Obesity Training

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Obesity Training

• Jacques Courseault, M.D.
• www.exercisemenu.com

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Fitness and Wellness

• Weight Management
• Who is overweight?
• What is obesity?
• Why are we overweight?
• Negative effects of obesity
• Nutrition and Weight
• Adapt eating habits to New Orleans culture
• Exercise and Weight Management

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Who is overweight?

• Facts
• 120 million U.S adults are overweight
• 60 million U.S adults are obese
• 9 million U.S adults are severely obese
• 64.5 are overweight
• 30.5 are obese
• Overweight and obesity increases steadily with
  age
• New Orleans is the 7th ranked city with the
  highest overweight rates (2005)
• Many college students gain 10-15 lbs. freshman
  year

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Health and Social Impact

• Too much fat increases the risk of illness from
  about 30 serious medical conditions.
• Obesity is associated with increases in deaths
  from all-causes.
• Earlier onset of obesity-related diseases, such
  as type 2 diabetes, are being reported in
  children and adolescents with obesity.
• Individuals with obesity are at higher risk for
  impaired mobility.
• Overweight or obese individuals experience social
  stigmatization and discrimination in employment
  and academic situations.
• Billions in healthcare expenditures

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Is Obesity Considered a Disease?

• Disease - an interruption, cessation or disorder
  of a bodily function, organ or system.
• 3 Criteria of Disease
• Recognized causes
• Identifiable signs and symptoms
• Consistent Anatomic Alteration
• Does obesity meet these criteria?

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Is Obesity Considered a Disease?

• Recognized Causes include
• Social- influence from friends, family, work,
  etc.
• Cultural- some favor certain unhealthy foods more
  than others.
• Psychological- stress can have an effect on
  habits
• Behavioral- Behavior can be learned to eat when
  angry or bored
• Metabolic sugar is not cleared from the
  bloodstream
• Genetic factors mutations in certain genes have
  been shown to cause obesity

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Is Obesity Considered a Disease?

• Signs and Symptoms include
• Excess accumulation of fat
• Increased size of fat cells
• Insulin resistance
• Increased blood sugar
• Increased blood pressure
• Elevated cholesterol and triglyceride levels
• Shortness of breath
• Back pain

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Is Obesity Considered a Disease?

• Consistent Anatomic Alterations include
• Increase in body mass

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Why are we Overweight?

• Simply put too much food, too little activity
• Today people are eating more food and exercising
  less
• Fatty convenience foods are more prevalent
• McDonalds, Burger King, Taco Bell, etc.
• Many are working more sedentary jobs

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Why are we Overweight?

• We drink anything but water
• Most soft drinks and juices have High Fructose
  Corn Syrup which cause blood sugar levels to
  spike.
• The body then produces high levels of insulin
  which causes the body to store excess sugar as
  fat.

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Why are we Overweight?

• We dont walk
• We should
• Walk to our destination
• Take the stairs
• Deliver messages by hand at work instead of email
  or instant message
• Park in the back of the parking lot
• Walk the dog
• Play with kids

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Why are we Overweight?

• Genetics
• If our parents are overweight, chances are we
  will be.
• However
• Genes can be beat!
• Regular exercise
• Healthy Diet
• Plenty of Water
• Ample Sleep

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Why are we Overweight?

• We Grow Older
• Metabolism slows down as we age because of loss
  of muscle mass
• We Eat Junk Food
• Potato Chips, Candy, Cookies, etc.
• These foods have little to no nutritional value!!
• Contains refined carbohydrates
• Is calorie dense
• Full of Fat!!!

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Why are we Overweight?

• We love Fried Food
• Fried Chicken, Shrimp, Beef, Crawfish, Fries,
  etc.
• Fried Foods contain
• High carbohydrates and calories
• Easy way to pack on pounds!

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Why are we Overweight?

• Excessive Alcohol
• Alcoholic drinks have tons of calories
• Alcohol slows the bodys fat-burning power
• Produces acetate which is used as fuel instead of
  fat
• Alcohol is an appetite stimulant
• Reduces testosterone levels, which slow fat burn
• But wine is good!

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Why are we Overweight?

• Never read food labels
• Check labels for
• Calories
• Refined Carbohydrates
• Total Fat
• Sugar

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Why are we Overweight?

• We dont exercise!!
• Sedentary lifestyles cause us to gain weight!
• Metabolism slows down
• Body stores extra weight because it isnt burning
  any
• Reduction of muscle slows metabolism

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Why are we Overweight?

