1
Chapter 11
1
© 2012 McGraw-Hill Higher Education. All rights reserved.
2
Weight Management
 National
Institutes of Health
 68% of American adults are overweight
 More than 33.8% of American adults are
obese
 In 2007-2008, 32.3% of adult men and 35.5%
of adult women were obese
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Figure 11.1 Obesity prevalence by age and
sex, of American adults, 2007-2008
Weight Management
3
© 2012 McGraw-Hill Higher Education. All rights reserved.
Basic Concepts of Weight Management

4
Body Composition
 Fat-free mass and body fat
○ Fat-free mass: bone, water, muscle, connective tissue, organ
tissues, and teeth

Body Fat
 Essential fat: necessary for body to function
○ 3-5% of total fat in men, 8-12% in women

Fat Storage
 Adipose tissue: connective tissue in which fat is stored
 Subcutaneous fat: Located under the skin
 Visceral Fat (intra-abdominal fat): Located around major organs

Factors Affecting Body Composition
 Genetically determined number of fat cells
 Cells can increase or decrease in size depending on
○ Age
○
○
○
○
Sex
Metabolism
Diet
Activity level
 1 pound of fat = 3500 calories
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
5
Energy Balance

Energy balance is key to keeping a
healthy ratio of fat and fat-free mass
 You take in energy (calories)
 You use up energy (calories)
 Energy in = energy out, you maintain
your current weight
 Energy in > energy out, you gain
weight
 Energy in < energy out, you lose
weight
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Figure 11.2 The energy balance
equation
Weight Management
6
© 2012 McGraw-Hill Higher Education. All rights reserved.
Evaluating Body Weight and Body
Composition



7
Overweight: Total body weight above
recommended range for good health
Obesity: A more serious degree of overweight
Body Mass Index (BMI)
 Based on the concept that weight should be proportional
to height
 Does not distinguish between fat weight and fat-free
weight
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Body Composition Analysis
8
Most accurate and direct way to determine
percent body fat
 Hydrostatic (underwater) weighing and Bod
Pod
 Skinfold measurements

 Thickness of fat under the skin

Electrical impedance analysis
 Electricity prefers fat-free tissue
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Figure 11.3 Body mass index
(BMI)
Weight Management
9
© 2012 McGraw-Hill Higher Education. All rights reserved.
Excess Body Fat and Wellness

10
The health risks of excess body fat
 Reduces life expectancy by 10-20 years
 Associated with: Unhealthy cholesterol and
triglyceride levels, impaired heart function, and
death from cardiovascular disease
 Other health factors: hypertension, cancer,
impaired immune function, gallbladder and kidney
disease, skin problems, impotence, sleep and
breathing disorders, back pain, arthritis, bone and
joint disorders
 Strong association with diabetes mellitus: a
disease that disrupts normal metabolism
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Body Fat Distribution and Health



11
Apple shape
Pear shape
Assessed by measuring waist circumference
 Total waist measurement of more than 40 inches for
men and 35 inches for women is associated with
increased risk of disease
 Large waist circumference can be a marker for
increased risk of diabetes, high blood pressure, and
CVD, even in people with a BMI in the normal range
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
12
Body Image

Collective picture of the body as seen
through the mind’s eye
 Perceptions
 Images
 Thoughts
 Attitudes
 Emotions
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Problems Associated with Very Low
Levels of Body Fat
Very low body fat is less than 8-12% for
women and less than 3-5% for men
Extreme leanness has been linked to
problems with






13
Reproductive disorders
Circulatory disorders
Immune system disorders
Female Athlete Triad
1.
2.
3.
Abnormal eating patterns
Amenorrhea
Decreased bone density
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Factors Contributing To Excess
Body Fat

14
Genetic Factors
 25% to 40% of an individual’s body fat
 The tendency to develop weight is inherited,
what you do does matter

Physiological Factors
 Metabolism
○ Resting metabolic rate (RMR): the energy
required to maintain vital body functions while
the body is at rest
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Lifestyle Factors
15
Eating
 Physical activity
 Psychosocial factors

 Emotions
○ Distraction from difficult feelings
○ Helps regulate emotions
○ Coping strategies
 Socioeconomic status
 Family and culture
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Adopting A Healthy Lifestyle For
Successful Weight Management

16
Diet and eating habits
 Total calories
○ MyPyramid suggestions
○ Best approach for weight loss is combining an increase of
exercise with moderate calorie restriction
Portion Sizes
 Energy (Calorie) Density
 Eating Habits

