Energy Balance and Healthy Body Weight

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Energy Balance and Healthy Body Weight
Chapter 9
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Energy Balance and Healthy Body Weight

• Being both overweight and underweight present
  risks to health
• Extreme Obesity BMI 40 Too much fat
• Obesity BMI 30-39.9 Too much fat
• Overweight BMI 25.0 - 29.9 Too much fat
• Healthy Weight 18.5- 24.9
• Underweight BMI

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Too Little or Too Much Body Fat

• In the U.S.
• Too little body fat is not a widespread problem
• Obesity is an escalating epidemic
• In the year 2000
• 64 of U.S. adults were overweight
• 30 were obese
• One of every seven U.S. children and teenagers is
  overweight

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Risks from Underweight

• Underweight people are at risk of dying
• During a famine
• When hospitalized if they go without food for
  days when undergoing tests for surgery
• Underweight people are at greater risk when
  fighting a wasting disease
• People with cancer often die from starvation, not
  the cancer itself
• Underweight people should gain body fat as an
  energy reserve

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Risks from Overweight

• Hypertension, diabetes, heart disease
• Abdominal hernias, arthritis, complications in
  pregnancy and surgery, flat feet, gallbladder
  disease, gout, high blood lipids, liver
  malfunction, respiratory problems, sleep apnea,
  some cancers, varicose veins, high accident rate
• Only tobacco contributes to more preventable
  diseases and premature deaths

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Overweight

• Central Obesity
• Fat within the central abdominal area of the body
  (waist circumference)
• Increases the risk of diabetes, stroke,
  hypertension, coronary artery disease
• Apple Shape (visceral fat)
• Pear shape (subcutaneous fat)

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Risks from Overweight?

• Who is prone to central obesity
• Men and postmenopausal women
• Smokers
• Those with high alcohol intake
• Those who are physically inactive

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Risks from Overweight

• Social and Economic Costs of Obesity
• Fat people are more likely to be judged on their
  appearance rather than their character
• Our society places enormous value on thinness,
  especially for women
• harder to get job, insurance, higher clothing
  costs
• Prejudice often stereotypes obese people as lazy,
  stupid and self indulgent
• Obese people suffer emotional pain when treated
  with hostility and contempt

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What Is The Bodys Energy Balance

• When more food energy is consumed than is needed,
  excess fat accumulates in the fat cells of the
  bodys adipose tissue
• Energy Balance
• Energy in Energy out
• energy in foods and beverages
• energy out lifestyle and metabolism

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The Bodys Energy Balance

• Estimated Energy Requirements (EER) on DRI chart
• Apply only to the characteristics of the
  reference man and woman
• Reference man active physical activity level,
  22.5 BMI, 510, 154 lb.
• Reference woman active physical activity
  level, 21.5 BMI, 54, 126 lb.

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The Bodys Energy Balance

• Taller people have a greater surface area
  require more energy
• Older people need less energy than younger
  people- 5 for each decade beyond the age of 30
  years
• Due to a slower metabolism and reduced muscle
  mass

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How Many Calories Do I Need Each Day?
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• Energy output
• Basal metabolism
• Sum total of energy expended on all of the
  involuntary activities needed to sustain life
• Excludes digestion
• Voluntary activities
• Thermic effect of food
• 5-10 of a meals energy is expended in
  stepped-up metabolism in the 5 hours after a meal

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How Many Calories Do I Need Each Day?

• Basal metabolic rate (BMR)
• Varies from person to person
• Varies with activity level
• Positively correlates with thyroxin secretion
• Lowest during sleep
• Lean tissue has a higher BMR than fat tissue

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How Many Calories Do I Need Each Day?

• Estimated Energy Intake
• EER is based on gender, age, weight , height, and
  physical activity
• This was built into the Food Pyramid.
• The equation is in your text book.

