Flashcards in Weight Management (Chapter 8) Deck (53):
1
Stats on Canadian health.
34% overweight
18% of women and 19% men are obese
2.0% are underweight
9% gain in obesity over past 25 years
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Overweight?
a body weight that falls above the range associated with minimum mortality (weighing 10% or more over recommended weight or having a BMI over 25)
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Obesity?
Severely overweight with an excess of body fat. Weighing 20% or more over recommended weight or having a BMI over 30
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Health implications of obesity + overweight
> 33% rise in type 2 diabetes
21000 premature deaths annually in Canada
obesity is one of the 6 major controllable risk factors for heart disease
weight loss of only 5-10% --> can reduce the risk of certain medical conditions and increase life expectancy
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health implications of obesity
2x healthy body weight can reduce life expectancy by 8-10 years
increased risk for:
CVD, hypertension, cancer, diabetes, gall bladder disease, joint diseases, skin problems, respiratory problems, impaired immune function & sleep disorders
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Can someone be fat & fit?
Yes, lower body fat levels are preferred but it is possible to have higher and in some cases overfat or obese level of fat and still be considered fit
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factors that contribute to excess body fat
genetic factors
physiological factors
Hormones
"yo-yo" dieting
lifestyle factors
eating patterns
lifestyle physical activity
psycho-social factors
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Genetics factors?
influence body size and shape, fat distribution and metabolic rate (genetic obesity 25-40%). Tendency to develop obesity may be inherited but environmental factors also have an effect - need a balance between the two
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metabolism
sum of all vital processes by which food energy and nutrients are made available to and used by the body
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RMR
resting metabolic rate = energy required to maintain vital body functions - the largest component of metabolism
higher in: men, people with more muscle mass, people who exercise
lower in: women, people who are sedentary, people who lost weight
heredity also influences it
exercise (low to high intensity CV activities & muscular endurance activities - metabolically active muscle tissue)
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food balance equations
energy in (food calories) = energy out (physical activity = 20-30%, food digestion +/- 10%, resting metabolism 65-70%)
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Hormones
play a role in the accumulation of body fat
leptin is involved in the regulation of appetite and metabolic rate
Female hormonal changes affect amount & location of body fat
carbohydrate craving - low levels of serotonin
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Canadians compared to 1991
>400 more calories a day
approx 50 g more of refined and simple carbs
eat out more oftern
more CHO, fat, same protein, larger portions, more sugar, more calories
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Eating patterns
people tend to underestimate how much they eat and overestimate how much they expend energy
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Lifestyle activity
60% connection between overweight and watching TV
activity level has declines
27% of sedentary men are overweight compared to 20% of active men
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Psycho-social factors
eating = means of coping for some
cultural and family influences
women tend to be obese at lower income levels and men obese at higher income levels
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What do you do for successful weight management?
Most weight problems are lifestyle problems. analyze and adjust habits - diet and eating habits, daily physical activity, thoughts, attitudes and emotions and coping strategies
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Diet and eating habits?
total calories = choose an appropriate energy intake to balance your energy expenditure
- calorie needs varies for each individual based on heredity, age, daily activity habits, fitness level...
eg 1600 (sedentary women and older adults) 2800 (teenage boys and very active individuals)
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Low energy density
heavy, but low in calories
vegetables, fruits, high fibre foods
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Fat calories?
easily converted to body fat
low fat burners - convert dietary fat to body fat
keep total fat intake moderate and limit intake of saturated and trans fats
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Carbohydrates?
emphasize whole grains, vegetables, fruits and other high fiber foods
limit foods in refined carbs, added sugars and easily digestible starch (causes blood sugar & hunger fluctuations, increase CVD risk and diabetes)
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proteins?
meet normal requirements of total daily grams of protein based on body weight or elevated endurance needs
high in protein - usually high in fat
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What types of food should you consume?
foods with high nutrient density and low energy density
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servings? (CFG)
grains - 5-12
vegetables and fruits - 5-10
milk products - adults 2-4
meat and alternatives - 2-3
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Physical activity
increase daily physical activity to at least 30 mins per day - to lose weight > 60 mins a day
to maintain weight loss 60-90+
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types of exercise?
