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Weight Management Educational Guide

 

Note: Overweight is used as both a noun and an adjective in this brochure.

 

Weight Loss - the National Pastime

Weight loss has become a national obsession. People are obsessed with weight loss because obesity has reached epidemic proportions. Statistics on overweight and obesity are alarming on many levels. The sheer numbers of obese people are staggering. Obesity related diseases are increasing at a shocking rate, and threaten to cripple or paralyze healthcare. A distressing number of people who aren’t obese are still considered overweight.

• Overweight refers to an excess of body weight compared to set standards. The excess weight may come from muscle, bone, fat and/or body water.

• Obesity refers specifically to having an abnormally high proportion of body fat. 

A person can be overweight without being obese; however, many who are overweight are also obese.

Nearly two-thirds of Adults in America are overweight

Over 30% are obese, according to the National Health and Nutrition Examination Survey. Being overweight reduces our prospects for a long, healthy, and productive life, and tends to lower our self-esteem. Little wonder most of us want to become thin — as quickly and effortlessly as possible. Everyone wants to be healthier, control their weight, and take off unwanted pounds.

The difference between Overweight and Obesity

A number of methods are used to determine if someone is overweight or obese. Some are based on the relation between height and weight; others are based on measurements of body fat. The most commonly used method today is Body Mass Index (BMI). 

BMI can be used to screen for both overweight and obesity in adults. It is the measurement of choice for many obesity researchers and other health professionals, as well as the standard used in most published information on overweight and obesity. BMI is a calculation based on height and weight, and it is not gender-specific. BMI does not directly measure percent of body fat, but it is a more accurate indicator of overweight or obesity than relying on weight alone. BMI is found by multiplying your weight in pounds by 704.5, then dividing the results by your height in inches, and dividing that result by your height in inches a second time.

An expert panel convened by the National Heart, Lung, and Blood Institute in cooperation with the National Institute of Diabetes and Digestive and Kidney Disease identified overweight as a BMI of 25-29.9 and obesity as a BMI of 30 or greater. However, overweight and obesity are not mutually exclusive, since people who are obese are also overweight.1 Defining overweight as a BMI of 25 or greater is consistent with the recommendations of the World Health Organizationand most other countries.

Calculating BMI is simple, quick, and inexpensive, but it does have limitations. One problem with using BMI as a measurement tool is that very muscular people who have lost muscle mass, such as the elderly, may be in the healthy weight category according to their BMI when they actually have reduced nutritional reserves. BMI, therefore, is usually helpful as a general guideline to monitor trends in the population, but by itself is not diagnostic of one’s health. 

Further evaluation should be done to determine one’s weight status and associated health risks.

Overweight satistics in America

Overweight and obesity are found worldwide, and the prevalence of these conditions in the United States ranks high, as it does in other developed nations. Many of today’s health concerns everywhere are attributable to unhealthy dietary habits and physical inactivity, or a sedentary lifestyle.

• Nearly two-thirds of U.S. adults are overweight — 129.6 million (64.5%).

• Eight out of 10 adults over 25 are overweight

• Less than half of adults 20-74 years old have a healthy diet

• 52% of all Americans do not meet basic activity level recommendations

• 25.4% are voluntarily completely sedentary

The incidence of overweight in adults has steadily increased over the years among both genders, all ages, all racial/ethnic groups, all educational levels, and all smoking levels. From 1960 to 2009, the occurrence of overweight people (age 20-74) increased from 31. 5% to 33.6%. But the prevalence of obesity during this same time period has more than doubled from 13.3% to 35.7%, with most of this rise occurring in the past 20 years.

Obesity statistics in America

The greatest increase noted in weight statistics was in people who are clinically obese. Someone who is clinically obese has a Body Mass Index of 30 or more. Obesity statistics in the U.S. are stunning, and the numbers increase daily.