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Body Weight versus Body Fatness

• Body Mass Index (BMI)
• Correlates with body fatness
• Used to evaluate health risks associated with
  underweight or overweight
• In general, for adults
• Overweight is defined as a BMI of 25.0 - 29.9
• Obesity as BMI 30
• Body Mass Index (BMI)
• BMI (weight in kg)/(height in m2)
• BMI ((weight in lb)/(height in in2)) x 705

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Body Weight versus Body Fatness
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• BMI values fail to distinguish between how much
  of a persons weight is fat and where the fat is
  located.
• This limits the value of BMI with
• Athletes highly developed muscle falsely
  increases BMI
• Pregnant and lactating women increased weight is
  normal during childbearing
• Adults over 65 because BMI values are based on
  data collected from younger people and because
  people shrink with age

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Body Weight versus Body Fatness

• Methods used to Measure Body Composition and Fat
  Distribution
• Anthropometry
• Fat fold tests
• Waist circumference
• Density
• Underwater weighing
• Conductivity Radiographic techniques
• Bioelectrical impedance
• Dual energy X-ray absorptiometry (DEXA)
• Radiographic techniques

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Body Weight versus Body Fatness

• How Much Body Fat Is Ideal?
• Varies with gender, age, stage of life
• Percent body fat
• Man of healthy weight 12 - 20
• Overfat greater than 22
• 25 if over 40 years
• Female of healthy weight 20 - 30
• Overfat greater than 32
• 35 if over 40 years

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Obesity

• Factors that correlate with obesity
• Birth order, Number of brothers
• Divorced/single parents, Nonprofessional parents
• Unemployed parents
• Early menstruation
• Ethnicity
• Exposure to a variety of foods
• Fast-food consumption
• Fat, protein, carbohydrate intake-too much
  food!!!
• Increased wealth (In developing nations)
• Less leisure time
• International travel
• Geographic location

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Obesity

• More factors that correlate with obesity
• Lower education level
• Lower social class
• Maternal famine
• Obesity during gestation
• Meal skipping, Meals eaten away from home
• Napping habits, Sleep deprivation
• Reduced alcohol intake, Increased alcohol intake
• Sedentary behavior, Television watching
• Substandard housing
• Everything!!! But mostly eating too much!!!!

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Eating Behavior

• Eating behavior is regulated by mechanisms that
  stimulate eating and mechanisms that signal the
  body to stop eating
• 1 Hunger and Appetite
• 2 Seek Food and Eat
• 3 Keep Eating
• 4 Satiation, End Meal
• 5 Post Absorptive Influences

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Eating Behavior

• What is Hunger?
• Sensation that signals a need for food
• Occurs roughly 4-6 hours after eating
• After the food has left the stomach and much of
  the nutrient mixture has been absorbed
• Triggered by a contracting empty stomach and
  empty small intestine
• The stomach hormone ghrelin produced between
  meals signals the hypothalamus (brain) to
  simulate eating
• The hunger response quickly adapts to changes in
  food intake (to larger or smaller quantities of
  food)
• Food deprivation can lead to overeating to
  overcompensate for the calories lost during
  deprivation

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Eating Behavior

• What is Appetite?
• The psychological desire to eat
• Can be experienced without hunger
• The sight and smell of food can stimulate the
  brains endorphins, molecules that create an
  appetite despite an already full stomach
• Illness or stress may result in the loss of
  appetite in a person in physical need of food

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Eating Behavior

• Other factors affecting appetite
• Hormones
• Inborn appetites (for salt, sweet, fat)
• Learned preferences, aversions, timings
• Customary eating habits
• Social interactions (companionship)
• Some disease states (cold flu)
• Appetite stimulants, depressants, mood-altering
  drugs
• Environmental conditions (hot and cold)

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Eating Behavior

• What are Satisfaction and Satiety?
• The perception of fullness that builds throughout
  a meal
• The stomach sends signals to the brain to tell it
  that its full
• The brain also detects nutrients in the blood
• Hunger strongly stimulates eating behavior
• Satiation and satiety exert weaker control over
  food intake and can be ignored
• (keep eating)

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Eating Behavior
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• Leptin A Satiety Hormone
• Leptin
• An appetite-suppressing hormone
• Produced by adipose tissue
• Travels to the brain
• Directly linked to appetite and body fatness
• Gain of body fatness stimulates leptin production
• Reducing food consumption resulting in fat loss
• Loss of body fat reduces leptin secretion
• Increasing appetite

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Why Did I Eat That?

• Energy Nutrients and Satiety
• At least 15 studies show that a low-glycemic
  index diets reduced or delayed hunger
• 16 studies have found the opposite or no effect
• Showed that diets based on refined grains are
  just as satisfying as diets based on low-glycemic
  index diets

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Why Did I Eat That?

