NCSF Personal Training Study Guide Chapter 11 – Weight Management

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Chapter Goals:

• Know the various factors that impact body weight and composition.
• Identify the obstacles that exist for those wishing to lose weight.
• Know the energy balance equation.
• Find the common errors and ways to improve accuracy in food logs and recalls.
• Be able to explain the variables involved in facilitating effective weight loss.

Factors that Impact Weight Management

The increase in obesity that we see is ever-worsening, and this works to threaten people of all ages in the US.

The current weight gain rate and its medical cost have prompted the government to make a formal initiative to fight the disease’s prevalence.

The costs for obesity-related medical care were over 150 billion annually and the indirect costs are over 8.65 billion dollars annually.

These reasons mean that the exercise professional is responsible for placing these things at a high priority level.

All of these factors have an impact on adherence and success in weight loss programs:

• Social
• Economic
• Physiological
• Psychological
• Emotional

Social factors that affect someone’s weight come from many parts of the American tradition, behaviors, and lifestyle factors.

Economic factors include access to food, which may be limited in places like big cities, or the fact that the higher calorie foods in fast food have been made cheap.

Higher quality food is often more expensive and harder to keep than inexpensive food items. This is a major factor leading people with very busy lives to resort to less healthy items.

Physiological factors typically look at people and their hunger levels.

Hunger is the drive to seek out food caused by hormones signaled from the peripheral tissues to the hypothalamus.

Peripheral mechanisms work to regulate food consumption through chemoreceptors and hormones, and they are not always consistent. There are often some variances in eating patterns.

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Psychological factors differ from hunger, as it is an appetite that does influence the physiological side.

Appetite is the desire to satisfy a need for food, often happening independently of hunger.

The psychological considerations to consider are:

• Behavioral patterns
• Environmental cues
• Learned eating behaviors
• The perception of the monetary value of food

Behavioral eating patterns relate to the times, locations, and events happening in our lives. These influence our eating patterns.

Learned eating behaviors come from the things we are taught and practiced as we are growing up. These can be changed, but it is not as easy.

Some emotions and mental states will drive people to eat when they are not even hungry. This frequently comes with boredom in the general population.

Energy Balance and Weight Management Strategies

When people practice routine consumption of excess food and calories, the energy balance shifts to a weight gaining side.

The energy balance is a simple comparison of the calories taken in and the calories expended.

A negative calorie balance would lead to losing weight, as you are in a calorie deficit and burning more than you take in each day.

A positive energy balance is one where you would gain weight, as you would be taking in more calories than you expend, and over time this adds weight.

Isocaloric means there is a balance of calories expended and consumed; this promotes weight maintenance.

Concerns of Significant Caloric Restriction

Significant restriction of calories has the effect of losing weight. The amount of weight lost depends on many things, and often we see water lost more than the actual body components.

With inadequate protein intake, it is common to see a loss of lean mass in the body.

With significant cuts in calories over a long time, we see a reduced metabolism due to the loss of lean weight and a drop in the RMR, or resting metabolic rate.

The resting metabolic rate is the energy we need to supply the body with energy during rest.

Severely obese people will often be prescribed very low-calorie diets, with an intake of 800 kcals or less each day and usually done with liquid meals.

Yo-Yo Dieting and Intermittent Fasting

Yo-yo dieting is the cyclical weight loss and gain that comes with failing to adhere to a strict healthy eating plan.

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Typically, people will lose a lot of weight from a new diet plan and then regain it when they get off the diet. This shows the ineffectiveness of dieting and not changing long-term eating patterns.

Intermittent fasting is an umbrella term for the many patterns of fasting and non-fasting over certain periods of time to restrict calories.

Food Recalls and Logs

To manage weight the best way, there must be a balance between food timing, calories expended, and calories taken in.

The factors that change the balance need to be pinpointed and addressed.

Food recalls are usually done on a 24-hour basis and have the client recall the food in that timeframe.

A similar food log has the person recording the food over a set amount of time, like a week.

The times and locations of the food and drink should be noted, as this can give some good insight into existing behavioral eating problems.

Advice for recalling food accurately is to:

• Recall the beverages separately
• Recall snacks consumed outside of main meals
• Recall activities in a sequence from waking until be time
• Show the quantity using a tangible model of measuring
• Be able to describe the eating experiences
• Identify what was added to the food, if anything
• Ask the client if they have recalled everything

Basic nutrients to note throughout the evaluation are:

• Percent of calories
• Carbs
• Sugar
• Fats
• Proteins
• Saturated fats
• Cholesterol
• Fiber
• Sodium
• Iron
• Calcium
• Water

Metabolism

Finding the caloric intake gives information for half of the energy-balance equation.

Next, it is important to determine the total daily energy expenditure or the TDEE.

The TDEE measures calories expended daily and is often estimated to find daily intake requirements.

The thermic effect of food is the last part of total daily caloric expenditure. This calorie cost is above the resting metabolic rate due to digestion and food processing.

The RMR represents around 60 – 70% of the total caloric expenditure.

Physical activity is around 15 – 35% of total caloric expenditure.

The last up to 10% is from the resting metabolism.

Weight Management Strategies

Most people adjust their diet as the only way to create a deficit of calories. Food nutrient content and timing are vastly important in influencing hormones with good metabolic outcomes.

For optimal loss of fat and weight in general, people must utilize a good diet, timing of nutrients, and physical activity.

The factors of energy output that should be controlled for optimal weight loss are the RMR, diet-induced thermogenesis, daily activity, and structured exercise.

The factors of energy input that need to be controlled for optimal weight loss are all the energy entering the body, the forms of energy intake, and specific quantities and intake patterns.

It is also important to control the actions that affect our input and output of calories.

Some active behaviors to substitute for their opposing sedentary behaviors are things like:

• Taking the elevator -> Taking the stairs
• Watching TV -> Walking the dog
• Shopping online -> Shopping at the mall
• Parking close to the office/work entrance -> Parking across the lot or down the street
• Driving to the store or work -> Biking/walking to the store or work
• Playing video game sports titles -> Playing sports in a recreational league
• Going to the movies -> Going to a nature park
• Sitting at a desk for 8 hours at work -> Standing 15 minutes or walking 5 minutes once every hour

Stress, Social Behaviors, and Weight Management

Stress and social behaviors work to affect weight management but in their own ways.

Social behaviors do not affect the body through hormonal changes but instead through presenting obstacles to the diet and adherence to physical activity.

Weight Gain

Some people do not wish to lose weight but instead gain it healthily.

The goals for gaining weight will often be vanity or performance.

It is important to gain weight slowly over time to gain weight healthily. This is usually within 150 – 300 calories per day. Protein will be a primary focus, as the goal is to gain lean mass over fat.

Feeding and Eating Disorders

The three most common eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Anorexia nervosa is the most well-known disorder, and it is characterized by a significant body image disorder, a fear of becoming fat, and a preoccupation with weight.

Bulimia nervosa is shown through binge-eating, purging, or diet pills and laxatives.

Binge-eating disorder is seen through large portions of food being taken in and feelings of guilt, depression, and low self-worth.

The most often seen characteristics of eating disorders are:

• Body dissatisfaction
• Use of illegal drugs
• Eating alone
• Emphasis on body weight
• Depression
• Feelings of guilt, remorse, or self-loathing related to eating behavior
• Body image distortion
• Intense fear of being fat
• Preoccupation with food and appearance
• Avoidance of eating or noticeable overconsumption
• Use of laxatives, appetite suppressants, purging, or diuretics
• Exercising excessively
• Smoking cigarettes