Read Chapter 10 in Health: The Basics - Managing Your Weight.

10
Managing Your Weight
FINDING A HEALTHY BALANCE
What are the health risks of being overweight?
How can I tell if I have too much body fat?
Is there a best diet plan for losing weight?
How can I help a friend who has an eating disorder?
OBJECTIVES
■ Define obesity, describe the current epidemic of obesity in the
United States, and understand risk factors associated with obesity.
■ Explain why so many people are obsessed with thinness.
■ Discuss reliable options for determining body fat content and the
right weight for you.
■ Describe factors that place people at risk for problems with obesity.
Distinguish factors that can and cannot be controlled.
■ Discuss the roles of exercise, dieting, nutrition, lifestyle modification,
fad diets, and other strategies of weight control, and evaluate which
methods are most effective.
■ Describe major eating disorders, explain their health risks, and
indicate the factors that make people susceptible to them.
ISBN: 0-558-34154-3
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

10–14%
20–24%
30%
15–19%
25–29%
Over the past 20 years,the United States has
become known as one of the fattest nations
on earth. From young children to seniors,
virtually no segment of the populace is
1996
immune to the epidemic of overweight and
obesity (Figure 10.1). Just how serious is
the problem?
According to a national survey of health behaviors and
nutrition, 66 percent of American adults are considered
overweight or obese, with obesity rates alone in excess of
32 percent.1 Even more alarming is the rapid rise in over-
weight and obesity among U.S. children; it is estimated that
over 17 percent of all youth are overweight, and there is a
clear trend of young people becoming obese with increasing
age.2 Obesity rates have been rising dramatically in nearly
every state. In a recent report, Mississippi ranked as the
2005
heaviest state, and Colorado ranked as the least heavy state.
Experts predict that at the current pace, 50 percent of
Americans will be obese by the year 2025.3
What does all of this excess weight mean to the health of
our population? Recent studies indicate that obesity is one
of the top underlying preventable causes
What are
of death in the United States. Obesity and
the health
inactivity increase the risks from three of
risks of
our leading killers: heart disease, cancer,
being
and cerebrovascular ailments, including
overweight?
strokes.4 Other associated health risks of
obesity include diabetes, gallstones, sleep
apnea, osteoarthritis, and several cancers (Table 10.1). Some
FIGURE 10.1 Obesity Trends Among U.S. Adults,
experts predict that the number of Americans diagnosed with
1996 and 2005
diabetes, a major obesity-associated problem, will increase
This map indicates the percentage of population in each state that
by a whopping 165 percent, from 15 million in 2005 to well
is considered obese, based on a BMI of 30 or higher, or about
over 30 million in 2030.5 It is noteworthy that other nations,
30 pounds overweight for a person 5 feet, 4 inches tall.
such as Canada, have already seen a rise of 69 percent in
Source: Centers for Disease Control and Prevention, “U.S. Obesity Trends:
diabetes rates in just the last decade, indicating that global
1985–2005,” 2007, www.cdc.gov/nccdphp/dnpa/obesity/trend.
rates may well exceed even the most dire predictions for
the next 20 to 30 years.6
Short- and long-term health consequences of obesity
Determining the Right
are not our only concern: the estimated annual cost of
obesity in the United States exceeds $152 billion in
Weight for You
medical expenses and lost productivity.7 Of course, it is
impossible to place a dollar value on a life lost prematurely
What weight is right for you? This depends on a wide
due to diabetes, stroke, or heart attack or to assess the cost
range of variables, including your body structure, height,
of social isolation and discrimination against overweight
weight distribution, and the ratio of fat to lean tissue. In
individuals. Of growing importance is the recognition that
fact, weight can be a deceptive indicator. Many extremely
obese individuals suffer significant disability during their
muscular athletes would be considered overweight based
lives, in terms of both mobility and activities of daily
on traditional height–weight charts. Many young women
living.
think that they are the right weight based on charts but are
This chapter will help you understand why we have such
shocked to discover that 35 to 40 percent of their weight
a weight problem in America today and provide simple strate-
is body fat!
gies to help you manage your own weight. (See the Assess
In general, weights at the lower end of the range on these
Yourself box on page 294 to obtain a better understanding of
charts are recommended for individuals with a low ratio of
your own dietary habits.) It will also help you understand
muscle and bone to fat; those at the upper end are advised for
what underweight, normal weight, overweight, and obesity
people with more muscular builds (Table 10.2). However,
ISBN: 0-558-34154-3
really mean and why managing your weight is essential to
because actual body composition is hard to determine, most
overall health and well-being.
charts give a general range.
