1. Eating for health vs. to lose weight Family support and involvement Setting SMART goals

2. Body Weight Food Drink E in E out PA RMR Energy Balance E in = E out

3. Body Weight Food Drink E in E out PA RMR Weight Gain E in > E out

4. Body Weight Food Drink E in E out PA RMR Weight Loss E in < E out

5. Can someone eat a 100% fat diet and lose weight?

6. Body Weight Food Drink E in E out PA RMR E in < E out 700kcals RMR and very light activity for 130 lb woman 5 Pepsis ~1500kcals

7. Kim (39 years old) after her Oprah Show make-over

8. Body Weight Food Drink E in E out PA RMR E in > E out I am training for a marathon, so why am I gaining weight? E for PA increases by 500 kcals/d E intake increases by 800 kcals/d

9. Body Weight Food Drink E in E out PA RMR My metabolism is slow. RMR lower than average 1,100 vs. 1,300 Average energy intake

10. Successful weight losers To be on the list have lost 30+ lbs, kept it off >1 yr Who are they? actual wt lost: >60lbs; maintained new wt: >5yrs middle aged; most overweight / obese as children most had at least 1 overweight / obese parent National Weight Control Registry http://www.nwcr.ws/

11. NWCR Weight loss: no one magical way to lose wt. Weight maintenance small changes in diet many areas = add up to a lot sustainable throughout life low-fat diet (~24% of E as fat) activity – more than 1 hour / day (2X recommended) self-monitoring What did they do?

12. Are wt loss programs, books, diets BAD?

13. Do we burn more calories digesting celery than it provides? 1 celery stalk = 6 calories How many calories do we save if we snack on celery instead of Wheat Thins? Wheat Thins: 1 serv. (16 crackers) = 140 cals

14. What kind of diet is best for weight management? Kennedy, ET, et al. Popular diets: correlation to health, nutrition, and obesity. J Am Diet Assoc 2001;101:411-420 Continuing Survey of Food Intake by Individuals (1994-1996) 10,000+ adults (19ys old+) Authors review of the literature Is there an optimal diet for weight loss? … any diet that reduces energy intake leads to weight loss. … Weight loss is independent of macronutrient composition.

15. Lowest BMI vegetarian high CHO/low fat high CHO Pyramid Nutrient profile Best: high CHO Pyramid Worst: low CHO diet What type of diet is best for weight maintenance?

16. …weight loss [on] low-CHO diets was [due to] decreased calorie intake and increased diet duration, but not to reduced CHO content. Efficacy and safety of low-carbohydrate diets: a systemic review. DM Bravata, et al. JAMA 289(14):1837;2003 But, what about evil carbs?! There remains no consensus about the optimal dietary composition for sustained weight loss. Das, et al. Am J Clin Nutr. 2007 Apr;85(4):1023-30

17. McGraw's 7 Keys 1.understand, face your "personal truth"--what you think about yourself and your weight --and replace toxic messages with positive thoughts 2.learn to counter emotional eating 3.change your environment 4.master impulse eating 5.choose foods 6.adopt an exercise habit 7.assemble a support circle … plan emphasizes foods with high nutritional yields for few calories, and that cannot be eaten quickly (generally because they're high in fiber), so you're less likely to overeat. http://www.drphil.com/

18. Good sources for healthy food choices

19. Guidance on weight loss

20. Eating for health vs. to lose weight Family support and involvement Setting SMART goals Step 1 – think specifically about your diet Step 2 – goals worksheet on CWR site