Transcript An Invitation to Health Chapter 6 Eating Patterns and Problems

An Invitation to Health
Chapter 6
Eating Patterns and Problems
Dr. Lana Zinger
©2004 Wadsworth Publishing Co.
The Overweight and Obesity
Epidemic
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64.5% of adult
Americans (2 out of 3
individuals) are
overweight or obese.
15% of children ages 619 are overweight or
obese.
Obesity’s Cost:
$100 billion/year
 300,000 excess deaths
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Body Dissatisfaction in AfricanAmerican and White Students
Weight Assessment
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Body Mass Index:
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Overweight: BMI > 25; Obesity: BMI >30.
Waist Circumference:
Men: > 40 inches; Women: >35 inches
 These measurements indicate that individuals
have excess central or visceral fat.
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Waist-to-Hip Ratio:
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Men: apple shape; Women: pear shaped.
The Pear versus the Apple
Waist-to-Hip Ratio
Men’s Goal:
Men<0.95
Women’s Goal:
<0.80
Definition: waist circumference measurement divided by
the measurement of the widest circumference around the hips.
Visceral Fat vs. Subcutaneous Fat
How Many Calories Do I Need?
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Calories:
The measure of the amount of energy that
can be derived from food.
 Multiply your current weight by:___x__=__
14 if you are sedentary
15 if you exercise 3 x/week; 40 min.
16 if you exercise 5-7x/wk; 40-60 min.
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Remember, regardless of whether you consume
carbohydrates, protein or fat, if you take in more
calories than your body requires, your body will
convert the excess to fat.
Globesity
How Did We Get So Fat?
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Americans are eating more and exercising
less.
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Americans are eating 200-400 more calories than they did
several decades ago, and they are expending 200-300
fewer calories than people did 25 years ago.
Portion distortion.
Refined carbohydrates.
Media and food marketing.
The Multiple Causes of Obesity
Genetics
Physical
Activity
Developmental
Factors
Social
Determinants
Emotional
Influences
Lifestyle
Health
Dangers
of Excess
Weight
Getting Ready for Weight Loss
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Make health a priority.
Follow a healthful eating regimen.
Incorporate regular physical activity
into your daily routine.
Set realistic, attainable goals.
Focus on a healthy lifestyle.
Focus your strategies so they are
action-oriented and specific.
Tailor your strategies to your lifestyle.
Think long term.
Treatment for Weight Problems
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Overweight (BMI = 25-29)
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Mild to Moderate Obesity (BMI = 30-39)
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Cut back moderately on food intake and concentrate on
developing healthy eating and exercise habits.
Six-month trial of lifestyle therapy, including a supervised
diet and exercise.
Goal: 10% reduction in weight to reduce obesity-related risks.
Severe Obesity (BMI = 40+)
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Gastric bypass or stomach stapling may be indicated.
Avoiding Diet Traps
Diet
Foods
The Yo-Yo
Syndrome
Very LowCalorie Diets
Diet Pills &
Products
Weight-Cycling Effect of
Repeated Dieting
Is It Physical Hunger or Emotional Hunger?
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Physical Hunger
Builds gradually.
Strikes below the neck.
No sense of compulsion.
Occurs several hours after a
meal.
General.
Goes away when full.
Eating leads to feeling of
satisfaction.
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Emotional Hunger
Develops suddenly.
Above the neck.
An urgent need to eat.
Unrelated to time since last
meal.
Specific, often for a particular
food or brand.
Persists despite fullness.
Eating leads to guilt and
shame.
Healthy Weight Management for Life
Establish your goals
Never say diet
Be realistic
Recognize that there are no quick fixes
Note your progress
Adopt the 90 percent rule
Try, try again
How Hormones Help Regulate Our Appetite
The Female Athlete Triad
Disordered Eating Patterns
Menstrual Dysfunction
Bone Mineral Disorders
Disordered Eating In College Students
The Facts
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Younger women are more likely than older women to
have an eating disorder.
Eating disorders equally affect women of different
races.
Eating disorders do not only affect women.
Body dissatisfaction and unhealthy eating patterns can
lead to eating disorders.
Extreme Dieting:
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Cutting calories, exercising, preoccupation with food and
weight.
Is The Freshman 15 Reality?
Signs of Compulsive Overeating
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Using food as an escape from depression, loneliness,
and rejection.
A history of failed diets and anxiety when dieting.
Thinking about food throughout the day.
Eating quickly and without pleasure.
Continuing to eat even when you’re no longer hungry.
Frequent talking about food, or refusing to talk about
food.
Fear of not being able to stop eating once you start.
Signs of Binge Eating
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Eating much more rapidly than usual.
Eating until they feel uncomfortably full.
Eating large amounts of food when not feeling
physically hungry.
Eating large amounts of food throughout the
day with no planned mealtimes.
Eating alone because they are embarrassed by
how much they eat and by their eating habits.
Do You Have An Eating Disorder?
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Do you make yourself sick because you feel
uncomfortably full?
Do you worry you have lost control over how much
you eat?
Have you recently lost more then 14 pounds in a threemonth period?
Do you believe yourself to be fat when others say you
are too thin?
Would you say that food dominates your life?
If you answered ‘yes’ to two or more of the questions
above you may be toying with anorexia nervosa or bulimia nervosa.
Common Factors Associated
with Eating Disorders
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Low self-esteem & negative body image
Major life transition or traumatic life event
Troubled family and/or personal relationships
Fear of failure & lack of control in life
Specific personality traits and psychological
disorders
Attraction to sports and exercise
Recommendation to lose weight without
guidance
Initiation of dieting at an early age
Cultural ideals and pressures
Clinical Diagnostic Criteria for
Anorexia Nervosa
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Refusal to maintain body weight at or
above a minimally normal weight for age
and height.
Intense fear of gaining weight or
becoming fat, even though underweight.
Disturbance in the way in which one’s
body weight or shape is experienced,
undue influence of body weight or shape
on self-evaluation, or denial of the
seriousness of the current low body
weight.
Amenorrhea
Medical Complications of Weight
Loss From Anorexia Nervosa
Clinical Diagnostic Criteria for
Bulimia Nervosa
A.
B.
C.
D.
Recurrent episodes of binge eating.
Recurrent inappropriate compensatory behavior in
order to prevent weight gain (laxatives, diuretics,
vomiting and excessive exercise).
Binge eating and inappropriate compensatory
behaviors both occur, on average, at least twice a
week for 3 months.
Self evaluation is unduly influenced by body shape
and weight.
Medical Complications Related to Purging
Treatment Options for Eating Disorders
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Anorexia Nervosa
Medical therapy
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“refeeding”
Behavioral therapy
Cognitive therapy
Psychodynamic therapy
Family therapy
Occasionally medications
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Bulimia Nervosa
Nutritional counseling
Psychodynamics
Cognitive-behavior
therapy
Individual and group
psychotherapy
Medications
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Fluoxetine (Prozac)