Solution Manual for Lifetime Physical Fitness and Wellness A Personalized Program 13th Edition
Hoeger 1285733142 9781285733142
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CHAPTER 5 WEIGHT MANAGEMENT
“Physical activity is the cornerstone of any sound weight management program. If you are unwilling to increase daily physical activity, you might as well not even attempt to lose weight because most likely you won’t be able to keep it off.”
OBJECTIVES
▪ Describe the health consequences of obesity.
▪ Expose some popular fad diets and myths and fallacies regarding weight control.
▪ Describe eating disorders and their associated medical problems and behavior patterns, and outline the need for professional help in treating these conditions.
▪ Explain the physiology of weight loss, including setpoint theory and the effects of diet on basal metabolic rate.
▪ Explain the role of a lifetime exercise program as the key to a successful weight loss and weight maintenance program.
▪ Be able to implement a physiologically sound weight reduction and weight maintenance program.
▪ Describe behavior modification techniques that help support adherence to a lifetime weight maintenance program.
MINDTAP
On your exercise log, check your progress.
Check your understanding of the chapter contents by logging on to MindTap and assessing the pre-test, personalized learning plan, and post-test for this chapter.
FREQUENTLY ASKED QUESTIONS
Why can’t I lose weight with exercise? Weight loss is greater with dieting only rather than exercising only. However, the source of the weight loss is healthier when exercising and making healthy diet choices.
Does the time of day when calories are consumed matter in a weight loss program? Larger lunches and smaller breakfasts and dinners contribute more to weight loss. Awake metabolism is lowest 3 hours prior to going to bed, so calories consumed are more likely to be stored.
Are some diet plans more effective than others? The plans that supply at least 1,500 calories and supply a wide variety of foods emphasizing grains, fruits, vegetables, and small amounts of low-fat animal products are more effective.
Why is it so difficult to change dietary habits? We have an overabundance of food that tastes good. Core values must be examined and followed.
REAL LIFE STORY
Sam’s experience with adding exercise to his diet for better results.
EXPANDED CHAPTER OUTLINE
I. INTRODUCTION
A. Obesity (Health Consequences of Excessive Body Weight Box).
1. A point at which excess fat can lead to serious health problems.
2. A body mass index (BMI) of 30 or greater.
3. Results from increased caloric intake and decreased activity.
4. Is becoming an epidemic (Figures 5.1 and 5.2).
5. A risk factor for:
a. Coronary heart disease (CHD)
b. Hypertension
c. High cholesterol levels
d. Diabetes
e. Certain cancers
f. Psychological maladjustment
g. Accidents
B. Overweight (Figure 5.1)
1. A body mass index of greater than 25.
2. 120 million Americans are overweight; the average weight has increased 25 pounds in the last 40 years.
II. OVERWEIGHT VERSUS OBESITY
A. Overweight and obesity are not the same thing.
1. Greatly overweight (the category of obesity), officially begins the status of disease risk.
a. Being overweight begins the processes of becoming obese.
b. As body fat increases, so do blood cholesterol and triglycerides.
2. How greatly does obesity contribute to the risk of disease?
a. Life expectancy is reduced an average of 3 years for individuals who are 10–30 pounds overweight in middle age (30–49 years of age).
b. Life expectancy is reduced an average of 7 years for individuals who are 30 or more pounds overweight in middle age (30–49 years of age).
c. Severe obesity (BMI >45) at a young age may cut up to 20 years off one’s life.
d. The higher the fitness level, the lower the mortality rate, regardless of body weight.
e. However, overweight status along with other risk factors (hyperlipidemia, hypertension, physical inactivity, and poor eating habits) may contribute risk for disease.
B. Recommended Body Composition
1. Permits the freedom for physical enjoyment of life by not being overweight.
a. Recreational activities with efficiency
b. Sports participation
c. Independence in later stages of life
2. Combats social pressures to be underweight that can result in:
a. Eating disorders (bulimia and anorexia nervosa).
b. Heart damage.
c. Gastrointestinal problems.
d. Shrinkage of internal organs.
e. Immune system abnormalities.
f. Reproductive system dysfunction.
g. Loss of muscle tissue.
h. Nervous system damage.
i. Death.