• Of the energy-yielding nutrients, protein may be
  the most satiating
• May account for the popularity of high-protein
  weight-loss diets
• Fat is also known for its satiety effects
• Protein and fat trigger the release of an
  intestinal hormone that slows stomach emptying
  and prolongs feelings of fullness
• Satiety is also associated with
• High-fiber foods
• Water
• Foods that have been puffed up from air
• ???What works for you???

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Inside-the-Body Causes of Obesity

• Selected Metabolic Theories of Obesity
• Attempt to explain the ease with which people
  gain/lose weight when eating more/less food
  energy than they use

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Causes of Obesity

• Genetics
• Decrease energy expended in activities required
  for daily living
• Inactivity
• Food Price, Availability, and Advertising
• High-calorie fast foods are relatively
  inexpensive, widely available
• A steady diet of them correlates with obesity
• External Cues to Overeating
• eat even when not hungry
• Loneliness, Yearning, Craving, Addiction,
• Compulsion, Depression, Time of day
• ???Do thin people deal with these things??

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Causes of Obesity

• End of Story?
• There is no clear evidence as to which factor(s)
  bears the greatest responsibility for obesity
• For most people, the best way to obtain a healthy
  body weight is to
• Maintain a proper diet
• Engage in daily physical activity
• Practice behavior modification
• Can low price, advertising and availability of
  healthy foods attract consumers????

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Activity for Healthy Body Weight

• Moderate exercise is defined by NIH as using 150
  calories per day (1,000 calories per week)
• Exercise does not have to be excessive to achieve
  fat loss
• The DRI definition of an active lifestyle
  requires walking for 1 hour per day
• Is this enough activity?????

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Activity for Healthy Body Weight

• Physical activity for weight loss or maintenance
• Moderate activities
• Use large muscle groups
• Increase in physical activity
• Adopt informal strategies to be more active
• Physical activity for building body mass
• Strength-building exercises
• Perform exercises with increasing intensity,
  resistance training

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Weight Loses and Gains

• Moderate Weight Loss versus Rapid Weight Loss
• When energy input is less than energy output, the
  body draws on its energy stores
• With exercise, moderate calorie restriction and a
  balanced diet, a body will use its stores of fat

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How the Body Loses and Gains Weight

• Rapid wt loss
• The Bodys Response to Fasting
• Less than 1 day into the fast liver glycogen
  stores are exhausted
• Protein is broken down and converted to
  carbohydrate to meet the brains need for glucose
• If left unchecked the breakdown of protein
  (muscle of the heart, skeletal muscle, liver,
  etc) results in death within about 10 days
• To prevent this, the body converts fat into
  ketone bodies, a fuel the nervous system can
  adapt to using

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How the Body Loses and Gains Weight

• Ketosis
• In ketosis, instead of breaking down fat to CO2
  and H2O, the body takes partially broken-down fat
  fragments and combines them to form ketone bodies
• Some amino acids that cannot be converted to
  glucose, are converted to ketone bodies
• After about 10 days of fasting, most of the
  nervous systems energy needs are met by ketone
  bodies

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How the Body Loses and Gains Weight

• Fasting may harm the body
• Ketosis upsets the acid-base balance of the blood
• Promoting excessive mineral loss in the urine
• In as little as 24 hours of fasting, the
  intestinal lining deteriorates
• Food deprivation leads to overeating/ binging
  when food becomes available
• Fasting breaks down the bodys lean tissues
• The body adapts to fasting by slowing its
  metabolic rate

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How the Body Loses and Gains Weight

• The Bodys Response to a Low-Carbohydrate Diet
• Responses are similar to those of fasting
• As carbohydrate runs low the body breaks down fat
  and protein for energy and ketones form to feed
  the brain
• To prevent this the DRI for carbohydrates is set
  at 130 grams/day 45-65
• Initial weight loss is the water and glycogen
  losses when carbohydrate is lacking
• Loss of appetite accompanies any low-calorie diet

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How the Body Loses and Gains Weight

• Weight Gain Energy-yielding nutrients contribute
  to excess body stores
• Protein excess amino acids have their nitrogen
  removed and are used for energy or converted to
  glucose or fat
• Fat fatty acids can be broken down for energy or
  stored as fat with great efficiency glycerol
  enters a pathway similar to carbohydrate
• Carbohydrate (other than fiber) glucose may be
  used for energy or excess may be converted to
  glycogen or fat and stored
• Alcohol used for fuel or converted to body fat
  and stored as visceral fat
• Excess consumption of any food will be turned to
  fat within hours

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Popular High-Protein, Low-Carbohydrate Diets

• Laboratory studies have shown that, when energy
  intake is the same, there is no difference in
  weight loss on a high-protein, low-carbohydrate
  diet or a lower-protein, higher-carbohydrate
  diet

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Popular High-Protein, Low-Carbohydrate Diets

• High in saturated fat
• Increased cardiovascular disease risk
• Increased risk of breast cancer
• Low Carbohydrate Intake
• Mixed results with regard to cardiovascular risk
• Missing nutrients from the diet
• Chronic ketosis

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What Strategies Are Best for Weight Loss?

