CHAPTER 9

DIET AND WEIGHT CONTROL

NORMAL WEIGHT

AVERAGE

IDEAL

DESIRED

OVERWEIGHT

10-20 PERCENT ABOVE Ideal Body Weight (IBW)

OBESE

GREATER THAN 20 PERCENT IBW

OVERWEIGHT AND OBESITY

HEALTH RISKS RELATED TO OBESITY AND FAT DISTRIBUTION

•HEART DISEASE

•DIABETES

•HYPERTENSION

•SOME TYPES OF CANCER

•STROKE

NUMBER 1 HEALTH PROBLEM

CONTRIBUTES TO HEALTH COSTS OF $140 BILLION PER YEAR

HEART DISEASE

RELATED TO WEIGHT CYCLING OR YO-YO SYNDROME-LIFETIME LOSING AND

REGAINING WEIGHT INCREASES RISK FOR CORONARY HEART DISEASE AND PREMATURE DEATH

OVERWEIGHT IS ASSOCIATED WITH 40% OF ALL HEART DISEASE IN US WOMEN

GAINING 20 X-TRA POUNDS IN ADULTHOOD INCREASES THE RISK

CANCER

POSSIBLE LINK BETWEEN ABDOMINAL FAT DISTRIBUTION AND BREAST CA FOR WOMEN

UPPER BODY OBESITY IS A RISK FACTOR IN UTERINE OR ENDOMETRIAL CANCER AND INCREASED INCIDENCE OF DIABETES AND HYPERTENSION

OTHER HEALTH PROBLEMS- BMI OF 27 OR GREATER

HIGHER INCIDENCE OF STROKE

REDUCED FERTILITY

CHRONIC HYPOXIA WITH CYANOSIS AND HYPERCAPNIA

SLEEP APNEA

GOUT

DEGENERATIVE JOINT DISEASE OF THE HIPS AND KNEES

FATTY LIVER

FUNGAL AND YEAST INFECTIONS OF THE SKIN

VENOUS CIRCULATORY DISEASE

GALLBLADDER DISEASE

HIGHER RISK FOR OSTEOPOROSIS

TREATMENT

DIET INTERVENTION STRESSING REDUCED KCAL INTAKE, LOW FAT COMBINED WITH BEHAVIOR MODIFICATION AND EXERCISE

FAD DIETS

CRASH-REDUCING- INTENDED TO CAUSE A VERY RAPID RATE OF WEIGHT

REDUCTION

MAY REQUIRE EXPENSIVE FOODS

INITIAL RAPID WEIGHT LOSS THOUGHT TO BE ASSOCIATED WITH LOSS OF BODY WATER RATHER THAN FAT

MAY LIMIT FOODS CREATING NUTRIENT DEFICIENCIES AND MAY BE BORING

MAY CONTAIN EXCESSIVE PROTEIN, CHOLESTEROL AND FAT

SURGICAL TREATMENT

JEJUNOILEAL BYPASS-MIDDLE SECTION OF THE SMALL INTESTINE IS SURGICALLY ATTACHED TO A SMALL SECTION OF THE ILEUM WHICH IS THE LAST PART OF THE SMALL INTESTINE