 Small, frequent meals
 Set rules to govern your food choices
 Eat in moderation
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Physical Activity and Exercise
17
Increasing physical activity is a better
approach to losing weight than cutting
food intake
 Regular physical activity:

 Protects against weight gain
 Maintains weight loss
 Improves quality of life
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Thinking and Emotions
18
Low self-esteem
 “Ideal self”
 “Self-talk” can either be selfdeprecating or motivating
 Realistic beliefs and goals

Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
19
Coping Strategies
Appropriate coping strategies help you deal
with the stresses of life and help with
weight management
 Overeating is not an appropriate coping
strategy
 Use food appropriately

 To fuel life activities
 Foster growth
 Bring pleasure

Find new coping strategies
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Approaches to Overcoming A Weight
Problem
 Doing it
20
yourself
○ Lose 0.5-2.0 pounds per week
○ Initial weight loss occurs from fluid loss
○ Smaller, mostly fat, losses later in the diet are better than
initial larger, mostly fluid, losses
○ Reasonable weight loss: 8-10% of body weight over 6
months
 Dietary supplements and diet aids
○ Formula drinks and food bars
○ Herbal supplements
○ Other supplements
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
21
Weight-Loss Programs

Noncommercial weight-loss programs
 TOPS (Take Off Pounds Sensibly)
 OA (Overeaters Anonymous)
Commercial weight-loss programs
 Clinical weight-loss programs

Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
22
Prescription Drugs
Appetite suppressants
 All prescription weight-loss drugs have
potential side effects
 Recommended only for people who have
been unable to lose weight with nondrug
options or who have a BMI over 30

Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Surgery
23
 Treatment
of last resort
 Only for severely obese
 5.7% of American adults qualify as
severely, or morbidly, obese
 NIH recommends gastric bypass for
individuals with a BMI of 40 or higher
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
24
Body Image

Severe body image problems
 Body dysmorphic disorder (BDD)
○ Affects about 2% of Americans
○ Usually begins before age 18
 Muscle dysmorphia

Acceptance and change
 Knowing what is a healthy lifestyle change
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
25
Eating Disorders
Problems with body weight and weight
control
 Characterized by severe disturbances in
body image, eating patterns, and eatingrelated behaviors
 Disordered eating affects an estimated 10
million American females and 1 million
males
 About 90% of eating disorders begin during
adolescence. Some begin as young as 8

Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
26
Anorexia Nervosa
Failure to eat enough food to maintain a reasonable
body weight
 Affects 3 million people – 95% are female
 Characteristics of anorexia nervosa






Fear of gaining weight
Distorted body image
Compulsive behaviors and rituals
Excessive exercise
Health risks of anorexia nervosa






Loss of menstruation
Intolerance to cold
Low blood pressure and heart rate
Dry skin covered by fine body hair
Hands and feet may swell and take on a blue tinge
Variety of medical complications – electrolyte imbalance, heart
failure, cardiac arrest
 Depression and suicide
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
27
Bulimia Nervosa



Recurring episodes of binge eating followed by purging
Begins in adolescence or young adulthood
Characteristics of bulimia nervosa
○ Rapidly consumes food, then purges
○ Done in secret
○ After a binge, individual feels ashamed, disgusted and physically and
emotional drained

Health risks of bulimia nervosa
○
○
○
○
○
○
○
○
○
Erodes tooth enamel
Deficient calorie intake
Liver and kidney damage
Cardiac arrhythmia
Chronic hoarseness
Esophageal tearing
Rupture of the stomach
Increased depression
Disturbances in cognitive functioning
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
28
Other Eating Disorders

Binge-Eating
 Similar to bulimia, except no purging
behavior
 Likely to be obese
 Increased health risks
 Higher rates of depression and anxiety

Borderline Disordered Eating
 Have some symptoms of eating disorders
but do not meet full diagnostic criteria for
eating disorder
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
Treating Eating Disorders
29
Combination of psychotherapy and medical management
Individual or group therapy
 Address problematic eating behaviors, misuse of food, and
managing emotions


 Anorexia Nervosa
○ Averting a medical crisis by restoring adequate body weight
○ Psychological aspects
 Bulimia Nervosa
○ Stabilizing eating patterns
○ Identifying and changing patterns of thinking
○ Improving coping skills
 Binge-Eating
○ Similar treatment protocol as bulimia nervosa
Weight Management
© 2012 McGraw-Hill Higher Education. All rights reserved.
30
Chapter 11
© 2012 McGraw-Hill Higher Education. All rights reserved.