CV type endurance exercise burns more calories compared to other forms
calories are burned during the exercise period and the recovery period
strength training builds muscle mass - more muscle tissues can increase metabolic rate
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Exercise
The number of calories burned varies according to the type of exercise, intensity, duration and weight of the body being moved
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high intensity exercise
burns more cals/min but it is usually performed for fewer minutes - may not be as sustainable are moderate intensity exercise over time
injury risk increased
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Physical Activity - intensity
> 30 mins moderate intensity exercise most days
low-intensity = more energy burned from fat
high intensity = more energy burned from CHO
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What about "thoughts about yourself"?
images of the "ideal" self can promote and reinforce low self esteem - criticism
self-talk: a person's internal comments and discussion
realistic "self talk": more balanced, promotes more accurate and positive & motivating beliefs
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Coping strategies?
deal with stress by overeating
food can provide comfort/distraction
analyze your eating habits to ensure that you are using food properly
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how to overcome a weight problem?
do it yourself
diet books
supplements
programs
prescription drugs
surgery
psychological helo
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When you do it yourself
dont try to lose more than 0.25-1 kg per week (daily negative energy balance of 250-1000 per week max)
cut calorie intake with physical activity to develop an effective lifestyle change
loss of 8-10% body weight in 6 months
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rate of weight loss?
initial weight loss is larger - water weight - can cause approx a 5-10 pound weight loss in the first week
after about week 3 - weight loss will slow down
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Maintaining weight?
only 10-15% of people who lost weight will maintain it - therefore choose strategies that help long term
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Diet books?
only accept books that demonstrate strategies that are supported by research and common sense: balanced diet of normal foods and exercise
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Low carbohydrate diet?
not safe long term - hight fat/protein diets may lead to heart disease, cancer...
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low fat diet
should focus on nutrient dense foods, especially whole grains-fruits and vegetables
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what makes a diet plan effective?
realistic food choices, eating habits, portion control habits, in authentic food situations faced in your own daily life (no shakes, food bars...)
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how to be successful in long-term weight loss?
track food intake
engage in > 60 mins physical activity a day
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what makes a weight loss program safe?
diet is safe and balanced, promotes slow/steady weight loss, includes plans for weight maintenance, provides info on fees/costs, social support options
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Dietary supplements
subject to fewer regulations than over the counter meds
ingredients and purity are variable
not proven safe/effective - most likely representations are falso
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Who needs prescription weight loss drugs?
- they affect mood and apetite and can lead to moderate weight loss but have risks and side effects
only recommended for people who are unable to lose weight after a lifestyle change of 6 months (without other medical conditions + BMI>30, with 2+ medical conditions + BMI > 27)
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Surgery?
may be recommended for people with a BMI >40 or >35 + other risk factors
weight loss - 40-70% of total body weight in a year - must be part of a lifestyle plan
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body image
mental representation a person holds about her or his body
perceptions, images, thoughts, attitudes and emotions
media - negative body image for men and women
different cultures have different ideals
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Body Dysmorphic Disorder (BDD)
related to OCD, can lead to depression, social phobia, suicide
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Muscle Dysmorphia
distorted body image - affected people perceive themselves as small and underdeveloped muscles (body builders, men)
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Eating disorder
disturbance in eating patterns and behaviours related to an unrealistically negative body image + inaccurate body weight or body fat assessment
affects females more than males
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Anorexia nervosa
fear of gaining weight/becoming fat
BDD
severe medical complications - muscles wasting, heart damage, death
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Bulimia Nervosa
secret episodes of binge eating + purging
overeating and then vomiting/excessive exercise to prevent weight gain
binge-purge cycles have tremendous stress on the body
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signs of bulimia
eat very quickly
eat until uncomfortably full
eat when not hungry
eats alone
lack of control over eating
feelings of guilt/shame/depression
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How to treat eating disorders?
Deal with the medical aspect, then deal with psychology
stabilize eating & exercise habits
change behaviour patterns and thoughs with therapy/meds
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