Weight Management Energy Balance Equation Balance: energy intake = energy expenditure energy intake > energy expenditure = weight gain energy intake.

Weight Management

Energy Balance Equation

Balance: energy intake = energy expenditure

energy intake > energy expenditure = weight gain

energy intake < energy expenditure = weight loss

Control of Food Intake

Control Center is the hypothalamus

hunger center

satiety center

Resting Energy Expenditure

metabolic requirements necessary to live, resting

anything above is additional energy requirements

Most Effective For Weight Loss

Caloric RestrictionMost regain weight

Exercise is less effective

Most Effective for Maintenance of Weight Loss

Physical Activity began during caloric restriction

Caloric Restriction

most common treatment of excess weight

composition of diet is also important

Very Low Calorie Diets

can be dangerous

many people have died of cardiac arrest

associated with serious cardiac arrhythmias

loss of hair

loss of lean body mass

thinning of skin

coldness in the extremities

gallbladder stones

gout

elevated cholesterol

Dehydration

diuretics

impermeable clothing

weight loss is due to dehydration, not fat loss

usually re-hydrate after the loss

Medical Procedures

Prolonged fasting

Bariatric bypass

Lipectomy (liposection)

Drugs to control weight

appetite suppressants

thermogenic drugs

DrugsXenical (fat absorption in the gut)

Meridia (brain chemistry)

7-10# more than if diet alone

Behavior Modification

Focus on elimination of the behavior that is associated with poor eating and exercise habits

30% of participants maintain weight loss after one year and continue to lose

Exercise

Single session of exercise will result in little fat loss

Regular exercise training will lead to adaptations that increase utilization of fat

Exercise adaptations

Begin to utilize fats earlier in the exercise bout

Utilize more fats

Females utilize fats more efficiently than males

Fat Metabolism and Gender

Females are more efficient at storing fat

Females store more fat

Females may store more from a similar meal as fat than a male would

Fat Metabolism

Adipocytes process and store lipidsProduce a variety of hormonesLipoatrophy: reduced or absent fat

depositsInsulin resistanceType II Diabetes

Leptin

Hormone produced by adipose tissue

Not just obesity, metabolic regulation of virtually all metabolic systems

Mediator of energy balance

Glucose and other substrates increase ATP production and stimulate leptin secretion

Deplete energy stores inhibits leptin secretion

Leptin Con’t

Starvationpromotes increased energy intakedecreased expenditureIncreased lipogenesis

Normal maturationAdequate stores for reproduction

Increased nitric oxide (NO)Homeostasis of BP

What is the best intensity?

What works for you

will not burn more fat at low intensity (in total) than if you exercise at high or moderately high intensity

1 mile = ~100 kcal

Whether you walk the mile or run the mile

Reasonable changes

Should be small

Should become part of your lifestyle

21 days to make a habit

Weight Loss Strategies

Meal Planning

Physical Activity

Behavior Therapy

Lifestyle Therapy

Pharmacotherapy

Weight Reduction Surgery

Weight Maintenance Plan

Weight Maintenance is more important that a “diet” or weight loss

Better long-term outcomes and long-term health