WEIGHT MANAGEMENT:  Synthesized and secreted by the stomach cells and

promotes a positive energy balance by stimulating

OVERWEIGHT AND UNDERWEIGHT appetite and promoting efficient energy storage.
 Overweight and underweight are both result from  Triggers the desire to eat
energy imbalance  Blood levels of ghrelin rise before meal and rapidly
 Overweight consumed more food energy. after meal
 Underweight consumed too little food energy  Blood levels of ghrelin correlate inversely with the
body weight
 Lean people have high ghrelin levels and obese have
low
CAUSES OF OBESITY
FAT CELL DEVELOPMENT- excess fat cells during childhood
1. Genetics and weight
2. Lipoprotein Lipase  Fat cell number increase more rapidly in obese
3. Leptin  Fat cells expand in size
4. Ghrelin  Fat cell shrinks but not in number
5. Fat cell Development
6. Set-Point Theory SET-POINT THEORY- proposes that body weight (like the
7. Environmental Stimuli body temperature), is physiologically regulated.
8. Learned Behavior ENVIRONMENTAL STIMULI- people may overeat in response
9. Physical Inactivity to stimuli in their surroundings
GENETICS AND WEIGHT- genetic makeup influences the  Availability of food
body’s tendency to consume or store too much food energy  Ready-to-go meals are offered in supersize
or to expend too little. combinations
 When both parents are obese, chances that their LEARNED BEHAVIOR- physiological stimuli triggers
children will be obese are quite high (80%) inappropriate eating behaviors
 Whereas neither parents are obese, chances is low
(10%)  Appropriate eating behavior is response to HUNGER
 Low metabolic rate is a major risk factor for weight  Hunger is a drive programmed into people by their
gain heredity
 APPETITE, in contrast, is learned and can lead to
LIPOPROTEIN LIPASE (LPL) - enzyme that promotes fat people to ignore hunger or to over-respond to it
storage in fat cells and muscle cells
PHYSICAL INACTIVITY- output of energy equation
 People with high LPL activity are especially efficient
at storing fat  The expenditure of energy
 1/3 of the overweight population reports no physical
LEPTIN- the “obesity gene” (protein)
 activity during their leisure time
 Hormone primarily produced and secreted by the fat
cells that helps maintain normal weight
 A gain in body fatness stimulates the production of OBESITY TREATMENT
leptin
 Suppression of leptin production increased appetite  weight- loss advise does not apply equally to all
and decreases the energy expenditure overweight people
 Increasing physical activity, getting enough sleep,  Some people may risk more through misguided
decreasing sugar intake and including more fish in efforts to lose weight than by remaining overweight,
your diet helps to increase the production of leptin whereas others may benefit from just a modest
 Extremely obese (blood levels of leptin are barely weight loss.
detectable)

GHRELIN- another protein that also Acts as a hormone

primarily in hypothalamus, but works opposite direction of
leptin.
INAPPROPRIATE OBESITY TREATMENT
1. Over-the- counter weight-loss supplement and drugs
2. Herbal products and dietary supplements
3. Other gimmicks
AGGRESSIVE TREATMENTS OF OBESITY (OBESITY DRUGS)
1. Sibutramine- appetite suppressant that works on
the brain neuro-transmitter
- Side effect dry mouth, rapid heart rate,
insomnia, headache and increase BP
- 8. Meal spacing
2. Orlistat – inhibit the action of fat-digesting enzyme
in the GI tractand reduces fat digestion and
absorption about 30%
-leaves the digestive tract intact, carrying with it fat
soluble and phytochemicals
-side effect: diarrhea and digestive distress
3. Surgery – gastric bypass and gastric banding
Gastric bypass, also called Roux-en-Y (roo-en-wy)
gastric bypass, is a type of weight-loss surgery that
involves creating a small pouch from the stomach
and connecting the newly created pouch directly to
the small intestine. After gastric bypass, swallowed
food will go into this small pouch of stomach and
then directly into the small intestine, thereby
bypassing most of your stomach and the first section
of your small intestine.
Gastric bypass is one of the most commonly
performed types of bariatric surgery. Gastric bypass
is done when diet and exercise haven't worked or
when you have serious health problems because of
your weight.
Laparoscopic gastric banding is surgery to help with
weight loss. The surgeon places a band around the
upper part of your stomach to create a small pouch
to hold food. The band limits the amount of food
you can eat by making you feel full after eating small
amounts of food.
REASONABLE STRATEGIES FOR WEIGHT LOSS
1. A healthful eating plan
2. A realistic energy intake
1000-1200 kcal/day for women
1200-1600 kcal/day for men
3. Nutritional adequacy
4. Small portions
5. Balancing carbohydrates, fats and proteins
6. Lower energy density
7. Sugar and alcohol
9. Adequate water
10. Physical activity
BEHAVIOR AND ATTITUDE
1. Behavior modification therapy provides ways to
overcome barriers to making dietary changes and
increasing physical activity
2. Becoming aware of behaviors-- establish a baseline
against which to measure future progress.
- Diary, that includes the time and places for
meals and snacks, the type and the amount of
food eaten
3. Making small changes- “how to” describes
behavioral strategies to support weight
management.
4. Maintaining weight- be aware that it can be hard to
maintain weight loss
- On arriving at the goal weight after months of
self- discipline and new habit formation, the
victorious weight loser must not :celebrate” by
resuming old eating habits.
5. Personal attitude- many people overeat to cope with
stresses of life. To break out of that pattern, they
must first identify the particular stressors that
trigger their urges to overeat.
-must kearn to practice problem solving.
Summary:
1. a person who adopts a lifelong “eating plan for good
health” rather than “diet for weight loss” will be
more likely to keep lost weight off.
2. Physical activity should be an integral part of weight
management program
3. Physical activity can increase energy expenditure,
improve body composition, help control appetite,
reduce stress and stress eating, and enhance
physical and psychological well being
4. Behavior modification provides ways to overcome
barriers to a successful weight management