Weight Management

Why Weight is Important to UsWhy Weight is Important to Us
Health and overall well-being
Disease prevention
Competitive sports/ training
Looks
Self-esteem

It is a constant tug-of-war between foods weIt is a constant tug-of-war between foods we
love to eat and the tight jeans we love tolove to eat and the tight jeans we love to
wear.wear.

Everyone is looking for theEveryone is looking for the
answer…answer…
If only it were this easyIf only it were this easy

Myth vs. FactMyth vs. Fact
Myth
?
Fact?

Creeping ObesityCreeping Obesity
Physical activity
decreases and
leads to a decrease
In metabolic rate.
If energy
expenditure
drops more than
energy intake,
weight gain will
occur

••
– Overweight is defined as 1-19% above one’sOverweight is defined as 1-19% above one’s
ideal weightideal weight
– Obese is defined as above 19% one’s idealObese is defined as above 19% one’s ideal
weightweight

BMI - Optimum Cut-Offs Asian IndiansBMI - Optimum Cut-Offs Asian Indians
BMI : Index of the relationship between height andBMI : Index of the relationship between height and
weight (weight (kg/m2)kg/m2)
Normal BMI : 18.5-22.9Normal BMI : 18.5-22.9
Overweight : 23- 24.9Overweight : 23- 24.9
Obesity : >25Obesity : >25

Many Health Risks AssociatedMany Health Risks Associated
– DiabetesDiabetes
– Heart diseaseHeart disease
– Dyslipidemia (high blood cholesterol)Dyslipidemia (high blood cholesterol)
– Sleep apnea and breathing problemsSleep apnea and breathing problems
– CancerCancer
– DepressionDepression
– Hypertension (high blood pressure)Hypertension (high blood pressure)

Risk Factors for ObesityRisk Factors for Obesity
• Increased energy intakeIncreased energy intake
• Decreased energy expenditureDecreased energy expenditure
Increased sedentary nature of many jobsIncreased sedentary nature of many jobs
TV and video games, automated equipmentTV and video games, automated equipment
• HeredityHeredity
• Psychosocial FactorsPsychosocial Factors
Eating as focal point of people’s livesEating as focal point of people’s lives
 Metabolic ChangesMetabolic Changes
Basal Metabolic RateBasal Metabolic Rate
Gender and ObesityGender and Obesity
Women more vulnerable to weight gainWomen more vulnerable to weight gain

Other Risk Factors for ObesityOther Risk Factors for Obesity
 Developmental FactorsDevelopmental Factors
 HyperplasiaHyperplasia
»Excessive number of fatExcessive number of fat
cellscells
 HypertrophyHypertrophy
»Increased size of cellsIncreased size of cells

Commonly UsedCommonly Used
ApproachesApproaches
By Obese PeopleBy Obese People

DietingDieting
 It is a HUGE business!It is a HUGE business!
 Billions of dollars spent annually andBillions of dollars spent annually and
yet everyone is STILL FAT!yet everyone is STILL FAT!
 Health product consumers areHealth product consumers are
desperate and uneducated!desperate and uneducated!

Prevalence of DietingPrevalence of Dieting
 40% of all women40% of all women
 25% of all men25% of all men
Diet products are a 33
billion dollar
industry.

Almost All Diets areAlmost All Diets are
UnsuccessfulUnsuccessful
 50% regain all weight50% regain all weight
within 2 yearswithin 2 years
 5-10% keep weight off5-10% keep weight off
permanentlypermanently
Why do diets fail?

Cycle of DietingCycle of Dieting
START DIETSTART DIET
INITIALINITIAL
MOTIVATIONMOTIVATION
POSITIVE RESULTSPOSITIVE RESULTS
TROUBLE WITH COMPLIANCETROUBLE WITH COMPLIANCE
FAIL W / DIETFAIL W / DIET
BLAME SELFBLAME SELF
REGAINREGAIN
INSPIRATIONINSPIRATION

Trend of Fad?Trend of Fad?
 Fad Diets are successful because in theFad Diets are successful because in the
end, you are eating fewer caloriesend, you are eating fewer calories
 Does the eating plan make you happy orDoes the eating plan make you happy or
are you constantly obsessed with food?are you constantly obsessed with food?
 The question is…Can you maintain this dietThe question is…Can you maintain this diet
for the rest of your life?for the rest of your life?

