1st ANNOUNCEMENT OF YOUR 1st ANNOUNCEMENT OF YOUR LIFELIFE

• a crying naughty boy !

• oh, what a beautiful girl !

• a movie star is coming !

• takes after his ugly father....

• ?

• ?

• anyway, this baby will pass away in ?? years..

SHE WEIGHS 4.2 KG

HEALTH RISKS OF OBESITY

• having a weight problem - and that can be underweight as well as overweight - is not a laughing matter.

• chronic disease is more prevalent among obese people than in individuals with normal body fat.

HEALTH RISKS OF OBESITY

• hypertension

• stroke

• renal disease

• gallbladder disease

• diabetes

• pulmonary disease

• problems with anesthesia during surgery

• osteoarthritis & gout

• flat feet

• breast & endometrial cancer

• abnormal plasma lipids & lipoproteins

• impaired cardiac function

• menstrual irregularities & toxemia in pregnancy

• impaired heat tolerance

• organ compression by adipose tissue

• psychological trauma

CONTROLLING YOUR WEIGHT

OVERWEIGHT / OBESE ARE NOT SCIENTIFIC TERMS, BUT LOADED WORDS THAT TRIGGER ANXIETY AND FRUSTRATION

OUR CULTURE IS PREOCCUPIED WITH WEIGHT

BATHROOM SCALES ARE ALMOST COMMON AS BATHROOMS, HOW MANY PEOPLE WEIGH THEMSELVES DAILY AS PART OF THEIR MORNING ROUTINE? THOUSANDS? TEN THOUSANDS? MILLIONS?

Body Composition

Body Composition– Lean body mass - all the body’s non-fat tissue:

bone, water, muscle, connective tissue

– Body fat

» Essential fat - fat incorporated into nerves and organs

» Nonessential fat - within fat cells, below the skin and around major organs

Overweight

People whose weight falls above the range recommended for their gender, age and height

What is Obesity?

WHAT IS OBESITY

• OBESITY IS A MEDICAL TERM MEANING THE STORAGE OF EXCESS FAT IN THE BODY

• NORMAL RANGE OF FAT %– MALE 3% - 20%, OVERFATNESS >20%

– FEMALE 12% - 30%, OVERFATNESS >30%

• A 250-POUND SIX-FOOT LINEBACKER: OVERWEIGHT ACCORDING TO ORDINARY STANDARDS, BUT, BELOW-AVERAGE AMOUNT OF BODY FAT

• A VERY SEDENTARY HABITS PERSON: NORMAL WEIGHT RANGE , BUT, SMALL MUSCLE MASS / EXCESS FAT

Research by Dr. Albert Behnke

• early 1940s, Dr. Behnke, a US Navy physician and foremost authority on body composition.

• detailed measurements on the size, shape, and structure of 25 professional football players.

• body weight ranged from 72.3 - 118.2 kg.

• body weight: 15% above the average “weight-for height” is overweight and rejected for entry into the military. 17 of them were classified as too fat.

• 11 of the 17 had a relatively low % of body fat - the excess weight resulted primarily from their large muscular development.

Assessing Body Weight

• Height-Weight Charts

• Body Mass Index (BMI)

BODY MASS INDEX (BMI)

BMI = Weight in kilograms

Height in meters

HOW FAT IS TOO FAT

• Percent Body Fat As a Criterion

• Fat Patterning As a Criterion

• Fat Cell Size and Number As a Criterion

MEASURE YOUR FATSKINFOLD MEASUREMENTS

SUM OF 3 SKINFOLDS / AGE– SKINFOLD LOCATIONS FOR WOMEN

» TRICEPS

» ILIAC CREST

» THIGH

– SKINFOLD FOR MEN

» CHEST

» ABDOMINAL

» THIGH

FAT PATTERNING

• Adipose cells display remarkable diversity depending upon where they are concentrated. Some are highly efficient at taking up excess nutrients calories from the bloodstream, while others readily release their stored energy for us by other tissues. This helps to explain why certain fat deposits are so difficult to reduce.

• It is also apparent that the patterning of adipose tissue distribution, independent of total body fat, effects the health risk of obesity.

WAIST-TO-HIP RATIO

FAT CELL SIZE AND NUMBER

The body increases its quantity of adipose tissue in two ways:

1. Fat cell hypertrophy: enlarging or filling existing fat cells with more fat

2. Fat cell hyperplasia: increasing the total number of fat cells

FAT CELL SIZE AND NUMBER

1. The person with the lowest fat content had the fewest number of fat cells, while the fattest subject had considerably more cells.

2. There was little relationship between total body fat in the obese and the average size of fat cells.

3. This suggests that there may be some biologic upper limit to how large fat cells can become. After this size is reached, cell number probably become the key factor determining the extent of obesity.

FAT CELL SIZE AND NUMBER

The excessive mass of adipose tissue in obesity, therefore, must occur by fat cell hyperplasia.

An average nonobese person : 25-30 billion fat cells

A moderately obese person: 60-100 billion fat cells

A massively obese person: may be as high as 300 billion or more

(1 billion = 1,000,000,000 = 1000 million)

FAT CELL SIZE AND NUMBER AFTER WEIGHT LOSS

1. THE NUMBER OF FAT CELLS REMAINED UNCHANGED

2. CELL SIZE WAS REDUCED (SHRINK)

The large number of relatively small fat cells in the reduced obese is somehow related to appetite control, causing the person to crave food, overeat, and regain the lost weight.