288 PART FOUR Building Healthy Lifestyles
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

TABLE 10.1
Selected Health Consequences of Overweight and Obesity
Premature Death
Cancer
■ Obese individuals have a 50–100% increased risk of death
■ Overweight and obesity are associated with increased risk of
from all causes compared with people of normal weight.
endometrial, colon, gallbladder, prostate, kidney, uterine, and
Among 25- to 35-year-olds, severe obesity increases the risk
postmenopausal breast cancer.
of death by a factor of 12.
■ Women gaining more than 20 pounds between age 18 and
■ At least 300,000 deaths per year may be attributable to obesity.
midlife double their risk of postmenopausal breast cancer
■ The risk of death rises with increasing weight.
compared with women whose weight remains stable.
■ Even moderate excess weight (10–20 pounds for a person of
Additional Health Consequences
average height) increases risk of death.
■ Sleep apnea and asthma are both associated with obesity.
Cardiovascular Disease
■ For every 2-pound increase in weight, the risk of developing
■ High blood pressure is twice as common in obese adults as it is
arthritis increases by 9–13%.
in those who are at healthy weights.
■ Obesity related complications during pregnancy include increased
■ Incidence of all forms of heart disease is increased among
risk of fetal and maternal death, labor and delivery complications,
overweight and obese people.
and increased risk of birth defects.
■ Obesity is associated with elevated triglycerides and decreased
■ Increased risk of osteoarthritis, especially in weight-bearing joints
HDLs (“good” cholesterol).
such as knees and hips.
Diabetes
■ A weight gain of 11–18 pounds increases a person’s risk of
developing type 2 diabetes to twice that of individuals who
have not gained weight.
■ More than 80% of people with diabetes are overweight or obese.
Sources: Mayo Clinic, “Obesity Consequences,” 2006, www.mayoclinic.com; National Institutes of Health, “Summary of Obesity,” 2005; S. J. Olshansky
et al., “A Potential Decline in Life Expectancy in the U.S. in the 21st Century,” New England Journal of Medicine 352 (2005): 1103–10.
Overweight or Obese?
Obesity is defined as an excessively high amount of body
fat (adipose tissue) in relation to lean body mass or a BMI of
Most of us cringe at the thought of being labeled as one of
30 or more. In determining obesity, it is important to consider
the “O” words. What is the distinction between the two?
both the distribution of fat throughout the body and the size of
Overweight refers to increased body weight in relation to
the adipose tissue deposits. Body fat distribution can be esti-
height when compared to a standard such as the height–
mated in a variety of ways, as will be discussed shortly. By
weight charts in Table 10.2. The excess weight may come
traditional standards, people 20 to 40 percent above their ideal
from muscle, bone, fat, and/or water. Historically, health
weight are labeled as mildly obese (90 percent of the obese
experts have defined overweight as being 1 to 19 percent
fall into this category). Those 41 to 99 percent above their
above one’s ideal weight and obese as over 19 percent.
ideal weight are described as moderately obese (about 7 to
Another measurement of overweight and obesity is a
8 percent of the obese fit into this category), and increasing
mathematical formula known as body mass index (BMI),
numbers of people are in the severely, morbidly, or grossly
which represents weight levels associated with the lowest
obese category, meaning that they are 100 percent or more
overall risk to health (see page 291 to calculate your BMI).
above their ideal weight (with a BMI greater than 40). Nearly
Desirable BMI levels may vary with age.8 About 34 percent
3 percent of obese men and almost 7 percent of obese women
of all Americans are classified as being overweight using
are in this category.10 In the last decade, more and more
BMI calculations.
