Obesity and Weight

Control
Exercise Physiology
McArdle, Katch, & Katch
Chapter 16
 Overweight and Obesity
 Overweight: body
weight that exceeds
some average for
stature, perhaps age.
 Overfat: body fat that
exceeds an age- and/or
gender appropriate
average by some amt.
 Obesity: overfat
condition that
accompanies
components of obese
syndrome.
Obese Syndrome Components
 Glucose intolerance
 Insulin resistance
 Dyslipidemia
 Type 2 diabetes
 Hypertenision
 Elevated plasma leptin
concentration
 Increased visceral
adipose tissue
 Increased risk of CHD &
some cancers
Obesity: A Global Epidemic
 Why is obesity
accelerating in
developing countries?
 Increased
consumption of
energy-dense,
nutrient poor foods
combined with
reduced physical
activity.
 Obesity: A Global Epidemic
 What is the prevalence of overweight and
obesity in the United States? 66% & 31%

obesity tre
nd
 Obesity Trends* Among U.S. Adults
BRFSS, 1990, 2000, 2010
(*BMI 30, or about 30 lbs. overweight for 5’4” person)

1990 2000

2010

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%

 Causes of Obesity
 Obesity is a long term You gonna
process. finish that?

 Obesity frequently
begins in childhood.
Obese parents likely
have overweight
children.
 Regardless of final body
weight as adults,
overweight children
exhibit more illnesses as
adults than normal kids.
 Causes of Obesity
 Excessive fatness also
develops slowly
through adulthood,
most weight gain
occurring between
ages 25 to 44 yrs.
 Typical American man
& woman gain .5 to
1.8 lb/year until 60.
 Causes of Obesity
 Overeating and Other Factors
 Factors that cause human obesity:
genetics, environmental, metabolic, behavioral, social
 Factors that predispose a person to gain
excessive weight gain.
 Eating patterns Eating environment
 Food packaging Food availability
 Body image Physical inactivity
 Basal body temp Dietary thermogenesis
 Fidgeting Biochemical differences
 Quantity & sensitivity to satiety hormones
 Overeating and Other Factors
 Nutrition transition shifts in dietary
structure toward higher energy density
with greater fat and added sugars, greater
saturated fat, reduced complex CHO and
fiber, and reduced fruits & vegetables.
 Food consumption expressed in kCal per
capita per day has increased.
 Decreased energy expenditure for all
populations of the world.
 Causes of Obesity
 Characteristics of fast
food linked to
increased adiposity:
 Higher energy density
 Greater saturated fat
 Reduced complex
carbohydrates & fiber
 Reduced fruits and
vegetables.
 Causes of Obesity
 Genetics plays a role.
 How much variation in
weight gain among
individuals can be
accounted for by genetic
factors?
 Familial association is not
proof of genetic
inheritance-families share
eating & exercise habits.
 Largest transmissible
variation is cultural.
 Causes of Obesity
 A Mutant Gene?
 What is leptin?
 A satiety hormone that influences the

appetite control in the hypothalamus.

 A defective gene may cause inadequate

leptin production.
 The brain receives an under assessment

of body’s adipose stores & urge to eat.

Causes of Obesity
Normally leptin blunts the urge to
eat when caloric intake maintains
ideal fat stores.

In essence, leptin availability, or

its lack, affects the
neurochemnistry of appetite and
the brain’s dynamic “wiring” to
possibly impact appetite and
obesity in adulthood.

Leptin alone does not determine

obesity or explain why some
people eat whatever they want
and gain little weight while
others become overfat with the
same caloric intake.
 Causes of Obesity
A defective ob gene How does Leptin affect
causes inadequate body fat?
leptin production.  Stimulates chemicals
Thus, the brain that suppress appetite
receives an under  Reduce levels of
assessment of body’s chemicals that
adipose stores and stimulate appetite.
urge to eat.
May be defective leptin
receptor action.
 Causes of Obesity
 Physical Inactivity: an
important component
 Each hour increase in TV
by adolescents 2%
increase obesity.
 Adults 15 & over spent
average 2.73 hr/day
watching TV in 2010.
 Each hour increase in TV
by adults increase risk of
death 11%.
 Obesity
 Health Risks of Obesity
 Primary risk factor for
coronary heart
disease.
 Associated with HTN,
DM, dyslipidemia, &
cerebrovascular
disease.
 Obesity-related
medical complications
account for 10% of
national health care.
 Obesity
 How Much Fat is TOO Much?
 List three criteria for evaluating a person’s
level of fatness.
 % Body Fat
 Fat Patterning
 Fat Cell Size and Number
 Percent Body Fat
 Overfatness Standard Men Women
corresponds to any
body fat value 5% Essential 3-5 11-14
above the average
Athletic 8-12 12-18
value for age & sex.
 Borderline obesity in Acceptable 13-20 19-25
young man > 20 & in
young woman >30%. Overfat 21-25 26-30

