weight management exam 2

stages of change/trans theoretical model

• takes into account thinking. feelings, behaviors, relationships, and many other factors

• 6 stages

precontemplation

• first stage in the TTM

• don’t even know the problem exists, not ready for change, denies the problem, blames others

contemplation

• second stage in the TTM

• thinking about making the change within the next 6 months

preparation

• third stage in the TTM

• getting ready to make a change, will likely do something within the next 30 days

action

• fourth stage in the TTM

• you are making the change, will have consistent effort for the next 6 months

maintenance

• fifth stage in the TTM

• maintain the behavior for 6 month

termination

• sixth stage of the TTM

behavioral strategies to consider

• self-monitoring

• stimulus control

• cognitive restructuring

• stress management

• social support

self-monitoring

• increase self-awareness

• establish a baseline

stimulus control

• establish and identify triggers that are helping or hurting the behavior

cognitive restructuring

• how do you personally define success

• make realistic expectations

• make small changes

stress management

• adding physical activity (movement)

• emotional eating (not good to always lean towards a treat when you have a bad day)

negatives of labeling foods

• leads to restrictive thinking and all-or-nothing thinking

• makes people feel bad and guilty

realistic management goals

• 5-10% body weight loss

• health, energy, fitness

• well-being and self-esteem

• mood and appearance

• functional and recreational activity

benefits of modest weight loss

• loss of 5-10% BW

• decreases obesity-related chronic disease factors and improves other factors

• decreases:

  • glucose/insulin

  • BP levels

  • A1C

  • TAGs

  • LDL

• increases

  • HDL

  • quality of life indicators

methods of measuring

• body fat %

• waist circumference (Nadiya does not do this anymore)

• inches

• sizing of clothes

• biochemical markers

challenging realities of weight loss

• effort and work for weight loss maintenance is the SAME OR MORE for weight loss

• average person wants to drop 30-35% of BW, most lifestyle changes lead to 8% loss

weight loss plateau

• weight loss is at a standstill - VERY COMMON

• usually around 6 months into making a change

• very predictable

why does the body reach a plateau

• the body weighs less - there is LESS of you to move around so the body burns less

• how has body composition changed

  • lean body mass burns more than body fat

  • make sure the LBM is being worked and not starved

• body becomes more efficient at both utilizing the calories put in AND the new exercise demands (when the body feels starved, the body will slow the metabolism)

what to do when you hit a plateau

• reevaluate the diet

  • evaluate the caloric intake

  • are macro needs being met to meet demands

• reevaluate activity

  • since you are in better shape, you can work more/harder

vulnerable periods for weight gain

• pregnancy

• childhood

• adolescence

• adulthood/menopause

how much should a person weigh

• calculate IBW

• need to know gender and height

• does NOT help determine body comp.

IBW equation for female

100 lbs for the first 60”

then add 5lbs for every inch

ex: 5’1 (100 +5) = 105lbs

THEN ± 10%

IBW equation for male

106lbs for the first 60”

then add 6lbs for every inch

ex: 6”2 (106 + 14×6) = 190 lbs

± 10%

pregnancy

• does NOT mean you get to eat 2

• gestation is 40 weeks

• weight gain starts in 2nd and third trimester

pregnancy weight gain saying

WHEN you gain weight during pregnancy is just as important as HOW much weight you gain

pregnancy chart

• if you gain a lot of weight in the beginning, it is not the fetus, it is just the mother putting on extra fat

caloric needs during pregnancy/breastfeeding

• only need 200 calories extra a day for pregnancy

• need 800 calories extra a day for breastfeeding (from body having to prepare another food source)

childhood

• high birth weight is linked to being overweight later in life

  • increases risk for C-section

  • typical BW weight 7-8.5lbs

• breastfeeding decreases the risk of obesity

  • baby KNOWS how much to eat

  • will stop sucking for milk when it is done

• early introduction of solid foods increases caloric intake TOO fast TOO quick

• gestational smoking (47% increased risk in an increase in BW LATER in life)

  • when born, the baby if often underweight

childhood to adolescence

• what happens we go through childhood that could increase risk for obesity

• increases

  • screen time

  • sedentary behaviors

  • energy intake

  • independent food choices

  • body fat mass for girls as they enter puberty

    • body fat is higher in women than guys

    • relates to increasing risk of eating disorder

    • due to hormones: estrogen, progesterone

adulthood

• decrease in lean mass with increase intramuscular fat

• sports or other physical injury

• stress

• life course transitions

menopause

• decrease in resting energy expenditure, lean body mass, energy requirements

• stable or increasing kcal intake WHILE lessening activity

• decreased sleep

• increased risk for depression (need for meds)

  • side effects of meds are often weight gain

• NEED to increase protein intake and start weightlifting (strengthens bones)

what causes weight gain in menopause (according to Nadiya)

• shift in hormone levels

why does hormone shift cause weight gain in woman

• redistribution of fat to the abd which increase visceral fat - increases risk for chronic disease

• hysterectomy: second most common surgical procedure among women

  • this removes the uterus - replicates going through menopause - the women will go through the same side effects of hormone changes no matter the age

metabolic syndrome

• needs there to be 3 indicators to be diagnosed

  • central of abdominal obesity (measure through waist circumference)

    • men - 40 inches or above

    • women - 35 inches or above

  • TAGs - greater than or equal to 150 mg/dL

  • HDL cholesterol (you WANT this to be hard)

    • men - less than 40 mg/dL

    • women - less than 50 mg/dL

  • BP - greater than or equal to 130/85 (normal is 120/80)

  • fasting glucose is greater than or equal to 100 mg/dL