5 Weight Loss

8/18/2019 5 Weight Loss

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Abazar Habibinia, MD, CSDTT, DFN


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Overweight and Obesity• Definitions:

• Overweight: Overweight specifically refersto an excessive amount of body weight that

may come from muscles, bone, fat tissue,and water.

• Obesity: Obesity specifically refers to an

excessive amount of fat tissue.


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BMI (Body Mass Index):

weight (kg)/height (m)²BMI Classification


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Obesity in Canada


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Mother :

Genetics plays an important role in obesity.

Most overweight adults have some problems with their weight during childhood and adolescence.

Family influences: eating patterns, food choices, selfimage within family, and psychosocial attitudes.

Childhood obesity is increasing:

American children : %52

European children: %38

Asian children: %20


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Motivation:

Lack of motivation results from:1) Higher failure rate of fad diets (Rebound: 80% to 90 % ).

2) Sedentary life style.

3) Lack of exercise

4) Poor and unhealthy eating habits.

5) Stress


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Metabolism:

Basal Metabolic Rate (BMR) or Resting Metabolic Rate

(RMR) is the daily amount of energy expenditure by thebody at rest, or it is the minimum calories needed for thebody to function properly at rest.


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Factors affecting BMR:

GeneticsGender: men have higher BMR than women.

Age: BMR reduces by age. After 20 years old, it deceases 2%per decade.

Weight

Body surface area (BSA)

Body fat percentage

DietExternal temperature

Exercise


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How to Calculate BMR:

The Harris-Benedict formula:

Men: BMR = 66 + (13.7 X wt in kg) + (5 X ht in cm) - (6.8 X age in years)

Women: BMR = 655 + (9.6 X wt in kg) + (1.8 X ht in cm) - (4.7 X age in

years)

Example: You are female You are 30 years old

You are 5' 6 " tall (167.6 cm) You weigh 120 lbs. (54.5 kilos) Your BMR = 655 + 523 + 302 - 141 = 1339 calories/day


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Energy Expenditures:

Organs Percentage of Expenditure

Liver

Brain

Skeletal muscles

Kidneys

Heart

Other organs

27

19

18

10

7

19


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Total Daily Energy Expenditure (TDEE):

is the total amount of calories that your body expends in 24hours, including all activities.

TDEE = BMR X Activity Multiplier

Activity Multiplier Sedentary = BMR X 1.2 (little or no exercise, desk job)Lightly active = BMR X 1.375 (light exercise/sports 1-3 days/wk)

Mod. active = BMR X 1.55 (moderate exercise/sports 3-5 days/wk) Very active = BMR X 1.725 (hard exercise/sports 6-7 days/wk)Extr. Active = BMR X 1.9 (hard daily exercise/sports & physical job or 2X day

training, i.e. marathon, contest etc.)


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TDEE:

Example:

Your BMR is 1339 calories per day Your activity level is moderately active (work out 3-4times per week) Your activity factor is 1.55 Your TDEE = 1.55 X 1339 = 2075 calories/day


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Effects of Foods on BMR:


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Calorimetery:

it is measuring the heat produced by chemical reactionsor physical changes of the body.

Direct Calorimetry :

Serves as the standard interpretation of energyexpenditure. However, direct calorimeters are difficultdevices to operate.

The whole body is placed inside the calorimeter for themeasurement.


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Calorimetry:

Indirect Calorimetry:

is the preferred method to estimate metabolic energyconsumption in the body (BMR).

It measures the exchange of respiratory gases: O2 uptake,and Co2 production, and ventilation.


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Indirect Calorimetry: fitmate


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Indirect Calorimetry: Quark RMR


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Indirect Calorimetry: OxyconPro


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Medicine: Medical Conditions: Low function thyroid

Liver and kidney diseases

Diabetes

Depression

Medications:

Antidepressants

Sedatives Anti-epilepsy

Anti-anxiety

Birth control pills , Corticosteroids


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Consequences of Obesity: Cardiovascular: Heart Attack, High Blood Pressure.

Endocrinologic: Diabetes II. Gynecologic: Polycystic Ovarian Syndrome, Infertility.

Neurologic: Stroke, Migraine, Dementia, Multiple Sclerosis,Sleep Apnea.

Musculoskeletal: Gout, Osteoarthritis, Low Back Pain.

Gastrointestinal : Acid Reflux, Fatty Liver, Gallstones.

Oncologic: Breast, Ovarian, Colon, Liver, Pancreas, Uterine,Prostate, Kidney.

Psychiatric: Depression (in women), Social Stigmatization.

“Obesity is the archenemy of your health”!


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Weight Management:

Take a complete history . Try to know your

client`s occupation, eating pattern, physicalactivity level, sleeping pattern, medical history etc.

Know his/her current weight and desired weight.

Learn the reasons(s) for weight loss, e.g.:

a) My mom thinks I am overweight.

b) I want to be in a good shape for my wedding.c) I want to stay healthy/I have diabetes.