• Stress
• Heightened stress increases amount of cortisol in
  the body
• Cortisol is a stress hormone that causes the body
  to store fat
• Antidepressants cause weight gain
• When depressed we overeat because eating makes
  us happier

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Negative Effects of being Overweight

• Obesity is the second leading cause of
  unnecessary deaths, smoking is 1
• Obesity is more damaging to the body than
  Smoking!!!
• Obesity affects all major body systems including
  the heart, lungs, muscles and bones

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Negative Effects of being Overweight

• Increases risks of 30 diseases including
• Diabetes
• Cardiovascular Disease
• Certain Cancers
• Sleep apnea
• Osteoarthritis

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Negative Effects of being Overweight
Table 1. Prevalence of Medical Conditions by BMI for Men        
Body Mass Index 18.5 - 24.9 25 - 29.9 30 - 34.9 gt 40
Medical Condition        
Type 2 Diabetes 2.03 4.93 10.1 10.65
Coronary Heart Disease 8.84 9.6 16.01 13.97
High Blood Pressure 23.47 34.16 48.95 64.53
Osteoarthritis 2.59 4.55 4.66 10.04
Source NHANES III, 1988 - 1994.        
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Negative Effects of being Overweight
Table 1. Prevalence of Medical Conditions by BMI for Women        
Body Mass Index 18.5 - 24.9 25 - 29.9 30 - 34.9 gt 40
Medical Condition        
Type 2 Diabetes 2.38 7.12 7.24 19.89
Coronary Heart Disease 6.67 11.13 12.56 19.22
High Blood Pressure 23.26 38.77 47.95 63.16
Osteoarthritis 5.22 8.51 9.94 17.19
Source NHANES III, 1988 - 1994.        
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Negative Effects of being Overweight

• Increased BMI increases risks of
• Osteoarthritis (OA)
• Obesity is associated with the development of OA
  of the hand, hip, back and especially the knee.
• Modest weight loss of 10 to 15 pounds is likely
  to relieve symptoms and delay disease progression
  of knee OA.
• Rheumatoid Arthritis (RA)
• Deep Vein Thrombosis (DVT)
• Obesity increases the risk of DVT, a condition
  that disrupts the normal process of blood
  clotting.
• Patients with obesity have an increased risk of
  DVT after surgery.
• Gallstones
• Obesity and rapid weight loss in obese persons
  are known risk factors for gallstones.
• Gallstones are common among overweight and obese
  persons. Gallstones appear in persons with
  obesity at a rate of 30 versus 10 in non-obese.
  

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Negative Effects of being Overweight

• Birth Defects
• Maternal obesity (BMI gt 29) has been associated
  with an increased incidence of neural tube
  defects (NTD)
• Obesity is reportedly associated with the
  increased incidence of overdue births, induced
  labor and longer labors.
• Women with maternal obesity have more Cesarean
  deliveries and higher incidence of blood loss
  during delivery as well as infection and wound
  complication after surgery.
• Complications after childbirth associated with
  obesity include an increased risk of endometrial
  infection and inflammation, urinary tract
  infection and urinary incontinence.

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Negative Effects of being Overweight

• Breast Cancer
• Postmenopausal women with obesity have a higher
  risk of developing breast cancer.
• Women who gain nearly 45 pounds or more after age
  18 are twice as likely to develop breast cancer
  after menopause than those who remain weight
  stable.
• Premenopausal women diagnosed with breast cancer
  who are overweight appear to have a shorter life
  span than women with lower BMI.
• The risk of breast cancer in men is also
  increased by obesity.
• Colorectal Cancer
• High BMI, high calorie intake, and low physical
  activity are independent risk factors of
  colorectal cancer.
• Endometrial Cancer (EC)
• Women with obesity have three to four times the
  risk of EC than women with lower BMI.
• Renal Cell Cancer
• Consistent evidence has been found to associate
  obesity with renal cell cancer, especially in
  women.

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Negative Effects of being Overweight

• Cardiovascular Disease (CVD)
• Obesity increases CVD risk due to its effect on
  blood lipid levels.
• Weight loss improves blood lipid levels by
  lowering triglycerides and LDL (bad)
  cholesterol and increasing HDL (good)
  cholesterol.
• Weight loss of 5 to 10 can reduce total blood
  cholesterol.
• The effects of obesity on cardiovascular health
  can begin in childhood, which increases the risk
  of developing CVD as an adult.
• Overweight and obesity increase the risk of
  illness and death associated with coronary heart
  disease.
• Obesity is a major risk factor for heart attack,
  and is now recognized as such by the American
  Heart Association.

