Managing Your Weight: Finding a Healthy Balance

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Chapter 8

• Managing Your WeightFinding a Healthy Balance

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WEIGHT CONTROL AND HEALTH

• Health risks associated with
• excess adipose tissue and
• inactivity
• heart disease
• diabetes
• hypertension
• cancer
• osteoarthritis
• Also question of self-concept
• and emotional health.

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BODY COMPOSITION

• Total body mass is composed of 2 components
• fat mass (FM)
• fat-free mass (FFM) (composed of muscles, bone,
  water, and viscera)

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Body composition is influenced by

• genetic factors
• environmental factors
• nutrition
• disease
• physical activity

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BODY FAT MASS

• energy
• storage / vitamins
• protects internal organs
• insulates body against extreme cold

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Essential Fat

• essential fat required for normal function of CNS
  
• stored in muscles, heart, lungs, liver, spleen,
  intestines, kidneys bone marrow
• men is 3
• women is 12

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Storage Fat (subcutaneous fat)

• storage fat is deposited in adipose tissue -
  energy
• of fat cells remains constant - size reduced
• location of storage fat varies
• protects internal organs

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HEALTH RISKS

• Underweight
• nutritional deficiencies
• anemia
• heart disease/defects
• chronic fatigue
• infection
• depression

• Overweight
• hypertension
• diabetes
• heart disease
• orthopedic problems
• respiratory problems

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Body Fat Distribution

• gender differences
• approx. 9-yr. boys deposit fat - abdomen
• approx. 9-yr. girls deposit fat - hips and legs
• differences accentuate with puberty and
  maturation

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Body Fat Distribution

• men - android pattern - apple-shaped (fat stored
  in trunk, chest, back, and abdomen)
• women - gynoid pattern - pear-shaped (fat stored
  in hips and legs)

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FAT-FREE MASS (FFM)

• muscle, skin, bone, and viscera
• midlife FFM declines/men and women/decrease in
  muscle mass
• FFM decreases 3 kg per decade/1.5 times greater
  in men than women
• decrease of FFM/decrease in growth hormone with
  aging
• physical inactivity

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OVERWEIGHT OR OVER-FAT?WAYS TO MEASURE BODY FAT
AND BODY COMPOSITION

• Body Weight vs.
• Body Composition
• Scales Body Weight Only
• Body Mass Index (BMI)
• mass (kg)
• stature (m2)
• Men gt 27,8 overweight
• Women gt27,3 overweight
• BMI gt30 obese

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WAIST TO HIP RATIO

• correlation between fat stored in mid-section and
  disease
• divide waist measure by hip measure
• if above 0.8 for females and gt0.95 for males
  people risk for heart disease, high blood
  pressure and diabetes.

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SKINFOLDS

• measure of subcutaneous fat
• fifty percent of body fat beneath skin -
  therefore percentage body fat can be calculated
  from skinfolds measures
• subject to error

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RESEARCH SETTINGS AND BODY FAT EVALUATION

• total body electrical conductivity (TOBEC) -
  electromagnetic force field
• bio-electrical impedance (BIA) - pass current
  through body
• soft-Tissue Roentgenogram - inject radioactive
  substance into lean body mass. Muscle - Fat
  Mass ID

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Hydrostatic Weighing Techniques

• Determines fat mass by submerging the body in
  water- displaced water is measured
• densities of lean and fat mass are known
• compares out-of-water and under-water weight

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CAUSES OF OBESITY

• Heredity
• Twins research different family Environments -
  Same Genetic Make Up
• 1 parent obese 55 - children tendency to being
  overweight or obese
• 2 parents obese 90 - children tendency to
  being overweight or obese

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Heredity Continued.

• neither parent obese 15 chance children will
  tend to be overweight or obese
• genes set metabolic rates
• nutritional choices exercise can modify the
  genetic effect

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Exercise / Lifestyle

• Increases metabolic rate- up to several hours
  after exercise
• F.I.T.T. principles
• energy from stored Fat/CHO/Protein
• critical component reset the Set Point
• one pound of body fat contains 3500 calories

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Errant Eating Thrifty Genes

• Errant Eating
• Ive had enough to eat - defective gene
• Thrifty Genes
• survival mechanism when food isnt available..
• lower metabolic rate

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Metabolic Rates

• BASAL METABOLIC RATE - lean muscle mass vs. fat
  mass
• RESTING METABOLIC RATE BMR other sedentary
  activities
• ( 90) of Energy
• EXERCISE METABOLIC RATE RMR (90) Moderate to
  Heavy Activity (10)
• Opportunity for Weight Loss

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Fat Cell Theory

• Approximate Number of Fat Cells (ADULT)
• Average Weight 25 to 30 Billion
• Moderately Overweight 60 to 100 Billion
• Obese 200 Billion

