Achieving a HealthyAchieving a Healthy WeightWeight..

UNDERSTANDING BODY COMPOSITION

1% Carbohydrates

6% Minerals

16% Protein

17% Fat

61% Water

1% Carbohydrates

5% Minerals

12% Protein

27% Fat

56% Water

Overweight Versus Obesity

Overweight refers to a body weight in excess of a recommended range for good health. Obesity refers specifically to having an excessive accumulation of body fat.

BMI

An expert panel that was convened in 1998 by the National Institutes of Health adopted the body mass index (BMI) as a method of classifying overweight and obesity. BMI is a direct calculation based on height and weight and has been universally adopted by health professionals to determine healthy weights and risky weights. BMI is computed from the following equations

BMI is computed from the following equations

Risks Associated with ObesityObesity contributes to cardiovascular disease by causing changes in the body that increase the risk factors:• Raises levels of LDL ("bad") cholesterol• Raises levels of triglycerides (fats in the blood)• Reduces levels of HDL ("good") cholesterol• Elevates blood pressureObesity can aggravate liver disorders and arthritisObesity is often found in conjunction with diabetes and gallbladder disease.

BMI is computed from the following equations

Location of FatFat distributed primarily in the abdominal area (called apple-shape obesity) is characteristic of many men (but also is present in some women). This apple-shape obesity is linked to increased risk for coronary heart disease, hypertension, high cholesterol, Type 2 diabetes, and some forms of cancer. Abdominal fat experiences much more enzyme activity, dumping more fatty acids into the bloodstream. Fat distributed in the lower extremities, around the hips, buttocks, and thighs (called pear-shape obesity). Hip-thigh fat activity is more stagnant, but is more difficult to lose than is abdominal fat

Healthy People 2010Healthy People 2010 The five principles are:Promote the recognition of overweight and obesity as major public health problems.Assist Americans in balancing healthful eating’ with regular physical activity to achieve and maintain a healthy or healthier body weight.Identify effective and culturally appropriate interventions to prevent and treat overweight and obesity.Encourage environmental changes that help prevent overweight and obesity.Develop and enhance public-private partnerships to help implement this vision.

WHAT CAUSES OBESITY?

energy balance

fat cells

set point

Heredity

metabolism.

Many societal factors contribute to overweight/obesity.

Weighing the risks: Percent increase in risk by level of obesity. At BMIs of 27 and higher, one's risk for various disorders increases significantly.

SOURCE: New England Journal of Medicine, Annals of Internal Medicine, American Journal of Clinical Nutrition, Journal of the

American Medical Association. Circulation, 2000.

The Energy Balance Equation

The energy balance equation states that energy input (calories consumed) must be equal to energy output (calories expended) for body weight to remain constant. Any imbalance in energy input or energy output will result in a change in body weight. If you eat more calories daily than your body expends in activity, you will store the excesses as fat. If you eat fewer calories than you burn, you will lose weight

Fat cellsThe size and number of fat cells in the body determine degrees of fatness. Fat cells (also known as adipose cells) are storage sites for energy. The body increases fat storage in two ways: by increasing the number of fat cells and by increasing the size of fat cells. As might be expected, the body increases its number of fat cells during infancy and puberty growth spurts.Fat cells also expand and contract as energy is stored or burned. They can expand to two to three times their normal size, but they cannot enlarge endlessly. At some point, new fat cells can be created in response to the body's need to store more excess energy. Unfortunately, once a fat cell has been created, it exists for life. Fat cells do not seem to be destructible. An individual of normal weight has 30 to 50 billion fat cells, while an obese person can have as many as 60 to 100 billion fat cells.

Set-Point Theorymaintains that every individual is programmed to be a certain weight and that the body regulates itself to maintain that "set" weight. Studies of people in alternating states of semistarvation and gorging have shown that once intervention ceases, they return to their former weights. The hypothalamus in the brain may act as a body weight thermostat, lowering body metabolism and increasing hunger if fat levels fall below the set point. Here is where the set-point theory and fat-cell theory merge. The set-point mechanism is thought to respond to signals sent out by the fat cells as to the amount of fat in storage. The weight at which this occurs may depend on the number of fat cells.

Heredity

Research about genetic influences on obesity lends some (but not total) credibility to this exclamation. Children with obese parents do have a greater tendency to become obese adults. Heredity seems to influence the number of fat cells in the body, how much fat is stored, where it is stored, and metabolic rates. However, scientists have concluded that genetics is responsible for only 25 percent of these factors.hormones may be linked to obesity. One of those hormones, leptin, is secreted by fat cells and informs the brain about how large or small the body's fat stores are. As a result, the brain regulates appetite and metabolism accordingly.

