Chapter 015

Williams' Basic Nutrition & Diet Therapy

Chapter 15

Weight Management

Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 1

14th Edition

Lesson 15.1: Causes of Obesity and Risks of Food Fads

Underlying causes of obesity include a host of various genetic, environmental, and psychological factors.

Short-term food patterns, or fads, often stem from food misinformation that appeals to some human psychological need but does not necessarily meet physiologic needs.

2Copyright © 2013 Mosby, Inc., an imprint of Elsevier Inc. All rights reserved.

Introduction (p. 280)

Currently in the United States 34.2% of adults are overweight 33.8% are obese 5.7% are extremely obese 16.9% of children and adolescents are obese


Introduction (cont’d) (p. 280)

Overweight and obesity, by age: United States, 1960-2004


Obesity and Weight Control(p. 280)

Body weight and body fat Definitions Body composition

Measures of weight maintenance goals Standard height/weight tables Healthy weight range

• Individual variation• Necessity of body fat


Obesity and Health (p. 286)

Weight extremes: clinically severe obesity is health hazard

Overweight and health problems: hypertension, diabetes, heart disease, arthritis, cancer


Causes of Obesity (p. 286)

Basic energy balance Hormonal control: leptin and ghrelin Genetic and family factors

Genetic control: obesity highly associated with genetics

Family reinforcement: teach food habits and exert social pressure

Physiologic factors: number of fat cells in the body Other environmental factors: availability of energy-

dense, fast foods, convenient foods


Case Study

Maria is a 22-year-old Non-Hispanic African American female who has struggled with her weight for many years. She is 5 feet 6 inches tall and weighs 230 lbs.


Case Study (cont’d)

Discuss factors that can contribute to Maria’s weight.


Individual Differences and Extreme Practices (p. 288)

Individual energy balance levels Extreme practices

Fad diets Scientific inaccuracies and misinformation Failure to address the necessity of changing long-

term habits


Extreme Practices (p. 289)

Fasting: negative health effects, rebound effect Specific macronutrient restrictions: no evidence to

support, carry health risks Clothing and body wraps: cause temporary water

loss Drugs: FDA regulates, should be combined with

lifestyle changes Surgery: gastric restriction, malabsorptive

procedures, lipectomy


Surgical Treatments for Obesity (p. 293)



Would surgical intervention be appropriate for Maria?


Lesson 15.2: Weight Management Tools and Risks of Being

Underweight

Realistic weight management focuses on individual needs and health promotion, including meal pattern planning and regular physical activity.

Severe underweight carries physiologic and psychological risk to the body.


A Sound Weight Management Program (p. 294)

Essential characteristics: food and exercise behaviors

Behavior modification Basic principles Basic strategies and actions

• Defining problem behavior• Recording and analyzing baseline behavior• Planning behavior management strategy


Dietary Principles (p. 294)

Dietary principles Realistic goals: ½ to 1 lb per week loss Negative energy balance: 500 to 1000 kcal/day Nutritional adequacy: choose nutrient-dense foods Cultural appeal: to allow permanent change in

habits Energy readjustment to maintain weight: when

desired weight is reached


Basic Energy Balance Components (p. 295)

Energy input: food behaviors Energy output: exercise behaviors


Principles of a Sound Food Plan (p. 296)

Energy balance: modifications to energy intake and output

Nutrient balance: carbohydrate, protein, fat proportions

Distribution balance: spread food throughout the day Food guide: American Dietetic Association Preventive approach: overweight children become

obese adults



Outline considerations for a sound weight management program for Maria.


Food Misinformation and Fads (p. 300)

Types of claims Food cures: certain foods cure specific conditions Harmful foods: certain foods are harmful Food combinations: specific combinations restore

health “Natural” foods: only “natural” foods can meet

body needs


Food Misinformation and Fads (cont’d) (p. 301)

Erroneous claims Dangers

To health Often expensive Perpetuates superstitions Distrust of modern food market

Vulnerable groups Elderly, young persons, obese persons, athletes

and coaches, entertainers


Underweight (p. 302)

General causes Wasting disease Poor food intake Malabsorption Hormonal imbalance Energy imbalance Poor living situation


Dietary Treatment (p. 303)

High-calorie diet High protein High carbohydrate Moderate fat Adequate sources of vitamins and minerals


Disordered Eating (p. 303)

Definition of normal eating Disordered eating

Anorexia nervosa: results in self-imposed starvation

Bulimia nervosa: binge-and-purge cycle Binge eating disorder: often follows stress or

anxiety Significant mortality rates, slow recovery Treatment



List some considerations for Maria so that she would not fall into these eating disorders.


Chapter 015

Health & Medicine

Transcript of Chapter 015