Weight ControlCharacteristics of Fad DietsLooking for a Sound Weight-Loss Program?Seek advice from a Registered DietitianControl calorie intakeIncrease physical activityAcknowledge need for lifelong changes to maintain healthy weightDo the Math?To lose one pound, you must create a deficit of 3500 kcalSo to lose a pound in 1 week (7 days), try cutting back on your kcal intake and increase physical activity so that you create a deficit of about 500 kcal per day- 500 kcal x 7 days = - 3500 kcal = ~ 1 pound of weight lossday week in 1 weekCharacteristics of Successful DietsWeight loss of > 30# maintained for > 1 yearWeight Loss DrugsPhen-FenAppetite Suppressant serotonin in brainSerotonin – decreases appetiteCaused heart valve defectsFDA removed from marketMeridiaXenicalWeight Loss DrugsLong term effectiveness?Most can only be taken for a year.Side Effects?Do you learn new eating habits?Bariatric SurgeryBariatric SurgeryCriteriaBMI > 40BMI between 35 and 40 with obesity related health concernsObesity present for min. 5 years, with several nonsurgical attempts to lose wt.No history of alcoholism or major psychiatric disorders. (person has to be able to follow a special diet and follow up with medical care)About 75% of pts lose >50% of wt.Wt loss occurs because of the limited amount of food consumed (Stomach can only hold small amount) and because of malabsorption (limited amount of calories absorbed)Cost - $30,000-$40,000Bariatric SurgeryComplications – Obese population @ higher risk for complications during surgeryDecreased calcium absorptionsBehavior ModificationImportant component to any wt loss programModify problem (eating) behaviorsChain-breakingStimulus controlCognitive restructuringContingency managementSelf-monitoringChain-BreakingBreaking the link between two behaviorsThese links can lead to excessive intakeStimulus ControlAlternating the environment to minimize the stimuli for eatingPuts you in charge of temptationsExample: not buying cookies and chips.Cognitive RestructuringChanging your frame of mind regarding eatingContingency ManagementForming a plan of action in response to a situationRehearse in advance appropriate responses to pressure of eating at partiesSelf-MonitoringNutrition Attitudes and BehaviorsWhy we eat what we eat? Why is it so hard to change eating behavior?Food SelectionFood preferencesEnvironmentMost develop food preferences by 1-4 years of ageThe environment you grow up in determines many of your food preferencesFamiliarityHabitsAcceptable FoodsFood Selection – CultureNutrition Knowledge and BeliefsHealth concernsEducationStudents in nutrition class eat better than general studentsExperiencesFood based on learned association not nutritionComfort foodsAssociated with positive experienceWe tend to eat these foods when feeling discomfort (sad, depressed, and stressed)Discomfort foodsAssociated with negative experienceWe avoid these foodsPractical ConsiderationsWeight ControlCharacteristics of Fad Diets- Missing food group or groups o Need supplements o Promise drastic results  20# in 1 week o Less than 1200 kcals  Low BMR  Supplements needed - Missing important nutrients - Rapid weight loss - Testimonials - Change diet radically - Little or no exercise - No behavioral therapy - No maintenance phase o What happens after weight is loss? Looking for a Sound Weight-Loss Program? Seek advice from a Registered Dietitian  Control calorie intake Increase physical activity Acknowledge need for lifelong changes to maintain healthy weightDo the Math? To lose one pound, you must create a deficit of 3500 kcal So to lose a pound in 1 week (7 days), try cutting back on your kcal intake and increase physical activity so that you create a deficit of about 500 kcal per day - 500 kcal x 7 days = - 3500 kcal = ~ 1 pound of weight loss day week in 1 weekCharacteristics of Successful Dietso Slow wt loss  #1 week = 3500 kcalso Exercise and behavior modification  Key to weight loss and maintenance o All food groups available o Permanent realistic lifestyle changeso Seek advice from a Registered Dietitian o Variety of foods o Written food and activity recordo Maintenance programs  60-90 minutes of exercise  Weighing once a week  Food logso Measuring food  Exercise  May need 60-90 minutes per day - Does not have to be continuous  Pedometers – measure daily steps - 10,000 steps a day  Exercise with others Find an activity you like  Incorporate activity into your daily life - Park farther away- Instead of emailing coworker, walk to their desk National Weight Loss Registry- Weight loss of > 30# maintained for > 1 year - 78% eat breakfast every day - 75% weigh themselves at least once a week - 62% watch less than 10 hours of TV per week - 90% exercise, on average, about 1 hour per day - Self-monitor by keeping a food log- Eat at restaurants only 1-2 times per week Weight Loss Drugs Phen-Fen Appetite Suppressant  serotonin in brain Serotonin – decreases appetite Caused heart valve defects FDA removed from marketMeridia- Appetite suppressant- Blocks serotonin reuptake o Is not broken = remains high o Decreases appetite- Side effect – may increase blood pressure Xenical- Inhibits production of fat digesting enzyme - Fat consumed is not digested - Fat is excreted - Loss of fat soluble vitamins - GI pain, oily stools - Must follow low fat diet to avoid above symptoms Qnexa- Combination of phentermine and topiramate - Approved o Adults with BMI > 30 o Adults with BMI > 27 with one weight related condition - Sides effectso Increase heart rate o Birth defects – oral clefts  Must not be used during pregnancy BelviqAppetite suppressant Weight Loss Drugs Long term effectiveness? Most can only be taken for a year. Side Effects? Do you learn new eating habits?Bariatric SurgeryTypes of procedures - Laparoscopic Adjustable Gastric Band- Roux en Y Bypass- Sleeve GastronomyBariatric Surgery Criteria BMI > 40 BMI between 35 and 40 with obesity related health concerns Obesity present for min. 5 years, with several nonsurgical attempts to losewt. No history of alcoholism or major psychiatric disorders. (person has to be able to follow a special diet and follow up with medical care) About 75% of pts lose >50% of wt. Wt loss occurs because of the limited amount of food consumed (Stomachcan only hold small amount) and because of