A person may be classified as overweight using these stan-
dards even if the weight gain is due to an increase in lean
muscle mass. For example, an athlete may be very lean and
overweight Increased body weight in relation to height.
muscular, with very little body fat, yet she may weigh a lot
more than others of the same height who have little muscle
body mass index (BMI) A technique of weight assessment
tissue. Conversely, a person may proudly proclaim that he
based on the relationship of weight to height.
weighs the same that he did in high school but have a much
obesity A weight disorder characterized by an accumulation
greater proportion of body fat, particularly in the hips, but-
of fat beyond that considered normal for a person based on
tocks, or thighs, than he did at a younger age. Therefore,
age, sex, and body type. Obesity is generally defined as a
BMI is a useful guideline, but by itself it is not diagnostic
body mass index of 30 or more.
of a person’s overall fitness and health status.9
ISBN: 0-558-34154-3
CHAPTER 10
Managing Your Weight
289
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

TABLE 10.2
Healthy Weight Ranges*
Height without Shoes
Weight† without Clothes
4 10
91–119
4 11
94–124
5 0
97–128
5 1
101–132
5 2
104–137
5 3
107–141
5 4
111–146
5 5
114–150
5 6
118–155
5 7
121–160
5 8
125–164
5 9
129–169
5 10
132–174
5 11
136–179
6 0
140–184
6 1
144–189
6 2
148–195
6 3
152–200
6 4
156–205
6 5
160–211
Obesity is increasing especially dramatically among children. Being
6 6
164–216
overweight or obese from an early age can have devastating physical
and emotional consequences.
*Each data entry applies to both men and women.
†In pounds
Source: Center for Nutrition Policy and Promotion, “Dietary Guidelines
people have reached the moderate and severe levels of obesity,
for Americans, 2005,” www.cnpp.usda.gov/DietaryGuidelines.htm.
meaning increased risks at all ages and stages of their lives.11
The difficulty with defining obesity lies in determining
what is normal. To date, there are no universally accepted
fat percentages of 8 to 13 percent, nearly all of which is
standards for the most “desirable” or “ideal” body weight or
essential fat.
body composition (the ratio of lean body mass to fat body
mass). Although sources vary slightly, most agree that men’s
Too Little Fat?
bodies should contain between 11 and 15 percent total body
fat and that women should be within the range of 18 to
A certain amount of body fat is necessary for insulating the
22 percent body fat. At various ages and stages of life, these
body, cushioning parts of the body and vital organs, and
ranges also vary, but generally, men who exceed 20 percent
maintaining body functions. In men, this lower limit is
body fat and women who exceed 30 percent body fat have
approximately 3 to 4 percent. Women generally should not
slipped into obesity.
go below 8 percent. Excessively low body fat in females may
Lean body mass consists of the structural and functional
lead to amenorrhea, a disruption of the normal menstrual
elements in cells, body water, muscle, bones, and other body
cycle. The critical level of body fat necessary to maintain
organs such as the heart, liver, and kidneys. Body fat is
normal menstrual flow is believed to be 8 to 13 percent, but
composed of two types: essential and storage fat. Essential
many additional factors can affect the menstrual cycle. Under
fat is necessary for normal physiological functioning, such
extreme circumstances, such as starvation diets and certain
as nerve conduction. Essential fat makes up approximately
diseases, the body uses all available fat reserves and begins
3 to 7 percent of total body weight in men and approximately
to break down muscle tissue as a last-ditch effort to obtain
15 percent of total body weight in women. Storage fat, the
nourishment.
part that many of us try to shed, makes up the remainder of
The fact is that too much fat and too little fat are both
our fat reserves. It accounts for only a small percentage of
potentially harmful. The key is to find a healthy level at
ISBN: 0-558-34154-3
total body weight for very lean people, and 5 to 25 percent of
which you are comfortable with your appearance and your
body weight of most American adults. Female bodybuilders,
ability to be as active as possible. Many options are available
who are among the leanest of female athletes, may have body
for determining your body fat and weight.
290 PART FOUR Building Healthy Lifestyles
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

BMI
Height*
18.5
25
30
6' 6"
6' 5"
6' 4"
FIGURE 10.2 Body Mass Index: Are You
6' 3"
at a Healthy Weight?
6' 2"
6' 1"
Source: National Heart, Lung, and Blood Institute,
6' 0"
2007.
5' 11"
5' 10"
5' 9"
5' 8"
5' 7"
5' 6"
5' 5"
5' 4"
5' 3"
5' 2"
5' 1"
5' 0"
4' 11"
4' 10"
50
75
100
125
150
175
200
225
250
275
Pounds†
Healthy Weight
Overweight
Obesity
* Without shoes.
† Without clothes.