Yo-Yo DietingYo-Yo Dieting
 Increased resistanceIncreased resistance
to weight lossto weight loss
 Increased efficiencyIncreased efficiency
of weight gainof weight gain

Problems withProblems with
Fad DietsFad Diets
• Weight loss is often water lossWeight loss is often water loss
• Supplements may be dangerousSupplements may be dangerous
• Diet may lack essential nutrientsDiet may lack essential nutrients
• Metabolism may slow down if caloricMetabolism may slow down if caloric
intake is very low.intake is very low.
• Most (if not all) simply do not work forMost (if not all) simply do not work for
people long term!people long term!
• Fixed MenuFixed Menu
• FlexibleFlexible

The Latest Fads…The Latest Fads…

Low-carb MarketingLow-carb Marketing
 Over 600 new low-carb products introduced thisOver 600 new low-carb products introduced this
yearyear
 Sales may exceed $15 billion this yearSales may exceed $15 billion this year
 Low-carb products appeal to convenience eatersLow-carb products appeal to convenience eaters
 Problem: A calorie is still a calorie. Many dietersProblem: A calorie is still a calorie. Many dieters
consuming these products are claiming to haveconsuming these products are claiming to have
stopped losing weight.stopped losing weight.
 Fact: Low-carb foods are not necessarily lowFact: Low-carb foods are not necessarily low
calorie foods.calorie foods. It is overeating calories that makesIt is overeating calories that makes
us gain weight, not overeating carbohydrates.us gain weight, not overeating carbohydrates.

Weight Loss SupplementsWeight Loss Supplements

Weight Loss SupplementsWeight Loss Supplements
Not a safe alternativeNot a safe alternative
 Not regulated by FDA!Not regulated by FDA!
 Affects each person differentlyAffects each person differently
 ExpensiveExpensive
 Non-ephedra products can be just as dangerousNon-ephedra products can be just as dangerous
Do you want to buy these for the rest of your life?Do you want to buy these for the rest of your life?

Problems with AppetiteProblems with Appetite
SuppressantsSuppressants
 Many people use non prescriptionMany people use non prescription
appetite suppressants to controlappetite suppressants to control
eating.eating.
 Ephedrine related products haveEphedrine related products have
been found to be dangerous andbeen found to be dangerous and
have been banned by the FDAhave been banned by the FDA

VERYVERY
IMPORTANT TOIMPORTANT TO
UNDERSTANDUNDERSTAND
25

Why We Gain WeightWhy We Gain Weight
 Real WEIGHT GAIN occursReal WEIGHT GAIN occurs when andwhen and
only whenonly when your CALORIES IN exceedyour CALORIES IN exceed
your CALORIES OUT for an extendedyour CALORIES OUT for an extended
period of timeperiod of time
 500 calories/day x 7 = 3500 calories = 1500 calories/day x 7 = 3500 calories = 1
kgkg
– Burn an additional 500 calories/day =Burn an additional 500 calories/day =
lose 1 kg/weeklose 1 kg/week

Principles of Weight ControlPrinciples of Weight Control
(A balance between intake and expenditure)(A balance between intake and expenditure)
EXEXININ
IN > EX - Gain WeightGain Weight
IN = EX - Maintain WeightMaintain Weight
IN < EX - Lose Weight

The Bottom LineThe Bottom Line
For weight loss to occur, there mustFor weight loss to occur, there must
be a calorie deficit!be a calorie deficit!

Right Solution ?Right Solution ?

