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Chapter 9 Energy Balance and Healthy Body Weight
Nutrition: Concepts & Controversies, 12e Sizer/Whitney
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Learning Objectives Delineate the health risks of too little and too much body fatness, with emphasis on central obesity and its associated health risks. Describe the roles of BMR and several other factors in determining an individual’s daily energy needs.
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Learning Objectives Calculate the BMI when given height and weight information for various people, and describe the health implications of any given BMI value. Compare and contrast the roles of the hormones ghrelin and leptin in appetite regulation, and name several other influences on both hunger and satiety.
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Learning Objectives Discuss the potential impact of “outside the body” factors on weight-control efforts. Develop a weight-loss plan that includes controlled portions of nutrient-dense foods to produce gradual weight loss while meeting nutrient needs. Discuss the role of physical activity in maintaining a healthy body composition.
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Learning Objectives Defend the importance of behavior modification in weight loss and weight maintenance over the long term. Compare and contrast the characteristics of anorexia nervosa and bulimia nervosa, and provide strategies for combating eating disorders.
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Introduction Health risks Weight “control” Body composition Overweight
Underweight Weight “control” Focus on weight Focus on controlling weight Focus on short-term endeavors Body composition
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The Problems of Too Little or Too Much Body Fat
U.S. prevalence Underweight Overweight Epidemic Children and adolescents
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Increasing Prevalence of Obesity
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Adult Obesity and Overweight Compared with Healthy People Target
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Underweight, Overweight, and Mortality
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What Are the Risks from Underweight?
Disadvantages Siege or famine Hospital stays Wasting disease Heart disease
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What Are the Risks from Too Much Body Fat?
Obesity-related illnesses Dying young Obesity vs. smoking Hypertension Central obesity Other risks
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What Are the Risks from Central Obesity?
Risks of visceral fat Subcutaneous fat Adipokines Regulate inflammatory processes Central obesity causes a shift Free fatty acids Factors affecting fat distribution
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Visceral Fat and Subcutaneous Fat
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How Fat Is Too Fat? Evaluate health risks of obesity
Body mass index (BMI) Waist circumference Disease risk profile Social costs of being overfat Economic costs of being overfat
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Chronic Disease Risks According to BMI Values and Waist Circumference
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Indicators of an Urgent Need for Weight Loss
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The Body’s Energy Balance
Energy budget Change in energy stores = energy in – energy out Energy in Foods and beverages Energy out Varies widely Lifestyle and metabolism
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The Body’s Energy Balance
Calorie needs Monitor activity and weight Energy output Basal metabolism (BMR) Voluntary activities Thermic effect of food
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Components of Energy Expenditure
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Factors That Affect the BMR
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The Body’s Energy Balance
Estimated energy requirements (EER) Reference man and woman Taller people Need more energy Energy need diminishes with age DRI method Gender, age, physical activity, body size and weight, and growth
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Body Weight Versus Body Fatness
Body Mass Index (BMI) Underweight Overweight Obesity Risks follow racial lines Drawbacks Amount or location of fat Diagnosis requirements
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Measuring Waist Circumference
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Measures of Body Composition and Fat Distribution
Skin fold test Underwater weighing Bioelectrical impedance Dual-energy X-ray absorptiometry Each method has advantages and disadvantages
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Average Body Composition of Men and Women
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Three Methods of Assessing Body Fatness
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How Much Body Fat Is Ideal?
Healthy BMI range Man: 12 to 20 percent Woman: 20 to 30 percent Declaration of being overfat Men age 40 and younger Men over age 40 Women age 40 and younger Women over age 40
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The Mystery of Obesity Obesity’s cause remains elusive Hunger Satiety
Response to physiological need Chemical messengers Stomach hormone Ghrelin Stomach capacity
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Hunger, Appetite, Satiation, and Satiety
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The Mystery of Obesity Appetite Initiates eating Endorphins
Factors affecting appetite
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The Mystery of Obesity “Stop” signals Satiation Satiety
Food in digestive tract Hormones Hypothalamus Satiety Regulates frequency of meals
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The Mystery of Obesity Leptin Energy nutrients Adipokine hormone
Appetite regulation Leptin resistance Energy nutrients Protein provides most satiation
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Inside-the-Body Causes of Obesity
Metabolic theories Variations in ease of body fat gain or loss Variety of theories Genetics Influence tendency to gain weight or stay lean Environmental factors
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Outside-the-Body Causes of Obesity
External cues to overeating Available foods Human sensations Larger portions Physical inactivity Nonexercise activity thermogenesis (NEAT) Inactivity epidemic Sitting still and death from heart disease
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Outside-the-Body Causes of Obesity
Built environment Can discourage physical activity Food access Food deserts Fast food Attain healthy body weight Diet Physical activity Behavior change
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How the Body Loses and Gains Weight
Tissue lost or gain Depends on what you do Water Fat or muscle Smoking Hazards
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Moderate Weight Loss Versus Rapid Weight Loss
Gradual weight loss is preferred Fasting Body adjustments Sacrifice lean tissue Death Ketosis Break down of fat molecules
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Feasting and Fasting
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Moderate Weight Loss Versus Rapid Weight Loss
Short-term fasting Seems to be tolerated Effects of deprivation Overeat or binge eating Weight loss technique Slowing of metabolism Low-carbohydrate diets DRI minimum carbohydrate intake level
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Weight Gain Energy-yielding nutrients contribute to body stores
Four sources of energy Alcohol Two types of energy stores An excess of any food will become fat
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Popular Fad Diets Effectiveness Adequacy Safety
Both sides of the coin Adequacy To be achieved via food, not supplements Safety Personal responsibility
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Achieving and Maintaining a Healthy Body Weight
Changing your body weight What is your motivation? Benefits of modest weight loss Focus on health or fitness
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Tips for Accepting a Healthy Body Weight
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What Diet Strategies Are Best for Weight Loss?