Obese >25 > 30

Fat Patterning
 Adipocytes from some
locations (gluteal &
femoral) efficiently
capture excess
nutrients from the
blood-stream for
storage, while others
accumulate TGs but
readily release them for
use by other tissues.
 Fat Patterning
 Visceral (intra-
abdominal) adipose
tissue (VAT) relates to
an altered metabolic
profile.
 Abdominal fat
described as android
(apple) has higher
health risk than gynoid
(pear) obesity.
 Fat Patterning
 Give an objective
standard for
establishing male- and
female-pattern
obesity.
 Male > .95 W:H ratio
 Female > .80 W:H
 Fat Cell Number and Size
 Increases in adipose
tissue occurs in two
ways:
1. Fat cell hypertrophy
2. Fat cell hyperplasia
 Fat Cell Number and Size
 After reaching a biological upper limit for fat cell
size, cell number becomes a key factor that
determines obesity.
 Weight Control
 What is the prognosis for long term weight
control?
 Participants who remain in supervised weight
loss program regain almost all within 5 years.
Weight Control
 One pound of fat
contains 3,500 kcal
 Unbalance the Energy
Equation (First Law
Thermodynamics)
1. Reduce kcal intake
2. Increase kcal output
3. Reduce intake and
increase output
 Altering the Energy Balance
 Total energy intake (not macronutrient
mixture) determines effectiveness of
weight loss with diet.
 Rapid weight loss during first few days
comes mainly from body water loss and
glycogen depletion.
 Continued weight reduction occurs at
expense of greater fat loss per unit weight
loss.
 Altering the Energy Balance
 Resting Metabolic
Rate Lowered.
 Blunted metabolism
conserves energy
causing diet to
become progressively
less effective.
 Could lead to difficulty
losing weight.
 Fat Cell Size and Number
 What happens to fat cell size and fat cell
number when adults lose weight?
 Fat cells shrink to a smaller size than adipocytes
of nonobese people, number remains same.
 The large # of relatively small adipocytes may
relate to appetite control; person craves food,
overeats & gains lost weight.
 Total number of fat cells increases 3 general
periods:
Last trimester pregnancy, 1st year life, adolescence
 Fat Cell Size and Number
 In non-obese subjects with moderate
weight gain, adipocyte size increased
substantially with no change in cell
number.
 Weight gain among severely obese, new
adipocytes develop in addition to
hypertrophy of existing cells.
 Select a Diet Program
Method Principle Disadvantage
Low CHO – Increased ketone excretion Ketogenic
ketogenic removes energy-containing High fat intake
substances from body. contraindicated.
High Low caloric intake favors Expensive, repetitious;
protein negative energy balance. difficult to maintain,
Elevated thermic effect. dehydrates.
Semi- Decreased energy input Possible malnutrition,
starvation assures negative balance. lethargy, LBM.

High CHO, Low carbohydrate favors Initial water retention.

low fat negative balance.
 Exercising to Tip Energy Balance
 Increased physical activity combined with
dietary restraint maintains weight loss more
effectively than caloric restriction alone.
 For previously sedentary, overweight,
moderate increases in physical activity do
not necessarily increase food intake.
 Recommend minimum of 3 days per week.
Intensity individualized, minimum 300 kcal/session
Diet Plus Exercise
 Combining exercise
and diet offers more
flexibility for weight
loss.
 Exercise facilitates fat
mobilization from
adipose depots and
fat catabolism.
Preserves fat free
body mass, blunts
decrease in RMR,
improves insulin
sensitivity.
Diet Plus Exercise
The Ideal Combination
 Exercise enhances fat

mobilization from
body’s adipose depots
and fat catabolism by
active muscles.
 Protects against

protein loss in skeletal

muscle and improves
insulin sensitivity.
Maintenance of Goal Body Weight
 Most weight loss occurs
during first 6 months.
Up to 85% those
starting a weight loss
program drop & regain.
 IOM recommend that
obese reduce initial
body weight by 5% to
15% as realistic.
Maintenance of Goal Weight
 Selective fat reduction
at specific body areas by
spot reduction does
NOT work.
 Exercise stimulates fatty
acid mobilization
through hormones and
enzyme action that
target fat depots
throughout the body.
 Gaining Weight
 Resistance training complemented by well-
balanced diet increases muscle mass.
 If all calories consumed in excess of energy
requirement during resistance training
would go towards muscle growth, 2000 to
2500 extra calories would support 0.5 kg
increase in lean tissue.
 Intense aerobic training will detract from
maximal increases in muscle mass.
 Conclusions
When traveling in Oia,
Santorini a Greek
Island, EAT, DRINK,
and BE HAPPY, for
tomorrow you may
die.
If you make it home,
exercise often, hard,
and a long time.
 Illustration References
 McArdle, William D., Frank I. Katch, and
Victor L. Katch. 2000. Essentials of
Exercise Physiology 2nd ed. Image
Collection. Lippincott Williams & Wilkins.
 Plowman, Sharon A. and Denise L. Smith.
1998. Digital Image Archive for Exercise
Physiology. Allyn & Bacon.