Critical Thinking: Do you consider yourself overweight? If so, how long have you had a weight problem, what attempts have you made to lose weight, and what has worked best for you?
III. TOLERABLE WEIGHT
A. Hereditary factors determine body shape and type.
1. Most people cannot attain the “perfect body.”
2. Extreme discipline is required for the few who can.
3. If you are not happy with your current body weight, either:
a. Do something about it, or
b. Learn to live with it.
B. The moderate category in Table 4.10:
1. Indicates adequate body fatness according to disease risk.
2. Might not be low enough if the individual desires a thinner look or higher achievement in athletics.
C. Tolerable weight means to take measures to change it or find ways to accept it.
IV. THE WEIGHT-LOSS DILEMMA
A. Even though weight loss is faster with yo-yo dieting, it is not permanent, and it carries as much risk as staying overweight.
1. The programs do not change lifestyle in a manner that can be continued.
2. The individuals are not seeing their behaviors realistically.
a. They do not realize how much they actually eat (Figure 5.4).
b. They are actually less active than they think (Figure 5.4).
B. Using exercise and dietary moderation, weight loss is slower but gives a chance for success (keeping the weight off).
C. Diet Crazes: Low-Carbohydrate/High-Protein (LCHP) Diets (Behavior Modification Planning Boxes: Healthy Breakfast Choices, Are Low-Carb/High-Protein Diets More Effective?, and How to Recognize Fad Diets)
1. Many fad diets are low in carbohydrates and claim that dieters will lose weight merely by following the instructions. This gives false hope.
2. Unfortunately, a majority of the weight lost is protein and water.
3. LCHP diets’ premise is that carbohydrates and insulin lead to weight gain.
a. Consumption of carbohydrates will only lead to weight gain when intake is excessive and glycogen levels are rarely depleted because of inactivity. The excess calories are then stored as fat.
b. High doses of simple carbohydrates will lead to high amounts of insulin response, but there is no evidence that this leads to weight gain, unless large amounts of calories are consumed over time.
c. Because 2.6 grams of water is stored with each gram of glucose to make glycogen, net loss of glucose storage in LCHP diets also reduces this water storage, amounting to as much as 3–4 pounds of lost body weight.
4. The glycemic index indicates how fast an amount of sugar is available to the body and how much insulin is necessary (Table 5.1; Figure 5.5)
5. LCHP diets’ premise is also that protein increases metabolism and suppresses hunger
6. However, LCHP diets can result in undesirable side effects:
a. A loss of vitamin B, calcium, and potassium.
b. Other nutritional deficiencies.
c. Weakness, nausea, lightheadedness, and fatigue.
d. Constipation
e. Bad breath
f. Higher fat intake
g. Greater cancer risk
A. Eating disorders:
1. Are physical and emotional conditions.
2. Result from a combination of individual, family, and social pressures.
3. Are characterized by an intense fear of becoming fat.
B. Anorexia Nervosa
1. Self-imposed starvation to lose and maintain very low body weight.
2. Weight gain is feared more than death from starvation.
3. Characteristics of anorexia likelihood include:
a. Genetic predisposition.
b. Mother-dominated home.
c. Family drug addiction.
d. Excessive and compulsive behavior.
4. Undesirable Side Effects
a. Malnutrition
b. Amenorrhea (stopping menstruation)
c. Digestive problems
d. Extreme sensitivity to cold due to low body temperature
e. Hair and skin problems
f. Fluid and electrolyte abnormalities
g. Injuries to nerves and tendons
h. Immune function abnormalities
i. Anemia
j. Growth of fine body hair
k. Mental confusion
l. Lethargy and depression
m. Osteoporosis
5. Diagnostic Criteria of Anorexia
a. Refusal to maintain body weight over a minimal normal weight.
b. Intense fear of gaining weight or becoming fat, even though underweight.
c. Disturbance in the perception of body weight, size, or shape.
d. Amenorrhea in postmenarcheal females.