• Dietary Guidelines for Americans 2005
• Energy in must be less than energy expended
• Calorie intake must decrease to attain weight
  loss
• Diet based on all the food groups may be the
  safest and easiest in the long term
• Increase physical activity

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What Diet Strategies Are Best for Weight Loss?

• Setting Goals
• For an overweight person
• First reasonable goal may be to prevent weight
  gain
• Reduce body weight by 5-10 over the course of a
  year
• Recognize that maintenance is often more
  difficult than weight loss
• Keep Records
• A tool for spotting trends and identifying areas
  in need of improvement
• Measure waist circumference to track changes in
  central obesity

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What Diet Strategies Are Best for Weight Loss?

• Realistic Calorie Intakes
• Energy intakes lower than 800 calories are not
  good for achieving lasting weight loss, and may
  promote eating disorders
• Diets for weight management should provide the
  DRI recommended ranges
• Carbohydrate 45 - 65 of total calorie intake
• Fat 20 - 35 of total calorie intake
• Protein 10 - 35 of total calorie intake

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What Diet Strategies Are Best for Weight Loss?

• Fats
• Avoid saturated and trans fats
• Include enough of the health-supporting fats to
  provide satiety but not so much as to oversupply
  calories olive, canola oil
• Protein
• Choose lean meats or other low-fat protein
  sources
• Limit these foods but dont eliminate them
• Carbohydrates
• Choose whole grains and starchy vegetables rather
  than refined grains, added fats, and sugars
• High-fiber, unprocessed or lightly processed
  foods offer bulk and satiety for fewer calories
  than quickly consumed refined foods

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What Diet Strategies Are Best for Weight Loss?

• Alcohol
• Limit intake
• Alcohol provides calories but no nutrients
• Alcohol reduces inhibitions and can sabotage a
  dieters plans
• Portion Sizes
• Be aware of portions in restaurants and food
  packages
• Use a measuring cup to learn portion sizes
• Learn fat grams- they add calories more quickly
  than carbohydrate or protein

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Demonstration Diet
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What Diet Strategies Are Best for Weight Loss?

• People who eat small, frequent meals are reported
  to be more successful at weight loss and weight
  management
• Make sure that hunger, not appetite, prompts
  eating
• Eat regularly, before becoming hungry
• Eat the entire meal
• Save calorie-free or favorite foods or beverages
  for a planned snack
• Eat breakfast
• Those who consume the majority of their calories
  after 600 p.m. often find it harder to lose
  weight

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Physical Activity for Weight Loss

• 30 - 60 minutes of moderate physical activity
  per day are needed to prevent weight gain and
  support weight loss
• Diet, in combination with exercise, promotes fat
  loss, promotes muscle retention, inhibits weight
  gain
• Exercise helps people follow diet plans more
  closely
• Exercise reduces abdominal obesity
• Improves BP, insulin resistance, heart and lung
  fitness even without weight loss

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Physical Activity for Weight Loss

• Benefits of Exercise
• Short-term it increases energy expenditure
• Long-term increase in BMR
• increase lean tissue
• Improved body composition
• Appetite control??
• Stress reduction and control of stress eating
• Physical and psychological well-being
• Improved self-esteem
• Any activity is better than no activity
• Expenditure of at least 2,000 calories per week
  in physical activity promotes weight management

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What Strategies are Best for Weight Gain?

• An underweight person should not necessarily try
  to gain weight
• If you are healthy, maintain your current weight
• Examples of those who may be at health risk from
  a too-low body weight
• Physician has advised you to gain weight
• You are excessively tired
• You are unable to keep warm
• You fall into the underweight category of the BMI
• You are a woman who has missed at least three
  consecutive menstrual periods

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What Strategies are Best for Weight Gain?

