Chapter Outline

UNDERSTANDING BODY COMPOSITION

• Americans are preoccupied with weight; dieting is a billion-dollar industry.

• Overweight and obesity account for 300,000 U.S. deaths per year, and the numbers are increasing.

• A combination of lean tissue and fat tissue make up body weight.

OVERWEIGHT VERSUS OBESITY

• "Overweight" refers to an excess of body fat (a BMI of 25-29.9).

• "Obesity" refers to an abnormally high proportion of body fat (a BMI equal to or greater than 30).

• Body Mass Index (BMI), a relationship between height and weight, is a guideline for determining healthy and risky weights.

• A BMI of 19-24.9 is considered a healthy weight.

RISKS ASSOCIATED WITH OBESITY

• 61 percent of American adults are overweight or obese (a BMI greater than 25).

• Obesity is a risk factor in 5 of the 10 leading causes of death.

• Being overweight or obese contributes to heart disease, stroke, some cancers, type 2 diabetes, atherosclerosis, hypertension, liver disorders, and gallbladder disease.

• Fat distributed in the abdominal area (apple-shape obesity) is more of a health risk than fat distributed in the hip/thigh area (pear-shape obesity).

• Waist-to-hip ratio is a predictor of weight-related health problems.

WHAT CAUSES OBESITY?

• Obesity is a complex puzzle of metabolic, genetic, psychological, behavioral, social, and environmental factors.

• In an attempt to explain the causes of obesity, several theories/factors have emerged.

THE ENERGY BALANCE EQUATION

• An imbalance of energy input (calories in) versus energy output (calories expended) results in changes in body weight.

• One pound of body fat equals 3,500 calories of stored energy.

• Because of the availability of snacks and fast foods, size of food portions, and lack of exercise, the energy balance equation is the best explanation for America's weight problems.

FAT-CELL THEORY

• Obesity can be a result of having an overabundance of fat cells and/or having enlarged fat cells.

SET-POINT THEORY

• States that every individual is programmed to be a certain weight and that the body regulates itself to maintain that "set" weight.

HEREDITY

• Maintains that genetics influence metabolic rates and fat levels.

METABOLISM

• Basal metabolic rate (BMR) is the amount of energy (calories) a body burns at rest, and accounts for 60-75 percent of the daily caloric expenditure.

• BMR is a result of several interrelated factors, including age, gender, body size, nutritional status, musculature, activity level, and genetics.

NUTRIENT COMPOSITION

• Fat calories convert into body fat more easily than carbohydrate calories.

WHAT ABOUT DIETING?

• "Going on a diet" is a temporary and ineffective way to approach weight loss.

• Crash or fad diets fail to teach lifelong eating habits; many are temporary and can be dangerous.

WEIGHT CYCLING

• Repetitive bouts of weight loss and weight gain, called weight cycling or yo-yo syndrome, may result in metabolic alterations.

RELIABLE WEIGHT LOSS PROGRAMS

• Reliable weight loss programs focus on using real food, teach lifelong changes, allow for a slow weight loss, encourage exercise, and should never be under 1,200 calories.

• Scarcity and deprivation should never be part of a lifetime weight management program. Ask the question . . . "can I live with this diet for the rest of my life?"

LIFETIME WEIGHT MANAGEMENT: STRATEGIES FOR SUCCESS

• Effective weight management involves a lifetime integration of three components: (1) food management; (2) emotional management; and (3) exercise management.

FOOD MANAGEMENT

• Need knowledge to make sensible, well-balanced food choices.

• Following the 2000 Dietary Guidelines, the food guide pyramid, as well as eating more fruits and vegetables and cutting fat are nutritional habits that contribute to a healthy weight.

• Awareness of portion and serving sizes (calorie control) is also essential.

EMOTIONAL MANAGEMENT

• Controlling eating habits begins with having an understanding of why you eat.

• We often confuse physical hunger with emotional hunger.

• Behavior modification techniques help enhance awareness or consciousness about a behavior and subsequently alter behavior. (Delay, Distract, Distance, Determine)

EXERCISE MANAGEMENT

• Americans have gotten fatter because calorie output has declined drastically.

• While exercise is an important part of an initial weight-loss program, it is the single best predictor of long-term weight maintenance.

• Regular exercise contributes to fat loss in several ways:

IT BURNS CALORIES

IT PREVENTS LOSS OF LEAN MUSCLE MASS

IT DECREASES ABDOMINAL FAT

IT IS A NATURAL APPETITE SUPPRESSOR

IT MAY LOWER YOUR SET POINT

IT HELPS MAINTAIN WEIGHT LOSS

IT IMPROVES SELF-ESTEEM

GAINING WEIGHT: A HEALTHY PLAN FOR ADDING POUNDS

• The key to gaining weight is shifting the body equation so that you take in more calories than you burn.

• Rather than eating high fat and sugary foods, choose "calorie-dense" foods packed with nutrients (beans, nuts, fruits, vegetables, whole grains, yogurt).

CULTURE AND WEIGHT

• Why people diet and other weight-related issues are shaped by cultural environments.

THERE SHE IS . . . MISS UNREALISTIC AMERICA

• The current standard of extreme thinness is perpetuated in all channels of social influence: families, peers, and the media.

• The cultural ideal for women's body size keeps getting thinner, making them at risk for extreme dieting and eating disorders.

MEN ARE JOINING IN

• Bombarded with images of muscular, lean men in magazines and in advertisements, a growing number of teenage boys and men are facing cultural pressures to diet, compulsively weight train, and abuse supplements.

EATING DISORDERS

• "Thin mania" has resulted in a large number of young people engaging in disordered eating.

• An eating disorder is a disturbance in eating behavior that jeopardizes a person's physical or psychosocial health. It is an extremely serious psychopathological state.

• Eating disorders are multidimensional in cause and nature: genetic, biological, psychological, personality, sociocultural, and familial factors all play a part.
• An estimated 8 million Americans struggle with eating disorders; one million are men.

BULIMIA

• Characterized by a compulsive need to eat large quantities of food (binging) to the point of gorging, followed by purging through vomiting, use of laxatives, or fasting.

• Bulimia is the most common eating disorder, and can result in electrolyte imbalance, low blood sugar, esophageal lacerations, dehydration, tooth enamel erosion, and nerve and liver damage.

ANOREXIA NERVOSA

• Anorexics have an intense fear of being fat, have a distorted body image, deny their impulse to eat, exercise excessively, and starve themselves of food.

• The mortality rate from anorexia is the highest of any mental disorder. The malnutritive state results in chronic fatigue, dry and scaly skin, low blood pressure, and cardiac complications.

BINGE EATING DISORDER

• Characterized by eating, in a discrete period of time, an amount of food much larger than most people would eat in a similar period of time, and accompanied by a sense of lack of control or a feeling that one cannot stop.

• Unlike the bulimic, the individual with binge eating disorder does not compensate for their behavior by purging or dieting. The result is obesity and intense feelings of guilt, depression, and embarrassment about how much is eaten.

WHAT CAN BE DONE?

• Prevention programs should be implemented, involving all facets of society---the media, advertising, entertainment, coaches, parents, peers.

• Professional treatment is necessary to deal with eating disorders, including psychotherapy, nutrition counseling, and medical intervention.