6. Treatment for Anorexia Nervosa
a. The reversibility of the changes depends on how soon interventions are begun.
b. A professional usually is needed.
c. Modification of the environment that triggered the syndrome.
d. Restoration of proper nutrition.
C. Bulimia Nervosa
1. Binge eating followed by the purging of the stomach’s contents.
2. More prevalent than anorexia nervosa.
3. Bulimics tend to be emotionally insecure and abnormally concerned with food and body weight.
4. Diagnostic Criteria of Bulimia Nervosa
a. Recurrent episodes of excessive eating over a relatively short period of time in which there is loss of eating control.
b. Recurring inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, laxative misuse, diuretics, enemas, or excessive exercise.
c. Self-evaluation is unduly influenced by body shape and weight.
d. The binge eating causes marked guilt and distress.
5. Undesirable Side Effects
a. Cardiac arrhythmias
b. Amenorrhea
c. Kidney and bladder damage
d. Ulcers
e. Colitis
f. Tearing of the esophagus and stomach
g. Tooth erosion and gum damage
D.
h. General muscular weakness
6. Treatment for bulimia is often available through a university counseling or health center, hospital, or community support groups.
Binge-Eating Disorder (compulsive overeating)
1. Most common of the three eating disorders; about 2 percent of American adults.
2. Characterized by uncontrollable episodes of excessive eating.
3. Can be triggered by depression, anger, sadness, boredom, and worry.
4. No purging is done.
5. Most binge-eaters are overweight or obese.
E. Emotional Eating
1. Consumption of large quantities of “comfort” food.
2. Used to fulfill psychological, social, and cultural needs
3. Help can come from professional therapy and:
a. Learning to differentiate between emotional and physical hunger.
b. Not storing and snacking on unhealthy food.
c. Keeping healthy foods handy.
d. Logging the eating habit to avoid emotional eating “triggers.”
e. Using countering techniques, such as exercise.
F. Treatment for Eating Disorders
1. Available on most school campuses through the counseling or health center.
2. Local hospitals also offer treatment for these conditions.
3. Many communities have support groups.
VI. PHYSIOLOGY OF WEIGHT LOSS
A. Energy-Balancing Equation
1. Expending the same number of calories as eaten maintains weight.
a. Because 1 pound of fat contains about 3,500 calories, at the rate of 500 less calories per day, it will take one week of reduced caloric intake to lose one pound.
b. The total daily energy requirement (TDEE) is composed of (Figure 5.6):
(1) Resting metabolic rate (RMR); 60–70 percent of TDEE.
(2) The thermic effect of food (TEF); 5–10 percent of TDEE.
(3) Physical activity (PA); 15–30 percent of TDEE.
B. Setpoint Theory
1. A theory that a body has an established weight and strongly attempts to maintain that weight.
2. This is known as a weight-regulating mechanism (WRM)
3. The setpoint or WRM controls both appetite and amount of fat stored like a thermostat: Some people have high settings, others low settings.
4. Setpoint and Caloric Input
a. Under strict calorie reduction (lower input), the body makes extreme metabolic adjustments, lowering the basal metabolic rate (BMR). This maintains the fat storage setpoint because fewer calories are used (lower output).
b. Under caloric increases (higher input), the body raises the BMR (higher output) to maintain caloric balance.
5. These factors seem to lower the body fat setpoint:
a. Exercise.
b. A diet high in complex carbohydrates
c. Nicotine (more destructive than extra fat weight).
d. Amphetamines (more destructive than extra fat weight)
6. These factors seem to raise the body fat setpoint:
a. A high-fat and simple carbohydrate diet
b. Near-fasting diets.
c. Possibly, artificial sweeteners
7. Many nutritionists believe that caloric intake should not be the focus in weight control, but rather, eating behavior
a. Change the focus to that of intentional food choices.
b. Follow MyPlate for variety and relative food group emphasis.
c. Fiber, vitamins, and minerals will naturally increase; fat and calories will decrease.
