Weight Management

Applied Nutrition Unit-III

Imran Waheed
Demonstrator
(INS-KMU)

1
 Objectives
• Discuss the concept of appropriate body weight
• Discuss the relationship of excess body weight to the
development of chronic disease
• Explain the concept of energy balance
• Calculate body mass index (BMI)
• Discuss the role of diet in weight management
• Identify factors in Pakistani diet that are conducive
to weight gain
• Explain the role of exercise in weight management
• Explain the role of behavior modification techniques
in weight management
• Council a patient regarding weight management
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 Concept Of Body Weight

Definition:
• The mass or quantity of heaviness of an
individual. It is expressed by units of pounds
or kilograms.
• Body weight appropriate for body height.
• Weight that is maximally healthful for a
person, based on height but modified by
factors such as gender, age, build.

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 Excess Body Weight And Diseases

• Maintenance of a healthy body weight has

health benefits and is important for
maintaining both physical and emotional well-
being and disease prevention.
• Excess weight, body fat, and obesity have
been associated with an increased risk for
numerous health conditions.

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 Conti…
• Risk of numerous diseases and clinical disorders
with excess body weight includes:
• Coronary Artery disease
• Cerebrovascular diseases
• Various cancers,
• Type 2 diabetes mellitus,
• Hypertension,
• Liver disease,
• Asthma, etc.
• Osteoarthritis,
• Sleep apnea
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 Excess Weight Causes Many
Health Problem

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 Energy Balance
Concept
• Energy balance simply describes the balance
between the calories you eat (energy in) and the
calories you use through daily living and activities
(energy out).
• This relationship, which is defined by the laws of
thermodynamics, dictates whether weight is lost,
gained, or remains the same.
• Energy is never really created and it’s never really
destroyed. Rather, energy is transferred between
entities.

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 Conti…

• We convert potential energy that’s stored

within our food (measured in Calories or kcals)
into three major “destinations”: work, heat
and storage.
• Negative energy balance occurs when caloric
intake is lower than energy expenditure.
• Positive energy balance occurs when caloric
intake exceeds energy expenditure.

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 Negative Energy Balance
 A severe negative energy balance can lead to :
 A decline in metabolism,
 Decreases in bone mass,
 Reductions in thyroid hormones,
 Reductions in testosterone levels,
 An inability to concentrate,
 And a reduction in physical performance.
 Weight loss.
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 Positive Energy Balance
• Overfeeding (and/or under exercising) has its
own consequences not only in terms of weight
gain but in terms of health and cellular
fitness.
• Plaques can build up in arteries
• The blood pressure and cholesterol in our body
can increase
• We can become insulin resistant and suffer from
diabetes
• We can increase our risk for certain cancers, and
so on.
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 Energy Balance Meter

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 Cont…

• In order to maintain your weight (i.e. stay the

same as you are now) the scales need to be level
so that the number of calories you take in
matches the number of calories you use.

If on the other hand you want to lose weight you

need to tip the scales in favor of energy out -- so
you burn more calories than you consume.

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 Body Mass Index

• The body mass index (BMI) is a measurement

of a human body shape based on an
individual's mass and height.
• It is actually a value derived from the mass
(weight) and height of a person.

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 BMI Categories (WHO)
Category BMI range – kg/m2

Very severely underweight Less than 15

Severely underweight From 15 to 16

Underweight From 17 to 18

Normal (healthy weight) From 18.5 to 25

Overweight From 25 to 30

Obese Class I (Moderately obese) From 30 to 35

Obese Class II (Severely obese) From 35 to 40

Obese Class III (Very severely obese) Over 40

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 Balanced Diet

• A balanced diet is one that provides all the

nutrients in required amounts and proper
proportions.
• A balanced diet should provide around 50 -60%
of total calories from carbohydrates.
• It should provide around 10 -15% of total
calories from Proteins.
• It should provide around 20 -30% of total
calories from visible and invisible fats.

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 Basic Five

Balanced diet can be easily achieved through a

blend of the five basic food groups.
1) Cereals and Millets
2) Pulses and Legumes
3) Vegetables and Fruits
4) Milk and Milk Products ,Egg ,Meat And Fish
5) Oils and Fats, Nuts and Oil Seeds

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 Pulses and Legumes

Cereal Grains & Products

Milk & Meat Products

Fat & Sugars

Fruits & Vegetables Imran Waheed 18
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 The Role of Diet in Weight
Management
• Body weight is regulated by several mechanisms
including genetic, physiologic, and behavioral
factors.
• Our body weight is determined by the amount of
energy that we take in as food and the amount of
energy we expend in the activities of our day.
• Major contributing factors to the increase of obesity
worldwide is the inappropriate dietary intake and
energy density of the diet, together with lower
physical activity levels.
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 Conti…
• If your weight remains constant, this is likely a sign that
you are taking in the same amount of calories that you
burn daily.
• If you're slowly gaining weight over time, it is likely that
your caloric intake is greater than the number of calories
you burn through your daily activities.
• Lifestyle and work habits partially determine how many
calories we need to eat each day.
• Heavy physical laborers will burn more calories in a day
than those who sits at a desk most of the day.