Let’s start with the basics…Let’s start with the basics…
 MacronutrientsMacronutrients
– CarbohydratesCarbohydrates
– ProteinProtein
– FatFat
 MicronutrientsMicronutrients
– VitaminsVitamins
– MineralsMinerals
– WaterWater
All are part of a healthy diet!

Calorie BreakdownCalorie Breakdown
Carbohydrates: 4 calories/gramCarbohydrates: 4 calories/gram
Protein: 4 calories/gramProtein: 4 calories/gram
Fat: 9 calories/gramFat: 9 calories/gram
Alcohol: 7 calories/gramAlcohol: 7 calories/gram
Carbohydrates and protein have the same caloriesCarbohydrates and protein have the same calories

How much?How much?
 Total calories distribution in diet :Total calories distribution in diet :
 55-60% calories from Carbohydrates55-60% calories from Carbohydrates
 20-25% calories from protein20-25% calories from protein
 15-20% calories from fat15-20% calories from fat

A Healthy EaterA Healthy Eater
……respects the difference between carbohydrate foods:respects the difference between carbohydrate foods:
nutrient-dense vs. nutrient-poor/calorie-dense carbsnutrient-dense vs. nutrient-poor/calorie-dense carbs
…… respects the difference between fats: saturated, trans-respects the difference between fats: saturated, trans-
fat, mono and poly unsaturated fatsfat, mono and poly unsaturated fats
……knows that in addition to choosing the right foodsknows that in addition to choosing the right foods
mostmost of the time, all foods can fitof the time, all foods can fit

HOW???HOW???
 Balance, variety, moderationBalance, variety, moderation
 Healthy food choicesHealthy food choices
 Watch portion sizesWatch portion sizes
 ExerciseExercise
 SleepSleep
 Stress managementStress management

Healthy or Hefty?Healthy or Hefty?
 Store-bought smoothiesStore-bought smoothies
 MilkshakesMilkshakes
 Lattes and coffee drinksLattes and coffee drinks
 GranolaGranola
 Energy barsEnergy bars
 MuffinsMuffins
 PopcornPopcorn
 CrackersCrackers

A Weight Loss PlanA Weight Loss Plan
 Think in terms of a lifestyle change, notThink in terms of a lifestyle change, not
short-term “diet”short-term “diet”
 Set realistic goalsSet realistic goals
 Make gradual changesMake gradual changes
 Each person is differentEach person is different
 Experiment to find whatExperiment to find what
works for youworks for you
 Expect to be successful!Expect to be successful!

DietsDiets
 Should consider:Should consider:
– Percentage of macronutrientsPercentage of macronutrients
– Kcal intakeKcal intake
– Vitamins & MineralsVitamins & Minerals
– Safety / efficacy of supplementsSafety / efficacy of supplements
– Is the diet sustainable?Is the diet sustainable?

Lifestyle Approach!Lifestyle Approach!
 Healthy eating patternsHealthy eating patterns
 Regular activity patternsRegular activity patterns
A simple AND effective
method for long-term
weight control.

Healthy Eating PatternsHealthy Eating Patterns
 Eating a variety of foodsEating a variety of foods
 Eating smaller, more frequent mealsEating smaller, more frequent meals
 Avoiding bingeingAvoiding bingeing
 Reducing fat intakeReducing fat intake
– Fat is calorically dense (high in calories)Fat is calorically dense (high in calories)
– Fat is more easily stored thanFat is more easily stored than
carbohydrates or proteincarbohydrates or protein

Healthy Eating Patterns……….Healthy Eating Patterns……….
 Low “glycemic load” diets may be a more sensibleLow “glycemic load” diets may be a more sensible
alternative to low-carbohydrate diets.alternative to low-carbohydrate diets.
 Artificial sweeteners and fat substitutes may help butArtificial sweeteners and fat substitutes may help but
cannot be considered a “sure cure” for body fatcannot be considered a “sure cure” for body fat
problems.problems.
 Avoid anything with ephedra.Avoid anything with ephedra.
 Restrict “empty” calories.Restrict “empty” calories.
 Learn the difference between craving and hunger.Learn the difference between craving and hunger.

