Chapter 9

Energy Balance and Healthy

Body Weight
Nutrition: Concepts & Controversies, 12e
Sizer/Whitney

Learning Objectives
Delineate the health risks of too little and
too much body fatness, with emphasis on
central obesity and its associated health
risks.
Describe the roles of BMR and several
other factors in determining an individuals
daily energy needs.

Learning Objectives
Calculate the BMI when given height and
weight information for various people, and
describe the health implications of any
given BMI value.
Compare and contrast the roles of the
hormones ghrelin and leptin in appetite
regulation, and name several other
influences on both hunger and satiety.

Learning Objectives
Discuss the potential impact of outside the
body factors on weight-control efforts.
Develop a weight-loss plan that includes
controlled portions of nutrient-dense foods
to produce gradual weight loss while
meeting nutrient needs.
Discuss the role of physical activity in
maintaining a healthy body composition.

Learning Objectives
Defend the importance of behavior
modification in weight loss and weight
maintenance over the long term.
Compare and contrast the characteristics of
anorexia nervosa and bulimia nervosa, and
provide strategies for combating eating
disorders.

Introduction
Health risks
Overweight
Underweight

Weight control
Focus on weight
Focus on controlling weight
Focus on short-term endeavors

Body composition

The Problems of Too Little or Too

Much Body Fat
U.S. prevalence
Underweight
Overweight
Epidemic

Children and adolescents

Increasing Prevalence of Obesity

Adult Obesity and Overweight

Compared with Healthy People Target

Underweight, Overweight, and

Mortality

What Are the Risks from

Underweight?
Disadvantages
Siege or famine
Hospital stays
Wasting disease
Heart disease

What Are the Risks from Too

Much Body Fat?
Obesity-related illnesses
Dying young
Obesity vs. smoking

Hypertension
Central obesity
Other risks

What Are the Risks from Central

Obesity?
Risks of visceral fat
Subcutaneous fat

Adipokines
Regulate inflammatory processes
Central obesity causes a shift

Free fatty acids

Factors affecting fat distribution

Visceral Fat and Subcutaneous

Fat

How Fat Is Too Fat?

Evaluate health risks of obesity
Body mass index (BMI)
Waist circumference
Disease risk profile

Social costs of being overfat

Economic costs of being overfat

Chronic Disease Risks According to

BMI Values and Waist Circumference

Indicators of an Urgent Need for

Weight Loss

The Bodys Energy Balance

Energy budget
Change in energy stores = energy in
energy out

Energy in
Foods and beverages

Energy out
Varies widely
Lifestyle and metabolism

The Bodys Energy Balance

Calorie needs
Monitor activity and weight
Energy output
Basal metabolism (BMR)
Voluntary activities
Thermic effect of food

Components of Energy
Expenditure

Factors That Affect the BMR

The Bodys Energy Balance

Estimated energy requirements (EER)
Reference man and woman
Taller people
Need more energy
Energy need diminishes with age

DRI method
Gender, age, physical activity, body size and
weight, and growth

Body Weight Versus Body

Fatness
Body Mass Index (BMI)
Underweight
Overweight
Obesity
Risks follow racial lines
Drawbacks
Amount or location of fat
Diagnosis requirements

Measuring Waist Circumference

Measures of Body Composition

and Fat Distribution

Body composition
Skin fold test
Underwater weighing
Bioelectrical impedance
Dual-energy X-ray absorptiometry
Each method has advantages and
disadvantages

Average Body Composition of

Men and Women

Three Methods of Assessing Body

Fatness

How Much Body Fat Is Ideal?

Healthy BMI range
Man: 12 to 20 percent
Woman: 20 to 30 percent

Declaration of being overfat

Men age 40 and younger
Men over age 40
Women age 40 and younger
Women over age 40

The Mystery of Obesity

Obesitys cause remains elusive
Hunger
Satiety
Response to physiological need
Chemical messengers
Stomach hormone
Ghrelin
Stomach capacity

Hunger, Appetite, Satiation, and

Satiety

The Mystery of Obesity

Appetite
Initiates eating
Endorphins
Factors affecting
appetite

The Mystery of Obesity

Stop signals
Satiation
Food in digestive tract
Hormones
Hypothalamus
Satiety
Regulates frequency of meals

The Mystery of Obesity

Leptin
Adipokine hormone
Appetite regulation
Leptin resistance

Energy nutrients
Protein provides most satiation

Inside-the-Body Causes of
Obesity
Metabolic theories
Variations in ease of body fat gain or loss
Variety of theories

Genetics
Influence tendency to gain weight or stay
lean
Environmental factors

Outside-the-Body Causes of
Obesity
External cues to overeating
Available foods
Human sensations
Larger portions

Physical inactivity
Nonexercise activity thermogenesis (NEAT)
Inactivity epidemic
Sitting still and death from heart disease

Outside-the-Body Causes of
Obesity
Built environment
Can discourage physical activity

