1. Weight Management : Part I It’s All About Balance Amy D. Eades PhD, RD, LD

2. Where are we at with weight management efforts? Healthy People 2010 Objective –Reduce prevalence of obesity among adults to < 15% of total population 64.5% of Americans are overweight or obese Little progress has been made in long-term maintenance interventions

3. Where are we at with weight management efforts?  Traditional lifestyle changes are often difficult to sustain over long-term.  Americans are aware of diet and health knowledge, but often fail to effectively operationalize it.  80% of individuals who lose weight are likely to regain it.

4. When deciding if you are at a healthy weight: Evaluate the “whole picture” –Weight, BMI, waist circumference, body fat –Family history of disease/health conditions –Current health

5. Body Mass Index (BMI)= Weight in Pounds (Height in inches) 2 EXAMPLE: A person who weighs 220 pounds and is 6 feet 3 inches tall has a BMI of: 220 lbs. (75 inches) 2 = 27.5kg/m 2 ) x 703 ( (

6. BMI: What the numbers mean? Below 18.5 Underweight 18.5 – 24.9 Normal 25.0 – 29.9 Overweight >30.0 Obese

7. Definitions of Obesity Body weight 20% above a desirable healthy weight. Excess amounts of body fat BMI: 25.0 – 29.9 Overweight >30.0 Obese

8. How Obesity Impacts Health Risk factor for developing health problems such as: High blood pressure & cholesterol Diabetes Gallbladder disease Gynecologic disorders Arthritis Some types of cancer Some lung problems

9. Food for Thought Can someone be over their ideal weight range or BMI and not be classified as overweight or obese?

10. Energy Balance Energy in= Energy out Energy in < Energy out Energy in > Energy out

11. Calorie/Activity Checkbook What are your needs? What are you taking in? What are you spending? Are you in balance?

12. Energy In Protein – 4 kcal/g Carbohydrates – 4kcal/g Fat – 9 kcal/g Alcohol – 7 kcal/g

13. Recommended Calorie Levels MalesFemales Sedentary 19-20 years 21-25 26-30 2600 2400 2000 1800 Moderately Active 19-20 years 21-25 26-30 2800 2600 2200 2000 Active 19-20 years 21-25 26-30 3000 2400

14. Activity 1.Write down everything you ate in a day’s time. 1.Log onto www.caloriecontrol.org. 2.Go to Enhanced Calorie Calculator. 3.“Enter Calculator” 4.Follow the online directions. 5.After entering in all your foods, see how many calories and fat grams you ate in one day.

15. Factors influencing intake Hunger –physiological need to eat Appetite –psychological desire to eat Satiety –feeling of fullness –absence of the desire to eat

16. Hunger Scale 0 1 2 3 4 5 6 7 8 9 10 1 - Extreme Hunger 5 - Perfectly comfortable satisfied 10 - Uncomfortable: Your button is popping off your pants!

17. Reject the diet mentality Honor your hunger Make peace with food Challenge the food police Feel your fullness Discover the satisfaction factor Cope with your emotions without using food Respect your body

18. Energy out (Total Daily Expenditure) Basal Metabolic Rate Physical activity Thermic effect of food

19. Basal Metabolic Rate (BMR) Accounts for 60-75% of TDE Involuntary activities, excluding digestion Factors affecting BMR –age, height, growth, –body composition, stress, –fitness, starvation

20. Food for Thought When you take away too many kcalories from your diet, does it affect your BMR?

21. Physical Activity Accounts for 15-30% of TDE Total kcalories depend on type, duration, and intensity of exercise Voluntary activities –running, walking, swimming

22. Thermic Effect of Food (TEF) Accounts for the remainder of TDE Energy needed for digestion, absorption, and storage of food 10% of energy in

23. Why do you eat? Hunger Upset Boredom Social Culture Angry Sad

24. Quote of the Day Gluttony is an emotional escape, a sign something is eating us. Peter De Vries

25. Emotional hunger is: Sudden For a specific food “above the neck” Urgency Paired with upsetting emotions Involves automatic and absent minded eating Does not notice or stop eating in response to fullness Feels guilty about eating

26. Are you an emotional eater? I feel out of control when I eat I eat when I’m not hungry I turn to food when stressed or upset. I use food as a source of pleasure or reward. I binge eat. I feel ashamed of myself and my eating. Food helps me deal with feelings.

27. Factors Influencing a Healthy Weight Individual factors Interpersonal factors Community factors Institutional factors Public Policy