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Fat Cell Size

• Hypertrophy (SIZE)
• Adults and children
• Hyperplasia (NUMBER)
• Last-Trimester Pregnancy (Mothers Dietary
  Habits)
• 1st Year of Life
• 9 to 13yr.
• extremely obese people

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Set Point Theory

• internal control mechanism for body to maintain
  certain weight
• research into dieting - lowers the metabolism -
  dieting ineffective (95) - need lifestyle
  changes as well
• also work done with overfeeding -similar shift
  but in opposite direction

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Psychosocial Factors

• Emotional insecurities, childhood rewards,
  unemployment, broken relationships, financial
  uncertainty, etc, etc
• A Bright Spot FOOD!
• Eating is a social ritual companionship,
  celebration, enjoyment.an event!

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Eating Habits

• Learned and perpetuated by family?
• Situation?
• Money?
• Break the Cycle Food Eating Analysis

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SUCCESSFUL WEIGHT MANAGEMENT

• Role Of Diet /Nutrition
• balanced nutrition vs. a diet"
• initial losses mostly water
• impairs physical function
• lowers basal metabolic rate
• repeat dieting leads to
• greater fat levels
• severe restrictions alter
• the optimal balance of
• nutrient intake

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Weight Loss

• Set Goals
• improve quality of life through lifelong weight
  management
• weight loss approximately 1 lb. / week

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Changing Attitudes

• examine reasons for eating - track behaviors
  that trigger eating
• Keep track of what you eat, when, and why!
• Hypothalamus senses hunger while the
• SATIETY CENTRE sends indication of fullness.

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Changing Attitudes

• A 20 minute delay occurs for satiety to be felt
• water / fruit before eating
• behavior modification is essential to any
  successful weight management program

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ROLE OF EXERCISE

• Very important moderate - will suppress appetite
• lean muscle development results in greater
  "burning" of calories
• basal metabolic rate
• resting metabolic rate
• exercise metabolic rate

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DANGERS OF QUICK-FIXESbehaviours arent changed

• gastric balloon insertion
• stomach stapling
• jaw wiring
• liposuction
• new behaviors are not learned
• always dangerous i.e. health and life!

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DISORDERED EATING Eating Disorders

• ANOREXIA NERVOSA
• a morbid fear of being fat
• relentless pursuit of thinness
• condition in which a very thin body is seen as
  normal
• distorted body image
• suppression of appetite rather than loss of
  appetite

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ANOREXIA NERVOSA

• self-induced starvation or dieting gone out of
  control
• starvation and over exercise are common
• many social classes and ethnic groups
• often well educated,
• achievement oriented

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ANOREXIA NERVOSA

• results in death in 5 to 18 of cases (suicide or
  medical complication)
• decrease in food intake
• increase in purging ( self-induced vomiting)
• misuse of laxatives or diuretics
• dangerous exercise habits
• affects bones, muscles, organs, immune system,
  nervous and digestive system

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ANOREXIA NERVOSA

• tooth decay vomit
• (stomach acids) dissolves enamel
• hair loss development of fine hair on face and
  body

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Treatment

• multifaceted medical and psychological
• drug therapy and behavior modification used
• prognosis often poor

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BULIMIA NERVOSAFEELING A LACK OF CONTROL

• uncontrolled binge eating followed by vomiting
  /purging the body of food
• purging through use of vomiting, laxatives,
  diuretics, exercise
• 95 are female

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BULIMIA NERVOSA

• also a technique used by anorexics
• similar risk profile as anorexic - though loss of
  self-control a factor
• used by athletes to lose weight fast
• treatment complicated
• multidisciplinary approach most effective

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UNDERWEIGHT

• regular meals
• increase caloric intake, particularly complex CHO
• regular physical activity - relate to self-esteem

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AMERICAN COLLEGE OF SPORTS MEDICINE GUIDELINES
FOR WEIGHT CONTROL

• AVOID PROLONGED FASTING
• MILD CALORIC RESTRICTION - MAX RESTRICTION OF
  500-1000/day
• EXERCISE
• MAINTAIN NUTRITION
• BEHAVIOR MODIFICATION

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Hunger, Appetite, Satiety

• Hypothalamus Regulates Appetite
• Monitors Levels of Nutrients in Blood
• Obese eating cues Frequency and Intensity
  increase!

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Adaptive Thermogenesis

• Large Amounts of food
• No Weight Gain
• Metabolic Activity Adjusts
• Brown Fat Cells control the thermogenesis
  response

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Satiety

• Feeling of Full
• Nutritional Needs
• Obese vs. Non-Obese

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Why We Eat.

• Hunger
• Inborn
• Physiological
• Need

• Appetite
• Learned Response
• Emotional//Psychological
• Craving