Critical Thinking: Do you see a difference in the amount of food that you are now able to eat compared with the amount you ate in your mid- to late-teen years? If so, to what do you attribute this difference? What actions are you taking to account for the difference?
VII. DIET AND METABOLISM
A. Fat can be lost by:
1. Selecting the proper foods, or
2. Exercising, or
3. Restricting calories
B. Restricting Calories to Lose Fat
1. Daily caloric intakes less than 1,500 calories cannot guarantee lean body weight retention.
2. Weight-loss on near-fasting diets amounts to as much as 50 percent lean body mass.
3. More likely to result in “rebound” overeating.
C. Diet and Exercise to Lose Fat (Figure 5.9)
1. Close to 100 percent of the weight loss is fat loss.
2. Lean tissue is maintained and may increase.
D. Metabolism
1. Basal metabolic rate (BMR) or basal metabolism is related to lean body weight.
2. Is normally reduced with age because individuals usually decrease activity levels, resulting in loss of lean body weight.
3. The same caloric intake is no longer matched by output (metabolism), so the calories are stored as fat (adipose tissue).
4. Yo-yo dieting behavior leads to a continual loss of lean weight and gain of fat weight (Figure 5.8).
VIII. HORMONAL REGULATION OF APPETITE
A. Ghrelin (stomach) and leptin (fat cells) are being studied extensively because they appear to play a role in appetite.
1. Ghrelin is primarily produced in the stomach and stimulates appetite.
2. Leptin is produced by fat cells and reduces appetite.
B. Lack of physical activity leads to leptin resistance, stimulating eating.
C. Sleep deprivation might also affect these hormones.
IX. SLEEP AND WEIGHT MANAGEMENT
A. Sleep is one of the 12 key components that enhance health and extend life.
B. Evidence points to sleep being important for weight management.
1. Correlation between sleep deprivation and obesity.
2. Hormonal balances are disrupted with sleep deprivation.
3. Shorter sleepers have a greater sense of hunger.
X. MONITORING BODY WEIGHT
A. Regularly checking body weight against recommended (tolerable, healthy) body weight allows one to consider adjustments in food intake and physical activity level.
B. Making changes immediately reduces the multiplication of ignoring undesired body weight status.
C. Realistic body weight perceptions, goals, and behavior changes are assumed to be employed.
XI. EXERCISE AND WEIGHT MANAGEMENT (Figure 5.9)
A. The Typical American’s Activity and Weight Pattern
1. Starting at age 25, the typical American gains one pound each year.
2. The average American would rather cut 300 calories on intake than increase 300 calories of output.
a. This can only be short-lived. Exercise can be long-lived.
b. Malnutrition is also more likely.
B. Burn calories through regular physical activity.
1. More calories lost enables greater dietary intake, making healthy nutrition more possible.
2. It maintains lean tissue and, therefore, the BMR.
3. It sets the fat thermostat lower, according to setpoint advocates.
4. Aerobic exercise is thought to best change this fat setpoint.
5. Strength training maintains (or increases) muscle tissue and the BMR.
a. One pound of muscle requires about 6–35 BMR calories per day.
b. After exercise, extra metabolism also burns calories, accounting for 20–100 calories per session and up to 4 pounds of fat calories.
6. Research shows weight loss is best accomplished and maintained with a continual exercise component of 60–90 minutes per day (Figure 5.9).
7. Exercise that expends 300 calories per session will yield the energy equivalent of more than 13 pounds of fat over a year, assuming three sessions per week.
