Weight, Body
Composition, and Health
Maintaining a Healthy
Body Weight
Weight and Health
 Goal

is to determine if an individual is:
Underweight
• Health risks


Healthy weight
Overweight (BMI > 25)
• Health risks if overweight and overfat
• Huge health issue in US (see page 280)
Increasing Prevalence of Obesity (BMI _
>30) among U.S. Adults
1991: Only four states had obesity
rates greater than 15 percent.
Key:
No Data
<10%
1996: Over half of the states
had obesity rates greater than
15 percent.
10%–14%
15%–19%
20%–24%
_>25%
2001: Only one state had an obesity
rate below 15 percent, most had
obesity rates greater than 20 percent
and one had an obesity rate greater
than 25 percent.
Obesity Trends* Among U.S. Adults
BRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2004
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
≥25%
Obesity Trends* Among U.S. Adults
BRFSS, 2007
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2008
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2009
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
Obesity Trends* Among U.S. Adults
BRFSS, 2010
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data
<10%
10%–14%
15%–19%
20%–24%
25%–29%
≥30%
U.S. Data







Obesity has risen 75% in 10 years.
Obesity has risen nearly 100% in 20 years.
Rates have doubled in children in 20 years.
Rates have tripled in teens in 20 years.
Self-reported data indicate that 61% of adults
are overweight or obese.
Data based on direct measurements indicate
that two-thirds of adults are overweight or obese.
U.S. Obesity Data by Race
40
35
30
25
White
Hispanic
Black
20
15
10
5
0
2007
Overweight Children
 Children
most likely to have a high BMI
when:





Either parent or both overweight or obese
They live in smaller families
They are poor
They consume a high proportion of calories
from fat
They are avid TV watchers – more screen
time is associated with higher weight
Maine Obesity Data
% Obese
10-14
15-19
15-19
15-19
15-19
15-19
15-19
20-24
15-19
20-24
24.8
25.8
26.5
Year
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2007
2009
2011
* BMI > 30, CDC
Evaluating Weight/Health Status
 Compare
weight to standard height-weight
tables

Tables are of limited value and use
 Body


Mass Index (BMI)
Preferred measure for evaluating weight
Based on significant amount of research
BMI
 Upper
end of BMI may not be a good
indicator of health for:


body builder or serious athlete’s weight/health
the elderly
 Low
end of the BMI is an appropriate
measure of being underweight for all
BMI
Weight/health
Less than 18.5
Underweight*
18.5 - 24.9
Healthy
25 - 29.9
Overweight*
30 -39.9
Obese*
Over 40
Severely obesity*
BMI
BMI – most use BMI
calculators or charts (see page 341)
 Calculating
BMI = weight in pounds x 703
(height, inches)2
Weight, lbs = desired BMI x (height, inches)2
703
BMI
 Calculating
the weight associated with a
desired BMI:
Weight, lbs = desired BMI x (height, inches)2
703
Health Risks and BMI
Weight Class
BMI
Health Risks
Overweight
25 – 29.9
Increased
Class I Obesity
30 – 34.9
Class II
Obesity
Class III
Obesity
Underweight
35 – 39.9
Moderate to
significant
High/very high
> 40
< 18.5
Extreme
Increased,
may be
significant
Health Risks and Weight

Health risks in each category increase if:






Waist is > 40” men, > 35” women
Smoke
Physically inactive
High blood glucose
High LDL levels or low HDL levels
Family history of heart disease, stroke, hypertension,
type II diabetes
Body Fat
 Need
enough body fat to meet basic
needs, but not so much as to increase
health risks

Essential Body Fat:
• Males: 3% body fat
• Females: 12% body fat, 20% for reproductive
health (menstruation and fertility)

The latter value has recently come into question
% Body Fat and Health
 Desirable


% body fat levels: text values
Males: 8 - 24 %
Females: 21 – 33 %
Measuring % Body Fat
% body fat is difficult to measure accurately
 Common methods for measuring:
1.
2.
3.
4.
5.
Fat fold measures with calipers
Bioelectric impedance
Underwater weighing
Air displacement
X-ray, MRI, CT and other expensive
techniques
Distribution of Body Fat Matters
 Central


Obesity (apple shape)
Fat stored around the organs of the abdomen
Associated with increased risk of:
• Heart disease
• Stroke
• Hypertension
• Some cancers
Distribution of Body Fat
 More



on central obesity
More common in men and post-menopausal
women
Associated with smoking
Abdominal fat is likely to go directly to the liver
and be used to make VLDL  LDL
Distribution of Body Fat
 Lower-Body