• 78 million adults are obese along with 12.5 million children and adolescents

• 3 million are morbidly obese 

While obesity is technically a condition describing excess body weight in the form of fat, morbid obesity is defined as being more than 100 pounds overweight, or having a Body Mass Index (BMI) of around 40 or above. People who are morbidly obese are at far greater risk for weight-related disease and have a much higher mortality rate than people who fall into the normal weight category. 

As the prevalence of overweight and obesity has increased in the United States, so have related health care costs both direct and indirect. Weight concerns make people far more vulnerable to most major disease conditions. A recent study estimated annual health care spending due to overweight and obesity to be as much as $147 billion in 2008.

Cost of related issues

In the U.S., a study broke down overweight and obesity related healthcare costs as:

• Type II diabetes — $224 billion

• Osteoporosis — $18 billion

• Hypertension — $93.5 billion

• Heart disease — $108.9 billion

• Post-menopausal breast cancer — $16.5 billion

• Colon cancer — $14 billion

• Endometrial cancer — $790 million

It is estimated that productivity at work suffers due to weight issues, and each year costs employers in these ways:

• Workdays lost — $39.3 million

• Physician office visits — $62.7 million

• Restricted activity days — $29.9 million

• Bed-ridden days — $89.5 million

Clearly, overweight and obesity impact more than just physical appearance. They affect quality of life, overall health, productivity, and the cost of healthcare for everyone.

Is there more information available on why people become overweight?

The Weight-control Information Network (WIN) is a national service of the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, which is the Federal Government lead agency responsible for biomedical research on nutrition and obesity. Authorized by Congress, WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues. Toll-free number: 1-877-946-4627.

Why do people who are overweight have trouble losing the excess fat?

There are hundreds of diets that claim to be the answer to the problem of overweight. But the basic formula for losing weight never changes — energy intake must be less than energy expenditure. In other words, eat less (decrease calorie intake) or exercise (increase the rate you burn calories). Or preferably both.

A successful program for weight reduction should consider a comprehensive approach to weight loss:

• proper diet

• adequate exercise

• a positive mental attitude

• and natural remedies to assist the body

All are interrelated, creating a system where no single component is more important than the others. Improvement in one facet may be enough to result in some positive changes, but working on all four components yields the greatest results.

Lifestyle suggestions and Weight loss tips

How physically active are you?

Less than one-third (31.9%) of U.S. adults get regular leisuretime physical activity (defined as light or moderate activity five times or more per week for 30 minutes or more each time, and/or vigorous activity three times or more per week for 20 minutes or more each time). About 10% of adults have no physical activity at all in their leisure time.9

About 25% of young people (ages 12-21) report no vigorous physical activity, and 14% report no recent vigorous or light to moderate physical activity.10

In addition to helping to control weight, physical activity decreases the risk of dying from coronary heart disease and reduces the risk of developing diabetes, hypertension, and colon cancer.10

Diet and nutrition choices

• Don’t skip breakfast. Research shows dieters who skip breakfast or meals don’t lose weight as rapidly as those who eat a well-balanced, low-fat breakfast every morning. In fact, as a result of skipping meals, the body’s ability to burn calories is slowed. This is due to the fact that humans have a built-in survival gene which automatically down regulates our calorie burning mechanism in order to help us survive during times of famine. Ultimately, chronic skipping of meals will cause weight gain.

• Drink lots of water between meals. It helps the digestive system work better, and eliminate toxins from the body.

• Leave the table as soon as you’re done eating. As long as you are at the table, your urge to eat will be strong. Try getting up when you’re done and you will find that you’re less likely to have seconds.

• Chew your food slowly (20 times per bite). It takes time before you perceive a sense of fullness from eating, so try to eat as slowly as possible. This also helps the digestive process.

• Incorporate thermogenic (hot) herbs, and spices into your meal selections. Individuals eating meals spiced with cayenne (red) pepper display higher rates of calorie burning due to the thermogenic action. Hot, spicy food may also temporarily reduce your appetite, encouraging you to eat less.

