UNDERSTANDING OBESITY

CALORIE INTAKE

Increased calorie intake "might" cause increased weight; but this is not necessarily so!

The type of calories eaten will be significant in affecting weight.

It is an efficient metabolic process to convert triglyceride fat molecules from foods, into triglyceride molecules stored in body fat.

It is NOT so efficient for the body to convert protein or carbohydrate molecules into body stored fat molecules.

Because of this.....fats are more fattening than carbohydrates or sugars.

LOW CALORIE DIETING

Eating very low quantities of calories is ineffective in reducing weight; and can be dangerous to health. Side effects of calorie deficiency can include:

  • feeling depressed or deprived
  • excessively strong cravings for food.
  • Low calorie diets (also called crash diets) may in fact encourage binge eating, which can exaggerate obesity problems.
  • A pattern of crash diets followed by binge eating is called "weight cycling". This may lead to replacement of muscle tissue with adipose tissue, and it may not result in any significant long term change in body weight.

INSULIN RESISTANCE

Abdominal obesity has been linked to insulin resistance (ie. sufficient insulin is produced, but insulin receptors in the cell membranes are not responsive enough to that insulin, hence blood insulin levels are increased. This in turn may lead to fluid retention, and raised blood pressure. Weight loss may help bring insulin back into balance.
(NB: Extra fat in the hips & thighs is not normally associated with insulin resistance).


POTENTIAL BARRIERS TO WEIGHT LOSS
There are many barriers to successful weight loss. You will need to be aware of potential obstacles and develop strategies that are appropriate for each individual client to overcome these obstacles and successfully lose weight. We have touched on a number of barriers earlier on in the course so you may wish to reflect back on what you have already learnt.
Potential barriers include:

Social Issues and Pressures

  • Most social occasions involve food. It can be very challenging to abstain, be moderate, or only eat healthy food when surrounded by family and friends who are all indulging.
  • Even in “everyday life” people may be negatively affected by poor lifestyle habits of friends and family, for example their partner might eat ice-cream for dessert every night, or their housemate might buy snack foods for the household to share that may be very tempting.
  • People may be afraid of losing friendships when their relationships with them are based around food (e.g. going out for a coffee, going out for dinner).
  • Constant media exposure to food which can be very tempting.
  • Other people may consciously or sub-consciously sabotage your client’s weight loss, through negative comments, or saying that they’re fine as they are.

Possible solutions: Develop plans around how your client might deal with a social situation that involves food; come up with healthy alternatives when eating out; thinking of other activities to enjoy with friends e.g. a walk on the beach, a bike ride, go to an art gallery etc; do goal setting to give your client clear focus to resist temptation and negative influence of others.

Time constraints

  • People often have limited time and often perceive healthy food to be to difficult and time consuming to cook.
  • People may not have time to make meals and be more inclined to eat out or convenience food.
  • Convenience food often has less health benefits than home cooked meals.
  • Eating healthy can require more planning and being organised.

Possible solutions: Developing a menu that is realistic for your client that they can plan for e.g. make a bigger portion and freeze for later in the week; teach fast/healthy cooking skills e.g. stir-fry, soups, wraps; find healthy convenience food alternatives.

Lifestyle

  • Many work environments are not conducive to losing weight. Many people work in offices, having limited opportunity for exercise and temptations of biscuits/coffee/cakes in the workplace. 
  • People often require stimulation to get them through the day, such as cakes, chocolate, coffee.
  • Stress can lead to emotional eating. Excessive levels of adrenaline can also contribute to weight gain.
  • Busy lifestyle often leads to sleep deficits. Inadequate sleep can also contribute to weight gain.

Possible solutions: Get your client to look at their lifestyle. Make suggestions to what they could change e.g. have a regular massage, improve time management skills. Come up with healthy alternatives that would still feel like a “treat” at work, e.g. herbal tea, fresh fruit, muesli bar etc.

 
Physical Limitations

  • People may have a physical condition that limits or prevents them from exercise.

Possible solutions: You may need to be creative to come up with ways in which your client can exercise. For example swimming, tai chi, working with a physical therapist, aqua-aerobics, Pilates etc.

Psychological Limitations

  • Mental disorders such as depression often go hand in hand with weight gain. People with depression often lack the energy and motivation to exercise and may emotionally eat. Medication to treat mental illness often contributes to weight gain.
  • Weight Loss can be hard work. Your client will have to change their lifestyle and their habits. They will need to use will power and determination.

Possible solutions: Help to change your client’s perception of losing weight into something fun; start slow so as not to overwhelm your client; recognise when you need to refer your client to a professional such as a psychologist.

Age

  • Ageing slows down metabolism
  • With age people start to lose muscle mass making it harder to exercise.

Possible solutions: encouraging your client to exercise safely will decrease or maintain the slowing of their metabolism and the rate of decline in muscle mass; work within your clients abilities and slowly increase exercise; introduce resistance exercises, using low level resistance in the beginning; consider other techniques to speed up metabolism e.g. frequently sipping on cold water.

Hormonal Issues

  • Fluctuating hormones (e.g. in puberty, pregnancy and menopause) can cause the body to store fat on the belly, hips and thighs.

    Possible solutions: Consider referring your client to a herbalist, acupuncturist or similar to address hormonal issues. 


 

Learn More with our course: Nutrition for Weight Loss click for details