Obesity (pear shape)
Fat stores are concentrated around the hips
and thighs
Doesn’t raise health risks as much as central
obesity.
See most often in women during reproductive
years
Waist Circumference
 Health
risks increase when waist
circumference is:


Greater than 40” in men
Greater than 35” in women
 Risk
is even greater if BMI is also > 24.9
What are the Health Issues?
 Health
issues associated with being
overweight or obese:




Type II diabetes
Hypertension
High cholesterol
Heart disease
Health Issues
 Health







issues continued
Gall bladder disease
Osteoarthritis
Respiratory problems
Hernias
Varicose veins
Flat feet
Complications during surgery and pregnancy
Health Issues - Underweight






Increased risk of infection and illness
Tired and weak (may be anemic)
Amenorrhea (periods stop)
Reduced fertility
Complications during surgery
Poor growth and development in kids
Summary
Methods for Evaluating Weight/Health Status
1.
Compare weight to standard tables (not
useful)
2.
Calculate BMI
3.
Determine % body fat
4.
Evaluate fat distribution
5.
Measure waist circumference
6.
Consider other risk factors
Who should lose weight?
 For
people who are overweight or obese
and have 2 or more risk factors weight
loss is recommended

even a small weight loss (10% of body
weight) will significantly decrease health risks
Who should lose/gain weight?
 Healthy
BMI - maintain current weight.
 Overweight, desirable waist measurement,
less than 2 other risk factors  prevent
further weight gain
 Obese – lose weight
 Individuals who are have a BMI of less
than ______ should gain weight.
Strategies for Weight Loss
 In
general need to decrease caloric
intake and increase physical activity

Generally need both for long-term weight loss
and health
 To
lose 1 pound per week you need to
reduce caloric intake (or increase caloric
output) by:

500 kcal per day = 3500 kcal/week
Strategies for Weight Loss
 Set



reasonable goals
1-2 pounds per week
Loss of 10% of body weight
May set interim goals if a large amount of
weight loss is desired
Making a Change!
Strategies for Weight Loss
 Avoid
fad diets and weight loss
supplements
 Avoid very low calorie diets and skipping
meals


Never less than 1200 kcal per day
Why??
Strategies for Weight Loss
 Increase


level of physical activity
30-45 minutes moderate intensity, 5 days a
week
Add weight bearing exercise to build muscle
• Why?
Strategies for Weight Loss
 Reduce
portion size
 Increase intake of fiber (why?)


More fruits and veggies
More whole grain products
 Eliminate

empty calories
Soda, alcohol, candy…..
 Decrease
calories from liquid sources
Strategies for Weight Loss
 Drink
plenty of water
 Eat a salad before dinner

Low calorie dressing
 Buy/make
fixed size portions
 Avoid buffets and family style serving
 Reduce fat content of foods w.o increasing
portion size
Strategies for Weight Loss
 Avoid
starving all day…..leads to binging
 Join a weight loss group


Provides support and accountability
Some offer nutritional guidance as well
Extreme Measures
 Extreme
weight loss measures may be
called in cases of severe obesity (BMI
>40)

When health issues of weight are greater than
the health issues associated with the
treatment
Extreme Measures
 Treatment

is usually:
Surgery to drastically reduce stomach size
and to bypass some of the SI
• Long-term success depends upon compliance with
dietary restrictions
• Lifetime medical supervision is needed
• At high risk of many vitamin and mineral
deficiencies

Medications
Weight Gain
 Goal
is to add lean body mass (as well as
body fat if extremely underweight)

Exercise is an important component of weight
gain
 Weight
gain can be just as challenging as
weight loss!
Strategies for Weight Gain
 Chose



energy dense foods
May be higher fat choices
Someone who is seriously underweight can
afford a little more fat
Examples:
• 2% milk vs. skim milk
• Peanut butter on anything
• Salmon vs. haddock
Strategies for Weight Gain
 Eat


regular meals
Do not call a “non-meal” a meal
Lettuce or carrots or an apple are not lunch
 Leave
salad for last
 Increase portion size


Extra meat or cheese on sandwich
Larger bowl of cereal, add a banana
Strategies for Weight Gain
 Snack
between meals, but not too close to
meals!

Chose nutritionally /calorie dense snacks
•
•
•
•
Peanut butter on apple or crackers
Bowl of cereal with milk
Trail mix (seeds, nuts, raisins….)
Slimfast or instant breakfast
 Drink

caloric beverages
Milk, juice …..