8. Even without weight loss, exercise offers protection against premature morbidity and mortality.
C. The Role of Exercise Intensity and Duration in Weight Management (Table 5.2)
1. Exercise volume is the combination of intensity and duration.
2. The lower the intensity:
a. The greater the proportion of burned calories from fat.
b. The longer the exercise must be done to reap health benefits
3. The higher the intensity:
a. The more total fat calories are burned, even though the proportion contributed from fat is less.
b. The less time required to reap health benefits.
4. Recent research appears to indicate that lengthy exercise sessions for women are met more closely with additional food consumption.
D. Healthy Weight Gain
1. Exercise is the healthiest choice because it builds muscle without adding fat.
2. Strength training is the most effective form of exercise to gain weight.
3. Strength training on a balanced diet requires an additional 500 calories to build one pound of muscle.
E.
Weight-Loss Myths
1. Cellulite is bad fat or some other substance to get rid of. This is a myth.
a. It is adipose tissue made of triglycerides, just as any storage fat.
b. It can be characterized as fat deposits that “dimple” or “bulge out.”
2. Spot reducing can be done by specialized exercises focused on a particular area. This is a myth.
a. Fat comes off proportionally from all body fat depots.
b. This means that greater amounts come off the largest depots and lesser amounts come off the smallest depots.
c. Water loss from wearing rubberized suits is ineffective at spot reducing, must be regained for body function, and is dangerous to thermoregulation.
d. Vibrators feel good in the area of use but do not promote fat loss.
XII. LOSING WEIGHT THE SOUND AND SENSIBLE WAY
A. Practical Concerns (Behavior Modification Planning Boxes: Eating Right When on the Run, Physical Activity Guidelines for Weight Management, Weight Maintenance Benefits of a Lifetime Exercise Program, and Weight Loss Strategies).
1. Exercise is a necessary element for weight loss.
a. With aerobic training, the exercised muscle tissue prefers fat (more fat-burning enzymes) in a greater proportion of the expended energy, even at rest!
b. Medical clearance might be required, based on age and disease risk factors. This might require a stress test
c. The exercise mode must safely match the body type and condition.
d. Recommendations for weight-loss exercise include 5–6 sessions each week, 60
90 minutes each session. Often this is begun with less duration, intensity, and frequency.
2. Sometimes lower caloric input is prescribed for weight loss because:
a. Most people underestimate their caloric intake and are eating more than they should be eating.
b. Very low beginning physical condition may make weight loss progress so slowly that the individual gives up.
c. Most successful dieters carefully monitor daily caloric intake.
d. Some individuals will not change their low-calorie eating habits.
e. Nonetheless, wise food choices are key in accomplishing proper nutrition within reasonable caloric intake levels (Figure 5.11).
3. Caloric output estimates for activities are given in Tables 5.3 and 5.4.
a. For Table 5.3, identify your gender and basic activity level and then multiply your body weight by the calories per pound figure to get daily caloric output.
b. Table 5.4 determines the caloric output of various activities. To get total energy burned, multiply body weight and number of minutes exercised by the figure given in the table.
4. Daily distribution of total calories should be:
a. About 60 percent carbohydrates (mostly complex carbohydrates);
b. Less than 30 percent fat; and
c. About 12 percent protein
5. Many experts believe a person can take off weight more efficiently by reducing the amount of daily fat to 10–20 percent of the total daily caloric intake.
a. Fats are stored as fat easier (less energy needed to process) than carbohydrates are stored as fat
b. Even though a very-low-fat diet is difficult to accomplish, it has been strongly suggested during the weight-loss period of a program (Figure 5.7).
6. Studies of eating patterns show that optimal weight loss occurs when:
a. Most food is consumed at least 7 hours before bedtime, so effective digestive processing takes place.
b. Food is not consumed in one meal only.
c. Daily calories are consumed in a percentage proportion of 25–50–25 for breakfast, lunch, and dinner, respectively.
d. Breakfast is not skipped. Skipping breakfast leads to more hunger and greater total daily caloric consumption and more weight management difficulty.
