Energy Balance and Weight Management – Chapters 8 and 9
 Regulation of food intake:
 Hunger
 Satiation
 Satiety
 Appetite
ENERGY IN
ENERGY OUT
 Basal Metabolism
 Factors that affect BMR
 Energy expenditure for physical activity:
 Depends on the activity duration, type, and intensity
 Also affected by body size and fitness level
 NEAT is the energy associated with unintentional activities like fidgeting, maintenance of
posture, or spontaneous muscle contraction
 Energy expenditure to process food:
 Thermic effect of food (TEF) – the energy used to digest, absorb, and metabolize energyyielding food
 TEF is lower for fat than for carbohydrate and protein
 TEF peaks one hour after eating, and normally dissipates within 5 hours
 Accounts for ~10% of total energy expenditure
MEASUREMENT of ENERGY EXPENDITURE
 Estimating energy expenditure: EER calculation (page 257)
BODY COMPOSITION
 Assessing body weight:
 weight tables
 body mass index (BMI) = weight (kg)/height (m2)
BODY FAT DISTRIBUTION
 gynoid obesity (pear-shaped figure), more common in women
 android obesity (apple-shaped figure), more common in men
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increases risk of heart disease and diabetes mellitus
ENERGY IMBALANCE: Overweight and Obesity
 Health risks (page 265)
 Prevalence of overweight and obesity – it is a worldwide public health problem. We are now
seeing an obesity epidemic in children as well as adults.
OBESITY in our CHILDREN
 National Center for Health Statistics suggests nearly 25% of children are overweight or obese
 There are now about 5 million obese children in the United States – up by 50% since 1991
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A 1999 Survey of Seattle High Schools showed that:
 9% of males and 6% of females were overweight
HEALTH CONSEQUENCES
 Overweight children and adolescents are more likely to become overweight or obese adults
 Type 2 diabetes, high blood lipids, hypertension, early maturation and orthopedic problems
also occur with increased frequency in overweight youth
ECONOMIC CONSEQUENCES
 In 2000, the total cost of obesity was estimated to be $117 billion
 Most of the cost associated with obesity is due to type 2 diabetes, coronary heart disease, and
hypertension
WHAT CAUSES OBESITY?
WEIGHT MANAGEMENT- What Works???
 Unfortunately, there is no magic pill, no perfect diet. The simple fact is, if you consume more
calories than you burn, you will gain weight
 A slow weight loss (1-2 pounds per week) is the best way
 To lose 1 pound of fat, you must burn an extra 3500 calories (in one week that = 500 calories
per day)
 Important Components:
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Diet composition
Physical activity
Behavioral change
Balancing acceptance and change
Support!
DIET COMPOSITION
 A Healthful Eating Plan Involves:
– Realistic energy intake
– Nutritional adequacy
– Small portions, small frequent meals
– Reduced simple sugar and alcohol intake
– Adequate water
– Physical activity!
PHYSICAL ACTIVITY
 Contributions to weight loss and maintenance:
– Direct increases in energy output (muscles and cardiovascular system)
– Indirect energy output (elevated BMR)
– Appetite control
– Psychological benefits
 Note: Spot reducing is not possible
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BEHAVIORAL CHANGE
 Behavior modification: the changing of behavior by the manipulation of antecedents (cues or
environmental factors that trigger behavior), the behavior itself, and consequences (the
penalties or rewards attached to behavior).
SUPPORT
• Family
• Friends
• Weight Loss Support Groups
WEIGHT MANAGEMENT
 Adjuncts to treatment
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Drugs
Self-help activities
Commercial programs
Professional private counselors
Surgery: gastric banding, gastric bypass
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