• To Gain Muscle and Fat
• Best achieved through physical activity
  especially strength training in combination with
  a high-calorie diet
• Diet alone can bring about weight gain in the
  form of fat
• Good for someone with a wasting disease
• Gaining a pound of muscle and fat requires an
  intake of 3,500 extra calories

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What Strategies are Best for Weight Gain?

• Weight Gain Supplements
• Most weight-gain supplements are useless
• No benefits beyond adding calories and a few
  nutrients
• Items such as instant breakfast powders or milk
  flavorings can do the same thing for less money
• Tobacco (avoid)
• Suppresses appetite
• Makes taste buds less sensitive

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What Strategies are Best for Weight Gain?

• Choose Foods with High Energy Density
• Chose nutritious energy-dense foods, for example
• Peanut butter in place of lean meat
• Avocado in place of cucumber
• Increase portion sizes
• Expect to feel full
• Eat frequently
• Make foods appealing

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Drugs and Surgery to Treat Obesity

• BMI30 and those with elevated disease risk may
  benefit from prescription medication, along with
  diet, exercise, and behavior therapy, to lose
  weight
• Extreme obesity (BMI40 BMI35 with coexisting
  disease) surgery may be an option
• Reduction of stomach size
• Not a cure for obesity
• Some do not lose the expected pounds
• Some who initially lose weight gain it back
  through the course of time

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Drugs and Surgery to Treat Obesity

• Gastric surgery- Long-term safety depends on
  compliance with diet
• Complications following surgery include
• Infections
• Nausea
• Vomiting
• Dehydration
• Vitamin and mineral deficiencies
• Psychological problems
• Such surgery requires lifelong medical
  supervision

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Drugs and Surgery to Treat Obesity

• Liposuction
• Cosmetic procedure-surgical
• There can be serious complications, including
  death
• Herbal Products
• For many, their effectiveness and safety have not
  been proved
• Natural does not mean safe
• Belladonna, hemlock, and sassafras all contain
  toxins
• Ephedra (ma huang) contains ephedrine
• weight loss
• Side effects--Cardiac arrest, abnormal heart
  beat, hypertension, stoke, seizure, death
• FDA has banned sales, available on internet
• TRIAC
• Sold as diet aid
• Hormone that interferes with thyroid function
• Has caused heart attack and stroke
• Marketed as dietary supplements and escape FDA
  scrutiny

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Drugs and Surgery to Treat Obesity

• Herbal laxatives containing senna, aloe, rhubarb
  root, cascara, castor oil, or buckthorn
• Sold as dieters tea
• Can cause temporary water loss of 1-2 pounds
• Side effects include nausea, vomiting, diarrhea,
  cramping, fainting, possible deaths

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Weight Control

• Weight loss strategy
• Behavior Modification
• Learning to say No might be the first habit to
  establish
• Learning not to clean your plate is another
  behavioral change
• Change enviornment

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Eating Disorders

• 5 million people in the U.S. suffer from eating
  disorders
• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• 85 of eating disorders start during adolescents

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Eating Disorders

• Causes of eating disorders
• Excessive pressure to be thin is partly to blame
• When low body weight becomes a goal, people begin
  to view normal, healthy body weight as too fat
• Excessive dissatisfaction with body weight or
  feeling fat

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Eating Disorders

• Eating Disorders in Athletes
• Athletes and dancers are at special risk of
  eating disorders
• Female athlete triad
• Disordered eating, Amenorrhea, Osteoporosis
• Female athletes often compare themselves to
  unsuitable weight standards
• An ultra-slim appearance has long been considered
  desirable in activities such as dancing,
  gymnastics, and figure skating
• Males have some of the same physical problems

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Eating Disorders

• Practices by wrestlers trying to make weight
  can compromise their abilities and endanger their
  lives
• Male athletes are susceptible to weight-gain
  problems
• Athletes with well-muscled bodies see themselves
  as underweight and weak
• Such distorted body image leads to frequent
  weighing, excessive exercise, overuse of special
  diets or protein supplements, or even abuse of
  steroid drugs

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Eating Disorders

• Characteristics of Anorexia Nervosa
• Most anorexia nervosa victims come from middle or
  upper-class families
• Males account for 5 to 10 of cases
• The incidence among male athletes and dancers may
  be higher
• Central to its diagnosis is a distorted body
  image that overestimates body fatness
• Family attitudes contribute to eating disorders
• Families of anorexics are likely to be critical
  and to overvalue outward appearances rather than
  inner self-worth

