MPU 3343 NUTRITION & PUBLIC HEALTH

CHAPTER 9 Weight Management – Overweight, Obesity and Underweight

Overweight and Obesity

- Major health problem in the U.S.
~ Growing concern worldwide
- Prevalence continues to increase
~ Women, poor, blacks and Hispanics
~ Children
- BMI of 25 or greater
- Epidemic is worldwide
~ Not merely among industrialised countries

Increasing Prevalence of Obesity among US Adults

Causes of Overweight & Obesity – Genetics & Epigenetics

- Causative role of genetics
~ Genetic influences do seem to be involved
- Genetics may determine predisposition to obesity
~ Genes interact with:
~ Diet and physical activity
~ Satiety and energy balance
- Ghrelin
~ Increases appetite
~ Decreases energy expenditure
~ Promotes positive energy balance
~ Inverse correlation with body weight
~ Roles in the body beyond energy regulation
- Obesity gene
~ Codes for the protein leptin
~ Acts as a hormone in hypothalamus
~ Promotes negative energy balance
~ Suppresses appetite
~ Increases energy expenditure
~ Genetic deficiency of leptin or genetic mutation
~ Rare

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 MPU 3343 NUTRITION & PUBLIC HEALTH

~ Leptin resistance
~ Fructose consumption
~ Leptin injections

Problems of Overweight and Obesity – Dangerous Interventions

- Intervention dangers
- Diet books and weight-loss programs
~ Little success with weight loss maintenance
- Fad diets
- Weight-loss products
- Herbal products
~ Laws for dietary supplements
- Other gimmicks

Aggressive Treatments for Obesity – Drugs

- Strategies for weight reduction depend on:
~ Degree of obesity
~ Risk of disease
- Use drugs as part of long-term comprehensive weight-loss programs
~ Assist with modest weight loss
- FDA approval

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Gastric Surgery Used in the Treatment of Severe Obesity

Weight Loss Strategies

- Successful strategies
~ Small changes
~ Moderate losses
~ Reasonable goals
~ Reasonable rate of weight loss
- Benefits of modest weight loss
- Incorporation of healthy eating and physical activity

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Weight Loss Strategies – Eating Patterns

- Be realistic about energy intake
~ Provide less energy than is needed
~ Avoid restrictive eating
~ Avoid rapid weight loss
- Goal: nutritional adequacy without excess
~ Deficit of 500 to 1000 kcalories per day
- Breakfast frequency
~ Inversely related to obesity
- Nutritional adequacy
~ Minimum of 1200 kcalories a day
- Eat small portions
~ Eat less food at each meal
~ Feel satisfies, not stuffed
~ Structured meal replacement plans
- Lower energy density
~ Cost
- Remember water
~ Assistance with weight management
- Focus on fiber
~ Low in energy and high in nutrients
~ Require effort to eat
~ Speed of food consumption
- Choose fats sensibly
~ Energy density and satiation

Weight-loss Strategies Description

Be realistic about energy intake Energy intake should provide nutritional adequacy without
excess.

Emphasize nutritional adequacy A well-balanced diet that emphasizes fruits, vegetables,

whole grains, lean protein foods and low-fat milk products
that offers many health rewards.

Eat small portions Learn to eat less food at each meal.

Slow down Eating slowly, taking small bites and chewing thoroughly
help to decrease food intake.

Lower energy density Reducing energy density by reducing fat and including fruits
and vegetables.

Remember water Foods with high water content increase fullness, reduce
hunger and consequently reduce energy intake.

Focus on fiber Eating high-fiber foods takes time, which eases hunger and
promotes satiety.

Choose fats sensibly Lowering the fat content of a food lowers its energy density.

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Select carbohydrates carefully A person trying to control energy intake might choose a low-
kcalorie food to help reduce the person’s total energy
intake.

Watch for other empty kcalories Not only does alcohol add kcalories, accompanying mixers
can also add both kcalories and fat; furthermore alcohol
reduces a person’s inhibitions, which can lead to excessive
eating.

Weight Loss Strategies – Physical Activity

- Combination of diet and physical activity
~ Increase metabolism
~ Lose more fat
~ Retain more muscle
- Choosing activities
~ Ones you enjoy & are willing to do regularly
~ Low-to-moderate intensity
~ Spot reducing

Weight Loss Strategies – Environmental Influences

- Factors surrounding eating experience and the food itself
- Atmosphere
~ Pleasant and comfortable equals more food
- Accessibility
~ Less effort needed to obtain food, more food eaten
- Socializing
~ Duration of meal
~ Visual cues
~ Distraction
- Distractions
~ Initiating eating
~ Interfering with internal controls
~ Extending duration of eating
- Multiple choices
~ Large assortments of foods increase consumption
- Package and portion sizes
- Serving containers

Preventing Weight Gain

- Preventing weight gain would benefit many people
- Strategies are similar to losing weight
~ Start earlier

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Underweight
- Affects no more than 2% of U.S. adults
- Weight gain is a matter of health
~ Individual matter
- Weight gain may be difficult
~ Physical conditioning combined with high energy intakes

Weight-Gain Strategies
- Key diet planning strategies
~ Adequacy and balance
- Energy-dense foods
~ Regular meals daily
~ Large portions
~ Extra snacks
~ Juice and milk
- Exercise to build muscles

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