Food access
Food deserts
Fast food

Attain healthy body weight

Diet
Physical activity
Behavior change

How the Body Loses and Gains

Weight
Tissue lost or gain
Depends on what you do
Water
Fat or muscle

Smoking
Hazards

Moderate Weight Loss Versus

Rapid Weight Loss
Gradual weight loss is preferred
Fasting
Body adjustments
Sacrifice lean tissue
Death

Ketosis
Break down of fat molecules

Feasting and Fasting

Moderate Weight Loss Versus

Rapid Weight Loss
Short-term fasting
Seems to be tolerated
Effects of deprivation
Overeat or binge eating
Weight loss technique
Slowing of metabolism

Low-carbohydrate diets
DRI minimum carbohydrate intake level

Weight Gain
Energy-yielding nutrients contribute to body
stores
Four sources of energy
Alcohol
Two types of energy stores

An excess of any food will become fat

Popular Fad Diets

Effectiveness
Both sides of the coin

Adequacy
To be achieved via food, not supplements

Safety
Personal responsibility

Achieving and Maintaining a

Healthy Body Weight
Changing your
body weight
What is your
motivation?

Benefits of modest
weight loss
Focus on health or
fitness

Tips for Accepting a Healthy Body

Weight

What Diet Strategies Are Best for

Weight Loss?
Aim for a realistic target
Reasonable goals
Specific and measurable objectives

Recommended weight loss

1 to 2 pounds per week
Weight maintenance

Keep records
Plan your diet

What Diet Strategies Are Best for

Weight Loss?
Realistic calorie intakes
Nutrient needs and caloric intake
Men
Women

Adequate diets
Choose sensibly

Consider a supplement
Calcium

Recommended Daily Food

Intakes for Low-Calorie Diets

What Diet Strategies Are Best for

Weight Loss?
Manage portion sizes
Reduced-calorie foods
Read labels

Calorie calculations
Little daily decisions add up

Energy density
Low energy density
May not reflect nutrient density

Examples of Energy Density

What Diet Strategies Are Best for

Weight Loss?
Artificial sweeteners
Soft drinks and milk consumption

Meal spacing
Hunger vs. appetite
Importance of breakfast
Night eating syndrome

Physical Activity in Weight Loss

and Maintenance
Weight loss
Physical activity alone

Weight maintenance
Appetite effects
Suppression of appetite
Heightened satiety

Other benefits
Choosing activities

What Strategies Are Best for

Weight Gain?
Physical activity
Resistance training

High-calorie diet
Increased daily caloric intake
High energy density foods

Portion sizes and meal spacing

Avoid tobacco

Medical Treatment of Obesity

Obesity medications
Over-the-counter (OTC) medications
Prescription medications

Obesity surgery
Extreme obesity
Not a sure cure
Complications

Lipectomy

Surgical Obesity Treatments

Herbal Products and Gimmicks

Herbals and botanicals
Sold as dietary supplements
Lack of FDA approval

Other gimmicks
Prohibited claims
Saunas or steam baths
Cellulite

Once Ive Changed by Weight,

How Can I Stay Changed?
Lifelong
commitment
Cultivate habits for
a healthy weight

Self-efficacy and
success keys
Physical activity
Weight cycling

Behavior Modification for Weight

Control
Behavior modification
Change behavior
Change thought processes

Food and activity diary

Dont attempt to modify all behaviors at once

A Sample Food and Activity Diary

Behavior Modification for Weight

Control
Modifying behaviors
Eliminate inappropriate cues
Suppress cues
Strengthen cues
Repeat the desires behaviors
Emphasize negative consequences
Emphasize positive consequences

Establish baseline
Cognitive skills

The Perils of Eating Disorders

Controversy 9

Introduction
Eating disorders
Anorexia nervosa
Bulimia nervosa
Binge eating
disorder

Young women
All people

Beginnings of
disorders

Societys Influence
Many causes to eating disorders
Societal pressure for thinness
Distorted body image

Media messages
Unrealistic ideals

Dieting as risk

Eating Disorders in Athletes

Motivations
Risk factors
Male and female athletes

Female athlete triad

Three medical problems

Male athletes and eating disorders

Muscle dysmorphia

The Female Athlete Triad

Tips for Combating Eating

Disorders

Anorexia Nervosa
Characteristics
Cannot recognize condition

Role of the family

Self-starvation
Physical perils
Damage to whole body
Death

Treatment

Criteria for Diagnosis of Anorexia

Nervosa

Bulimia Nervosa
Characteristics
More prevalent than anorexia nervosa

Role of the family

Binge eating and purging
Stages of a binge
Methods for purging

Physical and psychological perils

Treatment

Criteria for Diagnosis of Bulimia

Nervosa

The Cycle of Bingeing, Purging,

and Negative Self-Perception

Binge Eating Disorder

Differences from
bulimia nervosa
Responds more
readily to treatment

Criteria for Diagnosis of Binge

Eating Disorder