ObesityWeight Management
Objectives
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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
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Epidemic
2004- 66% of Americans overweight or obese
Chronic disease
Prevention
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10 pound gain, 2” increase in waist
Obesity Related Health Issues
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Hypertension
Heart Disease
Type 2 Diabetes
Gallbladder Disease
Pulmonary Disease
and Sleep Disorders
Bone and Joint
Disorders
Infections
Liver damage
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Cancer risk
Surgical risk
Accident risk
Skin Disorders
Pregnancy risk
Menstrual
irregularities
Infertility
Psychological
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Depression, low selfesteem, discrimination
Weight Loss Basics
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CALORIES OUT
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Metabolism
Physical Activity
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CALORIES IN
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Food and beverages
Calories Out- Physical Activity
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2010 Dietary Guidelines
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Adults 18-61 yo
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Children and Adolescents 6-17 yo
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2 hours and 30 minutes a week, moderate aerobic
1 hour and 15 minutes a week, vigorous aerobic
Strengthening activities 2 days week
60 minutes or more of physical activity a day
Exercise
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Strong research
No “news” story, no “best seller”
Few people can lose and maintain w/out
Aerobic Activity
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Duration/regular more important than intensity
10,000 steps a day
Increase activities of daily living
Any better than none!
Calories In- Diet
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Reduce portion sizes
Cut “empty calories”
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Fat
Sugars
Alcohol
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Ben Franklin – “To
lengthen thy life, lessen
thy meals”
Calories In
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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
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Setting Calorie Goals
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Determine current calorie intake; subtract
250-500 calories/day; (text 500-1000)
OR
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Decrease 250 calories a day from diet, 250
calories more physical activity
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3500 calories in a pound of body fat
Obese Culture
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Portion sizes
Convenience foods
Food accessibility, poverty
Food marketing and advertising
Inactive lifestyle
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TV, computer, games
Lack of sidewalks, public transportation, parks,
city design
Safety concerns
Body Mass Index (BMI)
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See text
One way to determine healthy body weight
Not perfect; men, athletes, genetically
muscular, short stature, health issues
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Healthy- 18.5-24.9
Overweight- 25.0-29.9
Obesity- 30- 39.0
Severely Obese- > 40
Other Thoughts….
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BodPod (air displacement), DEXA, bioelectric
impedence, caliper measures to determine body
fat
Waist Circumference
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Healthy-Fit Weight
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> 40” men, > 35” women
Abdominal fat affects liver function
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
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Brown University, University of Colorado
6000 people, lost 30+ pounds (average 66),
stable 5.7 years
98% modified food intake somehow…
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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
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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
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#1- Lower calorie, lower fat, sensible, long
term dietary intake
#2- Exercise
#3- Self Monitoring
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Food, exercise, weight records
Behavior modification
#4- Breakfast
#5- Support
Stages of Change
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Pre-contemplation
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Contemplantion
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Implement plan
Maintenance
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Gather information, make a plan
Action
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Realize need to make change
Preparation
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Unaware
Continue, revise plan
Termination
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New lifestyle