1. Overweight and Underweight
Weight Management
Overweight
and
Underweight

2. Dieting Bottom Line
Energy Density
Eat Less
Burn More
Portion Size

3. It’s The Calories Stupid
Your body can convert all macronutrients to fat.
3000 calories equals a pound, no matter how the macronutrient is consumed.
Spurlock ate 3000 extra calories a day and gained 25 pounds.

4. Increasing prevalence of obesity (BMI of 30 or greater) among U. S
Increasing prevalence of obesity (BMI of 30 or greater) among U.S. adults

5. Fat Cells
Let’s start with the fat cell.

6. Fat Cell Development Weight gain is not simply reversed.
In weight gain, the number and size of fat cells increases.
In weight loss, the size of fat cells decrease.
Your stuck with those extra cells, making it easier to regain. And, they keep releasing LPL (lipoprotein lipase).
It is better to limit weigh gain in the first place.

7. Fat Cell Metabolism
Two factors that affect whether fat cells store fat.
Lipoprotein lipase (LPL)
Set-point theory

8. Fat Cell Metabolism Lipoprotein lipase (LPL)
Tells fat cells to store fat
Tells chylomicrons and VLDL to give the cells some fat (thus becoming LDL to HDL)
Differs in activity in..
Obese versus trim individuals
Areas of the body
Men and women

9. Fat Cell Metabolism Set-point theory
The body tends to maintain a certain weight by means of its own controls.
If you eat more, metabolism increases
If you eat less, metabolism decreases.
What would this mean for methods to lose or gain weight?

10. Set Point Theory
Why have the world's setpoints gone up dramatically over the course of the past years?
Why is the world getting bigger so much faster (are all of our setpoints 1,000lbs?)
Why do the setpoints of indiginous peoples (like the Pima Indians) seem to change the moment they step into North America?

11. Causes of Obesity

12. Causes of Obesity
First, we will talk about some of the causes of obesity that are genetic

13. Causes of Obesity These genetics may affect… How much we eat
How we digest/metabolize food.

14. “Genetics loads the gun, behavior pulls the trigger.”

17. Genetics of how much we eat.
There are a great number of proteins/chemicals in the body associated with stimulating or inhibiting food intake.

18. Causes of Obesity
Some of the main suspects that control how much we eat.
Leptin
Ghrelin
PYY

19. Causes of Obesity
Genetics
Leptin
Ghrelin
PYY

20. Causes of Obesity PYY: signals “I’ve had enough food” Genetics
Leptin
Ghrelin
PYY
Leptin : plenty of stores, so don’t eat
Ghrelin: secreted by stomach to say “eat”

21. Causes of Obesity Genetics of how we digest/metabolize food.
Where we store fat is clearly genetic. How well we store fat may also be genetic.
Different enzymes may be genetically more or less able to store fat.
White body fat
energy
Brown body fat
heat

22. http://www. ecanadanow

23. Causes of Obesity
Overeating
Physical inactivity
What else?

24. The Psychology of Weight Cycling

25. Dangerous Interventions
Over-the-counter drugs
Benzocaine
Phenylpropanolamine
Fad Diets
Already covered.

26. Diet Drugs Meridia Xenical Enhances satiety (reduces food intake)
May increase blood pressure, heart rate, headaches, and dry mouth
Xenical
Partially blocks fat absorption
May cause oily stools, especially if high fat foods are eaten
Reduces absorption of fat-soluble vitamins

27. Weight Loss Drugs Drug Dose Action Adverse Effects
Sibutramine 5, 10, 15 mg Norepinephrine, Increase in heart
(Meridia) 10 mg po qd dopamine, and rate and blood pressure. o start, may be serotonin reuptake
increased to 15 mg or inhibitor.
decreased to 5 mg.
Orlistat 120 mg Inhibits pancreatic Decrease in lipase, decreases absorption
(Xenical) 120 mg po tid fat absorption of fat-soluble
before meals vitamins; soft stools
and anal leakage.
The drugs used to promote weight loss have been anorexiants or appetite suppressants. Two new drugs are sibutramine (Meridia) and orlistat (Xenical). Sibutramine and orlistat are FDA-approved drugs for weight loss.
Very few trials longer than 6 months have actually been done with any of these new drugs.
These drugs are associated with adverse health effects, including an increase in heart rate and blood pressure for sibutramine and, for orlistat, a decreased absorption of fat-soluble vitamins.
Ephedrine, caffeine, and fluoxetine have also been tested for weight loss but are not approved for use in the treatment of obesity. Mazindol, phentermine, benzphetamine, and phendimetrazine are approved for only short-term use for the treatment of obesity.
Herbal preparations are not recommended as part of a weight loss program. These preparations have unpredictable amounts of active ingredients and unpredictable and potentially harmful effects.
CORE SET VI

29. Dangerous Interventions
Herbal products and dietary supplements
St. John’s wort
Serotonin

31. Aggressive Treatments Of Obesity
Clinically severe obesity
Drugs
Sibutramine: appetite suppressent
Orlistat: inhibits pancreatic lipase

33. Surgical Procedures

34. Weight-Loss Strategies
Reasonable goals vs. expectations

37. Weight-Loss Strategies
Eating plans
Be realistic about energy intake
Emphasize nutritional adequacy
Eat small portions
Lower energy density
Remember water
Focus on complex carbohydrates
Choose fats sensibly
Watch for empty kcalories

38. Weight-Loss Strategies

39. Weight-Loss Strategies
Physical activity
Activity and energy expenditure
Activity and metabolism
Activity and body composition
Activity and appetite control
Activity and psychological benefits
Choosing activities
Spot reducing

40. Weight-Loss Strategies
Behavior and attitude
Behavior modification
Become aware of behaviors
Change behaviors
Personal attitude
Support groups

41. Weight-Loss Strategies

42. What Should the Government Do?
Public health programs

43. Weight-Loss Strategies

44. Enemies of Weight Management?
The remote-controlled remote control.
Can Johnny come outside and eat?
Decreased walking and stairs
Desk jobs