• The daily addition of Chromium may also boost your progress. According to recent research, this trace mineral may help to control sugar metabolism, and thereby contribute to the body’s effort to achieve a proper balance of fat and lean muscle.11

• Avoid using the scale everyday as a monitor of your progress. When dieting, fat, muscle and water levels are reduced. These components of your total body weight may be altered unevenly during periods of increased exercise and/or reduced calorie intake. Don’t be discouraged by temporary uneven, or up and down, weight loss. Instead rely on how you feel and fit in your clothes.

Exercise suggestions

• Replace “stress eating” with exercise. When you’re frustrated or stressed, food is often a reward that you may use to make yourself feel better. Instead, go for a walk to get those negative energies out.

• Walk as much as possible. Walking reduces your appetite and burns calories and fat. Make that small effort to walk more and enjoy it. Walk briskly for one hour each day. If you’re out of shape, be sure to build up slowly.

• Try on new clothes. Nothing seems to help focus a dieter more than shopping for new clothes. As the fat melts away, trying on new clothes will become your new reward, instead of food.

Taking control of Weight Management

One of the problems facing those trying to manage their weight is created by fad dieting. Until people recognize that a healthy weight requires a lifetime commitment, they will seesaw back and forth between weight loss and weight gain with “magic” diet pills and trendy diets. 

Weight management is a lifestyle that allows for control of one’s own health through an understanding of the role overweight and obesity play in overall health. People today are lead to believe that there are quick fixes to weight loss, and are deluged with advertising for diet products and pills that promise immediate weight loss. Quick weight loss is not only unhealthy, but is also unrealistic. 

Because it takes years to add pounds, weight management requires patience. Hoping for immediate significant weight loss is not a practical or realistic solution. Healthy weight loss is best achieved through lifestyle changes over a reasonable period of time, which is what weight management achieves. Weight management includes:

• a reasonable and realistic weight goal

• a healthy, balanced, reduced-calorie diet

• portion control

• regular exercise or physical activity

• supplementation to make sure the necessary nutritional requirements are met

NOTE: Individuals with high blood pressure, diabetes, heart, liver or kidney disease, pregnant or lactating women or anyone under the age of 18, consult your doctor before starting any weight loss program.

Weight Management Lifestyle, Nutrition and Exercise Plan

This Weight Management plan requires a commitment to a lifestyle that concentrates on developing healthy, nutritious eating habits. Coupled with increased activity that develops into a regular exercise program, the plan is designed to facilitate gradual weight loss while developing healthy eating behavior.

1. Eliminate Trans fats. While some fats are essential, trans fats are harmful and contribute to unhealthy weight gain and fat accumulation. Read labels carefully and avoid fast foods which are high in trans fats and calories. Do eat the good fats — found in most nuts, avocados, olives, and canola oil. These things should be eaten in moderation.

2. Calories count. Weight loss naturally occurs when the burning of calories exceeds the consumption of calories. Make certain the calories you eat have nutritional value. Don’t waste calories on empty foods like chips, soda pop, and sponge cake. Practice portion control. The more calories consumed, the more exercise is required to burn them off.

3. Small meals, small portions. To curb the appetite, many experts suggest 5 to 6 small meals each day. Eating small servings of healthy foods creates a feeling of fullness over the course of the day that discourages overeating and eating the wrong foods.

4. Eat at least 6 servings (1/2 cup) of vegetables and fruit daily. Fill up on leafy greens, onions, tomatoes, green beans, apples, oranges, berries, etc. They provide important nutrients and give a feeling of fullness that satisfies hunger. Vegetables have fewer calories from sugar and more fiber than fruit, so make certain vegetables are the primary source of fresh plant foods. Vegetables, fruits, and whole grains are excellent sources of dietary fiber that is essential for metabolism and helps curb the appetite.

5. Drink pure water. Water not only helps flush toxins from the system, but it creates a feeling of fullness when consumed throughout the day. It’s healthy, has no calories, and is a much better thirst-quencher than sodas and juices. Avoid diet drinks, especially carbonated diet drinks. Dieticians recommend a minimum of 64 ounces of pure water be consumed daily.

