Chapter Six:
Maintaining a Healthy Weight
© 2011 McGraw-Hill Higher Education. All rights reserved.
Defining Overweight and Obesity
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Desirable weight = weight range deemed
appropriate for people, taking into
consideration gender, age, and frame size
Overweight = a person’s excess fat
accumulation results in body weight that
exceeds desirable weight by 1-19%
Obesity = a person’s body weight is 20% or
more above desirable weight
© 2011 McGraw-Hill Higher Education. All rights reserved.
Rates of Overweight and
Obesity (Adult Americans)
© 2011 McGraw-Hill Higher Education. All rights reserved.
Obesity and Disease
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Problems caused or complicated by obesity:
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Increased surgical risk
Hypertension
Heart disease
Arthritis
Stroke
Type 2 diabetes
Cancer
Joint deterioration
Fat accumulation in the abdomen (“apple” shape) is
associated with greater health risks than fat
accumulation in the hips (“pear” shape)
© 2011 McGraw-Hill Higher Education. All rights reserved.
Sociocultural Standards for
Weight
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Body image: Subjective perception of how
one’s body appears to oneself and others
What is today’s Western cultural standard of
the ideal body?
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Hourglass shape?
Athletic?
How does it differ by gender?
Body image dissatisfaction affects self-concept
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More women than men are dissatisfied with their
weight
© 2011 McGraw-Hill Higher Education. All rights reserved.
Measuring and Assessing Weight
and Body Fat Composition
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Body mass index (BMI)
Height/weight tables
Waist and hip measurement
Appearance
Home scale
Body fat measurement
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Electrical impedance
Bod Pod
Skinfold measurements
Hydrostatic weighing
© 2011 McGraw-Hill Higher Education. All rights reserved.
Body Mass Index (BMI)
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A mathematical calculation based on weight and
height used to determine desirable body weight
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Weight (kg) ÷ [Height (m)]2
Classification
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Normal: 18.5-24.9
Overweight: 25.0-29.9
Obese: ≥30
Extreme obesity: ≥40
© 2011 McGraw-Hill Higher Education. All rights reserved.
Other Methods used to Assess
Weight
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Height/ Weight Tables
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Used to determine ideal weight based on
gender, height, and frame size
Waist and Hip Measurement
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Correlation between the amount of fat in the
abdominal cavity and serious health risks
Appearance
 Home Scale
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© 2011 McGraw-Hill Higher Education. All rights reserved.
Body Fat Measurement
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Young adult men
Normal = 10-15%
 Obese = >25%
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Young adult women
Normal = 22-25%
 Obese = >30%
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© 2011 McGraw-Hill Higher Education. All rights reserved.
Body Fat Measurement
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Electrical impedance: Use of a
harmless electrical current to calculate
percent body fat
Bod Pod: Measurement of air
displacement to determine percent
body fat
Skinfold measurements: Measurement
of the thickness of the fat layer just
below the skin; used to calculate percent
body fat
Hydrostatic weighing: Weighing the
body while it is submerged in water;
used to calculate percent body fat
© 2011 McGraw-Hill Higher Education. All rights reserved.
Causes of Obesity
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Calorie balance: Energy intake vs. energy
output
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Intake = Output: Calorie balance
Intake > Output: Positive calorie balance
• Weight gain
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Output > Input: Negative calorie balance
• Weight loss
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Energy needs:
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Basal metabolic rate (BMR)
Activity requirements
Thermic effect of food
© 2011 McGraw-Hill Higher Education. All rights reserved.
Causes of Obesity (cont.)
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Genetic factors
Physiological and hormonal factors
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Hypothyroidism
Hypercellular obesity
Hypertrophic obesity
Metabolic factors
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Set point
Adaptive thermogenesis
© 2011 McGraw-Hill Higher Education. All rights reserved.
Causes of Obesity (cont.)
Family, social, and cultural factors
 Environmental factors
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Local environment
 Packaging and price
 Unit bias
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Psychological factors
© 2011 McGraw-Hill Higher Education. All rights reserved.
Top States with the Highest and Lowest
Obesity Rates
© 2011 McGraw-Hill Higher Education. All rights reserved.
Facts About
Weight Loss
© 2011 McGraw-Hill Higher Education. All rights reserved.
Weight Management Strategies:
Lifestyle Approaches
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Balanced diet supported by portion control
Moderate physical activity
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60 minutes/day for weight maintenance
90 minutes/day for weight loss and maintenance
Sleep
Lifestyle support and problem solving
© 2011 McGraw-Hill Higher Education. All rights reserved.
Weight Management Strategies:
Specific Dietary Approaches
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Temporary calorie restriction (“dieting”)
Low-calorie foods and controlled serving
sizes
Controlled fasting
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For extreme obesity
Often in a hospital setting
Formal or commercial weight reduction
programs
© 2011 McGraw-Hill Higher Education. All rights reserved.
Weight Management Strategies:
Weight Loss Drugs
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OTC drugs and herbal supplements
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Prescription weight loss drugs
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Ephedrine, phenylpropanolamine (now banned)
Caffeine, laxatives
Phentermine
Sibutramine
Fat-blocking drugs
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Orlistat
• Prescription Xenical
• OTC Alli
© 2011 McGraw-Hill Higher Education. All rights reserved.
Weight Management Strategies:
Surgical Interventions
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Gastric bypass
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Gastric band
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Gastric sleeve
Vertical banded
Laproscopic adjustable
Cosmetic
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Liposuction
Abdominoplasty
Body wrapping
Lipodissolve
© 2011 McGraw-Hill Higher Education. All rights reserved.
Eating Disorders
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Most eating disorders involve psychological
issues as well as inappropriate food choices or
eating patterns
Types/categories
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Anorexia nervosa
Bulimia nervosa
Binge eating disorder
Chewing, spitting out food syndrome
Night eating syndrome
Body dysmorphic disorder
Bigorexia
© 2011 McGraw-Hill Higher Education. All rights reserved.
Anorexia Nervosa
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Diagnostic criteria:
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Body weight 15% or more below desirable weight
Fear of weight gain
Distorted body image
In women, absence or three of more menstrual
periods
In men, decreased sex hormone
Serious medical complications, including death
Treatment: Medical and dietary interventions,
psychological treatment
© 2011 McGraw-Hill Higher Education. All rights reserved.
Bulimia Nervosa
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Diagnostic criteria:
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Binge eating two or more times/week for at least 3
months
Lack of control over bingeing
Inappropriate compensatory behaviors (purging)
• Vomiting or use of laxatives, diuretics, or other medications
• Excessive exercise
• Fasting
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Overconcern with body image
Serious medical complications
Treatment: nutritional and psychological
counseling, medical consultation
© 2011 McGraw-Hill Higher Education. All rights reserved.
Other Eating Disorders
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Binge eating disorder
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Chewing and spitting out food syndrome
Night eating syndrome
Body dysmorphic disorder
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Bingeing without compensatory purging
Use food to cope; feel out of control during binge
Preoccupation with an imagined or slight flaw in one’s
appearance
Bigorexia
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Muscle dysmorphia, “Adonis complex”
An obsession with getting bigger and more muscular
Thinking that your body is never muscular enough
© 2011 McGraw-Hill Higher Education. All rights reserved.
Chapter Six:
Maintaining a Healthy Weight
© 2011 McGraw-Hill Higher Education. All rights reserved.