Chapter 15: Weight Management
In the early 1960s, fewer than 32% of Americans were overweight.
Currently, 67% of Americans are overweight.
Over 33% of adults and 16% of children are obese.
Americans spend over $60 billion annually on weight-loss solutions.
The U.S. health care system spends $190 billion annually on obesity-associated medical conditions.
Weight Management: Maintaining body weight within a healthy range (BMI of 18.5 to 24.9).
Healthy Weight: A body weight that does not increase the risk of weight-related health problems or diseases.
Healthy weight lowers the risk of chronic disease.
In 2013, the American Medical Association declared obesity a disease.
Benefits:
Clear warning of health hazards of being overweight.
Easier insurance coverage for treatment.
More research funding to address obesity.
Downsides:
Potential increased use of drugs and medical procedures instead of lifestyle changes.
Higher costs for treating obesity.
Overweight individuals face discrimination, denial of job promotions, and reduced college acceptance.
Perception of being lazy or weak-willed.
Higher rates of suicide and drug and alcohol use.
Underweight individuals may face irritability, anger, and depression.
Appetite: Desire to eat food, triggered by factors like time of day, social occasions, emotions, or food cues.
Hunger: Physical sensation associated with the need or intense desire for food.
Satiety: Feeling of fullness from food consumption.
Satiety: Triggered by the ventromedial nucleus.
Cholecystokinin (CKK) and peptide YY (PYY): Secreted by the small intestine to stimulate satiety.
Leptin: Produced in adipose tissue, decreases hunger and food intake, regulates fat storage, decreases with weight loss and intake of certain vitamins and minerals.
Protein promotes satiety and reduces food intake.
Hunger: Controlled by the lateral hypothalamus.
Ghrelin: Secreted by the stomach, increases hunger during fasting or low-calorie diet.
Neuropeptide Y: Produced in the hypothalamus, activated by ghrelin, stimulates hunger and lipoprotein lipase (LPL) activity.
Leptin: Drop in leptin when adipose tissue shrinks stimulates hunger.
Hypertrophy: Fat cells expand to store more fat.
Hyperplasia: Production of more fat cells when filled to capacity.
Average adult has 30 to 50 billion adipocytes, holding 0.4 to 0.5 micrograms of fat each.
Overweight or obese adults have larger adipose cells (0.6 to 1.2 micrograms each).
Fat cells shrink with weight loss, but their number does not decrease.
Fat growth and cell production continue throughout life, but hyperplasia slows with age.
Lipoprotein Lipase (LPL): Increases lipogenesis.
Hormone-Sensitive Lipase (HSL): Stimulates lipolysis.
Heavier individuals have increased LPL activity.
Men: LPL more active in visceral, abdominal fat cells.
Women: LPL activity higher in hips and thighs.
Nutrigenomics: Study of how genetic makeup interacts with diet.
Epigenetics: Changes in gene activity and expression without altering DNA sequence.
Genes can be turned on/off by DNA methylation and histone modifications.
Single-nucleotide polymorphisms (SNPs) alter the nucleotide sequence.
Epigenetic alterations and SNPs affect response to food intake.
Adiponectin: Hormone secreted by adipocytes, improves insulin response, reduces fat accumulation, enhances energy expenditure, lower in obese individuals and type 2 diabetics.
Genetic Set Point Theory: Body fights to remain at a specific weight, opposing weight loss.
Populations prone to obesity can overcome genetic predisposition with exercise and healthy eating.
Modern environment promotes positive energy balance and weight gain.
Lack of Time: More calories from foods eaten away from home.
Abundant Food Supply: Larger portions and easier access to food.
Lack of Physical Activity: Less manual labor, more driving, and sedentary behavior.
Reasonable Weight Loss: Aim for 10% body weight loss over six months.
Diet and Activity: Choose lower-calorie foods, reduce portions, increase physical activity.
Volume to Meals: Add protein and healthy fats for satiety.
MyPlate Guide: Use for balanced diet planning.
Physical Activity: 60-90 minutes of moderate-intensity daily, combining cardio and strength training.
Behavior Modification
Change Eating Behaviors: Keep a food log, control environmental cues, manage stress.
Weight Maintenance
Maintain energy gap reduction, reduce calorie intake, eat smaller meals, maintain high physical activity, and self-weigh weekly.
Weight Gain Strategies for Underweight
Goal: Gain muscle, not fat.
Methods: Add 500 kcal daily, choose energy-dense foods, include regular exercise and resistance training.
Medical Interventions for Extreme Obesity
Weight-loss Medications: Sibutramine, Orlistat, Lorcaserin.
Evaluate side effects.
Bariatric Surgery: Gastric bypass, gastric banding.
Post-surgery: Small, frequent meals, supplements (iron, B12, calcium, vitamin C).
Weight loss: Rapid initially, then 1-2 lbs per week.