Directions: Find your weight on the bottom of the graph. Go straight up from that point
until you come to the line that matches your height. Then look to find your weight group.
➢ BMI of 25 defines the upper boundary of healthy weight
➢ BMI of higher than 25 to 30 defines overweight
➢ BMI of higher than 30 defines obesity
Assessing Fat Levels
and Blood Institute (NHLBI) website at www.nhlbisupport
.com/bmi.
Healthy weights are defined as those associated with
Today, most weight-control authorities believe that looking at
BMIs of 18.5 to 25, the range of lowest statistical health
where you fall on some arbitrary chart may not be helpful.
risk.13 The desirable range for women falls between 21
Height–weight charts may lead some
and 23; for men, between 22 and 24.14 A BMI greater than
How can
people to think they are overweight when
25 indicates overweight and potentially significant health
I tell if
they are not and others to think that they
risks. A body mass index of 30 or more is considered
I have too
are okay when, in fact, they may be at
obese.15 Table 10.3 summarizes the various weight
much
risk. Other measures exist for calculating
classifications, their health risks, and the BMI and waist
body fat?
body content, and some provide a very
measurements associated with them.
precise calculation of body fat. They
Calculating BMI is simple, quick, and inexpensive—but
include body mass index, waist circumference, waist-to-hip
it does have limitations. One problem is that very muscular
ratio, and various measures of body fat.
people may fall into the overweight category when they are
actually healthy and fit. In addition, certain population
Body Mass Index
groups, such as Asians, tend to have higher-than-healthy
body fat at normal BMI levels, whereas other groups, such
A useful index of the relationship of height and weight, BMI
as Polynesians, have somewhat lower body fat than other
is a standard measurement used by obesity researchers and
populations at the same BMI.16
health professionals. It is not gender specific. Although it
These standards may seem almost impossible for people
does not directly measure percentage of body fat, it does pro-
who consistently exceed the target weights and who have
vide a more accurate measure of overweight and obesity than
difficulty keeping off any lost weight. Constant failure may
weight alone.12
lead them to stop trying. The secret lies in establishing a
We find BMI by dividing a person’s weight in kilograms
healthful weight at a young age and maintaining it—a task
by height in meters squared. The mathematical formula is
easier said than done. The U.S. Dietary Guidelines for
BMI
weight (kg)
height squared (m2)
Americans encourage a weight gain of no more than ten
pounds after reaching adult height and endorse small
To determine BMI using pounds and inches, see (Figure 10.2).
weight losses of one-half to one pound per week, if needed,
The BMI calculator also is available at the National Heart, Lung,
ISBN: 0-558-34154-3
CHAPTER 10
Managing Your Weight
291
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

TABLE 10.3
Classification of Overweight and Obesity by BMI and Waist Circumference,
and Associated Disease Risks
Disease Risk* Relative to Normal
Weight and Waist Circumference
Men: 102 cm (40 in.) or less
Men: 7 102 cm (40 in.)
BMI (kg/m2)
Obesity Class
Women: 88 cm (35 in.) or less
Women: 7 88 cm (35 in.)
Underweight
6 18.5
-
-
Normal
18.5–24.9
-
-
Overweight
25.0–29.9
Increased
High
Obesity
30.0–34.9
I
High
Very high
35.0–39.9
II
Very high
Very high
Extreme Obesity
40.0†
III
Extremely high
Extremely high
*Disease risk for type 2 diabetes, hypertension, and cardiovascular disease (CVD).
†Increased waist circumference can also be a marker for increased risk even in persons of normal weight.
Source: National Heart, Lung, and Blood Institute, 2007.
as well as smaller weight losses of 5 to 10 percent to make
The waist-to-hip ratio measures regional fat distribution.
a difference toward health.17
A waist-to-hip ratio greater than 1.0 in men and 0.8 in women
indicates increased health risks.19 Therefore, knowing where
Waist Circumference
your fat is carried may be more important than knowing your
total fat content. Men and postmenopausal women tend to
and Ratio Measurements
store fat in the upper regions of their body, particularly in the
abdominal area. Premenopausal women usually store their fat
Waist circumference measurement is a useful tool for
in lower regions of their bodies, particularly the hips, buttocks,
assessing abdominal fat. Research indicates that a waistline
and thighs.
