DIMENSIONS: Well Body Program. Fundamentals

Transcription

1 DIMENSIONS: Well Body Program Fundamentals

2 DIMENSIONS: Well Body Program Introduction Program Overview

3 Our Wellness Philosophy Leading a meaningful and fulfilling life through conscious and self-directed behaviors, focused upon living at one s fullest potential.

4 Eight Dimensions of Wellness Emotional Environmental Financial Intellectual Occupational Physical Social Spiritual

5 What is a Well Body? A Well Body is different for different people This program is designed to assist individuals to envision and actualize their unique definition of what a Well Body is to them The focus of this program is movement towards positive health behavior changes based on individual goals Weight Issues refers to obesity, overweight and underweight

6 Why this is important to you The physical and emotional health of an entire generation and the economic health and security of our nation is at stake. This isn't the kind of problem that can be solved overnight, but with everyone working together, it can be solved. So, let's move. First Lady Michelle Obama

7 DIMENSIONS: Well Body Program Discussion

8 DIMENSIONS: Well Body Program Module 1: Weight Issues in People with Behavioral Health Conditions

9 What is a Healthy Weight? Varies by height and muscle/fat mass Estimate using the Body Mass Index (BMI): Underweight Healthy Weight Overweight Obese BMI does not measure how much lean mass or fat mass is present Percent body fat is an alternative way to assess weight

10 Impact of Being Underweight on Health People who are underweight are at increased risk for: Premature death Osteoporosis Poor immune function Infertility (women) Malnutrition and associated disorders

11 Impact of Overweight and Obesity Overweight and obesity are connected to an increase in many health risks, including: Heart disease High blood pressure Type 2 Diabetes Stroke Respiratory illnesses Osteoarthritis Cancer

12 Impact of Overweight and Obesity 10 leading causes of death in U.S. 1) Heart disease * 2) Cancer * 3) Chronic lower respiratory diseases * 4) Stroke * 5) Accidents 6) Alzheimer s disease 7) Diabetes * 8) Kidney disease * 9) Influenza and Pneumonia 10) Suicide* Obesity can increase risk of at least 6 of the 10 leading causes of death in the United States

13 Behavioral Causes of Death in U.S. 500, , , , , , , , ,000 50, ,300 25,700 31,700 16,300 33,700 43,000 38, , ,000

14 The Burden of Obesity Both underweight and overweight have significant health risks, but overweight and obesity are much more common in the U.S. Approximately 68% of adults in the United States are either overweight or obese. Approximately 17% of youth are obese. Rates of obesity are rising rapidly. Over the past three decades, the percentage of persons who are overweight or obese has increased by approximately 40%.

15 U.S. Obesity Trends

16 U.S. Obesity Trends

17 U.S. Obesity Trends

18 U.S. Obesity Trends

19 U.S. Obesity Trends

20 Prevalence of Obesity Rates in People with Behavioral Health Conditions % % 28% Behavioral Health Conditions General Population 20 18% 10 0 Men Women

21 Prevalence of Obesity Rates in People with Behavioral Health Conditions x x 1.5x 2x Likelihood of Obesity 0 General population Depression Bipolar Disorder Schizophrenia The likelihood of a person being overweight or obese varies by diagnosis The difference of increased likelihood between diagnoses are due to many factors

22 Obesity Rates by Age and Gender Obesity rate (percent) Men Women

23 Obesity Rates by Socio-economic Status The impact of socio-economic status (SES), including factors such as family income and education, on obesity rates remains unclear Some research suggests that obesity rates vary by household income and education However other studies do not find this trend The high rates of obesity across the nation suggest that obesity affects all socio-economic groups

24 Obesity Rates and Ethnicity Rates of obesity are high across all ethnic groups. However, obesity is more prevalent among certain racial/ ethnic groups. Reasons include: Groups differ in health-related behaviors such as diet or physical activity Groups differ in attitudes and cultural norms around body weight Groups differ in access to healthy foods and safe places to exercise

