Transcript Windsor-Essex Cardiac Wellness Centre

How Did I Get Here?
Leading yourself
to your best life,
best health,
best weight!
SOAHAC 08/07
Adapted From: Windsor Essex Cardiac Wellness Centre
Shelley Amato RD
Working Through
Emotional Eating

Awareness- of
emotions/overeating/challenges/triggers
 Willingness to change-Are you ready to
lose weight?
 Taking action-Weight loss strategies and
goal setting
Reasons for Weight Gain
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Diet
Physical inactivity
Genetics
Psychological factors/coping skills
Age
Medications
Metabolic disorders – hypothyroidism, PCOS, etc.
Quitting Smoking
Focus today
Triggers
Coping
skills
Overcoming challenges
What is Shaping Our Eating Habits?
Eat Healthy Foods
Watch Portion Sizes
Cook More
Eat Only When Hungry
Healthy Choices
Food Availability
Abundance
Snacking
Convenience Stores
Vending Machines
Processed Foods
Cooking Less
Eating Out More
Large Portions
Fast Food Choices
Value Meals
Food Courts
All You Can Eat Buffets
Unhealthy Environment
What is shaping our physical activity habits?
Walk Up Stairs
Park Car Farther Away
Be More Active
Watch TV less
Do Less Passive Activities
Healthy Choices
Elevators
Escalators
Telephones
Snow Blowers
Remote Controls
Cars, Buses, Trains
Computers
Email
Drive-Thru Society
Television
Cable Channels
Video Games
VCR’s: Home Movies
Unhealthy Environment
What is shaping our coping habits?
Make Time to Exercise
Make Time to Eat Healthier
Make Time to Cook
Make Time to Relax
Healthy Choices
Living the Hurried Life
Always Rushing
Overscheduled
Overdoing It
Not Living in the Moment
Working Longer Hours
Less Leisure Time
Family Stresses
Juggling Schedules
Juggling Roles
No Time for Family
No Time for Self
Unhealthy Environment
Medical Complications of Obesity
Pulmonary disease
abnormal function
obstructive sleep apnea
hypoventilation syndrome
Nonalcoholic fatty liver
disease
steatosis
steatohepatitis
cirrhosis
Idiopathic intracranial
hypertension
Stroke
Cataracts
Coronary heart disease
Diabetes
Dyslipidemia
Hypertension
Gall bladder disease
Gynecologic abnormalities
Cancer
abnormal menses
infertility
polycystic ovarian syndrome
breast, uterus, cervix
colon, esophagus, pancreas
kidney, prostate
Osteoarthritis
Skin
Gout
Phlebitis
venous stasis
BMI-Associated Disease Risk
BMI (kg/m2)
Classification
Underweight
<18.5
Risk
Increased
Normal
18.5–24.9
Normal
Overweight
25.0–29.9
Increased
I
30.0–34.9
High
II
35.0–39.9
Very high
III
40
Obese
Extremely high
Additional risks:
• Large waist circumference (men >40 in; women >35 in)
• Poor aerobic fitness
• Specific races and ethnic groups
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight
and Obesity in Adults—The Evidence Report. Obes Res 1998;6(suppl 2).
Visceral Adiposity:
The Critical Adipose Depot
Subcutaneous
Fat
Abdominal
Muscle Layer
Intra-abdominal
Fat
All Fat Cells Are Not Created Equal
• Large InsulinResistant
Adipocytes
• Small Insulin-Sensitive
Adipocytes
• Adrenergic Receptors 
• Adrenergic
Receptors 
• Insulin-Mediated
Antilypolysis
• CatecholamineMediated
Lipolysis 
Fatty Acids 
High-Risk Waist
Circumference
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Men:
> 40 in (> 102 cm)
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Women:
> 35 in (>88 cm)
Weight loss strategies
Behaviour Changes
Food intake
Activity
Assessing Weight Loss
Readiness
• Motivation:
Person seeks weight reduction
• Stress level:
• Psychiatric issues:
Free of major life crises
Free of severe depression,
substance abuse, bulimia nervosa
Person can devote 15–30 min/d
to weight control
No
• Time availability:
Yes
Initiate weight loss
therapy
Ready?
Prevent weight gain and explore
barriers to weight reduction
Attributes that Predispose a Person
to Successfully Change Behavior
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Strongly wants and intends to change for clear,
personal reasons
Faces a minimum of obstacles to change
Has the requisite skills and self-confidence to make
a change
Feels positively about the change and believes it
will result in meaningful benefit
Perceives the change as congruent with self-image
and social group norms
Receives encouragement and support to change
from valued persons
Whitlock EP et al. Am J Prev Med 2002
Antecedent  Behavior 
Consequence
Antecedents
 Time
 Places
 Activities
 Thoughts
 Emotions
What Makes Us Eat More?

Smell
 Time of day
 Alcohol
 Sight
 Temperature
 Variety
 Refined carbohydrates
Nutritional Goal Sheet
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Select two or three goals that you are
willing and able to make
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Effective goals are specific, attainable, and
forgiving (less than perfect)
Goal Setting
What’s realistic for you?
For those that need to lose weight, reducing
your weight by 5% to 10% over 6 months is a
healthy and reasonable goal
Be realistic about time frames too!
Slow and steady weight loss has the greatest
impact (about a pound a week)
Self-Monitoring Food Intake
Types
of foods
Portion sizes
Calories (reduce by 500
kcal/d)
Times, places, and activities
Thoughts and moods
Brownell: Learn Program for Weight Control, 1998
How to Curb Your Appetite
 Eat
fibre
 Brush your teeth
 Be consistent- eat 3 meals a day
 Slow down