Strategies based on Intervention Goals Exam 3 Secondary prevention Primary prevention Tertiary prevention Primary Prevention I II Secondary Prevention disorders develop frequent dieting Tertiary Prevention III Prevent the development of maladaptive eating Population based efforts to promote healthy eating and exercise habits Designed to diagnose and treat early signs of maladaptive eating before clinical eating Example psychoeducation about eating habits to adolescent females who endorse Reduce the negative impact of an active eating disorder by treating the disorder and reducing the complications related to it Example inpatient treatment for an individual with anorexia nervosa Targeted Primary Secondary Prevention Programs Targeted At risk groups 13 year olds 16 year olds Healthy eating guidelines recommendations Primary Include a screening component to identify harmful behaviors Secondary What are iatrogenic effects Individuals use material to learn ways to restrict or purge 3 Core Principles of Intuitive Eating Eat for Physical Rather than Emotional Reasons Rely on Internal Hunger and Satiety Cues Unconditional Permission to Eat Eating Mindfully might respond Using your mind to make decisions when needed Allows us to think about how we are reacting and make decisions based on how we Allowing yourself to become aware of the positive and nurturing opportunities that are available through food preparation and consumption by respecting your own inner wisdom Intuitive Eating Listen to your body know your hunger and fullness cues Eat WHAT you WANT when you are hungry STOP when you are FULL Consider balance variety and moderation in your food choices Unconditional permission to eat when hungry and what food is desired no rules Eating for physical rather than emotional reasons Reliance on internal hunger and satiety cues to determine when and how much to eat Mindful Eating Eating mindfully means simply paying attention with an open nonjudgmental mind to what and how you eat You should not overly restrict yourself but neither should you respond to every impulse to eat Normal Eating Eat when you are hungry stop when you are full Choose foods that you like consider balance variety and moderation Avoid labeling foods as good or bad Enjoy eating all types of foods without guilt Avoid Self Imposed Food Rules Food rules can be wildly conflicting or illogical The rules often don t take into account the situation or circumstance The origin of food rules are often from unscientific sources Logically challenge food rules You don t have to eat a perfect diet to be healthy You will not get a nutrient deficiency or gain weight from one snack meal or day of eating You should never feel guilty about what you eat Worry less about what s in your food and enjoy it more Eating nutritiously should not have to be about deprivation Intuitive Eating is about Acceptance Accept yourself just like you accept your shoe size Avoid unrealistic expectations about yourself It s difficult to be mindful when you re feeling bad or critical about yourself Eating Personalities Perfect eaters I Careful eater Highly nutrition conscious Anguishes over each morsel of food Tend to undereat and monitor the quantity of food eaten Scrutinizes food labels II Professional dieter Perpetually dieting tried every diet Eating changes are for losing weight not health Bingeing and engaging in the last supper is common III Unconscious eater Eating and doing another activity at the same time Whatever is available vending machine fast food etc Difficulty identifying biological hunger Vulnerable to food lying around Waste not versus Emotional eater What do the authors describe how toddlers eat Natural Intuitive eaters They will eat what they need if given free access to food Free from societal messages about food and weight Innate wisdom about food Are Supplements Necessary Considerations Not approved by FDA Claims based on anecdotal evidence Natural doesn t always safe Expense Use the product at your own risk Is there any supporting research Dietary Supplements Steven S Bechler a pitcher for the Baltimore Orioles was one of many athletes who died after using an ephedra supplement 1994 A 22 year old and a 32 year old Army soldier collapsed and died with DMAA dimethylamylamine found in Jack3d found in their bodies 2011 Why do people take supplements A random sample of 1579 adults were asked why they are taking dietary supplements The top responses were To feel better 41 0 To improve overall energy levels 40 8 To boost the immune system 35 9 Content of Energy Drinks Niacin excessive amounts causes flushing Vitamin B6 excessive amounts can be toxic Taurine excessive amounts mixed with caffeine may cause reduced blood supply to the heart Guarana Excessive amounts linked to irregular heartbeat Alcoholic Energy Drinks Alcohol companies target college students These drinks have caused multiple hospitalizations Some have been taken off the market Natural Energy Sources Adequate sleep 7 9 hours Adequate hydration 64 ounces day Regular physical activity Adequate nutrition HAES Wellness Wellbeing Health 1 2 soundness of body or mind freedom from disease or ailment the general condition of the body or mind with reference to soundness and vigor 1 the quality or state of being healthy in body and mind especially as the result of deliberate effort 2 an approach to healthcare that emphasizes preventing illness and prolonging life as opposed to emphasizing treating diseases a good or satisfactory condition of existence a state characterized by health happiness and prosperity What is a Healthy BMI Range BMI ranges related to lowest mortality 29 for black women 27 for black men 26 for white women 24 5 for white men 25 29 9 for men and 25 32 4 for women 23 29 for males 22 31 for black men and women Health at Every Size HAES Expansion of non diet approach Emphasizes global health rather than weight loss Health centered approach rather than weight centered Non dieting philosophy Encourages a positive body image Discourages weight preoccupation focus on weight loss may be counterproductive Promotes well being Positive effects of a HAES program Reduce anxiety Normalize eating behaviors Reduce guilt Improve self esteem Improvements in cholesterol triglycerides etc Problems with Obesity Research Flawed Metropolitan Life Insurance charts Obesity researchers are funded through diet programs Weight recommendations different for women than for men Gender bias in