is dividing the waist measurement by the hip measurement.

Women should be below .8 and men below .95. Waist circumference alone can also be a predictor of risk.

Men with waists over 40 inches and women with waists over 35 inches are classified as high risk, no matter what their weight.


Theories Energy balancing equation

– Calories eaten versus calories burned. An imbalance can create a change in weight.

– 3500 calories = 1 pound.

Fat-cell – Can increase number and size. Genetics can play a part. – Can build new fat cells during growth, pregnancy, and

obesity. Fat cells are indestructible. – The overfat usually have more fat cells, so are more at

risk for obesity due to increased fat cells.– Fat produces hormones and proteins than contribute to

disease.

Set-point – Weight regulating mechanism in the brain. May be related to number of fat cells. – May be able to change set-point to lower or higher number.


Genetics and Metabolism Twin studies indicate there may be a genetic factor in

obesity. Genetics can create a tendency for obesity, but we still

have a lot of control despite our genes. Basal metabolic rate (BMR) accounts for 65-75% of the

calories burned in a day for bodily functions. BMR is a result of age, gender, body size, nutritional

status, musculature, activity level and genetics. BMR can be increased with exercise and muscle

hypertrophy. Dietary fat doesn’t take as much energy to digest or be

stored than protein or carbs.


Dieting Implies a way of eating that

involves special foods, caloric restrictions, powders, pills, or shake – but it actually should be a balanced way of eating for a lifetime.

Avoid very low calorie “diets.” They can actually slow your metabolism and cause muscle loss and increased fat.

Avoid very low carb diets. Can cause ketosis which is poisonous to the body.


Weight Cycling Weight cycling is the repeated loss and regaining

of body weight. Starvation diets (less than 800 calories a day)

are detrimental and can affect BMR by decreasing muscle mass and metabolism. They also affect emotional status.

Fad diets are usually detrimental to the dieter! If it seems too good to be true, it usually is!

It is important to learn skills for maintaining weight loss and preventing obesity. A healthy diet is a lifetime commitment.


Healthy Weight Loss Should use real, regular food. Should allow a slow weight loss of 1-2 pounds per week. Should encourage the reduction of fat and sugar in the

diet. Should encourage safe and personalized exercise. Should not promise a quick fix or easy answer. Should teach lifelong skills that allow for some flexibility in

eating and exercise patterns. Should make social eating and eating out possible. Should allow for basic caloric needs – never under

1200(women)/1500(men) calories per day. Should not be too costly. Should teach techniques to maintain positive behavior.


Lifetime Weight Management Strategies

Food management – Balanced diet (low in fat and sugar, high in fruits, veggies, whole grains, moderate

low-fat proteins) with appropriate amount of calories.– Recognize portion distortion.– Avoid mindless eating.

Emotional management – Delay, distract, distance.– Avoid eating primarily for emotional needs (stress, bored, lonely, angry, habit).– Observe your eating patterns – when, why, with who, how you feel.

Exercise management – Exercise is the key to maintaining weight loss.– It burns calories.– It prevents loss of lean muscle mass.– It decreases abdominal fat.– It is a natural appetite suppressor.– It may lower your set point.– It helps maintain weight loss.– It improves self-esteem.


Culture and Weight In the past, fat was a sign of beauty and success. Over time, culture changed (for numerous reasons)

and by the 60s, thin was in. Media and society have shifted the expectation for

what is “attractive” and promote the idea that thin is desirable.

Most women don’t (and maybe cannot) meet the expectation of very thin. The average woman in America is 144 pounds and wears a size 12-14. This problem affects men as well as women.

Most women have a distorted body image. The problem is increasing among men also.


Eating Disorders Desire to be thin has become an obsession for many and

can begin early in life. Thinness is associated with popularity and attractiveness. Estimated that 2/3 of teenage girls have dysfunctional

eating behavior. Fear of fat gain, obsessive dieting, and a distorted body

image can lead to eating disorders. An eating disorder is a disturbance in eating behavior that

jeopardizes a person’s physical or psycho-social health. Estimated that 8 to 10 million Americans struggle with

eating disorders.


Eating Disorders

Some general causes are: – social pressure for thin and lean body– family with overly high expectations– perfectionist personality– genetic propensity to be overweight– pressure from others to lose weight– appearance-obsessed friends– low self-esteem

Bulimia, Anorexia, Binge Eating


Bulimia Nervosa Recurrent binge eating large quantities of food. Feeling of lack of control over eating during binges. Self-induced purging: vomiting, using laxatives and/or

diuretics, fasting, or excessive exercise. Two binge episodes a week for at least 3 months. Self-evaluation unduly influenced by body shape and

weight. Bingeing and purging are not accompanied by

anorexia nervosa. Treatment goal is to get bulimics to cope with stress

and body image insecurities through less destructive ways and to feel more comfortable with who they are.


Anorexia Nervosa Found primarily in early and middle adolescent

females. May lead to physical deterioration to the point of hospitalization or death.

Rigid dieting. Excessive exercise and energy. Criteria include:

– Refusal to maintain body weight at or above a minimal normal level for age and height (15% below normal).

– Intense fear of weight gain or becoming fat despite being significantly underweight.

– Distorted body image.– Amenorrhea for at least 3 consecutive cycles.

Treatment involves medical, psychological, and nutritional help. Denial is the major obstacle to treatment. Entire family should be involved.


Binge Eating Disorder Sometimes called compulsive overeating. The most

common eating disorder. Eating an amount of food much larger than most people

would eat in a similar period and accompanied by a sense of lack of control or a feeling that one can’t stop eating.

Criteria include:– Eating much more rapidly than normal.– Eating until uncomfortably full.– Eating large amounts of food when not hungry.– Eating alone because of embarrassment about how much is eaten.– Feeling disgusted with oneself, depressed, or guilty about eating.– The binge eating occurs, on average, at least 2 days a week for 6

months. Treatment

– Goal is to normalized eating – to refuse overeating.– Help in adopting a plan of healthy eating and moderation without rigid

rules.– Help coping with underlying emotions – anxiety, loneliness, depression,

shame, inferiority, and fear of criticism. Finally, to accept their bodies.


What Can Be Done

Prevention – helping people understand the concept of health/wellness and healthy body image.

Encouraging self-acceptance and esteem. Professional counseling or support groups

are available. May need medical attention. Support, love, and encouragement. May have

to be persistent to get some help.


Rx for Action Keep a food journal to see what, how much, and why

you are eating. Take a favorite recipe and investigate ways to make it

less caloric and more nutritious. Resign from the “clean plate club.” Even if it feels

somewhat uncomfortable, leave a small amount of food on your plate.

Do some form of exercise that burns a minimum of 300 calories.

Make a rule. No TV or Internet until you’ve exercised for 30 minutes.


What Do You Think?

What are your thoughts on weight and body image in America?

What is your BMI? Are you in a risk category? What are the health conditions associated

with obesity? What are healthy weight loss or weight

maintenance strategies? Do you engage in any of them?

Do you know anyone that has an eating disorder? How could they get help?


Questions?


Chapter 12 Achieving a Healthy Weight A Wellness Way of Life Ninth Edition Robbins/Powers/Burgess ©...

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