1. Topic 9: Weight Management Chris Blanchard
BMS208 Human Nutrition
Topic 9: Weight Management
Chris Blanchard

2. Learning objectives
Define overweight and obesity using the body mass index.
Explain fat cell development and its role in obesity.
Discuss the role of lipoprotein lipase in obesity.
Discuss the set point theory of obesity.
Discuss the role of genetics, leptin, and ghrelin in the development of obesity.
Identify environmental causes of obesity.
Describe the consequences of obesity including health, social and psychological problems.

3. Learning objectives (Cont.)
Explain the risks of fad diets, dietary supplements, and herbs in the treatment of obesity.
Explain the drugs used to treat obesity and their side effects.
Discuss the risks and benefits of surgery for obesity.
List strategies for successful weight loss.
Explain the role of exercise in weight management.
Discuss the causes and treatment of underweight.
Evaluate fad diets for effectiveness, safety and long-term weight control.

4. Overweight
Overweight (BMI ) and obesity (≥ 30) are widespread health problems that are continuing to increase.
Many refer to overweight and obesity as an epidemic.
For good health, weight management is important.

5. Fat Cell Development Fat cell numbers
Fat cell numbers increase most rapidly in later childhood and early puberty.
Fat cell numbers increase in times of positive energy balance.
Hyperplastic obesity

6. Fat Cell Development Fat cell size
Fat cell sizes increase when energy intake exceeds expenditure.
Hypertrophic obesity
The adverse effects of fat in non-adipose tissue are called lipotoxicity.

7. Fat Cell Metabolism Lipoprotein lipase promotes fat storage.
Gender differences
Men are at increased risk for developing central obesity and women are at increased risk for lower body fat.
Enzymes that break down fats affect men and women differently.

8. Set-Point Theory
The body’s natural regulatory centers maintain homeostasis at set point.
The human body tends to maintain a certain weight.

9. Causes of Obesity
Obesity may not be as simple as food intake exceeding metabolic needs.
Some factors, such as overeating and inactivity, are within our control.
Genetic, hormonal and emotional factors may require professional intervention.

10. Causes of Obesity Genetics Leptin (also called the ob protein)
Protein that acts as a hormone to increase energy expenditure and decrease appetite
Produced by fat cells under the direction of the ob gene
May be deficient in obese individuals
More research is needed.

11. Causes of Obesity

12. Causes of Obesity Genetics Ghrelin
Protein that acts as a hormone to decrease energy expenditure and increase appetite
Produced by stomach cells
Has an inverse relationship with PYY
PYY: a peptide secreted by GI cells after a meal in proportion to the kcalories ingested

13. Causes of Obesity Genetics Uncoupling Proteins
Influence energy metabolism
White adipose tissue stores fat to be used for energy.
Brown adipose tissue stores fat to be used for heat.
May inhibit the development of obesity

14. Causes of Obesity
Environment – The gene pool of our population remains relatively unchanged.
Overeating
Present and past eating influences current body weight.
Increased availability of convenient food, large portions, and energy-dense foods
Physical Inactivity
Modern technology replaces physical activities.
Physical activity is important to allow people to eat enough food to get needed nutrients.

15. Problems with Obesity
Obesity problems depend on many factors such as the extent of overweight, age, health status and genetic makeup.
Risk factors may differ among individuals.

16. Problems with Obesity
Health risks are evaluated using BMI, waist circumference and disease profiles.
Overweight people who are in good health may not need to lose weight.
Obese or overweight people with risk factors could improve health by losing weight or using other diet and exercise strategies. Risk factors include:
Hypertension
Cigarette smoking
High LDL
Low HDL
Impaired glucose tolerance
Family history of heart disease
Men ≥ 45 years, women ≥ 55 years

17. Problems with Obesity Health Risks
Obese or overweight people with the following life-threatening-conditions may improve health by losing weight:
Heart disease
Type 2 diabetes
Sleep apnea

18. Problems with Obesity Perceptions and Prejudices Social Consequences
Prejudices and discrimination
Judged on appearance rather than character
Stereotyped as lazy and lacking self-control
Psychological Problems
Feelings of rejection, shame and depression are common.
Ineffective treatments can lead to a sense of failure.

19. Problems with Obesity

20. Problems with Obesity Dangerous Interventions Fad Diets False theories
Inadequate diets
Can be a danger to health

21. Problems with Obesity Dangerous Interventions Weight-Loss Products
Ephedrine-containing products inhibit serotonin and suppress the appetite. Supplements containing Ephedra have been banned due to potential health risks.
Herbal laxatives do not prevent absorption.
Current laws do not require safety tests and effectiveness tests for these products.
Other Gimmicks
Don’t work
There is no such thing as cellulite.

22. Aggressive Treatments of Obesity
Individuals with clinically severe obesity and major medical problems may benefit from drugs or bariatric surgery.
But changing and improving eating and exercise habits offer the greatest benefit.