In the early 1960s, fewer than 32% of Americans were overweight.
Currently, 67% of Americans are overweight.
Over 33% of adults and 16% of children are obese.
Americans spend over $60 billion annually on weight-loss solutions.
The U.S. health care system spends $190 billion annually on obesity-associated medical conditions.
Weight Management: Maintaining body weight within a healthy range (BMI of 18.5 to 24.9).
Healthy Weight: A body weight that does not increase the risk of weight-related health problems or diseases.
Healthy weight lowers the risk of chronic disease.
In 2013, the American Medical Association declared obesity a disease.
Benefits:
Clear warning of health hazards of being overweight.
Easier insurance coverage for treatment.
More research funding to address obesity.
Downsides:
Potential increased use of drugs and medical procedures instead of lifestyle changes.
Higher costs for treating obesity.
Overweight individuals face discrimination, denial of job promotions, and reduced college acceptance.
Perception of being lazy or weak-willed.
Higher rates of suicide and drug and alcohol use.
Underweight individuals may face irritability, anger, and depression.
Appetite: Desire to eat food, triggered by factors like time of day, social occasions, emotions, or food cues.
Hunger: Physical sensation associated with the need or intense desire for food.
Satiety: Feeling of fullness from food consumption.
Satiety: Triggered by the ventromedial nucleus.
Cholecystokinin (CKK) and peptide YY (PYY): Secreted by the small intestine to stimulate satiety.
Leptin: Produced in adipose tissue, decreases hunger and food intake, regulates fat storage, decreases with weight loss and intake of certain vitamins and minerals.
Protein promotes satiety and reduces food intake.
Hunger: Controlled by the lateral hypothalamus.
Ghrelin: Secreted by the stomach, increases hunger during fasting or low-calorie diet.
Neuropeptide Y: Produced in the hypothalamus, activated by ghrelin, stimulates hunger and lipoprotein lipase (LPL) activity.
Leptin: Drop in leptin when adipose tissue shrinks stimulates hunger.
Hypertrophy: Fat cells expand to store more fat.
Hyperplasia: Production of more fat cells when filled to capacity.
Average adult has 30 to 50 billion adipocytes, holding 0.4 to 0.5 micrograms of fat each.
Overweight or obese adults have larger adipose cells (0.6 to 1.2 micrograms each).
Fat cells shrink with weight loss, but their number does not decrease.
Fat growth and cell production continue throughout life, but hyperplasia slows with age.
Lipoprotein Lipase (LPL): Increases lipogenesis.
Hormone-Sensitive Lipase (HSL): Stimulates lipolysis.
Heavier individuals have increased LPL activity.
Men: LPL more active in visceral, abdominal fat cells.
Women: LPL activity higher in hips and thighs.
Nutrigenomics: Study of how genetic makeup interacts with diet.
Epigenetics: Changes in gene activity and expression without altering DNA sequence.
Genes can be turned on/off by DNA methylation and histone modifications.
Single-nucleotide polymorphisms (SNPs) alter the nucleotide sequence.
Epigenetic alterations and SNPs affect response to food intake.
Adiponectin: Hormone secreted by adipocytes, improves insulin response, reduces fat accumulation, enhances energy expenditure, lower in obese individuals and type 2 diabetics.
Genetic Set Point Theory: Body fights to remain at a specific weight, opposing weight loss.
Populations prone to obesity can overcome genetic predisposition with exercise and healthy eating.
Modern environment promotes positive energy balance and weight gain.
Lack of Time: More calories from foods eaten away from home.
Abundant Food Supply: Larger portions and easier access to food.
Lack of Physical Activity: Less manual labor, more driving, and sedentary behavior.
Reasonable Weight Loss: Aim for 10% body weight loss over six months.
Diet and Activity: Choose lower-calorie foods, reduce portions, increase physical activity.
Volume to Meals: Add protein and healthy fats for satiety.
MyPlate Guide: Use for balanced diet planning.
Physical Activity: 60-90 minutes of moderate-intensity daily, combining cardio and strength training.
Behavior Modification
Change Eating Behaviors: Keep a food log, control environmental cues, manage stress.
Weight Maintenance
Maintain energy gap reduction, reduce calorie intake, eat smaller meals, maintain high physical activity, and self-weigh weekly.
Weight Gain Strategies for Underweight
Goal: Gain muscle, not fat.
Methods: Add 500 kcal daily, choose energy-dense foods, include regular exercise and resistance training.
Medical Interventions for Extreme Obesity
Weight-loss Medications: Sibutramine, Orlistat, Lorcaserin.
Evaluate side effects.
Bariatric Surgery: Gastric bypass, gastric banding.
Post-surgery: Small, frequent meals, supplements (iron, B12, calcium, vitamin C).
Weight loss: Rapid initially, then 1-2 lbs per week.