6. Choose unprocessed foods. Whole grains, brown rice, unrefined flour and sugar, and fresh fruits and vegetables rather than canned. Avoid fast food and junk food, and processed cheeses and meats.

7. Choose foods with a low glycemic index. The epidemic of diabetes has created labeling that now lists the glycemic index of a number of foods. Consuming foods with a low glycemic index results in improved appetite control and a longer lasting feeling of satiety. (The Glycemic Index is a numerical ranking of foods based on their immediate effect to raise your blood sugar. It measures how fast the carbohydrate of a particular food is converted to glucose and enters the bloodstream.) Foods with a low glycemic index are absorbed more slowly, so the calories from these foods are more likely to be burned throughout the day as energy, rather than stored as fat. Low glycemic index foods help the body burn more body fat and create a feeling of fullness for a sustained period of time. 

8. Choose lean meats and other sources of protein. Fish, chicken, lean cuts of meat, tofu, whole grains and beans are excellent protein sources. Avoid eating too much protein, and balance the diet with proper portions of protein, carbs, vegetables, fruit, and good fats.

9. Exercise. (Don’t groan!) Physical activity is vital to healthy weight loss, and to overall good health. Start slowly if there has been no activity for some time. For those who are already active, concentrate on strengthening the core and engaging in aerobic, low-stress exercise. Calories count – whether they are being consumed or burned. Exercise sensibly to stimulate fat metabolism and fat loss. Whether it’s walking, running, basketball, volleyball, rowing, yoga, skiing, swimming or working out, get moving, and make it a lifetime habit.

References

Reference Books

1. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health. National Heart, Lung, and Blood Institute. June 1998. http://www.nhlbi.nih.gov/guidelines/obesity/e_txtbk/intro/intro.htm

2. World Health Organization. “Obesity: Preventing and managing the global epidemic.” Report on the WHO Consultation on Obesity. Geneva, 3-5 June, 1997. World Health Organization. Geneva: 1998.

3. Flegal KM, Carroll MD, Ogden CL, Johnson CL. “Prevalence and trends in obesity among US adults, 1999-2000.” JAMA 2002; 288:1723-1727. http://jama.ama-assn.org/cgi/reprint/288/14/1723

4. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. “Prevalence of obesity, diabetes, and obesity related health risk factors, 2001.” JAMA. 2003;289(1):76-79.
http://jama.ama-ssn.org/cgi/reprint/289/1/76

5. Finkelstein EA, Fiebelkorn IC, Wang G. National medical spending attributable to overweight and obesity: How much, and who is paying? Health Affairs Web Exclusive. 2003:W3:219-226. Available at: www.healthaffairs.org/WebExclusives/Finkelstein_Web_Excl_051403.htm

6. Barnes MA, Schoenborn CA. “Physical activity among adults: United States, 2000.” National Center for Health Statistics. Advance Data. 2003;(333). http://www.cdc.gov/nchs/data/ad/ad333.pdf

7. U.S. Department of Health and Human Services. The Surgeon General Call to Action to Prevent and Decrease Overweight and Obesity, 2001.

8. Pastor PN, Makuc DM, Reuben c, Xia H, Chartbook on Trends in the Health of Americans, United States, 2002 Hyantsville, MD: National Center for Health Statitistics. 2002.

9. Brown CD, Higgins M, Donato KA, Rohde RC, Garrison R, Obarzanek E, Ernst ND, Horan M. “Body mass index.” Obesity Research. 200;8(9):605-619.

10. U.S. Department of Health and Human Services. Physical Activity and Health: A Report of the Surgeon General. Centers for Disease Control and Prevention. 1996.

11. Kaats GR, Fisher JA, Blum K. “The effects of chromium picolinate supplementation on body composition in different age groups.” Abstract, American Aging Association, 21st Annual Meeting, October 1991.

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