Aim for a realistic target Reasonable goals Specific and measurable objectives Recommended weight loss 1 to 2 pounds per week Weight maintenance Keep records Plan your diet
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What Diet Strategies Are Best for Weight Loss?
Realistic calorie intakes Nutrient needs and caloric intake Men Women Adequate diets Choose sensibly Consider a supplement Calcium
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Recommended Daily Food Intakes for Low-Calorie Diets
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What Diet Strategies Are Best for Weight Loss?
Manage portion sizes Reduced-calorie foods Read labels Calorie calculations Little daily decisions add up Energy density Low energy density May not reflect nutrient density
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Examples of Energy Density
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What Diet Strategies Are Best for Weight Loss?
Artificial sweeteners Soft drinks and milk consumption Meal spacing Hunger vs. appetite Importance of breakfast Night eating syndrome
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Physical Activity in Weight Loss and Maintenance
Physical activity alone Weight maintenance Appetite effects Suppression of appetite Heightened satiety Other benefits Choosing activities
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What Strategies Are Best for Weight Gain?
Physical activity Resistance training High-calorie diet Increased daily caloric intake High energy density foods Portion sizes and meal spacing Avoid tobacco
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Medical Treatment of Obesity
Obesity medications Over-the-counter (OTC) medications Prescription medications Obesity surgery Extreme obesity Not a sure cure Complications Lipectomy
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Surgical Obesity Treatments
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Herbal Products and Gimmicks
Herbals and botanicals Sold as ‘dietary supplements’ Lack of FDA approval Other gimmicks Prohibited claims Saunas or steam baths Cellulite
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Once I’ve Changed by Weight, How Can I Stay Changed?
Lifelong commitment Cultivate habits for a healthy weight Self-efficacy and success keys Physical activity Weight cycling
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Behavior Modification for Weight Control
Change behavior Change thought processes Food and activity diary Don’t attempt to modify all behaviors at once
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A Sample Food and Activity Diary
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Behavior Modification for Weight Control
Modifying behaviors Eliminate inappropriate cues Suppress cues Strengthen cues Repeat the desires behaviors Emphasize negative consequences Emphasize positive consequences Establish baseline Cognitive skills
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The Perils of Eating Disorders
Controversy 9
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Introduction Eating disorders Young women Beginnings of disorders
Anorexia nervosa Bulimia nervosa Binge eating disorder Young women All people Beginnings of disorders
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Society’s Influence Many causes to eating disorders Media messages
Societal pressure for thinness Distorted body image Media messages Unrealistic ideals Dieting as risk
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Eating Disorders in Athletes
Motivations Risk factors Male and female athletes Female athlete triad Three medical problems Male athletes and eating disorders Muscle dysmorphia
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The Female Athlete Triad
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Tips for Combating Eating Disorders
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Anorexia Nervosa Characteristics Role of the family Self-starvation
Cannot recognize condition Role of the family Self-starvation Physical perils Damage to whole body Death Treatment
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Criteria for Diagnosis of Anorexia Nervosa
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Bulimia Nervosa Characteristics Role of the family
More prevalent than anorexia nervosa Role of the family Binge eating and purging Stages of a binge Methods for purging Physical and psychological perils Treatment
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Criteria for Diagnosis of Bulimia Nervosa
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The Cycle of Bingeing, Purging, and Negative Self-Perception
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Binge Eating Disorder Differences from bulimia nervosa
Responds more readily to treatment
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Criteria for Diagnosis of Binge Eating Disorder
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