WeightManagement

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WEIGHT MANAGEMENT

• M.Prasad Naidu
• MSc Medical Biochemistry, Ph.D,.

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Energy Balance and Weight Management

• ENERGY IN
• Regulation of food intake
• Hunger
• Satiation and satiety
• Appetite

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ENERGY OUT

• Energy expenditure at rest
• BMR - basal metabolic rate rate of energy
  expended at rest (kcal/hr or kcal/day), also
  called RMR (resting metabolic rate).
• Factors that affect BMR (page 257)

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ENERGY OUT

• Energy expenditure for physical activity
• Depends on the activity duration, type, and
  intensity
• Also affected by body size and fitness level

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ENERGY OUT

• NEAT is the energy associated with unintentional
  activities like fidgeting, maintenance of
  posture, or spontaneous muscle contraction

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ENERGY OUT

• Energy expenditure to process food
• Thermic effect of food (TEF) the energy used to
  digest, absorb, and metabolize energy-yielding
  food
• TEF is lower for fat than for carbohydrate and
  protein
• TEF peaks one hour after eating, and normally
  dissipates within 5 hours
• Accounts for 10 of total energy expenditure

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MEASUREMENT of ENERGY EXPENDITURE

• Estimating energy expenditure
• EER an equation used to estimate REE based on
  age, weight, height, and sex
• Page 260

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BODY COMPOSITION

• Assessing body weight
• weight tables
• body mass index (BMI)
• weight (kg)
• height (m2)

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BODY COMPOSITION

• As the BMI table shows, healthy weight falls
  between a BMI of approximately 18.5 and 24.9.

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BODY FAT DISTRIBUTION

• gynoid obesity (pear-shaped figure), more common
  in women
• android obesity (apple-shaped figure), more
  common in men
• increases risk of heart disease and diabetes
  mellitus

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• apple pear

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WHAT CAUSES OBESITY?Current Thinking

• Hereditary and genetic factors
• Sociocultural influences
• Age and lifestyle
• Sex
• Race and ethnicity
• Socioeconomic status
• Employment
• Psychological factors

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ENERGY IMBALANCE Overweight and Obesity

• Health risks (page 265)
• Prevalence of overweight and obesity it is a
  worldwide public health problem. We are now
  seeing an obesity epidemic in children as well as
  adults.

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OBESITY in our CHILDREN

• National Center for Health Statistics suggests
  nearly 25 of children are overweight or obese
• There are now about 5 million obese children in
  the United States up by 50 since 1991

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OBESITY in our CHILDREN

• A 1999 Survey of Seattle High Schools showed
  that
• 9 of males and 6 of females were overweight

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HEALTH CONSEQUENCES

• Overweight children and adolescents are more
  likely to become overweight or obese adults
• Type 2 diabetes, high blood lipids, hypertension,
  early maturation and orthopedic problems also
  occur with increased frequency in overweight
  youth

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ECONOMIC CONSEQUENCES

• In 2000, the total cost of obesity was estimated
  to be 117 billion
• Most of the cost associated with obesity is due
  to type 2 diabetes, coronary heart disease, and
  hypertension

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WEIGHT MANAGEMENTWhat Works?????

• Unfortunately, there is no magic pill, no perfect
  diet. The simple fact is, if you consume more
  calories than you burn, you will gain weight
• A slow weight loss (1-2 pounds per week) is the
  best way
• To lose 1 pound of fat, you must burn an extra
  3500 calories (in one week that 500 calories
  per day)

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WEIGHT MANAGEMENT

• Important Components
• Diet composition
• Physical activity
• Behavioral change
• Balancing acceptance and change
• Support!

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DIET COMPOSITION

• A Healthful Eating Plan Involves
• Realistic energy intake
• Nutritional adequacy
• Small portions, small frequent meals
• Reduced simple sugar and alcohol intake
• Adequate water

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PHYSICAL ACTIVITY

• Contributions to weight loss and maintenance
• Direct increases in energy output (muscles and
  cardiovascular system)
• Indirect energy output (elevated BMR)
• Appetite control
• Psychological benefits
• Note Spot reducing is not possible.

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BEHAVIORAL CHANGE

• Behavior modification the changing of behavior
  by the manipulation of antecedents (cues or
  environmental factors that trigger behavior), the
  behavior itself, and consequences (the penalties
  or rewards attached to behavior).

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SUPPORT

• Family
• Friends
• Weight Loss Support Groups

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WEIGHT MANAGEMENT

• Adjuncts to treatment
• Drugs
• Self-help activities
• Commercial programs
• Professional private counselors
• Surgery gastric bypass, gastric banding

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THANK YOU