Week 23 Weight Management Flashcards
Obesity Background
- Complex health issue resulting from a combination of contributing factors
- Individual factors-genetics, behaviors, medications
- Societal factors- environments, education, food politics, toxic chemicals
- Associated with reduced quality of life, poor mental health, heart disease, diabetes
Family History & Other Factors
- Obesity does run in families (shared genes, shared environments)
- Studies have identified gene variants
- Some illnesses may lead to weight gain or obesity (cushions, POS
- Some medications such as steroids and antidepressants may cause weight gain
- Science still emerging on microbiome and role of obesogens (chemical exposures)
Obesogens
- May increase a person’s sensitivity, or susceptibility, to gaining weight
- Chemicals are believed to change how a person’s lipid (fat) cells develop
- May make it more difficult for a person to maintain a healthy weight
- May impact how the body regulates feelings of hunger and fullness, or increase the effects of high fat and high sugar diets
- Most sensitive time for obesogens exposure is early development
Obesogen Examples
Examples of chemicals • Cigarette smoke • Air pollution • Tributyltin (used in PVC piping) • Flame retardants • Phthalates (toys, detergents, nail polish, shampoos, food packaging) • Some pesticides • PCBs paints, cement, fluorescent lights, sealants,
Health Consequences of Obesity
- Increased risk for all causes of death
- Hypertension
- Dyslipidemia (high LDL cholesterol, low HDL cholesterol, high triglycerides)
- Type 2 diabetes
- Coronary artery disease
- Stroke
- Gallbladder disease
- Sleep apnea
- Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
- Mental illness (clinical depression, anxiety, other mental disorders)
Societal Consequences of Obesity
- More than 2 in 3 adults are overweight or obese
- Increased medical costs
- Direct: preventative, diagnostic, treatment services
- Indirect: morbidity and mortality costs; productivity
- Medical care costs was $147 billion in 2008
- Implications on armed forces recruitment
Body Mass Index (BMI)
- One of the assessments that can be used as a screening tool to measure disease risk
- BMI is not diagnostic of body fatness or health of an individual
- Simple calculation using a person’s height and weight
- BMI = kg/m2 (kg is weight in kilograms; m2 is their height in meters squared)
- High BMI- may be an indicator of having too high body fatness
- Low BMI- may be an indicator of having too low body fatness
BMI Categories
- BMI < 18.5: underweight range
- BMI 18.5-24.9: normal range
- BMI 25.0-29.9: overweight range
- BMI 30.0+ : obese range
- BMI 30.0-34.9: class 1 obesity
- BMI 35.0-39.9: class 2 obesity
- BMI 40.0+: class 3 obesity
Waist Circumference
Another tool used to estimate disease risk
• Excessive abdominal fat poses a greater risk for health conditions such as diabetes, CAD
• Can be used as a screening tool but is not diagnostic of body fatness or health
• Higher disease risk associated with waist circumference
• Men: 40+ inches
• Non-pregnant women: 35+ inches
Waist Circumference Quick Reference
Low-Risk men 37 in- women 31.5 in-
Intermediate Risk men 37 to 40 women 31–35
High Risk 40 in + 35 in+
BMI vs. Waist Circumference
BMI is a good estimation tool- more accurate than skinfold measurements
• BMI does not reflect the difference between muscle weight and body fat
• BMI does not reflect how body fat is distributed across the body
• Waist measurement is more prone to errors than measuring height and weight
• Best approach is to use both BMI and waist circumference
• BMI: best estimate of total body fatness
• Waist circumference: best estimate of visceral fat/risk of obesity-related disease
Considerations for Weight Loss
• There is no single strategy/approach/dietary plan for weight loss
• Important to consider what is realistic for the client’s preferences/lifestyle
• Consider the impacts of the top 4 health pillars
1. Nutrition (incl alcohol, caffeine, intolerances, hydration)
2. Physical activity
3. Sleep
4. Stress management
• Consider belief systems, environment, relationships w/self and others, mental health/trauma
• Consider weight history, health history, family history, medication impacts, social support
4 Key Habits for Weight Loss
- Tracking physical changes
Weighing, using clothing as measurement, using body measurements - Journaling food intake
- Follow a whole-foods based eating pattern
An anti-inflammatory diet, Mediterranean, DASH - Increase physical activity
• Work up to 180 minutes/week during weight loss
• Work up to 250 minutes/week for weight maintenance
Healthy Eating Plate
¼ plate: Complex carbohydrates (starchy vegetables, whole grains) ¼ plate: Protein-rich foods ½ plate: Non-starchy vegetables 1-3 tablespoons: Healthy fat Water!
