Obesity, Energy Balance, Weight Loss and Dangerous Dietary Practices

FIT401 Nutrition and Performance Topic 6

Objectives
Describe the Aetiology of Obesity Explain the causes and physiological changes of obesity Explain the modification of energy balance Analyze a range of diet Define and describe a range of eating disorders Discuss Trainers guidelines for eating disorders
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Overweight in Australia 1980-2000.

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Aetiology of Obesity
Genes havent changed Environment has changed
Relative affluence Food Availability Urbanisation Alteration in Food intake Less Activity
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Causes of Obesity
Amount of food eaten Type of food eaten

Restrictive dieting
Cyclic weight loss & gain Lack of physical activity Genetics Age Gender Medications
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Physiological Changes in Obesity

Fasting insulin **

Insulin response to Glu ***

Insulin sensitivity Growth hormone Adrenal hormones Cholesterol synthesis

Hormone sensitive lipase

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Goals for Weight Loss

Duration
Short Term

Weight Change
1 - 4 kg / month

Waist Circumference
1 - 4 cm / month

Medium Term

10% initial weight

5% after 6wks

Long Term

10-20% initial weight

88 cm females 102cm males

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Modification of Energy Balance

Diet + exercise + behaviour modification Must create ve energy balance Must be able to be maintained long term Requires long term support

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 Exercise is the only voluntary component BMR can be increased by adaptations to www.fiafitnation.com.au exercise
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Modification of Energy Expenditure

60 minutes of light to moderate physical activity must be performed daily to achieve weight loss (NHMRC)

Cumulative
60 90 minutes of activity daily are necessary for weight maintenance.

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Modification Energy Intake - Diets

Quick fix - not long term Eliminates macronutrients Unbalanced nutritionally Can lead to fatigue Can lead to food obsession Good & bad foods Guilt after eating bad food Does not address behavioral problems
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Metabolic Problems with Diets

Rapid early weight loss due to water loss Fat is major fuel source

FA metabolism & ketone bodies acidosis

After a period of time LBM decreases BMR decreases ( thyroid hormones decrease? ) Body adapts to lower energy state

Other Side effects

Gallstones Nausea Fatigue Constipation
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Behaviour Modification
Flexible control of eating behaviour Meal frequency and rhythm, snacking

Quality of food choice

Meal situation and circumstances

Food quantity restriction

Exercise and sport

Stress management and relaxation

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Individuals at Risk of Poor Body Image?

Women
menopausal
teenagers

Women & men who are overweight Underweight or slightly build men or adolescent males who want to bulk up
Aspiring athletes
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Behaviours Associated with Poor Body Image

Chronic dieting

Appearance checking
Weighing daily or more

Avoidance of social events

Excessive exercise

Preoccupation with food, exercise, weight

High achievers

Low self esteem

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Anorexia Nervosa
Dramatic weight loss Preoccupation with food, body weight, Unusual handling or hoarding of foods Vomiting or purging Wearing baggy or layered clothing

Mood swings
Avoiding food related social activities Enjoyment in weight loss

Compulsive rituals
Laxatives and diuretics.
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Bulimia
Usually normal or near normal body weight Frequent changes in weight

Excessive concern about weight

Going to the bathroom frequently after meals Laxatives and diuretics Obsessive compulsive behaviours Withdrawal from social and sexual relationships

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Muscle Dysmorphia (Bigorexia)

Obsess about being small, frail and /or undeveloped Lift weights and exercise compulsively Steroids or other drugs More common in males

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Trainers Guidelines for Eating Disorders

Act in conjunction with qualified health professionals

Aim to regain healthy outlook on life and their body

Aim to stabilize the weight in healthy weight range Decrease focus on weight, food , body shape & size Promote health and wellness from exercise Promote safe exercise levels with an emphasis on stretching, relaxation and massage Avoid competitive exercise Aerobic exercise should only be undertaken when the person is within 1-2 kg of their ideal body weight.
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Objectives - Recap
Describe the Aetiology of Obesity Explain the causes and physiological changes of obesity Explain the modification of energy balance Analyze a range of diet Define and describe a range of eating disorders Discuss Trainers guidelines for eating disorders
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