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 Conti…

• Fats:
• Fat is a very dense source of energy. It has
more than twice the calories per gram than
protein or carbohydrate.
• Cutting back on fat is the best way to reduce
the total number of calories in your diet.
• Animal foods such as meats and dairy
products can be a source of hidden fats.

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 Conti…
• Carbohydrates:
• It is easy to get too many calories by eating or
drinking too much sugar or simple CHO.
• Try to limit sweets, soda, and fruit drinks. They
give few nutrients and no fiber.
• Choose complex carbohydrates instead. They
give you lots of nutrients and fiber without as
many calories.
• They are found in whole grains, vegetables, and
dried beans.

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 Conti…

• Even though fruits are a simple carbohydrate

food, they are good for you because they also
have lots of fiber and nutrients.
• Proteins:
• Some high-protein diets severely restrict
carbohydrates and can result in nutritional
deficiencies and a lack of fiber, which can lead
to constipation.
• A high-protein diet can lead to bad breath.

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 Conti…

• A high protein diet worsens kidney function in

people with kidney disease.
• A high protein diet may increase blood sugar.
The body converts excess protein to glucose to
be used for energy.
• People with diabetes may find a high-protein
diet can raise their blood sugar levels.

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 Conti…
• Remember diets alone rarely help sometimes
but not always.
• They may help you lose a few pounds quickly.
But following a strict diet for a long time is too
hard for most people.
• If you stop dieting and exercising, the weight
comes back.
• You can fall into an unhealthy cycle of losing
and gaining weight.
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 Conti…

• The best way to manage your weight is through

healthy eating and being physically active.
• Eating plenty of fruits and vegetables and
choosing lean meats, nonfat and low-fat dairy
products, and whole grains.
• Limiting sweet liquids, such as soda, fruit drinks,
and sport drinks.
• Eating less fat, sugar, and highly processed
foods.
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 Strategies to Overcome Diet
Barriers to Healthy Weight
• Rather than focusing too much on weight loss,
focus on getting healthy.
• A lifestyle of healthy eating and regular exercise
will improve your health and quality of life, no
matter what you weigh.
 Set goals you can reach.
• Set small goals that you can change if you need
to.
• When you reach one goal, set another.

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 Conti…
 Think about your relationship with food.
• Do you overeat? If so, what causes you to
overeat?
• Are you bored, stressed, or sad?
• Do you use food as a reward?
• Pay attention to your feelings of hunger and
fullness.
• Do not skip meals.
• Skipping meals may make you so hungry that you
overeat during the next meal.

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 Conti…

 Keep track of how you eat.

• Keep a food diary of everything you eat and
drink.
• Pay attention to serving sizes. Check to see if
you are eating a variety of foods.
• You might find that making a few small
changes will help you eat a healthy, balanced
diet.

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 Conti…

 Take time to eat healthy food.

• Do you rely on fast foods or convenience
foods because you do not know how to cook
or do not have time?
• You can find cookbooks at the library or
bookstore that can help you make quick and
healthy meals.

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 Conti…

 Slowly change your eating habits.

• Try filling half your plate with vegetables.
• Fill one-fourth of the plate with lean meat or
chicken, and one-fourth with whole grains.
• Or, set a goal of eating at least 5 servings of
fruits and vegetables a day.
• If you make small, reasonable changes, rather
than depriving yourself of everything you love,
you will have more success.

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 The Role of Exercise in Weight
Management
• Combining exercise with a healthy diet is a more
effective way to lose weight than depending on
calorie restriction alone.
• Exercise can prevent or even reverse the effects of
certain diseases.
• Exercise lowers blood pressure and cholesterol,
which may prevent a heart attack.
• Exercise lowers the risk of developing certain types
of cancers such as colon and breast cancer.

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 Conti…
• Exercise plays an important role in maintaining a
healthy body.
• It makes you lose your weight without starving
your body.
• It increases the proportion of muscle and
decreases fats.
• Muscle is a metabolically active tissue, the more
muscular you are the higher your metabolism will
be and ultimately you will burn more calories
even at rest.
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 Conti…

• Exercise is also known to help and contribute

to a sense of confidence and well-being, thus
possibly lowering rates of anxiety and
depression.

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 Factors in Pakistani Diet that are
Conducive to Weight Gain

• Pakistan is a country where the concept of

healthy diet among the general public is totally
changed.
• Pakistani diet is usually “energy-dense” with
higher proportion of saturated fats, trans-fatty
acids and free sugar contributing to high caloric
intake.
• Use of “desi ghee”
• High intake of meat

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 Conti…

• Excess salt intake in foods

• Excessive use of sweets in celebrating
important events of life
• In addition over eating are common dietary
practices in Pakistan.
• Use of industrial processed foods, fast foods,
junk food and sugared fizzy drinks is getting
very popular in younger generation.