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Negative Effects of being Overweight

• Carpal Tunnel Syndrome (CTS)
• Obesity has been established as a risk factor for
  CTS.
• The odds of an obese patient having CTS were
  found in one study to be almost four times
  greater than that of a non-obese patient.
• Seventy percent of persons in a recent CTS study
  were overweight or obese.
• Chronic Venous Insufficiency (CVI)
• Patients with CVI, an inadequate blood flow
  through the veins, tend to be older, male, and
  have obesity.
• Daytime Sleepiness
• People with obesity frequently complain of
  daytime sleepiness and fatigue, two probable
  causes of mass transportation accidents.

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Negative Effects of being Overweight

• Diabetes (Type 2)
• As many as 90 of individuals with type 2
  diabetes are reported to be overweight or obese.
• Obesity has been found to be the largest
  environmental influence on the prevalence of
  diabetes in a population.
• Obesity complicates the management of type 2
  diabetes by increasing insulin resistance and
  glucose intolerance, which makes drug treatment
  for type 2 diabetes less effective.
• A weight loss of as little as 5 can reduce high
  blood sugar.

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Negative Effects of being Overweight

• Gout
• Obesity contributes to the cause of gout -- the
  deposit of uric acid crystals in joints and
  tissue.
• Heat Disorders
• Obesity has been found to be a risk factor for
  heat injury and heat disorders.
• Hypertension
• Over 75 of hypertension cases are reported to be
  directly attributed to obesity.
• Weight or BMI in association with age is the
  strongest indicator of blood pressure in humans.
• The risk of developing hypertension is five to
  six times greater in obese adult Americans, age
  20 to 45, compared to non-obese individuals of
  the same age.

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Negative Effects of being Overweight

• Impaired Immune Response
• Obesity has been found to decrease the bodys
  resistance to harmful organisms.
• A decrease in the activity of scavenger cells,
  that destroy bacteria and foreign organisms in
  the body, has been observed in patients with
  obesity.
• Impaired Respiratory Function
• Obesity is associated with impairment in
  respiratory function.
• Obesity has been found to increase respiratory
  resistance, which in turn may cause
  breathlessness.
• Decreases in lung volume with increasing obesity
  have been reported.
• Infections Following Wounds
• Obesity is associated with the increased
  incidence of wound infection.
• Burn patients with obesity are reported to
  develop pneumonia and wound infection with twice
  the frequency of non-obese.

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Negative Effects of being Overweight

• Infertility
• Obesity increases the risk for several
  reproductive disorders, negatively affecting
  normal menstrual function and fertility.
• Weight loss of about 10 of initial weight is
  effective in improving menstrual regularity,
  ovulation, hormonal profiles and pregnancy rates.
  
• Liver Disease
• Excess weight is reported to be an independent
  risk factor for the development of alcohol
  related liver diseases including cirrhosis and
  acute hepatitis.
• Low Back Pain
• Obesity may play a part in aggravating a simple
  low back problem, and contribute to a
  long-lasting or recurring condition.
• Women who are overweight or have a large waist
  size are reported to be particularly at risk for
  low back pain.

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Negative Effects of being Overweight

• Pain
• Bodily pain is a prevalent problem among persons
  with obesity.
• Greater disability, due to bodily pain, has been
  reported by persons with obesity compared to
  persons with other chronic medical conditions.
• Obesity is known to be associated with
  musculoskeletal or joint-related pain.
• Foot pain located at the heel, known as Severs
  disease, is commonly associated with obesity.
• Pancreatitis
• Obesity is a predictive factor of outcome in
  acute pancreatitis. Obese patients with acute
  pancreatitis are reported to develop
  significantly more complications, including
  respiratory failure, than non-obese.
• Sleep Apnea
• Obesity, particularly upper body obesity, is the
  most significant risk factor for obstructive
  sleep apnea.
• There is a 12 to 30-fold higher incidence of
  obstructive sleep apnea among morbidly obese
  patients compared to the general population.
• Among patients with obstructive sleep apnea, at
  least 60 to 70 are obese.