41
Regular Activity PatternsRegular Activity Patterns
 Benefits of Exercise for Weight ControlBenefits of Exercise for Weight Control
– Burns caloriesBurns calories
– Maintains LBMMaintains LBM
– Increases metabolismIncreases metabolism
– Promotes greater fat lossPromotes greater fat loss
– Suppresses appetiteSuppresses appetite
 What type of exercise is best?What type of exercise is best?
– Aerobic exerciseAerobic exercise
– Strength or muscle endurance exerciseStrength or muscle endurance exercise

Meals vs. GrazingMeals vs. Grazing
Should I eat:Should I eat:
 3 regular meals3 regular meals
 3 small meals with snacks3 small meals with snacks
 6 small meals/ snacks6 small meals/ snacks
 This is a personal preference and depends on yourThis is a personal preference and depends on your
schedule and what you consider a “meal” and aschedule and what you consider a “meal” and a
“snack”“snack”
 Keep calorie needs in mindKeep calorie needs in mind

Healthy SnacksHealthy Snacks
 Air-popped or “light” popcornAir-popped or “light” popcorn
 Raw veggies and low-fat dipRaw veggies and low-fat dip
 Baby carrotsBaby carrots
 FruitFruit
 PretzelsPretzels
 PB & B sandwichPB & B sandwich
 Sliced turkeySliced turkey
 Dry cerealDry cereal
 HummusHummus
 YogurtYogurt
 Homemade smoothieHomemade smoothie
 Baked chips and salsaBaked chips and salsa
 Latte with skim milkLatte with skim milk

Next…Next…
Get a journal- record progress, set-backs,Get a journal- record progress, set-backs,
thoughts and feelingsthoughts and feelings
Try new recipesTry new recipes
Take healthy snacks with youTake healthy snacks with you
Try to eat at home more and eat out lessTry to eat at home more and eat out less
If you do eat away from home, makeIf you do eat away from home, make
healthy choices- Don’t be afraid tohealthy choices- Don’t be afraid to
ask for modificationsask for modifications
Eat slowly and savor mealtimeEat slowly and savor mealtime
Not sure if you are hungry?Not sure if you are hungry?
 Take a walk firstTake a walk first

Drink plenty of waterDrink plenty of water
If you like soda- drink dietIf you like soda- drink diet
You’re never to old to pack your lunchYou’re never to old to pack your lunch
Don’t starve yourself…you’ll end up overeating laterDon’t starve yourself…you’ll end up overeating later
Let yourself indulge in your favorite foods…justLet yourself indulge in your favorite foods…just
watch portion sizeswatch portion sizes
Get an exercise buddyGet an exercise buddy
Do active things that you actually like!Do active things that you actually like!
Curb late night eatingCurb late night eating
Watch out for the Saturday night 6 packWatch out for the Saturday night 6 pack
Don’t be too hard on yourselfDon’t be too hard on yourself
Indulge…but in moderation!Indulge…but in moderation!

• Do it for you, not anyone elseDo it for you, not anyone else
• Focus on health benefits and the way you feel and youFocus on health benefits and the way you feel and you
• won’t be disappointedwon’t be disappointed
• Don’t get discouraged if you don’t see resultsDon’t get discouraged if you don’t see results
immediately- healthy weight loss takes timeimmediately- healthy weight loss takes time
• You may hit a plateau in your weight loss…this isYou may hit a plateau in your weight loss…this is
natural and you may have to reevaluate your plannatural and you may have to reevaluate your plan
• Reward yourself with things other than foodReward yourself with things other than food
Remember, eating is supposed to be FUN and there isRemember, eating is supposed to be FUN and there is
more to life than obsessing over food!more to life than obsessing over food!

You have to do what is right forYou have to do what is right for
you!you!

Weight Management

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