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 Conti…

• Rapid urbanization and modernization is also

leading to the use of high fat diet instead of
traditional low fat diets.
• Lack of appropriate policies and non-enforcement
of food safety regulations have multiplied the
number of street food vendors who sell low
quality foods in schools, markets, canteens and
other public places, increasing the prevalence of
food borne diseases, malnutrition and mortality.

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 Conti…

• In Pakistan, fast foods may be defined ready to

eat food available in public places, food
streets, food corners and restaurants.
• They may include burgers, shami kababs,
pizzas , sandwiches, chat, cholay, samosas,
pakoras , haleem, french fries, ice creams,
doughnuts and all other traditional and non-
traditional foods that are dispensed quickly.

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 Conti…

• They are classified as energy dense foods

because they provides:
• High amounts of sodium, sugar, cholesterol
and fat but are low in vitamins and minerals
and dietary fibre content.
• Despite of their low nutritional value, fast
foods have become a symbol of modern
culture and their taste appeal more to
children and youth.

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 Conti…

• Traditional foods are slowly losing their appeal, as

fast foods are alluring to the population due to
their convenience and easy availability.
• Home cooking hours have been comparatively
minimized and people prefer eating outside
in food streets and fast food restaurants.
• Along with Pakistani foods, Chinese, Western,
Italian and Continental cuisines have also gained
a lot of liking and are becoming a part of the
Pakistani menu.

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 Conti…

• The impact of fast foods on health is quite

staggering when consumed on a regular basis.
• By replacing fresh wholesome food with
processed additive-laden food, it has been
noted that blood pressure rises, cholesterol
level increases, metabolic rate altered and the
immune system is weakened.

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 Behavior Modification and
Weight Management

• Weight management involves adopting a healthy

lifestyle that includes a knowledge of nutrition
and exercise, a positive attitude and motivation.
• Internal motives such as better health, self-
esteem and personal control increase your
chances of lifelong weight management success.

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 Cont…
• Eat only while sitting down. Do not eat while
reading, cooking, talking on the phone, working on
the computer or watching television.
• Take small bites and chew your food well..
• During your breaks, go for a walk instead of eating.
• If you get hungry between meals, plan healthy
snacks.
• Do not skip meal as it may result in overeating at
the next meal.
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 Cont….
• Use smaller plates, bowls and glasses.
• Wait 20 minutes before eating something you are
craving.
• Eat on empty stomach.
• Drink a large glass of water before eating.
• Eat slowly. Remember it takes about 20 minutes for
your stomach to send a message to your brain that it
is full.
• Don't let fake hunger make you think you need
more.
• Make your healthy weight management priority.
• Think long term while developing new healthy
behaviors.
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 Counseling a Patient for Weight
Management
• Motivate the patients to manage their weight
through multiple approaches.
• Effective counseling begins with patient education
on several topics, including the effectiveness of
popular diets.
• Compared with people at a healthy weight, those
carrying extra pounds have a harder time walking a
quarter-mile, lifting 10 pounds, and rising from an
armless chair.
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 Conti…

• Counseling should address unrealistic patient

expectations.
• Excess weight plays a role in so many common
and deadly diseases.
• Some patients may be puzzled by the fact that
they are eating less, but are not losing
weight.
• This occurs when the brain senses reduced
intake and attempts to compensate by
decreasing energy expenditure.
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 Conti…

• Emphasize that even a small weight loss can

have significant results; a 5% weight loss, for
example, reduces type 2 diabetes risk by 60%.
• Overweight and obesity may shorten your life
span.
• The overall goal in weight loss counseling is to
help patients consume fewer calories and eat
more healthfully.

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 5As for Obesity Management

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 Reference
s
• W. P. T. James, “ epidemiology of obesity: the size of the problem,”
Journal of Internal Medicine, vol. 263, no. 4, pp. 336–352, 2008.
• http://www.nhlbi.nih.gov/health/educational/wecan/downloads/ca
lreqtips.pdf
• Centers for Disease Control and Prevention. Body mass
index. www.cdc.gov/healthyweight/assessing/bmi/. Accessed
April 15, 2020.
• Linda P. Case MS, ... Melody Foess Raasch DVM, in Canine and
Feline Nutrition (Third Edition), 2011
• Samir N, Mahmud S, Khuwaja A. Prevalence of physical inactivity
and barriers to physical activity among obese attendants at a
community health-care center in Karachi, Pakistan. BMC Research
Notes2011; 4(1): 174.

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Fall Down Seven
Times, Stand Up
Eight.

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