Weight Management
Energy Balance Equation
Balance: energy intake = energy
expenditure
energy intake > energy expenditure =
weight gain
energy intake < energy expenditure =
weight loss
Control of Food Intake
Control Center is the hypothalamus
hunger center
satiety center
Resting Energy Expenditure
metabolic requirements necessary to live,
resting
anything above is additional energy
requirements
Most Effective For Weight Loss
Caloric Restriction
Most regain weight
Exercise is less effective
Most Effective for
Maintenance of Weight Loss
Physical Activity began during caloric
restriction
Caloric Restriction
most common treatment of excess
weight
composition of diet is also important
Very Low Calorie Diets
can be dangerous
many people have died of cardiac arrest
associated with serious cardiac arrhythmias
loss of hair
loss of lean body mass
thinning of skin
coldness in the extremities
gallbladder stones
gout
elevated cholesterol
Dehydration
diuretics
impermeable clothing
weight loss is due to dehydration, not fat
loss
usually re-hydrate after the loss
Medical Procedures
Prolonged fasting
Bariatric bypass
Lipectomy (liposection)
Drugs to control weight
appetite suppressants
thermogenic drugs
Drugs
Xenical (fat absorption in the gut)
Meridia (brain chemistry)
7-10# more than if diet alone
Behavior Modification
Focus on elimination of the behavior that is
associated with poor eating and exercise
habits
30% of participants maintain weight loss
after one year and continue to lose
Exercise
Single session of exercise will result in little
fat loss
Regular exercise training will lead to
adaptations that increase utilization of fat
Exercise adaptations
Begin to utilize fats earlier in the exercise
bout
Utilize more fats
Females utilize fats more efficiently than
males
Fat Metabolism and Gender
Females are more efficient at storing fat
Females store more fat
Females may store more from a similar
meal as fat than a male would
Fat Metabolism
Adipocytes process and store lipids
Produce a variety of hormones
Lipoatrophy: reduced or absent fat deposits
Insulin resistance
Type II Diabetes
Leptin
Hormone produced by adipose tissue
Not just obesity, metabolic regulation of
virtually all metabolic systems
Mediator of energy balance
Glucose and other substrates increase ATP
production and stimulate leptin secretion
Deplete energy stores inhibits leptin
secretion
Leptin Con’t
Starvation
promotes increased energy intake
decreased expenditure
Increased lipogenesis
Normal maturation
Adequate stores for reproduction
Increased nitric oxide (NO)
Homeostasis of BP
What is the best intensity?
What works for you
will not burn more fat at low intensity (in
total) than if you exercise at high or
moderately high intensity
1 mile = ~100 kcal
Whether you walk the mile or run the mile
Reasonable changes
Should be small
Should become part of your lifestyle
21 days to make a habit
Weight Loss Strategies
Meal Planning
Physical Activity
Behavior Therapy
Lifestyle Therapy
Pharmacotherapy
Weight Reduction Surgery
Weight Maintenance Plan
Weight Maintenance is more
important that a “diet” or weight
loss
Better long-term outcomes and long-term
health