B. Monitoring Your Diet with Daily Food Logs
1. Daily food logs and exercise/weight control status sheets are included in the chapter:
a. Computing Your Daily Caloric Requirement (Activity 5.1)
b. Weight-Loss Behavior Modification Plan (Activity 5.2)
c. Daily Food Intake Record: 1,200-Calorie Diet Plan (Activity 5.3)
d. Daily Food Intake Record: 1,500-Calorie Diet Plan (Activity 5.3)
e. Daily Food Intake Record: 1,800-Calorie Diet Plan (Activity 5.3)
f. Daily Food Intake Record: 2,000-Calorie Diet Plan (Activity 5.3).
g. Healthy Dietary Plan for Weight Maintenance or Weight Gain (Activity 5.4)
h. Weight Managament: Measuring Progress (Activity 5.5).
2. How to use the food logs:
a. Use the diet plan that approximates your target caloric intake.
b. The caloric values for one serving of each food group are: 80 calories for the bread, cereal, rice, and pasta group; 60 calories for the fruit group; 25 calories for the vegetable group; 120 calories for the dairy, yogurt, and cheese group; and 300 calories for the meat, poultry, fish, dry beans, eggs, and nuts group.
c. Know what size constitutes one serving.
d. Read the food labels.
e. Record what you actually eat.
C. Low-Fat Entrees
1. Target lean meats and foods that contain less than 300 calories and less than 6 grams of fat.
2. Supplement with lower calorie foods from the MyPlate food guidance system (e.g., fruits and vegetables).
D. Effect of Food Choices on Long-Term Weight Gain
1. Data shows that food choices have a significant effect on weight gain.
2. A 20-year study showed that regular consumption of potato chips, potatoes, sugarsweetened beverages, and unprocessed and processed red meats leads to weight gain.
3. The same study showed that regular consumption of vegetables, whole grains, fruits, nuts, and yogurt leads to weight loss and maintenance.
XIII. BEHAVIOR MODIFICATION AND ADHERENCE TO A WEIGHT MANAGEMENT PROGRAM
A. Required Personal Qualities
1. Desire
2. Commitment
3. Perception that it will take time
4. Willingness to be honest (Activity 5.5)
5. Ability to plan and evaluate realistically (Activity 5.5)
B. Other Support
1. Social networks affect behavior for the better or worse.
2. Close friends or siblings of the same gender are the most influential.
C. Strategies for Success (Behavior Modification Planning Box: Weight-Loss Strategies)
1. Decide to change.
2. Set realistic goals.
3. Incorporate exercise into the program.
4. Differentiate hunger and appetite.
5. Eat less fat.
6. Pay attention to calories.
7. Cut unnecessary items from your diet.
8. Add foods to your diet that reduce cravings.
9. Avoid automatic eating.
10. Stay busy.
11. Plan meals ahead of time and cook wisely.
12. Do not serve more food than you should eat.
13. Try “junior size” instead of “super size.”
14. Eat out infrequently.
15. Eat slowly and at the table only.
16. Avoid social binges; get support from others.
17. Do not raid the refrigerator or the cookie jar.
18. Avoid evening food raids
19. Practice stress-management techniques.
20. Monitor changes and reward accomplishments.
21. Prepare for slips and think positively.
Critical Thinking: What behavioral strategies have you used to properly manage your body weight? How do you think those strategies would work for others?
XIV. THE SIMPLE TRUTH
A. Weight management is accomplished by making a lifetime commitment to physical activity and proper food selection.
B. The three most common reasons for relapsing into former behaviors are:
1. Stress-related factors (such as major life changes, depression, job changes, illness).
2. Social reasons (entertaining, eating out, business travel).
3. Self-enticing behaviors (placing yourself in a situation to see how much you can get away with).
C. Making mistakes or having a temporary relapse does not mean failure.
1. Evaluation of behavior must allow for imperfection
2. Failure is giving up; the persistence necessary to resume weight management goals after a relapse will be rewarded