Obesity

obesity What is obesity? • Obesity is defined as an excessively high amount of body fat in relation to lean body mass (NRC p. 114; Stunkard, p. 14). • about 20% more than your ideal body weight • Obesity is an ongoing disease, not a cosmetic problem. It means that you have excess body fat that is putting your health at risk. How do I know if I am obese? • Body Mass Index (BMI) of 30 or higher are considered obese • The body mass index compares your height and weight based on the concept that a person’s weight should be proportional to height. BMI Formula BMI = Weight in Kilograms (Height in Meters) x (Height in Meters) OR BMI =[ Weight in Kilograms ÷ [ (Height in cm) x (Height in cm)] ] x 10,000 BMI Table BMI Weight Status Below 18.5 Underweight 24.9 – 18.5 Normal 29.9 – 25.0 Overweight and above 30.0 Obese Calculate BMI Subject Height Weightً 1 1.80 50 2 1.66 76 3 1.45 43 4 1.59 79 What is your BMI? Body Mass Index & Type 2 Diabetes Skinfold Caliper Skinfold measurements: Folds of skin are measured with a caliper. The measurements are used in equations that link the thickness of skinfolds to percent body fat calculations made from more precise .experiments  Bioelectrical Impedance Analysis (BIA) Electrical current travels more easily through tissue containing water. Fat does not contain much water; therefore, electrical flow is impeded. Fat can be estimated by the impedance encountered when electrical currents pass through the body. OMRON Body Fat Analyzer What causes obesity? Causes of Obesity  Causes of obesity are often not simple to identify.  Genetics play a role in obesity.  Lifestyle choices (i.e., food intake and caloric expenditure) are the most important factors leading to obesity.  Knowledge of nutrition  Stress level  Use of medications, such as antidepressants  Environmental influences •Your family's behavior •Availability of food •Culture Caloric Balance Positive caloric balance Caloric intake > caloric expenditure Leads to weight gain Negative caloric balance Caloric intake < caloric expenditure Leads to weight loss Daily Caloric Need Resting Metabolic Rate Number of calories expended to maintain body during resting conditions Typically represents 60 to 70% of daily caloric need Can be estimated with equations Is proportional to body weight Decreases with age More calories are needed to sustain muscle than fat What are the Treatment of Obesity? Treatment • Requires long-term management • Treatment consists of modifying your eating behaviors, physical activity, and monitoring your behavior, such as understanding what may trigger you to eat. • Treatment also covers the psychological and social components of obesity (stress management) • In extreme cases (for some people who have a BMI of 40 or higher) surgical procedures can reduce the size of the stomach Activity Level and Risk of Obesity Data from Hu, F. B., et al. 2003. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in .women Changing Lifestyle to Promote a Healthy Weight Reduce total calories. Reduce fat intake. Increase physical activity. Change unhealthy eating behaviors. Keep records. Plan meals and snacks. Solicit support. Develop a reward system. Gimmicks and Gadgets for Weight Loss People look for quick and easy ways to lose weight. This makes them vulnerable to those selling “quick fixes.” Saunas and sweat suits are sometimes marketed as weight loss aids, when in fact they merely contribute to dehydration. Electrical stimulators for the abdominal muscles have come under recent examination by government authorities for their unproven claims. Spot reduction is a myth that certain exercises can cause weight loss in targeted areas. What is body image? & How were develop our body image? Body Image • Body image = the mental representation a person holds about her or his body • It consists of perceptions, images, thoughts, attitudes, and emotions • Media images are linked to negative body image • Different cultures have different ideas of the “ideal” body type • Poor body image can cause psychological distress Coping Strategies • Some people cope with stress by overeating • Analyze your eating habits to determine if you are using food appropriately • Develop adequate and appropriate strategies for dealing with stress Signs of Disordered Eating A preoccupation with food, calories, and weight Repeatedly expressed concerns about being or feeling fat, even when weight is average or below average Increasing self-criticism of one’s body Secretly eating or stealing food Eating large meals, then disappearing or making trips to the bathroom Consumption of large amounts of food not consistent with the individual’s weight Bloodshot eyes, especially after trips to the bathroom Vomit or odor of vomit in the bathroom Signs of Disordered Eating (continued) Wearing baggy or layered clothing Mood swings Preoccupation with the eating behavior of others Continuous drinking of diet soda or water Periods of severe caloric restriction Excessive laxative use Compulsive, excessive exercise that is not part of the individual’s training program Unwillingness to eat in front of others Strategies for Weight Gain Increase caloric intake by 200 to 1000 kcal per day. This can be done by increasing meal size, number of meals, or number of between-meal snacks. Increase the number of healthy snacks consumed. Choose bread, fruit, and other nutritious foods. The majority of additional calories consumed should be complex carbohydrates (e.g., pasta, bread, rice, potatoes). Strategies for Weight Gain (continued) Add resistance training to the daily routine. Weight training is an effective means for increasing the body’s fat-free mass. When training intensely, be sure to consume 1.5 g of protein for each kilogram of body weight daily. Increase consumption of milk and fruit juices. These excellent choices provide not only additional calories but also essential nutrients. What are the Health Consequences of Overweight and Obesity? Overweight and Obesity: Health Consequences Overweight and obese individuals are at increased risk for many diseases and health conditions, including the following: – Hypertension – 33% rise in type 2 diabetes Stress – Heart disease (Obesity is one of the six major controllable risk factors for heart disease) – Stroke – Respiratory problems – Some cancers (breast, colon) – Excess body fat decreases the ability to perform physical activities – 400,000 premature deaths annually – Weight loss of 5-10% in obese individuals can reduce the risk of certain diseases How many times I need to exercise every day so I can loss weight or maintain good health? & What type of exercise I need to do? Prevention of Obesity Through Physical Activity (continued) Once excess weight has been gained, exercise alone can result in modest weight loss. Caloric restriction combined with aerobic exercise seems to be most useful in weight loss and weight maintenance. Exercise Prescription A minimum of 150 min per week of aerobic activity. 200 to 300 min per week may be more effective for long-term weight control. Exercise 40 to 60 min per day at least 3 days per week. Initial intensity should be 40 to 50% ˙ 2max, with goal of 50 to 70% VO ˙ 2max. VO Exercise Prescription (continued) Target exercise energy expenditure is 300 to 500 kcal each day. Use care to maintain hydration and avoid overheating. Resistance exercise can be used to help sustain lean tissue. Combining Caloric Restriction With Exercise Appropriate weight loss goals are typically 0.5 to 1 kg per week. Avoid diets that consist of fewer than 1200 kcal/day. Choose a varied diet with attention to adequacy of vitamin and mineral intake. Choose a diet low in fat.