Weight Management

• Obesity can lead to serious health problems

• ~35% of adults in industrialized nations are obese
• The average weight of American adults has
increased by 25 pounds or more since 1965
• The prevalence of obesity is higher in African
Americans and Hispanic Americans
• Being underweight is also a problem that can lead
to many medical disorders and death –about 14%
of people in the US are underweight

© Cengage Learning 2015

 Overweight and Obese in the US

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 Weight Management (cont’d.)

• Excessive body weight combined with physical

inactivity contributes to preventable death
• Obesity and unhealthy lifestyle habits are the
most critical public health problems we face in
the 21st century

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 Overweight versus Obesity

• Overweight and obese are not the same thing

• Obesity results in:
– Increased risk of chronic disease
– Decrease in life expectancy
– Decrease in quality of life
– Increase in illness and disability

© Cengage Learning 2015

 Tolerable Weight

• When people set their own target weight, they

should be realistic
– What is this based on?
• “Ideal” body shapes illustrated in popular
magazines are achieved mainly through
airbrushing and medical reconstruction
• Failure to attain a “perfect body” may lead to
eating disorders in some individuals and
emotional distress

© Cengage Learning 2015

 The Weight Loss Dilemma

• Diet without exercise

– Only ~10% of people who begin program are able
to lose desired weight
– Only ~5% are able to keep it off
• Traditional diets fail because few of them
incorporate permanent behavioral changes
– So, what is the trick to weight loss?

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 Diet Crazes

• Fad diets deceive people and claim that

dieters will lose weight by following all
instructions
– With diets that are very low in calories, a lot of
the weight loss is water and protein, not fat
– Dropout rates are high because of difficulty
adhering to limited dietary plans
– Popular diets: DASH, Volumetrics, Best Life,
Weight Watchers, Ornish, Zone, Atkins, South
Beach, Glycemic Index Diet, Biggest Loser,
Mediterranean (these are not fad diets)
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 Crash Diets

• Less than 800 calories/day

– Glycogen storage is depleted in a few days
– Half the weight loss is lean (protein) tissue,
including heart muscle
– Increases risk of heart attacks or fatal cardiac
arrhythmias
– Sodium depletion may cause a dangerous
drop in blood pressure
– Issues with concentration and congnition
– Inability to exercise
© Cengage Learning 2015
 Low-Carb Diets

• Low-carbohydrate/high-protein (LCHP) diets

– Eat all the protein foods you want
– No or limited fruits and vegetables
– No grains
– High in fat
– Low glycemic index; slows insulin response
• Rapid weight loss due to loss of lean tissue and
body water; effectiveness dwindles over time
• Increases the risk for heart disease, cancer, and
kidney or bone damage
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 Eating Disorders
• Eating disorders are medical (psychological)
illnesses characterized by intense fear of becoming
fat –thought to stem from environmental pressures
– Anorexia nervosa: self-imposed starvation
– Bulimia nervosa: pattern of binge eating and purging
– Binge-eating disorder: uncontrollable episodes of
eating excessive amounts of food within a relatively
short time
– Emotional eating: consumption of large quantities of
food to suppress negative emotions
– Orthorexia Nervosa: an obsession with eating foods
that one considers healthy
© Cengage Learning 2015
 Eating Disorders

• Most prevalent in women 25 to 50

• Often a coping mechanism to avoid dealing with
family, stress and social problems
– Clinical depression
– Obsessive-compulsive behavior
– Chemical dependency
– Abuse victims
– Perfectionist personalities
– Opportunity to exert control over self and
environment
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 Anorexia Nervosa

• Fear of weight gain is greater than fear of death

• Distorted image of body
• Preoccupation with food/meal planning
• Diagnostic criteria:
– Refusal to maintain body weight
– Intense fear of gaining weight or becoming fat
– Altered perception of body weight, size, or shape
– Amenorrhea
• Treatment requires professional help
© Cengage Learning 2015
 Bulimia Nervosa
• More prevalent than anorexia nervosa
• Binge-purge cycle
– Eating large and uncontrollable amounts
– Short period of satisfaction
– Feelings of guilt, shame, and fear
– Purging
• Diagnostic criteria:
– Recurrent episodes of binge eating
– Self-induced purge; laxatives, diuretics, medications,
enemas, excessive exercise
– Behaviors occur at least twice a week for three months
– Focus on body shape and weight
© Cengage Learning 2015
 Binge-Eating Disorder

• Causes are unknown; triggered by depression,

anger, sadness, boredom
• Do not purge; may be overweight or obese
• Diagnostic criteria:
– Eating an unusually large amount of food
– Eating until uncomfortably full
– Eating out of control; faster than usual
– Eating alone because of embarrassment
– Feeling disgusted, depressed, or guilty

© Cengage Learning 2015

 Emotional Eating

• Involves consumption of large quantities of

“comfort” food to suppress negative emotions
• Foods such as chocolate cause the body to release
mood-elevating opiates to offset negative emotions
• Coping with the triggers:
– Differentiate between emotional and physical hunger
– Avoid unhealthy foods
– Keep healthy snacks handy
– Use countering techniques
– Keep a “trigger log”
– Work it out with exercise instead of food
© Cengage Learning 2015
 Physiology of Weight Loss

• Three “incorrect” assumptions:

– Balancing food intake against output allows a
person to achieve recommended weight
– All fat people simply eat too much
– The human body doesn’t care how much (or little)
fat it stores
• Obesity involves a combination of genetics,
behavior, and lifestyle factors

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 Energy-Balancing Equation
• Energy-balancing equation
– If caloric input equals output, a person will not gain or
lose weight
• Estimated energy requirement (EER): average
energy (caloric) intake that is predicted to maintain
energy balance for a specific person
• Three components of total daily energy requirement:
– Resting metabolic rate (energy required to maintain
vital body processes in resting state)
– Thermic effect of food
– Physical activity

© Cengage Learning 2015

 Energy-Balancing Equation (cont’d.)