NUMBER OF FAT CELL

• LAST TRIMESTER BEFORE BIRTH: THE FETUS PREPARES FOR THE UNCERTAINTIES OF LIFE OUTSIDE THE WOMB BY BEGINNING TO ACCUMULATE FAT CELLS

• 1ST SIX MONTHS OF INFANCY: CONTINUES TO INCREASE

• THROUGH CHILDHOOD: SLOWS, AND THE TOTAL NO OF ACCUMULATED CELLS DEPENDS ON GENETIC AND ENVIRONMENTAL FACTORS (OVEREATING)

• PUBERTY: AGAIN SIGNIFICANTLY INCREASES. FEMALES TAKE ON MORE THAN MALES (FOR PREGNANCY AND LACTATION)

• EARLY ADULTHOOD: THE BODY HAS ACCUMULATED THE FAT CELLS IT WILL EVER HAVE

NUMBER OF FAT CELL

• PEOPLE MAY GAIN WEIGHT, BUT FAT CELLS GENERALLY DO NOT INCREASE IN NUMBER BUT ONLY IN SIZE

nonobese subjects who had no previous personal or family history of obesity, body mass increased an average 16.4 kg from voluntary overeating.

average size of fat cells had increased substantially with no change in cell number.

when the subjects reduced to their normal weight through caloric restriction, body fat was decreased and fat cells returned to their original size.

FACTORS EFFECT WEIGHT• CHANCE OF BECOMING OVERWEIGHT

– 10%, NORMAL WEIGHT PARENTS

– 40%, ONE OVERWEIGHT PARENT

– 80%, TWO OVERWEIGHT PARENTS

• RACE, GENDER, ECONOMIC STATUS

WEIGHT REDUCING PROCESS

• 1ST PHASE: THE TIME IT TAKES TO DROP THE DESIRED NUMBER OF POUNDS, WHICH MOST PEOPLE WANT TO DO AS QUICKLY AS POSSIBLE

• 2ND PHASE: THE DEVELOPMENT OF A LIFE STYLE THAT WILL KEEP THE WEIGHT OFF. IT IS THE HARD PART BECAUSE IT HAS TO CONTINUE FOR THE REST OF LIFE

MOST WEIGHT CONTROL PROGRAM EMPHASIZE THE 1ST PHASE ONLY - EASY PART

EVALUATING A WEIGHT-CONTROL PLAN

HOW TO DISTINGUISH A GOOD PLAN FROM INEFFECTIVE OR HARMFUL ONES

• Emphasizes a particular food above all others (grapefruit)

• Guarantees that you’ll lose a certain number of pounds, especially a large number of pounds - “Lose up to 10 pounds a week”

• Described as “first”, “new”, “easy”, “fast” or “innovative”

• Recommends a total daily intake of fewer than 1,200 Kcal.

• Tells you to take megadoses of vitamin and mineral supplements to make up for losses in foods

•Do not take the above programs !!!

EVALUATING A WEIGHT-CONTROL PLAN

• Relies on low-calorie foods that are high in nutrients, particularly fruits, vegetables, and whole grains, and is low in fat

• Offers variety so you don’t get bored with the diet

• Emphasizes slow weight loss and long-term change of eating habits. It shouldn’t promise weight loss exceeding 2 pounds weekly

• Includes exercise as part of the weight loss program

• Designed or reviewed by someone with good credentials in nutrition (degree in nutrition or related academic discipline)

• Offer strict medical care by a trained nutritionist or physician, if you look for a rigorous formula or special diet

Look for the above programs

DIETER

LIMIT AND SELECT THE FOOD ONE EATS TO LOSE WEIGHT

• BAD NEWS:

1. THE BODY RATHER QUICKLY ADAPTS TO A LOWER FOOD INTAKE BY LOWERING ITS METABOLIC RATE AND THUS RESISTS BURNING OFF FAT

2. THE WEIGHT LOST IN THE EARLY PART OF A STRICT DIET PROGRAM IS NOT FAT, BUT WATER

3. IF THE DIETER CONSUMES LESS THAN 1,200 Kcal A DAY, HE MAY LOSE MUSCLE TISSUE AS WELL AS FAT

CONTROL YOUR WEIGHT

HEALTHY LIFE-STYLE

HEALTHY DIET

REGULAR EXERCISE

HEALTHY DIET

• DIET KEY – EATING LOW FAT (?% of daily energy is from fat? /

saturated fat?)

– COMPLEX CARBOHYDRATES (Why?)

• EATING REGULARLY

REGULAR EXERCISE

AEROBIC EXERCISE - ONLY EXERCISE THAT BURNS FAT, AND THUS HELPS YOU TO LOSE WEIGHT

• AT LEAST 3D/WK

• 20-30 MIN IN DURATION

• AT A MINIMUM INTENSITY OF 60% OF HRmax

HEALTHY LIFE STYLE

• EATING BEHAVIOR

• BAD RESPONSE: EATING / STRESS, BORING

• LACK OF WILL POWER

DESIRABLE WEIGHT LOSS PROGRAM (ACSM)

Eating Disorders

Anorexia refusal to maintain body weight at a minimally healthy level and an intense fear of gaining weight or becoming fat; self-starvation

Bulimia repeated episodes of binge eating followed by compensatory behaviors such as self-induced vomiting or excessive exercise

Binge eating begin eating without any compensatory behaviors