Weight Control: a Side Effect of Healthy Living

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Weight Controla Side Effect of Healthy Living
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• Excessive weight is a problem of the Westernized
  world
• Lifestyle trials designed to lower health risks
  all produced weight loss
• We live is a world that encourages over
  consumption and discourages physical activity

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• Kelly Brownell of Yale Center for Eating and
  Weight Disorders labels our unhealthy culture a
• toxic environment

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• Dietary fat consumption on a percentage basis has
  decreased from 45-32 since 1970
• But, we eat more fat on a calorie basis
• Cheese consumption increased from 11 to 28
  lbs/person/year

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• 27 of meals are eaten outside the home
• Food portions sized have increased
• Soda consumption increased from 34.7 to 44.4
  gallons/person/year since 1987
• Aggressive marketing
• Vending machines
• Channel one

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The Number of Larger-Size Portions Introduced by
Fast Food Chains and Restaurants
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• Can genetics explain the increase in body weight?

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Most common weight loss methods
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Treatment success/failure

• 76 Obese women
• VLCD Very low calorie diets 400-500 calories/day
  for 2 months
• Behavior modification 1,200 cal/day plus
  behavior training for 6 months
• Both

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Weight loss effectiveness
pounds
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Treatment options

• Diet and exercise, and behavior modification
• Diets
• Medication
• Surgery

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Diets

• All have caloric restriction and a lot of media
  hype
• Moderate diet deficit 1,000-1,200 cal/day for
  women 1,200-1,600/day for men
• Low calorie diets. 800-1,200/day
• Very low calorie diets. lt800/day
• Fasting lt100 /day

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Very low calorie diets

• Can result in muscle wasting and sudden death
• Patients lose 3-5 lbs/week
• BMR drops 10-20 but returns upon eating
• ½ of patients dont finish the program
• After 30 months most regain 60-80 of lost weight

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Long-term effects of VLCD
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Long-term success of VLCD
Percent
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Optimal diet

• 500-1000 calories
• Dietary fat below 30
• Low saturated fat lt10
• Foods high in fiber

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Optimal Behavior

• Self monitor habits, keep diary
• Control events that precede eating
• Control act of eating, slow down
• Think positive
• Use positive rewards

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Surgery

• Use with BMI gt40 or BMI gt35 with co-morbid
  conditions
• Large amounts of weight can be lost, 30 lose
  25-50
• At 5 years, half lose more than half of the
  excess weight
• 20 fail to lose weight
• Many risks involved, but not as great as doing
  nothing

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Surgery
Gastric bypass Surgery
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Vertical Banded Gastroplasty
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Laparoscopic adjustable gastric banding
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Drug Therapy

• Part of diet and behavior
• Lots of side effects
• Sibutramine, appetite suppressant
• Orlistat, decreases fat absorption

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Weight Loss Masters

• Most had a weight loss trigger
• Most restricted calories
• Most exercised regularly

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• Eat fewer calories-eat on the defensive
• Exercise every day
• Weigh yourself often
• Cultivate social support
• Commit to doing it, get a trigger
• Slow and steady wins the race
• Healthy emotional state before healthy body
  weight
• Dont buy bigger clothes

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• How much should you weigh?

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Weight (lbs)
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What is your body mass index? ________ Body
Mass Index Categories lt19 Underweight
1924 Ideal weight, low risk
2529 Overweight, moderate risk 30 Obese,
high risk
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Weight loss benefits of exercise

• Maintain lean body mass, maintain and increase
  metabolism
• Lose body fat
• Lose total weight
• Reduce other health risks

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