greater than 40 inches (102 cm) in men and 35 inches (88 cm)
in women may indicate greater health risk. If a person is under
5 feet tall or has a BMI of 35 or above, waist circumference
Measures of Body Fat
standards used for the general population might not apply.18
Hydrostatic Weighing Techniques From a clini-
Measure waist circumference by wrapping a tape measure
cal perspective, hydrostatic weighing techniques offer the
comfortably around the smallest area below the rib cage and
most accurate method of measuring body fat. This method
above the belly button.
measures the amount of water a person displaces when
completely submerged. Because fat tissue is less dense than
muscle or bone tissue, a relatively accurate indication of
actual body fat can be computed by comparing underwater
waist circumference measurement Assessment of
and out-of-water weights.
healthy body fat by measurement of the circumference of
the waist.
Pinch and Skinfold Measures The most accurate
waist-to-hip ratio Ratio that indicates increased risks due
method of measuring body fat using the skinfold measurement
to unhealthy fat distribution.
technique is the skinfold caliper technique. A specially cali-
hydrostatic weighing techniques Method of determining
brated instrument called a skinfold caliper is used to measure
body fat by measuring the amount of water displaced when
the fat layer. In making this assessment, a technician pinches a
a person is completely submerged.
fold of skin on a predetermined body location, such as the
triceps area or waist, with the calipers. Special formulas are
skinfold caliper technique A method of determining
employed to arrive at a combined prediction of total body fat.
body fat whereby folds of skin and fat at various points on
the body are grasped between thumb and forefinger and
Dual Energy X-Ray Absorptiometry One of
measured with calipers.
the newer technologies available for assessing body fat,
dual energy X-ray absorptiometry (DEXA) Technique
dual energy X-ray absorptiometry (DEXA) is also among
ISBN: 0-558-34154-3
using low-dose X rays that read bone and soft tissue mass at
the most accurate and precise. Essentially, DEXA is a
the same time.
whole-body scanning technique involving two low-dose
292 PART FOUR Building Healthy Lifestyles
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

X rays that read bone and soft tissue mass at the same time.
DEXA is more precise than other methods and is relatively
easy for anyone to have done. The downside is that it isn’t
as accurate for extremely obese individuals, and it is
expensive because of the high cost of the machines. Many
universities have DEXA machines in their exercise
physiology or biomechanics labs.
Near-Infrared Interactance Another newer tech-
nique is near-infrared interactance (NIR), in which a
fiberoptic probe is connected to a digital analyzer that indi-
rectly measures tissue composition (both fat and water).
Usually, the biceps are used to assess fatness; once measures
are taken, an equation that includes your height, weight,
frame size, and level of activity is used to calculate body
fat. It is relatively inexpensive and fast, but it is not nearly
as accurate as the other methods described above. Very fat
and very lean, muscular people are likely to have inaccurate
measures.
The Bod Pod is a new fat assessment machine with a chamber in
which a person sits, and the air displaced by the body is measured
Magnetic Resonance Imaging Magnetic reso-
to determine body fat.
nance imaging (MRI) uses magnetic fields to assess how
much fat a person has and where it is deposited. Generally
MRIs are not performed solely for the purpose of measuring
Risk Factors for Obesity
body fat; however, if you were having a full body MRI for
diagnosis of other illnesses, it is possible that you could ask
In spite of efforts to keep Americans fit and in good health,
the technician to determine your body fat.
obesity is the most common nutritional disorder in the United
States, with rates that have increased dramatically among
The Bod Pod and Pea Pod The Bod Pod (for
children and adults in recent decades.20 The prevalence of
adults) and Pea Pod (for children) are relative newcomers on
obesity and overweight is generally higher among minorities,
the body fat assessment scene. Both are egg-shaped cham-
especially minority women.21
bers. The person sits inside, and then the pod is closed with a
In a major report, the U.S. Surgeon General stated it quite
tight seal, so that the machine can measure the amount of air
plainly: overweight and obesity result from an energy imbal-
the body displaces. Bod Pods use this air displacement mea-
ance. This means eating too many calories and not getting
sure, along with body weight, to assess overall body fat.
enough exercise.22 However, many have criticized such a
simplistic view. If it were that simple, Americans would
Bioelectrical Impedance Analysis Essentially,
merely reevaluate their diets, reduce the amount they eat, and
bioelectrical impedance analysis (BIA) measures how lean
exercise more.
you are, rather than how fat you are, yet the net results are
What are some of these factors that influence our collective
just as informative. This is the only method based on mea-
trend toward overweight and obesity? We know that body
suring electrical signals as they pass through fat, lean mass,
and water in the body, rather than estimating fat from other
(Text continues on page 298.)
measures. BIA reliability is related to the sophistication of
the machine doing the testing and the knowledge of the
near-infrared interactance (NIR) Fiberoptic measure-
technician.
ment of tissue composition.
