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Obesity
- Development of Stereotypes
- Thin ideal preferences appear to be established between 5-6 years
- By 3 years old children learn negative stereotypes about
overweight individuals (Latner & Schwartz, 2005)
- This bias appears to intensify during teenage
years, then possibly diminish slightly
- In boys, attributing negative characteristics to larger figures and
positive characteristics to thinner figures were associated with
fathers having more negative attitudes towards obese persons.
In girls, attributing positive characteristics to thinner figures was
only associated with greater maternal dietary restraint.
- Thin ideal preferences appear to be established between 5-6 years
- The Biology of Energy Storage
- Energy storage is biologically adaptive
- Differences between males and
females in energy storage needs.
- Energy storage is biologically adaptive
- Main Health Risks of Obesity
- Cardiovascular disease
- Diabetes
- Sleep apnea
- Osteo-arthritis
- Gall bladder stones
- Cancer of the colon
- Cardiovascular disease
- Fat Distribution Patterns And Health Risks
- Gluteal-femoral obesity (hip and thigh) (typical
female pattern of fat deposition)
- Relatively low health risk
- Relatively low health risk
- Abdominal (visceral) obesity (typical male pattern of fat deposition)
- Associated with hypertriglyceridemia, low high density
cholesterol and high low density cholesterol levels.
- Associated with an insulin resistant state (pre-diabetic)
- Associated with raised blood pressure.
- Associated with hypertriglyceridemia, low high density
cholesterol and high low density cholesterol levels.
- Gluteal-femoral obesity (hip and thigh) (typical
female pattern of fat deposition)
- Waist Circumference as a Measure of
Increased Health Risk
- Waist circumference can give an indication of fat
located the abdominal region (and associated
with greater risk of diabetes, CHD etc);
- ForCaucasians: Overweight:
Men >94 cm; Women >80 cm
Obese: men >102 cm; Women >
88cm Limited use in obesity
- ForCaucasians: Overweight:
Men >94 cm; Women >80 cm
Obese: men >102 cm; Women >
88cm Limited use in obesity
- Waist circumference can give an indication of fat
located the abdominal region (and associated
with greater risk of diabetes, CHD etc);
- Consequences: Economic
- Australia 2008- Total $58.2 billion, Direct costs $8.2
billion, Indirect costs (lost wellbeing/ “burden of
disease”) $49.9 billion
- Australia 2008- Total $58.2 billion, Direct costs $8.2
billion, Indirect costs (lost wellbeing/ “burden of
disease”) $49.9 billion
- Benefits of Management of Obesity
- Benefits of a 10 kg weight loss
- Over 20% fall in mortality, Over 30% fall in
diabetes-related deaths, Fall of 10mmHg systolic and 20
mmHg diastolic blood pressure, Fall of 10% total
cholesterol, Fall of 30% triglycerides, Improved lung
function
- Over 20% fall in mortality, Over 30% fall in
diabetes-related deaths, Fall of 10mmHg systolic and 20
mmHg diastolic blood pressure, Fall of 10% total
cholesterol, Fall of 30% triglycerides, Improved lung
function
- Benefits of a 10 kg weight loss
- Causes
- Genetic Factors
- Eating and appetite
- Sedentary lifestyle
- Psychosocial factors
- Genetic Factors
- Treatments in Adults
- Options for weight loss:
- Calorie reduced diets, Behavioural interventions,
Exercise, Pharmacotherapy, Surgery, Health at Every
Size (HAES) – focus on weight neutral outcomes
- Calorie reduced diets, Behavioural interventions,
Exercise, Pharmacotherapy, Surgery, Health at Every
Size (HAES) – focus on weight neutral outcomes
- Cognitive Behavioural Interventions
- Assessment:
- Assessing motivations
- Collect relevant health information
- Self-monitoring:
- Monitoring, diet diary recording food consumed, where,
when, feelings, thoughts before, feelings thoughts after
- Cornerstone of behavioural treatment and
strong predictor of success
- Monitoring exercise and other relevant lifestyle issues
- Look for eating and activity patterns, triggers
- Monitoring, diet diary recording food consumed, where,
when, feelings, thoughts before, feelings thoughts after
- Clinicians often more ‘resistant’ than clients
- Assessing motivations
- Assessment:
- Goal Setting
- Long-term outcome goals
- Weight goals - realistic
- Primary goals - target directly (e.g. health
outcome so how to measure)
- Weight goals - realistic
- Short-term behavioural goals
- Nutrition
- Physical activity
- Behavioural strategies (to manage barriers)
- Nutrition
- Long-term outcome goals
- Other Approaches
- Stimulus control (make
healthy choice the easy option
- Problem solving (problem identification
and plan development)
- Cognitive restructuring (addressing
unhelpful beliefs and thought patterns)
- Stimulus control (make
healthy choice the easy option
- Options for weight loss:
- Health Eating Pattern
- Regularising eating
- Regular eating, healthy meals and snacks, Meal
planning, Break dieting mentality, Continue
monitoring, Listening to your body, Emphasize
healthy lifestyle change, Nutritional advice
- Regular eating, healthy meals and snacks, Meal
planning, Break dieting mentality, Continue
monitoring, Listening to your body, Emphasize
healthy lifestyle change, Nutritional advice
- Emotional Triggers to Eating
- Identify non-hungry eating patterns
- Negative moods that might encourage eating
- Negative self-thoughts that might encourage eating
- Challenging negative thoughts
- Food as a “mood regulator”
- Identify non-hungry eating patterns
- Regularising eating
- Hormones, Satiety and Hunger
- Some hormones send messages from the gut to the
brain to signal hunger. These include: Ghrelin
- Some hormones send messages from the gut to the
brain to signal satiety. These include: Leptin , Amylin,
Cholecystokinin (CCK), Peptide YY
- Some hormones send messages from the gut to the
brain to signal hunger. These include: Ghrelin
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