25 Obesity Rates and Ethnicity % 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 35.7% 23.7% 28.7% White, Non-Hispanic Black, Non-Hispanic Hispanic

26 Obesity Rates and People with Medical Conditions Some medical conditions can slow metabolism or affect hormone balance Hypothyroidism Cushing s syndrome Conditions that reduce movement or physical activity can also contribute to weight gain Arthritis Conditions that cause chronic pain Disabilities that limit mobility

27 Desire to Lose Weight Many individuals who are overweight or obese want to achieve a healthy weight People need to support each other in their efforts to reach a healthy weight

28 Contributing Factors To address weight issues we need to understand: Factors that contribute to or sustain obesity These factors are different for different people

29 Addressing Weight Issues Factors to Consider Biological Health conditions medications Behavioral Habits, emotions, decisions Environmental Social, physical and occupational environment Biomedical approaches Behavior change strategies Policy & practice change Services should address the biological, behavioral and environmental factors that affect weight

30 Genetic make-up Biological Factors Chronic health problems Medication side effects Increased appetite Sedation Effects on regulation of blood sugar Increased risk for metabolic syndrome

31 Hunger and satiety are affected by the types of foods eaten and meal frequency Biological Factors Natural preference for foods with high energy density, such as high fat and high sugar foods

32 Biological Factors Blood Sugar Levels min Hours Healthy Eating Insulin Resistence Type 2 Diabetes

33 Biological Factors Sleep is important to good health Sleep restriction can lead to: Changes in hormones that affect appetite Craving energy dense foods Daytime sleepiness Difficulty managing stress and other emotions throughout the day

34 Addressing Weight Issues Factors to Consider Biological Health conditions medications Behavioral Habits, emotions, decisions Environmental Social, physical and occupational environment Biomedical approaches Behavior change strategies Policy & practice change Services should address the biological, behavioral and environmental factors that affect weight

35 Behavioral Factors Habits, or routines, impact health behaviors like diet and physical activity When healthful behaviors require thought and self-discipline, they can be a challenge When healthful behaviors are part of normal daily routine, they are often easier to follow

36 Emotional Factors Connect certain foods, or types of food, to pleasant feelings, such as happiness Use of food to deal with negative emotions Boredom Stress Hopelessness Helplessness

37 Personal Factors Lack of recovery Boredom Knowledge

38 Financial Factors Cost of healthful food People with little time, energy and other resources are more likely to buy convenience foods Decisions based on financial resources

39 Addressing Weight Issues Factors to Consider Biological Health conditions medications Behavioral Habits, emotions, decisions Environmental Social, physical and occupational environment Biomedical approaches Behavior change strategies Policy & practice change Services should address the biological, behavioral and environmental factors that affect weight

40 Social Environment Cultural eating patterns/acceptance of obesity Family norms and learned behaviors Social Isolation Behavioral Settings Access to Quality Healthcare Care

41 Environmental Factors Ready access to fast food and empty calorie foods Environment encourages sedentary lifestyle Type and quality of food available in behavioral health settings

42 Occupational Factors Workplace stress Long work hours Busy schedules No lunch break Eating at desk Exhaustion Use sugar & caffeine to stay awake Travel schedule

43 Policy Environment Policies that affect how we eat Agricultural subsidies Subsidized crops such as corn, sugar, soy and wheat could increase consumption of fattening food if they lower food prices Mandatory nutrition labeling Labels may guide consumers towards more healthy food choices if consumers are motivated for health and use the labels

44 DIMENSIONS: Well Body Program Discussion

45 DIMENSIONS: Well Body Program Module 2: Weight Management Strategies

46 Diets vs. Your Healthy Eating Plan Diet Diets are temporary. Healthy weight management requires adopting healthy habits and living a healthy lifestyle.