23. Aggressive Treatments of Obesity
Drugs
Sibutramine suppresses the appetite and is most effective when used with a reduced kcalorie diet and increased physical activity. There are many side effects.
Orlistat blocks fat digestion and absorption. There are many side effects.
Other drugs are still under study.

24. Aggressive Treatments of Obesity
Surgery
Surgery is an option for those who have tried weight loss programs and failed, have a BMI ≥ 35, and are having health problems due to their weight.
Gastric surgery has short-term and long-term problems and requires compliance with dietary instructions.
Liposuction is a popular procedure that is primarily cosmetic but poses risk.

25. Aggressive Treatments of Obesity

26. Weight-Loss Strategies
A life-long eating plan for good health, which includes nutritionally adequate eating, reasonable expectations, regular physical activity, and permanent lifestyle changes, is best for achieving permanent weight loss.
Weight loss of 1-2 pounds per week or 10% of body weight in six months is safe.

27. Weight-Loss Strategies

28. Weight-Loss Strategies

29. Weight-Loss Strategies
Eating Plans
Be Realistic about Energy Intake
kcalories/day reduction for BMI between 27 and 35
kcalories/day reduction for BMI ≥ 35
Dietary Guidelines should be followed.
Diet should be nutritionally adequate while avoiding excessive consumption.
Smaller portions are recommended to feel satisfied, not stuffed.

30. Weight-Loss Strategies

31. Weight-Loss Strategies
Eating Plans
Eat foods of lower energy density, that are high in fiber, high in water and low in fat.
Water is important to increase fullness and reduce hunger.
Complex carbohydrates offer abundant vitamins, minerals and fiber with little fat.
Choose fats sensibly and reduce the quantity of fat.
Watch empty kcalories from sugar and alcohol.

32. Weight-Loss Strategies

33. Weight-Loss Strategies
Physical Activity
An individual’s body weight as well as intensity and duration of activity influence energy expenditure.
Physical activity increases the amount of discretionary kcalories that can be consumed.
Metabolic rates can rise with daily vigorous activity.
Activity can decrease body fat and increase lean body mass.
Exercise may help to curb appetite.
Activity can reduce stress and improve self-esteem.

34. Weight-Loss Strategies

35. Weight-Loss Strategies
Physical Activity
Choosing Activities
Choose activities that you enjoy and are willing to do regularly.
Low to moderate intensity for long duration is recommended.
Daily routines can incorporate energy activities.
Spot Reducing
Regular aerobic exercise and weight loss will help trouble spots.
Strength training can improve muscle tone.
Stretching can help flexibility.

36. Weight-Loss Strategies
Behavior and Attitude
Behavior modification requires time and effort.
Awareness of behavior is the first key.
Changing behaviors one at a time works best.
Do not grocery shop when hungry.
Eat slowly.
Exercise while watching television.
Personal attitudes toward food and eating must be understood.
Support groups may be helpful for some people.

37. Weight-Loss Strategies

38. Weight-Loss Strategies
Weight Maintenance
Successful weight-loss maintenance programs use different criteria so they are difficult to compare.
Vigorous exercise and careful eating plans are key.
Frequent self-monitoring is recommended.

39. Weight-Loss Strategies
Prevention
Eat regular meals and limit snacking.
Drink water in place of high-kcalorie beverages.
Select sensible portion sizes and limit daily energy intake to energy expended.
Limit sedentary activities and be physically active.

40. Weight-Loss Strategies
Public health programs have been suggested to:
Develop safety standards for foods.
Control commercial advertising.
Control conditions under which foods are sold.
Control prices to reduce consumption.

41. Underweight
Incidences of underweight and associated health problems are less prevalent than overweight and obesity problems.

42. Underweight Problems of Underweight Causes are diverse.
Energy demands may be great and foods are needed to support growth and physical activities.
Eating disorders are severe cases.

43. Underweight Weight-Gain Strategies
Energy-dense foods can be included but choose fat wisely to avoid the associated cardiac risks.
Regular meals each day must become a priority.
Use large portions and expect to feel full.
Consume extra snacks between meals.
Juice and milk are easy ways to increase kcalories.
Exercising to build muscles will support increases in muscle mass.

44. The Latest and Greatest Weight-Loss Diet--Again

45. The Latest and Greatest Weight-Loss Diet--Again
Fad diets do not offer safe or effective plans for weight loss.
Diet recommendations should be research based.
There are guidelines for identifying fad diets and weight-loss scams.

46. The Diet’s Appeal
There are many misconceptions and distortions of facts.
Results are not long lasting.

47. The Diet’s Achievements
Don’t Count kCalories
Satisfy Hunger
Follow a Plan
Limit Choices

48. The Diet’s Shortcomings
Too Much Fat
Too Much Protein
Too Little of Everything Else

49. The Body’s Perspective
Adverse side effects of low-carbohydrate, ketogenic diets
Nausea
Fatigue
Constipation
Low blood pressure
Elevated uric acid
Stale, foul taste in the mouth
Fetal harm and stillbirth