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Negative Effects of being Overweight

• Stroke
• Elevated BMI is reported to increase the risk of
  ischemic stroke independent of other risk factors
  including age and systolic blood pressure.
• Abdominal obesity appears to predict the risk of
  stroke in men.
• Obesity and weight gain are risk factors for
  ischemic and total stroke in women.
• Surgical Complications
• Obesity is a risk factor for complications after
  a surgery.
• Surgical patients with obesity demonstrate a
  higher number and incidence of hospital acquired
  infections compared to normal weight patients.
• Urinary Stress Incontinence
• Obesity is a well-documented risk factor for
  urinary stress incontinence, involuntary urine
  loss, as well as urge incontinence and urgency
  among women.
• Obesity is reported to be a strong risk factor
  for several urinary symptoms after pregnancy and
  delivery, continuing as much as 6 to 18 months
  after childbirth.

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Negative Effects of being Overweight

• Several other obesity-related conditions have
  been reported by various researchers including
• abdominal hernias, acanthosis nigricans,
  endocrine abnormalities, chronic hypoxia and
  hypercapnia, dermatological effects, depression,
  elephantitis, gastroesophageal reflux, heel
  spurs, hirsutism, lower extremity edema,
  mammegaly (causing considerable problems such as
  bra strap pain, skin damage, cervical pain,
  chronic odors and infections in the skin folds
  under the breasts, etc.), large anterior
  abdominal wall masses (abdominal paniculitis with
  frequent panniculitis, impeding walking, causing
  frequent infections, odors, clothing
  difficulties, low back pain), musculoskeletal
  disease, prostate cancer, pseudo tumor cerebri
  (or benign intracranial hypertension), and
  sliding hiatil hernia.

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Calories In Calories Out Weight Loss

• Weight loss can be achieved either by eating
  fewer calories or by burning more calories with
  physical activity, preferably both.A healthy
  weight loss program consists of
• A reasonable, realistic weight loss goal 2.5
  lbs/week
• A reduced calorie, nutritionally-balanced eating
  plan
• Regular physical activity
• A behavior change plan to help you stay on track
  with your goals

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Keep in Mind

• Calories count
• Portions count
• Nutrition counts
• Even a small amount of weight loss can lead to
  big health benefits Strive to develop good habits
  to last a lifetime
• Feel free to discuss your weight loss plans with
  us!
• To lose about 1 pound per week, subtract 500
  calories each day from the daily amount. To lose
  about 2 pounds per week, subtract 1000 calories
  daily.
• DO NOT LET A SLIP TURN INTO A SUBSTANTIAL WEIGHT
  GAIN!

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New Orleans Diet

• Red Beans and Rice- Use brown rice- Helps Lower
  LDL
• Grill or Bake fish instead of Frying it
• Boil Seafood instead of Frying it- DO NOT FRY
  ANYTHING!
• Add a Salads to your meals
• Avoid anything with High Fructose Corn Syrup

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New Orleans Diet

• Drink More Water- 8 Glasses
• Eat more Fiber- Whole Weat, Use Whole Grain Wheat
  Bread instead of White/French Bread
• Add vegetables to every meal
• If you must drink alcohol, choose light beer,
  wine

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New Orleans Diet

• By Lean Meats
• Eat smaller portions throughout the day
• Avoid Trans-Fat
• Boost Fiber to lose weight/prevent cancer
• All Bran Cereal
• Fruit/Vegetables
• Eat skin on Fruits/Potatoes

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The Key to Weight Loss!

• Its like putting gas in a car!
• Join a gym, and hire a personal trainer
• Find a friend and go walk/jog/run
• Buy light weights and exercise at home
• Take stairs at work
• Park far away from work or store (ensure safety)
• Use a pedometer and aim for 5,000/steps/day

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Exercise

• Dance
• Improve posture
• Play with your kids/ grandkids
• Resistance Bands
• Yoga/Pilates Class

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Goal

• Gradual Change of Lifestyle
• Slip ups are okay, just bounce back
• Small changes exponentially add years to your
  life!

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Cardio

• 5 days/week
• 30 min/day
• Anything that gets you moving!

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Weight lifting tips

• Endurance training- 12-15 reps
• Toning training 8-10 reps
• Strength training 3-6 reps
• Burnouts!! To Lose Weight!
• Warmup
• Stretch
• Muscle is 70 water!

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Weight Lifting Tips

• 3x per week, but if can just do once a week
  thats okay
• Work out entire body/workout
• One exercise per muscle group is enough
• Stay hydrated