47 Your Healthy Eating Plan Controls your hunger Is pleasing & satisfying to you Meets your body s need for energy & nutrients Minimizes your risk of chronic disease

48 Your Healthy Weight Depends on a number of factors, including: What you eat Your genes Your lifestyle Your culture

49 What You Eat Your Healthy Weight Calories Consumed Calories Expended Must equal your activity level to maintain your current weight

50 Your Healthy Weight Your genes contribute to your weight Predisposed to weight gain Fat storage around chest and waist

51 Your Healthy Weight Your Lifestyle The activities you perform daily, including physical activity, television watching, alcohol use, sleep duration, eating pattern, among others

52 Your Healthy Weight Your Culture Teaches you about What food means What to eat How much to eat

53 Recipe for Healthy Weight Management Know Your Body Mass Index (BMI) Calorie Balance Portion Control Physical Activity Stay Hydrated

54 Body Mass Index (BMI)

55 Calorie Balance Key to healthy weight management Obesity epidemic linked to calorie imbalance (calories consumed > calories burned) To lose weight reduce calories from food, increase physical activity To maintain healthy weight calories consumed must equal calories burned

56 Calorie Balance Sex and Age Not Physically Active* Physically Active** Females years old 2000 Total Calories Per Day Total Calories Per Day Males years old 2400 Total Calories Per Day Total Calories Per Day Females years old 1800 Total Calories Per Day Total Calories Per Day Males years old 2200 Total Calories Per Day Total Calories Per Day Females 51+ years old 1600 Total Calories Per Day Total Calories Per Day Males 51+ years old 2000 Total Calories Per Day Total Calories Per Day *These amounts are for people who get less than 30 minutes of moderate physical activity most days. **These amounts are for people who get at least 30 minutes (lower calorie level) to at least 60 minutes (higher calorie level) of moderate physical activity most days.

57 Calorie Balance Even small changes can have a big effect Number of 20- Ounce Sodas Consumed Calories Per Day Calories Per Week (7 days) Calories Per Month (30 days) Calories Per Year (365 days) ,750 7,500 91, ,500 15, , ,250 22, , ,000 30, , ,750 37, ,250 Reminder: A reduction of 3,500 calories in a week equals weight loss of one pound of body fat

58 Calorie Balance 1 cup Mint Chocolate Chip Ice Cream 320 Calories 20 Potato Chips 320 Calories Large Poppy Seed Muffin 670 Calories 1 box Kraft Macaroni & Cheese 1,230 Calories

59 Tips for Balancing Calories Eat more whole grains, vegetables, and fruits Reduce sugar consumption Eat lean protein Moderate fast foods Moderate alcoholic beverages

60 Tips for Portion Control Pay attention to serving size information on nutritional labels Eat half of the meal served to you in restaurants Use smaller plates to reduce portion size Serve your food from the kitchen rather than the dining table

61 Portion Control Deck of cards = one serving of meat, fish or poultry Golf ball = ¼ cup dried fruits or nuts Computer mouse = one serving of a baked potato 6 Dice = one serving of cheese

62 Physical Activity Adults should get at least 2.5 hours moderate to intense activity per week Important for healthy weight management Relieves stress, increases energy, improves sleep, mood, and memory Make it fun! There are a variety of ways to increase physical activity

63 Physical Activity Reduces risk of: Cardiovascular disease Hypertension Type 2 Diabetes Metabolic syndrome Some cancers Obesity

64 Calories Burned During Activities Activity Calories Burned (10 Min) Cleaning Walking (3.5 mph) Bicycling (5.5 mph) Playing basketball Jogging Swimming Cross-country Skiing

65 Staying Hydrated Our bodies are 70% water Important for our bodies to function normally Good hydration helps with: Digestion Transportation of nutrients Temperature regulation Extremely important when physically active Avoid sugary beverages with empty calories (fruit juice, soda)

66 Food Diaries Many people are not aware of what or how much they eat Tracking food on a log or diary helps to increase awareness of eating habits Many weight loss/ weight management programs recommend keeping a food diary

67 Food Diaries 9:30 Eggs, scrambled White toast, butter Coffee, cream and sugar 2 1 piece 2 cups 1:00 Soup, broccoli cheddar ½ Turkey sandwich (mayo and cheese) Potato chips 1.5 cups 1 bag 4:00 Popcorn 2 cups 7:30 Cheeseburger Fries Coke 1 Large 16 oz

