Judith E. Brown

Prof. Albia Dugger • Miami-Dade College

www.cengage.com/nutrition/brown

Weight Control: The Myths and Realities

Unit 10

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