1. Chapter 12 Achieving a Healthy Weight A Wellness Way of Life Seventh Edition Robbins/Powers/Burgess © 2008 McGraw-Hill Higher Education. All rights reserved.

2. Weight and Health Many Americans are preoccupied with weight and appearance issues. Approximately 60% of Americans are trying to lose weight. 65% of American adults are overweight or obese (31% are obese). BMI is often used as a quick way to assess disease risk – but is based on weight and height so should be taken into consideration with other factors. © 2008 McGraw-Hill Higher Education. All rights reserved.

3. Overweight Versus Obese Overweight refers to a body weight in excess of a recommended range for good health. Obesity refers specifically to having an excessive accumulation of body fat. Body Mass Index (BMI): weight in pounds divided by height in inches squared multiplied by 703 (this measure is not appropriate for athletes or body builders). A BMI of 25 to 30 is considered overweight. A BMI over 30 is considered obese. © 2008 McGraw-Hill Higher Education. All rights reserved.

4. Risks Associated with Obesity Risk factor in four of the ten leading causes of death. Heart disease, cancer, stroke, diabetes, and atherosclerosis. Aggravate liver disorders and arthritis and is a factor in gallbladder disease. Complicates surgery and pregnancy. Also becoming a big problem for children. © 2008 McGraw-Hill Higher Education. All rights reserved.

5. Location of Fat Fat distributed primarily in the abdominal area is linked to increased risk for heart disease, hypertension, high cholesterol, Type 2 diabetes, and cancer. Abdominal fat causes more fatty acids to be in the bloodstream versus lower body fats. Waist to hip ratio might be a better predictor of fat- related health problems. Waist to hip ratio is dividing the waist measurement by the hip measurement. Women should be below.8 and men below.95. Waist circumference alone can also be a predictor of risk. Men with waist over 40 inches and women with waist over 35 inches are classified as high risk, no matter what their weight. © 2008 McGraw-Hill Higher Education. All rights reserved.

6. Theories Energy balancing equation –Calories eaten versus calories burned. An imbalance can create a change in weight. –3500 calories = 1 pound. Fat-cell –Can increase number and size. Genetics can play a part. –Can build new fat cells during growth, pregnancy, and obesity. Fat cells are indestructible. –The overfat usually have more fat cells, so are more at risk for obesity due to increased fat cells. Set-point –Weight regulating mechanism in the brain. May be related to number of fat cells. –May be able to change set-point to lower or higher number. © 2008 McGraw-Hill Higher Education. All rights reserved.

7. Healthy Weight Loss Should use real regular food. Should allow a slow weight loss of 1-2 pounds per week. Should encourage the reduction of fat in the diet. Should encourage safe and personalized exercise. Should not promise a quick fix or easy answer. Should teach life long skills that allow for some flexibility in eating and exercise patterns. Should make possible social eating. Should allow for basic caloric needs – never under 1200 calories per day. Should not be too costly. Should teach techniques to maintain positive behavior. © 2008 McGraw-Hill Higher Education. All rights reserved.

8. Lifetime Weight Management Strategies Food management –Balanced diet (low in fat and sugar, high in fruits, veggies, whole grains, moderate low-fat proteins) with appropriate amount of calories. –Recognize portion distortion. –Avoid mindless eating. Emotional management –Delay, distract, distance. –Avoid eating primarily for emotional needs (stress, bored, lonely, angry, habit). –Observe your eating patterns – when, why, with who, how do you feel. Exercise management –Exercise is the key to maintaining weight loss. –It burns calories. –It prevents loss of lean muscle mass. –It decreases abdominal fat. –It is a natural appetite suppressor. –It may lower your set point. –It improves self-esteem. © 2008 McGraw-Hill Higher Education. All rights reserved.

9. Culture and Weight In the past, fat was a sign of beauty and success. Over time, culture changed (for numerous reasons) and by the 60s, thin was in. Media and society have shifted the expectation for what is “attractive” and that thin is desirable. Most women don’t (and maybe cannot) meet the expectation of very thin. The average woman in America is 144 pounds and wears a size 12-14. Although, the problem affects men as well as women. Most women have a distorted body image. The problem is increasing among men also. © 2008 McGraw-Hill Higher Education. All rights reserved.

10. Eating Disorders Desire to be thin has become an obsession for many and can begin early in life. Thinness is associated with popular and attractive. Estimated that 2/3 of teenage girls have dysfunctional eating behavior. Fear of fat, obsessive dieting and distorted body image can lead to eating disorders. Eating disorder is a disturbance in eating behavior that jeopardizes a person’s physical or psycho-social health. Estimated that 8 to 10 million Americans struggle with eating disorders. © 2008 McGraw-Hill Higher Education. All rights reserved.

11. Eating Disorders Some general causes are: –social pressure for thin and lean body –family with overly high expectations –perfectionist personality –genetic propensity to be overweight –pressure from others to lose weight –Appearance-obsessed friends –low self-esteem Bulimia, Anorexia, Binge Eating © 2008 McGraw-Hill Higher Education. All rights reserved.

12. Bulimia Nervosa Recurrent binge eating large quantities of food. Feeling of lack of control over eating during binges. Self-induced purging – vomit, laxatives, diuretics, fasting or excessive exercise. Two binge episodes a week for at least 3 months. Self-evaluation unduly influenced by body shape and weight. Bingeing and purging are not accompanied by anorexia nervosa. Treatment goal is to get bulimics to cope with stress and body image insecurities through less destructive ways and to feel more comfortable with who they are. © 2008 McGraw-Hill Higher Education. All rights reserved.

13. Anorexia Nervosa Found primarily in early and middle adolescent females. May lead to physical deterioration to the point of hospitalization or death. Rigid dieting. Excessive exercise and energy. Criteria include: –Refusal to maintain body weight at or above a minimal normal level for age and height (25% below normal). –Intense fear of weight gain or becoming fat despite being significantly underweight. –Distorted body image. –Amenorrhea for at least 3 consecutive cycles. Treatment involves medical, psychological, and nutritional help. Denial is the major obstacle to treatment. Entire family should be involved. © 2008 McGraw-Hill Higher Education. All rights reserved.

14. Binge Eating Disorder Sometimes called compulsive overeating. The most common eating disorder. Eating an amount of food much larger than most people would eat in a similar period and accompanied by a sense of lack of control or a feeling that one can’t stop eating. Criteria include: –Eating much more rapidly than normal. –Eating until uncomfortably full. –Eating large amounts of food when not hungry. –Eating alone because of embarrassment about how much is eaten. –Feeling disgusted with oneself, depressed, or guilty about eating. –The binge eating occurs, on average, at least 2 days a week for 6 months. Treatment –Goal is to normalized eating – to refuse overeating. –Help in adopting a plan of healthy eating and moderation without rigid rules. –Help coping with underlying emotions – anxiety, loneliness, depression, shame, inferiority, and fear of criticism. Finally, to accept their bodies. © 2008 McGraw-Hill Higher Education. All rights reserved.

15. What Can Be Done Prevention – helping people understand the concept of health/wellness and healthy body image. Encouraging self-acceptance and esteem. Professional counseling or support groups are available. May need medical attention. Support, love, and encouragement. © 2008 McGraw-Hill Higher Education. All rights reserved.

16. Questions? © 2008 McGraw-Hill Higher Education. All rights reserved.