Conceptualization Of The Problem Of Weight Regain

A complex interaction of physiological, environmental, and psychological factors makes the maintenance of lost weight difficult to achieve. Following a period of restrictive dieting, people often experience a heightened sensitivity to palatable food (22). Consequently, exposure to an environment rich in tasty high-fat, high-calorie foods virtually guarantees occasional lapses in dietary control (23,24). Moreover, increased caloric intake during the postdieting period may easily translate into...

Medical And Health Care Discrimination

Health care is an additional arena where weight discrimination appears to occur. Negative antifat attitudes have been reported among physicians, nurses, and medical students. Perceptions of obese patients include beliefs that they are unsuccessful, unpleasant, unintelligent, overindulgent, weak-willed, and lazy (19-23). Attributions about the cause of obesity may be partially responsible, and include assumptions that obesity can be prevented by self-control (22), that patient noncompliance...

Increased Physical Activity

An increase in physical activity promotes weight loss through increased expenditure of energy and possibly through inhibition of food intake. Physical activity also helps to maintain a desirable weight and to reduce CHD risk beyond that produced by weight reduction alone. Several experts contend that a decrease in the amount of energy expended for work, transportation, and personal chores is a major cause of obesity in the United States. They note that total caloric intake has not increased...

Exercise and Metabolism

The 24-h energy expenditure can be broken down into several components, including resting metabolic rate (RMR), the thermic effect of feeding, and the energy cost of physical activity. Less than 20 of the RMR is attributed to skeletal muscle (1). Nonetheless, the factor that can cause the most dramatic effect on metabolic rate is strenuous exercise. During strenuous exercise, the total energy expenditure of the body may increase 15-25 times above resting levels (1). This enormous elevation in...

Dissecting Obesogenic Environments The Angelo Framework

The development and execution of health promotion programs, including environmental interventions requires the following steps (1) needs analysis, (2) problem identification, (3) strategy development, (4) intervention, and (5) evaluation (34). Major barriers to progressing through these steps for environmental programs include the lack of suitable paradigms and tools for understanding and measuring the environment (35). We have previously described the development and use of the ANGELO...

Clinical Classification

A Anatomic Characteristics of Adipose Tissue and Fat Distribution Obesity is a disease whose pathology lies in the increased size and number of fat cells. An anatomic classification of obesity from which a pathologic classification arises is based on the number of adipocytes, on the regional distribution of body fat, or on the characteristics of localized fat deposits (1,2). The number of fat cells can be estimated from the total amount of body fat and the average size of a fat cell (3)....

Sociocultural Factors

It has been proposed that''dieting disorders'' is a more proper term than ''eating disorder'' because the underlying essential feature of anorexia nervosa, bulimia nervosa, and associated conditions is the ''inappropriate and excessive pursuit of thinness'' (32). For individuals with either anorexia nervosa or bulimia nervosa, attempts at weight loss and dietary restriction (often severe) almost invariably precede the development of the significant symptoms of disordered eating. The current...

Natural History Of Obesity

Individuals can become overweight at any age, but this is more common at certain ages. At birth, those who will and those who will not become obese later in life can rarely be distinguished by weight (87), except for the infants of diabetic mothers, for whom the likelihood of obesity later in life is increased (88). Thus, at birth, a large pool of individuals will eventually become overweight, and a smaller group will never become overweight. I have labeled these pools ''preoverweight'' (Fig....

Iiiobesogenic And Leptogenic Environments

A central concept to emerge from considering these models is that, while environments are external to the person, they have a powerful influence on the person's behaviors and thus energy balance and obesity. The term obesogenic environments can be defined as ''the sum of influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals or populations'' (19). By contrast, leptogenic environments would promote healthy food choices and encourage regular...