Judith E. Brown www.cengage.com/nutrition/brown Weight Control: The Myths and Realities Unit 10

Prof. Albia Dugger • Miami-Dade College

Hot Dogs, Apple Pie, and Weight • Americans spend $60 billion annually on weight-loss, but are gaining weight rather than losing it • Only 5-10% of people who lose weight keep it off

Weight Loss vs Weight Control • Diets and weight loss do not cure overweight • People return to old habits, regain weight • Improved and enjoyable eating and exercise habits are needed to keep excess weight off

The Business of Weight Loss • More than 29,000 weight-loss products and services are available • Almost none of them work

Lack of Consumer Protection • No laws require a weight-loss product must be effective in order to be sold • Weight-loss products are not tested for safety before they reach the market – some cause serious problems, even death

Discontinued Weight-Loss Methods

Pulling the Rug Out • Complaints about products and services that make fraudulent claims are investigated by the Federal Trade Commission

Bogus Weight-Loss Products

If Truth Had to Be Told • If weight-loss claims had to be backed by scientific evidence, the US weight-loss industry would have to change

Diet Pills • Two types of diet pills are currently approved for obese people in the US • • Meridia (sibutramine) Xenical (orlistat) • Both cause side effects, and weight is often regained when pills are stopped

Popular Diets • Five popular diets have been evaluated: • Dr. Atkins New Diet Revolution, Weight Watchers Pure Points Program, Slim-Fast Plan, Zone Diet, Eat-Yourself-Slim Diet • All produced a reduction in calorie intake • Weight loss averaged 7 pounds

Low Carbohydrate, High Protein Diet • Most people found diets too hard to follow

Fad Diets • Many diet books contain made-up approaches to weight loss • None has been shown to lead to sustained weight loss, or weight-loss maintenance

Fad Diets

Internet Weight-Loss Frauds • The Internet has hundreds of bogus weight-loss sites • Other than lipase inhibitor (alli) no diet pill sold on the Internet is FDA approved

Weight Regain With Popular Diets • People can’t stick to difficult or unpleasant popular diets long – then weight is regained • The best way to sustain weight loss is by making small, easy changes to diet and physical activities

Physical Activity and Weight Control • Regular physical activity reduces abdominal fat stores, and improves blood cholesterol, insulin sensitivity, and blood pressure • Regular resistance exercise increases lean body mass and reduces fat mass • Moderate physical activity with calorie reduction increases weight loss

Activity for Overweight and Obese

Weight Loss Benefits • Loss of 5-10% of body weight benefits the overweight and obese • Lowers blood insulin, triglycerides, glucose, and C-reactive protein • • Increases insulin sensitivity and HDL cholesterol Reduces risk of heart disease and diabetes

Obesity Surgery • Bariatric surgery is a method of last resort for people with BMIs over 40, or BMIs 35-40 with serious weight-related health problems •

Bariatrics

• Field of medicine concerned with weight loss

Gastric Bypass Surgery • Gastric bypass surgery is the most effective method for weight loss and maintenance • • Results in loss of 50-60% excess weight Resolution of weight-related health problems • Stomach pouch holds only 2 tablespoons of food – eating more causes vomiting

Lap Band Surgery • A constricting band reduces the amount of food the stomach can hold • Results in loss of about 48% of excess weight

Gastric Bypass and Lap Band Surgery

Concerns With Bariatric Surgery • High rates of complications • • 22% post-surgery, 40% in first 6 months Chance of death 0.5 to 1.1% • High cost ($30,000 or more) • $60,000 with complications • Nutrient deficiencies and emotional issues

Body Contouring Surgery • Excess skin folds that develop after weight loss surgery may be removed by body contouring surgery • • Expensive May have to be repeated several times

Body Contouring Surgery

Liposuction • Liposuction to reduce fat deposits in thighs, hips, arms, back, or chin is the most common cosmetic surgery in the US • Risk of infection and other complications

Effects of Liposuction

Weight Loss: Making It Last • Weight loss is successful only if it is safe, healthful, and prevents weight gain • Successful losers who maintain their weight loss focus on lifestyles of healthy eating and exercise rather than “dieting”

Weight Loss: Making It Last • Activities you enjoy are key to weight loss

Successful Weight Loss

Small, Acceptable Changes • Gradual losses in body fat do not require dramatic changes in diet or activity level • Reduction in food intake of 100 calories/day can produce a 10-pound weight-loss/year

100-Calorie Changes

Identifying Acceptable Changes • List weak points in diet and activity • Identify options that seem acceptable and enjoyable • Include small changes that are acceptable in the long run

Take Action:

Small Steps • • • • For Healthy Eating • • • Eat cereal for breakfast Eat fruit before dinner Eat more vegetables than meat • • Drink skim milk Switch from soft drink to flavored water Stop eating when full Eat only when hungry Reduce dessert size • • • • • • For Physical Activity • • • • Add 2000 steps Park farther away 10-minute walk in park Lift weight while watching TV (10 min) Do 10 sit-ups Use the stairs Walk neighbor’s dog Jump rope 2 minutes Dance 5 minutes

What to Expect • Expect gradual weight loss with peaks, valleys, and plateaus – not a straight downward curve • Sometimes weight will be gained • Small changes should become an enjoyable part of daily life

Gradual Weight Loss