Metabolism

Every individual expends a certain amount of energy, even at rest, to sustain vital functions of the body such as brain activities, organ function, and temperature regulation. This energy requirement is called the basal metabolic rate (BMR) and accounts for approximately 60 to 75 percent of the calories burned in 1 day. A true measure of basal (resting) metabolism is taken when you have been lying quietly but awake and without food for 12 to 15 hours. Most men have a BMR requirement of 1,600 to 2,000 calories daily; most women need 1,200 to 1,500 calories daily.

Factors That Affect Basal Metabolic Rate

Your total daily caloric expenditure is influenced by:1. Basal Metabolism = 60 to 75 percent.2. Digestion = 10 percent (e.g., if you consume 2,000 calories a day, you burn 200 of them by digesting the food).3. Physical Activity and Exercise = anywhere from 15 to 40 percent (you control this!). Remember, all physical activity burns calories.

LIFETIME WEIGHT MANAGEMENT: STRATEGIES

FOR SUCCESS

Maintaining a reasonable body composition is, rather than isolated bouts of crash dieting or sporadic exercise, a result of lifelong integration of three management components:1. Food management2. Emotional management3. Exercise management

Food management

Emotional management

Eating behavior is strongly influenced by psychological, social, and emotional factors. We eat out of emotional needs. We eat when we're happy; we eat when we're sad. We confuse physical hunger with emotional hunger

Emotional management

Controlling eating habits begins with having an understanding of why you eat and what cues trigger eating. Food stops taking on the role of nurturer when people learn to nurture themselves. Emotional management works best when you are reinforced by social support family, friends, dietitians, community, and weight-loss support groups.

Exercise Management

Exercise is crucial to losing weight and maintaining weight.

In adults there is a direct relationship between the number of hours spent watching television and a person's level of obesity. The Internet, computers, video games, and home movies have decreased overall activity levels.

The secret to lifelong weight management is exercise, not dieting.

While exercise is an important part of an initial weight-loss program, it is the single best predictor of long-term weight maintenance:It Burns CaloriesIt Prevents Loss of Lean Muscle MassIt Decreases Abdominal FatIt Is a Natural Appetite SuppressorIt May Lower Your Set PointIt Helps Maintain Weight LossIt Improves Self-Esteem

CULTURE AND WEIGHT

The desire for an unrealistic slimness, particularly among women, has caused many to be preoccupied with their bodies and with dieting. Diet books become instant best-sellersThis thin standard is perpetuated in all channels of social influence: families, peers, and the media. The message is pounded home over and over: "You can never be thin enough." Only about 5 percent of the population can look like the models and actresses we are exposed to daily. Our bodies are genetically programmed to be a certain build-tall, skinny, stout, short, muscular, big boned, and so on.

The dilemma of preventing obesity yet avoiding a fostering of "thin mania" presents

a tremendous challenge.Some of the general causes for eating disorders include:1. Society's definition of the "perfect body" as unrealistically thin and lean.2. Family characteristics such as over involvement and high expectations; overvalue physical appearance; rigid and cold emotionally.3. Personality traits like "perfectionism," the desire to achieve; feelings of inadequacy and loneliness.

General causes for eating disorders :

4. A genetic propensity to being overweight.5. Pressure from others to lose weight, including media images.6. Appearance-obsessed friends (dance troupes, school cliques, sororities, cheerleaders).7. An inherent presence of low self-esteem.

EATING DISORDERS

Bulimia Nervosa (criteria)1. Recurrent episodes of binge eating (rapid consumption of a large amount of food in a discrete period).2. A feeling of lack of control over eating behavior during the eating binges.3. Self-induced vomiting, misuse of laxatives or diuretics, strict dieting or fasting, or excessive exercise to prevent a weight gain.4. Two binge episodes a week for at least 3 months.5. Self-evaluation unduly influenced by body shape and weight.6. The bingeing and purging are not accompanied by anorexia nervosa.

Anorexia Nervosa (criteria)

1. Refusal to maintain body weight at or above a minimal normal level for age and height (i.e., a body weight that is 15 percent below normal).

2. Intense fear of weight gain or becoming fat despite being significantly underweight.

3. A disturbed perception of body weight, size, or shape (i.e., feeling "fat" although emaciated).

4. In females, amenorrhea (lack of menstrual periods) for at least three consecutive cycles.

Binge Eating Disorder

Binge eating disorder (BED) is defined as recurrent episodes of eating characterized by eating, in a discrete period, an amount of food much larger than most people would eat in a similar period and accompanied by a sense of lack of control or a feeling that one cannot stop. At least three of the following must be part of the binge episode:1. Eating much more rapidly than normal.2. Eating until uncomfortably full.3. Eating large amounts of food when not hungry.4. Eating alone because of embarrassment about how much is eaten.5. Feeling disgusted with oneself, depressed, or guilty about eating.

Thank you for attention!Thank you for attention!