68 Medical Treatments Prescription Weight Loss Drugs Fat absorption inhibitor Orlistat For use up to 2 years Average weight loss over one year is 6 pounds Appetite suppressants Phentermine, benzphetamine, diethylpropion, phendimetrazine For short term use only (weeks) Average weight loss over one year is 9 pounds Phentermine combined with Topiramate Generates a feeling of fullness, food tastes less appealing and increases calorie burning Designed for long-term use

69 Medical Treatments Surgical Interventions For people with BMI over 40 or BMI over 35 with co-occurring physical conditions Gastric Restriction Gastric Bypass Combination Procedures

70 Websites and Free Tools

71 DIMENSIONS: Well Body Toolkits for Healthcare Providers Toolkit.pdf Behavioral-Health.pdf

72 DIMENSIONS: Well Body Program Discussion

73 DIMENSIONS: Well Body Program Module 3: Motivational Intervention for Weight Management

74 Motivational Intervention 30-minute semi-structured interview Work with people to assess their readiness to start a weight management program Provide brief, personalized feedback to people about their Body Mass Index (BMI) Encourage individual to set concrete and manageable goals Discuss and list the supports they need to reach their Well Body goals

75 What if I meet people who are not Some people: ready to change? May feel unsure or hopeless about changing their health behaviors May have tried to manage their weight in the past and been unsuccessful May feel unsupported by people in their lives or stigmatized by their social networks

76 What if I meet people who are not ready to change? People may be able to: Read handouts you give them Keep track of their current food consumption Think about the benefits of weight management Describe their current eating patterns and physical activity level

77 What if I meet people who are not ready to change? People may be able to: Read handouts you give them Keep track of their current food consumption Think about the benefits of weight management Describe their current eating patterns and physical activity level Remind people: To keep an open mind You will not pressure them to change They can still benefit by learning more about healthy living There are other steps they can take that can be helpful

78 DIMENSIONS: Well Body Program Handout Well Body Motivational Intervention

79 Well Body Motivational Intervention

80 Well Body Motivational Intervention

81 Well Body Motivational Intervention

82 Well Body Motivational Intervention

83 Well Body Motivational Intervention

84 Well Body Motivational Intervention Role Play

85 DIMENSIONS: Well Body Program Discussion

86 DIMENSIONS: Well Body Program Next Steps

87 DIMENSIONS: Well Body Program An evidence-based nutrition and weight management program that promotes positive health behavior change The program supports health behavior change through motivational engagement strategies, group process, community referrals, and educational activities

88 Who can be Well Body Program Facilitators? The Well Body Program can be led by: Peer Advocates Persons who are trained and supervised to provide services for people with a similar history or background, for example, a history of a behavioral health condition, a university student, a co-worker or colleague, among others Providers Healthcare providers who have experience with training, facilitation, or direct healthcare services

89 Role of the Well Body Program Facilitators Raise awareness through center in-services, lunch and learns, and trainings Conduct individual motivational interventions Facilitate Well Body groups Make referrals to other healthcare providers and community cessation services Create a positive social network

90 Well Body Group Overview Weekly group, 60- to 90-minutes Participants can join at anytime Some information builds on previous sessions Participants may attend as many sessions as needed

91 Plan-Do-Study-Act Process Act Study Plan Do Three key questions: What are we trying to accomplish? How will we know a change is an improvement? What change can we make that will result in improvement?

92 Steps for PDSA Process Plan: Decide what change will be made, who will do it, and when it will be done Do: Carry out the change Study: Ensure that you leave time to reflect and use experience of change to discuss results Act: Based on what you learned, what will your next plan be? What will be different? Act Study Plan Do

93 Change Exercise

94 DIMENSIONS Action Plan

95 Behavioral Health & Wellness Program Behavioral Health and Wellness Program BHWP_UCD