Chapter Eight - Part Three Weight Control Food & Nutritional Health NUT SCI –242 Karen Lacey, MS, RD, CD © Spring 2005

Weight Gain Strategies Learn new habits Learn to like new foods Use patient & consistent training Consuming enough calories to support weight gain Eat more frequently

Behavior Modification A key component of weight loss & maintenance Breaking Old Habits: – Keep a record or journal of eating stimuli or cues – Eliminate/suppress cues that inspire inappropriate eating

Cont’d Strengthen cues that inspire exercise and healthy eating Alter the response itself Develop consequences and rewards

Stages of Behavior Change 1. Precontemplation: need to change, but not ready 2. Contemplation: want to change, but not sure how or if possible 3. Preparation: 4. Action 5. Maintenance: adherence to new behavior 6. Termination: have achieved a lasting change in behavior

Behavior Modification Steps 1. Identify the goal 2. Identify the present behavior patterns 3. Identify behaviors that will lead to the goal 4. Commit yourself to new behaviors that will lead to permanent change 5. Plan 6. Try out the plan & modify if needed 7. Evaluate progress on a regular basis

Eating Disorders A. Wide Spectrum of Eating Disorders Disordered eating Unspecified eating disorder Binge-eating disorder Anorexia nervosa Bulimia nervosa

B. Anorexia Nervosa Pathological loss of appetite; self- starvation Occurs most commonly in young females Resembles an addiction; characterized by obsessive, compulsive behavior

Cont’d Family characteristics that may surround the person with anorexia: – Valuing of achievement – Valuing of outward appearances – Little value placed on self-worth

Characteristics of Anorexia Perfectionism Highly sensitive to negative cultural & social images Feels a need to be in control Preoccupied with food Distressed by physical changes accompanying maturation

Cont’d Excessive exercise Excessive use of laxatives Cessation of menstruation in females Distorted & inaccurate self-image Denies existence of a problem Abnormalities of the digestive system

Treatment Goals Restore adequate nutrition Avoid medical complications Alter psychological & environmental patterns that support the illness Establish a positive interaction between the individual & a therapist

Treatment Outcomes Three-fourths of those in treatment regain weight up to within 25% of desired weight One-half to three-fourths resume normal menstrual cycles Two-thirds fail to eat normally on follow-up, but better than before Approximately 6% die, 1% by suicide

C. Bulimia Typical Characteristics of Bulimia – Single – Caucasian – Well-educated – Close to ideal body weight – Anxious over social situations – Depressed – Secret binge eating

Stages of Compulsive Binging Anticipation, planning Anxiety Urgency to begin Rapid & uncontrollable consumption of food Relief, relaxation Disappointment Shame, disgust

Consequences of Repeated Behavior Fluid & electrolyte imbalance caused by vomiting Abnormal heart rhythms Injury to kidneys Irritation/infection of pharynx, esophagus, salivary glands Erosion of teeth

Cont’d Dental caries Injury to intestinal tract by laxatives Possible injury from induced vomiting

Goals of Therapy Help person gain control Encourage normal eating at all times Alleviate depression with medication if necessary