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Eating Disorders

• Anorexics may be perfectionists
• Respectful of authority polite, controlled,
  rigid
• Rejecting food is a way of gaining control
• Anorexia Nervosa Self-Starvation
• Discipline is used to strictly limit portions of
  low-calorie foods
• Hunger is denied
• Become accustomed to little food
• Calorie contents of foods are memorized
• Calorie expended during exercises are memorized

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Eating Disorders

• Anorexia Nervosa
• Causes the same damage as classic protein-energy
  malnutrition
• Body tissues are depleted of needed fat and
  protein
• In young people, growth ceases and normal
  development stops
• So much lean tissue is lost that BMR slows for
  self preservation
• In athletes
• The loss of lean tissue impairs performance
• The heart pumps inefficiently and irregularly
• Heart muscle becomes weak and thin
• Blood pressure falls
• Electrolytes that help to regulate heart beat go
  out of balance
• Many deaths are due to heart failure

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Eating Disorders

• Treatment of Anorexia Nervosa
• Requires a multidisciplinary approach
• Low risk clients may benefit from
• Family counseling
• Cognitive therapy
• Behavior modification
• Nutrition guidance
• High risk clients may also need
• Other forms of psychotherapy
• Supplemental formulas to provide energy and
  nutrients
• Drugs are commonly prescribed, but their
  usefulness is limited

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Eating Disorders

• Few anorexics seek treatment on their own
• Denial makes treatment difficult
• Many relapse into abnormal eating behaviors
• Anorexia nervosa has a high mortality rates among
  psychiatric disorders

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Eating Disorders

• Bulimia Nervosa
• More common then anorexia nervosa
• People often suffer in secret and may deny the
  existence of a problem
• More men suffer from bulimia nervosa than from
  anorexia nervosa
• However, more common in women

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Eating Disorders

• Binge Eating and Purging
• Food is not consumed for its nutritional value
• Eating is accelerated by hunger from previous
  caloric restriction
• Nearly 1,000 extra calories are consumed at a
  time
• There may be several binges in a day
• Typical binge foods
• Easy-to-eat foods
• Low-fiber
• Smooth-texture
• High-fat
• High-carbohydrate

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Eating Disorders

• After the binge
• Hands may be scraped raw against the teeth during
  induced vomiting
• Swollen neck glands and reddened eyes from
  straining to vomit
• Bloating, fatigue, headache, nausea, pain
• Vomiting causes
• Irritation and infection of the pharynx,
  esophagus, salivary glands
• Erosion of the teeth and dental caries
• The esophagus or stomach may rupture or tear
• Overuse of emetics (cause vomiting) can lead to
  death by heart failure

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Eating Disorders

• Bulimia Nervosa Physical and Psychological
  Problems
• Fluid and electrolyte imbalances are caused by
  vomiting or diarrhea
• They can cause abnormal heart rhythms and injury
  to the kidneys, UTIs can lead to kidney failure
• Unlike anorexics, bulimics are aware that their
  behavior is abnormal, and they are ashamed of it
• Bulimics are less likely to be in denial and more
  likely to recover

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Eating Disorders

• Treatment of Bulimia Nervosa
• To regain control over food and establish regular
  eating patterns requires adherence to a
  structured eating plan
• Regular exercise may be of benefit
• Restrictive dieting is forbidden
• Steady maintenance of weight
• Prevention of relapse into cyclic gains and
  losses
• Learning to consistently eat enough food to
  satisfy hunger needs
• 50 of females recover completely after 5 - 10
  years with or without treatment
• Antidepressant medication may be of benefit

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Eating Disorders

• Binge Eating Disorder
• Up to 50 of all people who restrict eating to
  lose weight periodically binge without purging
• Obesity itself does not constitute an eating
  disorder
• Binge eating behavior responds more readily to
  treatment than other disorders
• Successful treatment improves physical health,
  mental health, and the chances of breaking the
  cycle of rapid weight losses and gains

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Eating Disorders

• Eating Disorders in Society
• Eating disorders have many causes
• Sociocultural
• Known only in developed nations
• Become more prevalent as wealth increases and
  food becomes plentiful
• Psychological
• Heredity
• Probably neurochemical unbalance
• Society sets unrealistic ideals for body
  weight-Especially for women