Weight loss & management - Essay Example

? “WEIGHT LOSS & MANAGEMENT” “KAMBIZ SADRAEI” HEALTH SCIENCE 533 CSUN Sheri Strahl, MPH 05/09/11 FINAL PROJECT REPORT Introduction and Overview The target of my study is a 32 year old Middle Eastern woman. She is an immigrant from IRAN. She has been living in United States for the past 10 years. She is a full time graduate student at CSUN. She lives in Beverly Hills with her parents. Her BMI is 27.5 which is considered overweight, she is 5 feet 4 inches and weighs 160 pounds, and her waist circumference is 35 inches. She rarely works out due to lack of time in her busy schedule. She is under a lot of stress because of her sick parents that she takes care of. She is also stressed because of financial hardships. She is out of the house most of the day so she doesn’t have time to cook healthy food so she ends up eating fast food. The Transtheoretical Model (About Us, 2010) will be used. The subject is taking advanced classes which will add to the stress that she encounters on a daily basis. In this case the test subject feels that she does not have the time to have nutritious meals since she is always on the go. My subject started in the middle stage which is the contemplation stage. She wants to make a change within the next 6 months. She is thinking about it but has not does anything in the form of acting on it just yet. The reason I chose this subject is because she is one of my good friends and she is very reliable and professional and she has promised to make herself available to me throughout this project. Her dad suffers from Type II diabetes and she has wanted to control her weight through diet and exercise. She has decided to lose 10 pounds of fat specifically around her belly and waist to lower her risk of getting diabetes. Some health damaging behaviors that are being considered are: substance abuse, refusing to exercise, eating habits, stress, and alcohol consumption. All of these can be hindrances of losing weight (Thurauf, 1984). Sometimes people do not know that they are hindering themselves from losing weight and they need some guidance on how not to do that. The subject is experiencing the stress factor as well as the poor eating habits and lack of exercise. Sometimes stress leads to the consumption of food and beverages that are convenient but otherwise low in nutritional value. For example, you might be on the run and grab a McDonald’s Mc Double which is on most menus for $1.00. This burger has 390 calories with 22 grams of protein (McDonald's, 2011). Now this may seem like it is high in nutritional value but when you factor the 920 grams of sodium it seems like a sacrifice that most people should not make. Needs Assessment Obesity is an excess proportion of total body fat. A person is considered obese when his or her weight is 20% or more above normal weight. The most common measure of obesity is the body mass index or BMI. A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30. My subject is considered overweight based on her BMI. Obesity occurs when a person consumes more calories than he or she burns. There are other factors involved such as: Age, Gender, Physical Activity and stress level. The latest results from the 2005 Los Angeles County Health Survey (Los Angeles County, 2005) show that the prevalence of adult obesity in the county continues to increase, with 1 out of every 5 adults in the county now obese. From 1997 to 2005, the prevalence of adult obesity in the county increased from 14% to 21%. My subject needs to modify her eating habits as well and she needs to follow a healthy diet regiment. The Dietary Guidelines describe a "healthy diet" as one that: consists of fruit, vegetables, whole grains and fat free milk products. Meats poultry fish beans eggs nuts low in saturated fat and trans fats, cholesterol, salt (sodium) and added sugars. Exercise not only sheds body fat and creates muscle; it promotes a feeling of psychological well being. A daily regime of 30 minutes of sustained exercise has shown to reduce the risk of heart disease and other chronic diseases. It boosts the immune system promoting an overall health. Exercise increases HDL (good cholesterol levels). Significant data support the concept that abdominal adipose tissue is biologically and metabolically different than subcutaneous fat tissue and may play a causal role in the clustering of major cardiovascular risk factors such as dyslipidemia, elevated blood pressure, and diabetes. Body-fat distribution appears to be determined by a combination of aging, hormonal, environmental, perinatal, and genetic factors. While abdominal adiposity and total body adipose levels are highly correlated, data are accumulating that support the idea that the distribution of adipose tissue may be of greater importance than the total burden of adiposity. The methods and tools used were simplified to only include a log of the exercises that were done and of the food that was eaten. The food log is similar to that of most dietary plans such as Weight Watchers which has a points plan. Every type of food is given a point value and each day you can only have a certain amount of points. The change in our plan is that the subject would write down what she ate daily including any condiments added to the food. This would give a total daily caloric intake and then we could assess how efficient those calories were. A pound is about 3500 calories (What It Takes to Lose a Pound, 2010). Since our subject wants to lose 30 pounds of body fat, it would seem that she would need to burn off 105000 calories. This means that our subject would need to have a deficit of 105000 calories. So if our subject took in 2000 calories per day for 7 days they would consume 14000 calories per week. If our subject burned 2500 calories per day this would be a deficit of 500 calories per day or 3500 per week. This would accomplish a weight loss of 1 pound per week. A reduction of 2 pounds per week is considered healthy therefore given this theory our subject would need a deficit of 7000 calories per week and attain her goal in 15 weeks. Based on a 2000 calorie diet our subject would need to burn off 3000 calories. The initial pound per week can be attained by cutting out certain foods however without exercise the additional pound might be a bit tough to accomplish. This is where the exercise log would come in. Certain exercises can burn off a certain amount of calories per hour. The easiest thing anyone can do is walk. Walking at a slow 2 mile per hour pace can burn about 136 calories per hour (Bright, 2011). Various exercises will be used to accomplish the desired results. An assessment of the subject’s current living situation would have to be done to determine what means or obstacles stand in the way. If the subject is close to a gym and the fees do not