Total Body Electrical Conductivity
magnetic resonance imaging (MRI) Diagnostic
Much like
technique using magnetic fields, which can be used to
an MRI, total body electrical conductivity (TOBEC) uses
measure body fat.
an electromagnetic force field to assess relative body fat. Also
like MRI, it requires elaborate, expensive equipment and
Bod Pod/Pea Pod A body fat assessment tool that
therefore is not practical for most people.
measures the air your body displaces in a sealed chamber.
Although all of these methods can be useful, they also can
bioelectrical impedance analysis (BIA) A technique of
be inaccurate and even harmful unless the testers are skillful
body fat assessment in which electrical currents are passed
and well trained. Before undergoing any procedure, make
through fat and lean tissue.
sure you understand the expense, potential for accuracy, risks,
total body electrical conductivity (TOBEC) Technique
and training of the tester.
using an electromagnetic force field to assess relative body fat.
ISBN: 0-558-34154-3
CHAPTER 10
Managing Your Weight
293
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

ASSESS yourself
READINESS FOR WEIGHT LOSS
Fill out this assessment online at
www.aw-bc.com/myhealthlab
or www.aw-bc.com/donatelle.
How well do your attitudes equip you for a weight-loss program? For each question,
circle the answer that best describes your attitude. As you complete each
section, tally your score, and analyze it according to the scoring guide.
I. GOALS, ATTITUDES, AND READINESS
1. Compared to previous attempts, how motivated are you to lose weight this time?
1
2
3
4
5
Not at all motivated
Slightly motivated
Somewhat motivated
Quite motivated
Extremely motivated
2. How certain are you that you will stay committed to a weight-loss program for the time it will take to reach your goal?
1
2
3
4
5
Not at all certain
Slightly certain
Somewhat certain
Quite certain
Extremely certain
3. Considering all outside factors at this time in your life—stress at work, family obligations, and so on—to what extent can you
tolerate the effort required to stick to a diet?
1
2
3
4
5
Cannot tolerate
Can tolerate somewhat
Uncertain
Can tolerate well
Can tolerate easily
4. Think honestly about how much weight you hope to lose and how quickly you hope to lose it. Figuring a weight loss of
1 to 2 pounds per week, how realistic is your expectation?
1
2
3
4
5
Very unrealistic
Somewhat unrealistic
Moderately unrealistic
Somewhat realistic
Very realistic
5. While dieting, do you fantasize about eating a lot of your favorite foods?
1
2
3
4
5
Always
Frequently
Occasionally
Rarely
Never
6. While dieting, do you feel deprived, angry, and/or upset?
1
2
3
4
5
Always
Frequently
Occasionally
Rarely
Never
Analyzing This Section
6 to 16: This may not be a good time for you to start a diet.
17 to 23: You may be close to being ready to begin a
Inadequate motivation and commitment and unrealistic goals
program but should think about ways to boost your
could block your progress. Think about what contributes to
readiness.
your unreadiness, and consider changing these factors before
24 to 30: The path is clear: you can decide how to lose
undertaking a diet.
weight in a safe, effective way.
II. HUNGER AND EATING CUES
7. When food comes up in conversation or in something you read, do you want to eat, even if you are not hungry?
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
8. How often do you eat for a reason other than physical hunger?
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
9. Do you have trouble controlling your eating when your favorite foods are around the house?
ISBN: 0-558-34154-3
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
294 PART FOUR Building Healthy Lifestyles
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

Analyzing This Section
3 to 6: You might occasionally eat more than you should, but
you if you try to resist external cues and eat only when you
apparently not because you are highly responsive to environ-
are physically hungry.
mental cues. Controlling the attitudes that make you eat may
10 to 15: Some or much of your eating may be in response
be especially helpful.
to thinking about food or exposing yourself to temptations to
7 to 9: You may have a moderate tendency to eat just
eat. Think of ways to minimize your exposure to temptations
because food is available. Losing weight may be easier for
so you eat only in response to physical hunger.