• Remember “4 Must-To-Do Things”:


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1) Explain patterns of weight loss

Everybody has a dif ferent pattern of losing weight:

a) Sharp weight loss.

b) Diagonal weight loss (Steady and slow)

c) Staircase weight loss.d) Initial Resistance Late Accelerated (IRLA) weight

loss.

e) Complex pattern of weight loss.


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2) Explain “plateau” in weight loss

“Plateau” means that there is no change in weight orpercentage of body fat for 3 weeks or more.

Some clients do not hit plateau at all, while some hitonce, and some may hit more than two times.

The clients who hit plateau more than 2 times, they would have what I call it “staircase weight loss”.


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3) Explain “body resistance”

Explain to your client that he/she might resistlosing weight at the beginning in the followingconditions (7D):

D ysfunctional thyroid.

Diabetes. Diseases of the liver, and kidneys.

Depression.

Drugs for depression, anxiety, epilepsy,corticosteroids, and birth control pills.

Diet yo-yo.

Distress.

4) M k i ht l j t


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4) Make weight loss a journey, not a

process. And do NOT give any false

hope.


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Weight can be managed by: Exercise

Diet

Food Supplementations

Medications Surgery

“The cornerstones of a successful weight loss are diet andexercise”. However, anti-obesity medications and surgerymight be needed in severe obesities.

Bariatric Medicine is a branch of medicine that deals with

causes, prevention, and treatment of obesity.


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Stages of Weight Loss

Abazar`s Classification of Weight Loss for Non-Gym Goers:

Step 1: Diet and Behavioral Modifications.

Step 2: Diet + Slight Food Supplementation. Step 3: Diet + Moderate Food Supplementation.

Step 4: Diet + Food Supplementation + Exercise.

Step 5: Diet + Detoxification / Body Cleansing.

Step 6: Aggressive Weight Loss (Celebrity-Type WeightLoss).


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Step 1: Diet and Behavioral Modifications

Ask your client to:

1) Eat small frequent meals throughout the day and not toskip any meals.

2) Try to eat every 2-3 hours even if you are not hungry. 3) Keep your body hydrated by drinking one glass of water

every 2 hours (average 2 liters a day).4) Increase protein intake to 1.5 gr/kg/day ( maximum 40

grams per meal).5) Avoid taking simple carbs (sugar and any sweets).6) Do three changes with complex carbs:

a) Choose low GI.b) Reduce carbs intake at least %50.c) Avoid having them after “Carbs Cut Off Time”.

7) Keep fiber intake at 30 gr/day or more.


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8) Eat most of your foods early in the day.

9) Drink 1-2 glass of water about 30 minutes beforemeals to reduce appetite.

10) Eat slowly and chew food well.

11) Practice food combining.12) Eat variety of foods (“Food Rotations”).

13) Use smaller plates and portions.

14) Fill up first on low-calories foods, such as soups and vegetables.

15) Avoid high-calories snacks and desserts.

16) Avoid overeating when being at a restaurant.


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Step 1: Diet and Behavioral Modifications 17) Take at least 20 to 30 minutes to eat a meal.

18) Avoid eating while watching TV, driving, or doingother things.

19) Do grocery shopping after eating, not when hungry.

20) Make a list of your healthy foods, shop for them,

and carry them with you wherever you go if possible.21) Put snacks and sweet foods away at home.

22) Learn about foods: carbs, fats and proteins.

23) Check your weight with the same scale at the same

time.24) If you were off the track, go right back to your plan,and do not make it an excuse to indulge.


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25) Plan activities to occupy your free time when youmight binge.

26) Learn about “Travel Diet”.

27) Allow yourself to indulge (within reason) once a

week without guilt or self- judgement (Have a “cheatday”).

28) Keep a good self-image and positive attitudetoward life.

29) Tell family and friends to support you and not pushfoods.

30) See your nutrition advisor for any help or foodadjustment you might need.


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Step 2:

Diet + Slight Food Supplementation

A) Follow all instructions in step 1.

B) Add CLA (Conjugated Linoleic Acid).

C) Add a high quality Vitamin B-Complex.


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Step 3:

Diet + Moderate Food Supplementation


B) Stop taking CLA.

C) Add ALA (Alpha Lipoic Acid). D) Keep Vitamin B-Complex.

E) Add Chromium Picolinate.


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Step 4:

Diet + Food Supplementation + Exercise


B) Do two major changes in your client`s life style:

1) Remove “dairy products”, “nuts” and “acidic

foods” (if possible) from your client`s diet for 3 weeks .

2) Ask your client to do WJR (Walk-Jog-Run):

- 4 times a week.

- 30 to 40 minutes (3-3-3/3-3-3/3-3-3/3-3-3)

Or at least a brisk walking.


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Step 5:

Diet + Detoxification/ Body Cleansing: Follow all instruction in step 4.

Do Detox or Body Cleansing.


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Step: 6

Aggressive Weight Loss(Celebrity-Type Weight Loss)

Only less than %5 of weight loss-seeking clients

might end up following advices in step 6.

Step 6 includes a blend of thermogenic-stimulatoryfood supplements, ketogenic diet, and medications.


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Thank you for your time

andfor listening to this

lecture.

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