cost much then this will be considered as a way to burn those excess calories. If a park is close by this can also be a way to lose weight. Also purchase of a bicycle could also be a solution. As said before this would depend on the subject’s means and ability to make purchases or access a facility. Interventions A low calorie diet was introduced starting at 2000 calories per day. Our subject was use to taking in 2500 or more calories so the reduction of 500 calories will be a good jumpstart to weight loss. An exercise plan was also developed but with various options so that the subject would not get bored of doing one type of exercise all of the time. Also the types of exercises were alternated daily so that the same exercises were not being repeated the same day each week. The idea was to not make the adult bored and feel as if exercising was monotonous and dull. We want to encourage the subject to exercise and not further encourage her to shy away from it. A list of foods from each food group was also given to the subject as well its nutritional value. For example, chicken was on the list as a good source of protein. Other foods also were given along with the most important nutritional value they provided. Exercises that could be done outside were given as well as those that could be done inside. Weight training could be done inside a gym or inside a home or apartment. Swimming was also highlighted as a good way to tone muscles and for leisure exercise. The subject was to do mostly cardio and to increase the time by 15 minutes per week. Subject was given a diary where she could not only write what exercises she did, the food she ate, but also how she felt each day. This could lead to good reflection on the progress she is making as well as unveiling the reasons why bad decisions were being made. Evaluation Plan The ways to evaluate the effectiveness was to see if the subject was falling within the caloric requirement per day, if exercises were being done, and if they were actually losing weight. Part of the evaluation was to also check for other signs such as increased energy and a better feeling about themselves. Usually when someone is feeling well they tend to make better decisions and vice versa. Our subject’s diary will come in handy here to help determine this part of the evaluation. If she was able to lose a maximum of 30 pounds in 15 weeks then she was on the right track. If she could keep up with the diet and exercise for the majority of the time then she was also on the right track. My subject managed to get use to the new diet and exercise by the 3rd week. It was difficult for her to keep up within the first two weeks due to the learning curve for a new habit. She had been so use to eating fast food and not exercising that she needed encouragement to exercise and reminder to prepare her lunches daily. My suggestion was that she prepared her meals on a Sunday and therefore was prepared for the rest of the week. She agreed and this seemed to work well by the 3rd week. By the 6th week she hit a plateau but she didn’t start to gain the weight, the weight loss was a bit slower. Summary and Conclusions My test subject is a 32 year old graduate student who normally ate fast food as often as possible and who did not exercise. The eating of the fast food was a bad decision that led to the gaining of excess pounds. Normally the older we get the more difficult it is to lose weight. The test subject made it hard on herself to lose weight because of the bad habits that she developed. Also lack of exercise and activity helped her gain weight and to keep gaining weight. An exercise regime was given to her as well as a dietary plan to follow. In the beginning the subject had a hard time adjusting to these new habits. It was touch and go at first for a while but she did get use to dieting and exercise. Unfortunately throughout the process she didn’t lose all the weight that was intended but she was on a good road to losing it all. She had lost half of what we wanted. I did not see too many things I would have done differently except to have her do more variety of exercises other than just cardio. Doing other exercises may have burned more calories therefore leading her to losing more weight. Also introduction of some stress relieving foods and exercises might have also played a role. Although conventional methods were used it might be a good idea to look into some unconventional methods of weight loss. Some areas of the body seem to have a harder time losing weight than others such as the stomach. There could have been some methods used to make sure that the entire body was being exercised and not just pinpointing certain areas. This might have provided better results as well. Some questions I still have about Health Behavior Change Process are: How would this method have been used for various addictions such as drugs or alcohol? How could this method be used in business? Can this method be adapted to any situation? What are the pros and cons of using this method in weight loss? Have there ever been any relapses with this method and if so, how severe? How has this method failed in the past? How can this method be improved? What are the other alternatives? Is this method considered conventional or non conventional? What method do the experts prefer? How would my results have changed if I had used a different method? I think if given more time the subject would be able to achieve her goals. The main thing is that she will need continued encouragement especially since it is hard to lose weight without a support system. If she receives the support she needs, then it should not be too hard for her to continue on the rest of the way. Bibliography About Us. (2010). Retrieved May 5, 2011, from Pro Change Behavorial Systems: http://www.prochange.com/ttm Bright, P. (2011, February 14). How Many Calories Does Walking Burn? Retrieved May 5, 2011, from eHow.com: http://www.ehow.com/how-does_4569224_many-calories-walking-burn_.html Los Angeles County. (2005). Health Assessment. Retrieved May 5, 2011, from lacounty.gov: http://publichealth.lacounty.gov/ha/LACHSBackMeth2005.htm McDonald's. (2011). McDonald's USA Nutrition Facts for Popular Menu Items. Retrieved May 5, 2011, from McDonald's.com: http://nutrition.mcdonalds.com/nutritionexchange/nutritionfacts.pdf NACDD. (2011). Definition of Health Disparities. Retrieved May 5, 2011, from National Association of Chronic Disease Disparities: http://www.diseasechronic.org/i4a/pages/index.cfm?pageid=3447 Thurauf, J. (1984). Individual health-damaging behavior--extent and importance. Retrieved May 5, 2011, from PubMed.gov: http://www.ncbi.nlm.nih.gov/pubmed/6720140 What It Takes to Lose a Pound. (2010). Retrieved May 5, 2011, from Caloriesperhour.com: http://www.caloriesperhour.com/tutorial_pound.php Read More