III. CONTROLLING OVEREATING
If the following situations occurred while you were on a diet, would you be likely to
eat more or less immediately afterward and for the rest of the day?
10. Although you planned to skip lunch, a friend talks you into going out for a midday meal.
1
2
3
4
5
Would eat
Would eat
Would make
Would eat
Would eat
much less
somewhat less
no difference
somewhat more
much more
11. You “break” your plan by eating a fattening, “forbidden” food.
1
2
3
4
5
Would eat
Would eat
Would make
Would eat
Would eat
much less
somewhat less
no difference
somewhat more
much more
12. You have been following your diet faithfully and decide to test yourself by eating something you consider a treat.
1
2
3
4
5
Would eat
Would eat
Would make
Would eat
Would eat
much less
somewhat less
no difference
somewhat more
much more
Analyzing This Section
3 to 7: You recover rapidly from mistakes. However, if you
8 to 11: You do not seem to let unplanned eating disrupt your
frequently alternate between eating that is out of control and
program. This is a flexible, balanced approach.
dieting very strictly, you may have a serious eating problem
12 to 15: You may be prone to overeat after an event breaks
and should get professional help.
your control or throws you off the track. Your reaction to
these problem-causing events can be improved.
IV. BINGE EATING AND PURGING
13. Aside from holiday feasts, have you ever eaten a large amount of food rapidly and felt afterward that this eating incident
was excessive and out of control?
2
0
Yes
No
14. If you answered yes to question 13, how often have you engaged in this behavior during the past year?
1
2
3
4
5
6
Less than once
About once
A few times
About once
About 3 times
Daily
a month
a month
a month
a week
a week
15. Have you purged (used laxatives or diuretics, or induced vomiting) to control your weight?
5
0
Yes
No
16. If you answered yes to question 15, how often have you engaged in this behavior during the past year?
1
2
3
4
5
6
Less than once
About once
A few times
About once
About 3 times
Daily
a month
a month
a month
a week
a week
(continued)
ISBN: 0-558-34154-3
CHAPTER 10
Managing Your Weight
295
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---

ASSESS yourself
READINESS FOR WEIGHT LOSS (continued)
Analyzing This Section
0: It appears that binge eating and purging are not problems
12 to 19: You show signs of having a potentially serious
for you.
eating problem. See a counselor experienced in evaluating
eating disorders right away.
2 to 11: Pay attention to these eating patterns. Should they
arise more frequently, get professional help.
V. EMOTIONAL EATING
17. Do you eat more than you would like to when you have negative feelings such as anxiety, depression, anger, or loneliness?
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
18. Do you have trouble controlling your eating when you have positive feelings—do you celebrate feeling good by eating?
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
19. When you have unpleasant interactions with others in your life or after a difficult day at work, do you eat more than you’d like?
1
2
3
4
5
Never
Rarely
Occasionally
Frequently
Always
Analyzing This Section
3 to 8: You do not appear to let your emotions affect your
12 to 15: Emotional ups and downs can stimulate your eating.
eating.
Try to deal with the feelings that trigger the eating and find
other ways to express them.
9 to 11: You sometimes eat in response to emotional highs
and lows. Monitor this behavior to learn when and why it
occurs, and be prepared to find alternate activities.
VI. EXERCISE PATTERNS AND ATTITUDES
20. How often do you exercise?
1
2
3
4
5
Never
Rarely
Occasionally
Somewhat Frequently
frequently
21. How confident are you that you can exercise regularly?
1
2
3
4
5
Not at all
Slightly
Somewhat
Highly
Completely
confident
confident
confident
confident
confident
22. When you think about exercise, do you develop a positive or negative picture in your mind?
1
2
3
4
5
Completely
Somewhat
Neutral
Somewhat
Completely
negative
negative
positive
positive
23. How certain are you that you can work regular exercise into your daily schedule?
1
2
3
4
5
ISBN: 0-558-34154-3
Not at all
Slightly
Somewhat
Quite
Extremely
certain
certain
certain
certain
certain
296 PART FOUR Building Healthy Lifestyles
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

---