FEWER NUTRIENTS ARE ABSORB AND LOSS OF WEIGHT

COMPLICATIONS

DIARRHEA

ELECTROLYTE AND FLUID IMBALANCES

LIVER PROBLEMS

KIDNEY STONES

BONE DISEASE- RELATED TO REDUCED ABSORPTION OF MINERALS AND

VITAMINS

GASTRIC BYPASS

STOMACH IS STAPLED SAO THAT ONLY A PART OF IT IS ATTACHED TO THE JEJUNUM WHERE ABSORPTION TAKES PLACE

REDUCED STOMACH CAPACITY REDUCES THE AMOUNTS OF FOOD THAT CAN BE EATEN

COMPLICATIONS

NAUSEA AND VOMITING-POST SURGERY

FEWER THAN THE JEJUNOILEAL BYPASS

PHARMACEUTICAL TREATMENT

AMPHETAMINES

PEP PILLS PRESCRIBED FOR THE TREATMENT OF OBESITY THAT DEPRESS THE APPETITE

EFFECTIVENESS REDUCED WITHIN SHORT PERIOD OF TIMES

DIURETICS AND LAXATIVES

BELIEVED BY SOME TO PROMOTE WEIGHT LOSS

PRIMARILY REDUCTION OF WATER

UNDERWEIGHT

INADEQUATE CONSUMPTION OF FOOD

MAY BE RELATED TO DEPRESSION, ANOREXIA OR POVERTY

CAUSED BY EXCESSIVE ACTIVITY

CERTAIN DISEASES AND POOR ABORTION OF NUTRIENTS, INFECTION O HYPERTHYROIDISM

HYPERTHYROIDISM

CONDITION IN WHICH THE BMR IS INCREASED AND INCREASES THE NUMBER OF KCAL NEEDED FOR ENERGY

TREATMENT

HIGH-KCAL DIET (MAY OR MAY NOT BE COMBINED WITH PSYCHOLOGICAL

COUNSELING

EATING DISORDERS

I remember a high school friend who had anorexia nervosa. She was a very bright girl and seemed to have it all. Is that uncommon for a girl with anorexia nervosa?

NOT AT ATLL

PROFILE:

USUALLY FEMALE

TEENS

EDUCATED

MIDDLE CLASS FAMILY

PSYCHOLOGICAL PROFILE

DEPRESSION

EARLY DEVELOPMENTAL FAILURE

CHARACTERISTIC CLUSTER OF FAMILY CIRCUMSTANCES-DOMINANT MOTHER, FATHER ABSENT OR DISTANT

PERFECTIONIST

IDENTIFIES WITH CHARACTERISTICS OF FAMILY GOALS

LOSE THEIR OWN IDENTITY

DESIRES TO CONTROL SELF

RATIONALE

"THIN " DRIVEN SOCIETY

What are the consequences of anorexia nervosa?

Affects the GI System, the Circulatory System (weakened heart muscle), Increased amount of fine body hair and skin dryness, always cold, Abnormal brain activity, sleep disturbances, amenorrhea, infertility, loss of sex drive.

SUCCESSFUL TREATMENTS

Health professionals to treat and motivate to sustain with gain. Nurses, dietitians, psychiatrists, family psychologist and dietitians.

BULIMICS

BINGE AND PURGE

MORE COMMON THAN ANOREXIA NERVOSA

PROFILE

MORE COMMON IN FEMALES THAN MALES

WELL EDUCATED

EARLY TWENTIES

CLOSE TO IDEAL BODY WEIGHT

HIGH ACHIEVER

STRONG FEELING OF DEPENDENCE ON PARENTS

SOCIAL ANXIETY AND DIFFICULTY ESTABLISHING RELATIONSHIPS

SPEND A LOT OF TIME THINKING ABOUT FOOD AND BODY WEIGHT

PREOCCUPATION MANIFESTS IN SECRETIVE BINGE EATING EPISODES FOLLOWED BY PURGING

PATTERN OF RESTRICTIVE DIETING

WEIGHT FLUCTUATIONS WITHIN 10 POUNDS

aware of consequences of behavior, feel it is abnormal and are ashamed

feel inadequate, unable to control

Consequences

swollen hands and feet

bloating

fatigue,

headache

nausea

pain

repeated binges

fluid and electrolyte imbalance

abnormal heart rhythms

injury to the kidneys

infections of the bladder and kidneys

irritation and infection of the pharynx, esophagus- may rupture and tear

erosion of the teeth

dental caries

treatment

easier to treat than anorexia

help clients gain control

team approach

Binge

abnormal eating

not a response to hunger

food not consumed for nutritional value

compulsion to eat

occurs periodically

done in secret, usually at night, lasts an hour or more

frequently followed with rigid eating

consume 1000 to several thousand calories

food is usually high in sugar and fat

requires little chewing

assignment chapter 9