• One pound of fat = 3,500 calories

• Two people with similar measured caloric intake and
output seldom lose weight at the same rate
• Several theories might explain individual variations
• Set Point:
– Every person has his or her own body fat percentage
that the body attempts to maintain
– Under calorie reduction, the body may make metabolic
adjustments to maintain its setpoint
– The basal metabolic rate (BMR) may drop dramatically
under a consistent negative caloric balance, and weight
loss may plateau
© Cengage Learning 2015
 Recommendation
• Daily caloric intake of about 1,750 calories,
distributed properly over the basic food groups
– This is not appropriate for everyone!
– Remove 250 calories from diet & 250 by PA
• Result: weight loss of one pound per week
• Combine a sensible calorie-restricted diet with
an increase in daily physical activity

© Cengage Learning 2015

 Diet and Metabolism

• Weight loss by dietary restrictions alone results in

loss lean body mass – weakens the organs and
muscles and slows metabolism
• When diet is combined with exercise, almost
100% of weight loss is fat, and lean tissue actually
may increase
• Being sedentary is the main cause of lower
metabolic rate, not aging
• Basal metabolism is related to lean body weight
• Severe caloric restrictions always prompts the
loss of lean tissue
© Cengage Learning 2015
 Regulation of Appetite

• Ghrelin stimulates appetite

• Leptin, produced by fat cells, lets the brain know
when you are full & signal energy storage
– Lack of physical activity leads to leptin resistance,
leading to excessive eating
• Sleep deprivation (and stress) elevates ghrelin
levels and decreases leptin levels, potentially
leading to weight gain or keeping you from
losing weight

© Cengage Learning 2015

 Exercise and Weight Management

• Physical inactivity may be the primary cause

leading to excessive weight and obesity
• How much exercise do we need?
– For health benefits
• 30 minutes five days per week
– To prevent weight gain
• 60 minutes daily
– To maintain substantial weight loss
• 90 minutes daily

© Cengage Learning 2015

 The Role of Exercise Intensity and Duration

• Compared with vigorous intensity, a greater

proportion of calories burned during light-
intensity exercise are derived from fat
• Overall, you can burn twice as many calories
during vigorous-intensity exercise and,
subsequently, more fat as well

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 Overweight and Fit Debate

• Can a person be overweight and fit?

– Studies show higher aerobic fitness = lower
mortality rate regardless of overweight or not
– However, debate rages based on the definition of
fit
• Many fitness professionals do not agree that a
person can be fit and fat

© Cengage Learning 2015

 Healthy Weight Gain

• For underweight people, the only healthy way to

gain weight is through exercise (strength-
training) and a slight increase in caloric intake
• Higher caloric intake must be accompanied by a
strength-training program; otherwise, the
increase in body weight will be in the form of fat,
not muscle tissue

© Cengage Learning 2015

Losing Weight the Sound and Sensible Way

• Don’t try to do too much too fast

• Benefits of exercise for weight control
• Sensible caloric reduction
– Exception: those already eating too few calories
• Make wise food choices
– Think long-term benefits instead of instant
gratification
– Estimate daily energy requirement (EER) based
on age, total body weight, and gender

© Cengage Learning 2015

Losing Weight the Sound and Sensible Way

• Successful diets: about 24% calories from fat,

56% from carbohydrates, and 20% from protein
– You cannot remove CHOs or fat.
• Breakfast is a critical meal while on a weight-
loss program
– Consuming most of your daily calories in one
meal may cause more calories to be stored as fat
– Consuming most calories earlier in the day helps
lose weight and manage atherosclerosis

© Cengage Learning 2015

 Monitoring Your Diet with Daily Food Logs

• People who monitor daily caloric intake are more

successful at weight loss than those who don’t
• To lose weight, use the diet plan that most
closely approximates your target caloric intake
• Pay particular attention to food serving sizes,
and read food labels carefully

© Cengage Learning 2015

 Behavior Modification and Adherence

• If weight management is to become a priority, people

must transform their behavior
• Surround yourself with people who have the same
goals as you do
• Regardless of other lifestyle habits, individuals who
consume unhealthy foods gain more weight, and
those who make healthy food choices gain less weight
• Weight gain is strongly associated with the
consumption of potato chips, potatoes, sugar-
sweetened beverages, and red meats
• Focus on Health! Not Weight!
© Cengage Learning 2015
 The Simple Truth

• Weight management is a lifetime commitment

– When taking part in a weight (fat) reduction
program, people also have to decrease caloric
intake moderately, be physically active, and
modify unhealthy eating behaviors
• Three common reasons for relapse
– Stress-related factors
– Social reasons
– Self-enticing behaviors
• Those who persist will reap the rewards
© Cengage Learning 2015
 Key Terms
• Glycogen: Storage form of carbohydrates in the human body,
predominantly in the liver and muscles.
• Glycemic index: System used to rate glucose response of
carbohydrate-containing foods with the response produced by
the same amount of a standard carbohydrate, usually glucose
or white bread
• Weight-regulating mechanism (WRM): The hypothalamus of
the brain controls how much the body should weigh
• Setpoint: Weight control theory that the body has an
established weight and strongly attempts to maintain that weight
• Basal metabolic rate (BMR): The lowest level of oxygen
consumption necessary to sustain life
• Very-low-calorie diet: Diet that allows an energy intake of only
800 calories or less per day
© Cengage Learning 2015