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CNN Presents Classroom: Fat Chance

(CNN Student News) -- Set your VCR to record CNN Presents Classroom Edition: Fat Chance when it airs commercial-free on Monday, February 6, from 4:00am - 5:00am ET on CNN.

Program Overview

In Fat Chance, CNN Medical Correspondent Elizabeth Cohen examines the issue of obesity and finds that losing weight isn't the problem for many people. The problem lies in not regaining the lost weight. Cohen talks to two people, Karen Brown and Robert Romaniello, who were successful in losing weight and keeping it off, and reports on research that suggests genetics may play a role in predisposing people to be overweight.

Grade Level: 7-12, and college

Subject Areas: Health, Science

Objectives

The CNN Presents Classroom Edition: Fat Chance and its corresponding lessons challenge students to:

•Identify the differences between being overweight and being obese;

• Determine why obesity is considered a public health issue;

• Understand the possible causes of obesity;

• Explain the health consequences of being overweight and obese;

• Examine the impact of obesity on young people;

• Learn about different treatments for obesity.

Curriculum Connections

Health

Standard 1: Knows the availability and effective use of health services, products, and information

Level III Grade : 6-8

Benchmark 2: Knows how to locate and use community health information, products, and services that provide valid health information

Level IV Grade : 9-12

Benchmark 2: Knows how to determine whether various resources from home, school, and the community present valid health information, products, and services

Standard 2: Knows environmental and external factors that affect individual and community health

Level III Grade : 6-8

Benchmark 2: Understands how various messages from the media, technology, and other sources impact health practices (e.g., health fads, advertising, misconceptions about treatment and prevention options)

Level IV Grade : 9-12

Benchmark 6: Understands how cultural diversity enriches and challenges health behaviors (e.g., various food sources of nutrients available in different cultural and ethnic cuisines, influence of cultural factors on the treatment of diseases)

Standard 4: Knows how to maintain mental and emotional health

Level III Grade : 6-8

Benchmark 1: Knows strategies to manage stress and feelings caused by disappointment, separation, or loss (e.g., talking over problems with others, understanding that feelings of isolation and depression will pass, examining the situation leading to the feelings)

Level IV Grade : 9-12

Benchmark 6: Knows strategies for coping with and overcoming feelings of rejection, social isolation, and other forms of stress

Standard 6: Understands essential concepts about nutrition and diet

Level III Grade : 6-8

Benchmark 1. Understands how eating properly can help to reduce health risks (in terms of anemia, dental health, osteoporosis, heart disease, cancer, malnutrition)

Benchmark 2. Knows appropriate methods to maintain, lose, or gain weight according to individual needs and scientific research

Level IV Grade : 9-12

Benchmark 2. Understands the reliability and validity of various sources of food and nutrition information (e.g., dietary supplements, diet aids, fad diets, food labels)

Benchmark 3. Understands the role of food additives and their relationship to health

McREL: Content Knowledge: A Compendium of Standards and Benchmarks for K-12 Education (Copyright 2000 McREL) is published online by Mid-continent Research for Education and Learning (McREL) (http://www.mcrel.org/standards-benchmarksexternal link), 2550 S. Parker Road, Suite 500, Aurora, CO 80014

Background

The medical community uses a term called "Body Mass Index," or "BMI," to determine how overweight a person is. According to the standard definitions of overweight and obesity used by the Centers for Disease Control (CDC) and the World Health Organization, adults with a BMI of 25 to 29.9 are considered overweight, while adults with a BMI of 30 or more are considered obese.

Obesity is among the most significant public health problems in America today. Experts estimate that approximately 97 million adults in the United States are overweight or obese. According to the CDC, "the percentage of obese children and adolescents has more than doubled since the early 1970s. About 13 percent of children and adolescents are now seriously overweight."

Being overweight and obese puts people at higher risk for developing serious health problems like cancer, stroke, cardiovascular disease, Type 2 diabetes, gallbladder disease, sleep apnea, osteoporosis and osteoarthritis. The National Institutes of Health estimates that "the total costs attributable to obesity-related disease approach $100 billion a year."

Researchers are still learning about how and why obesity occurs, however, most heath experts agree that obesity develops as a result of an interaction between a person's genetic makeup and his/her environment, and that social, behavioral, cultural, psychological, and metabolic factors play a role.

Pre-viewing Questions

Pose the following questions for class discussion to students prior to watching this CNN Presents Classroom Edition: Fat Chance. As they watch the program, students should add to their understanding of these topics. After viewing, you may wish to return to these focus questions to check for any changes in student responses.

1. What is obesity?

2. What are the health problems associated with being overweight?

3. To what extent is obesity a problem among your peers and in society in general?

4. What factors contribute to obesity?

5. Why is obesity considered a public health problem?

6. Why is it so difficult for many people to lose weight and keep it off?

7. What strategies can people employ to lose weight and keep it off?

Discussion Questions

1. Perspectives on a Moment in Time

Segment One: Keeping Weight Off is Hard to Do

Successful weight loss -- losing weight and keeping it off -- is so unusual that Professor James Hill, Ph.D. at the University of Colorado, keeps a list of people who've managed to do it. Karen Brown and Robert Romaniello are two of the people on the National Weight Control Registry.

Karen went from 194 pounds to 124 pounds while Robert lost 60 pounds. Both managed to do it while fighting against our body's natural physical instincts to eat when food is available and in a society that seemingly discourages exercise.

1. What is the difference between being overweight and being obese?

2. What percentages of Americans are obese and overweight?

3. What are the health implications of this trend?

4. What genetic and biological factors make it difficult for people to lose weight? Why weren't prehistoric people obese? According to the video, why do 95 percent of the people who lose weight gain it back?

5. Who is Jim Hill? What is the focus of his research? What does Dr. Hill mean when he says, "The epidemic of obesity is a byproduct of our success as a society"? How has modern society actually prevented humans from being active when they want to be?

6. Why are Karen and Robert two of Dr. Hill's success stories? How much did each once weigh? What does each weigh now?

Segment Two: Expect Failure But Keep Trying

According to Dr. Hill, only five percent of dieters actually keep the weight off, like Karen Brown and Robert Romaniello have. After studying the roughly 3,000 people in the National Weight Control Registry, Dr. Hill and his colleagues have come up with seven keys to losing weight and keeping it off. The first tip: Expect failure but keep trying.

Both Karen and Robert say they used food as an emotional crutch, eating when they felt lonely and unhappy. And both of them cite health considerations as the factor that finally motivated them to change their habits and keep the weight off.

1. What factors contributed to Karen's weight gain? What does Karen mean by "food is your friend"? What emotions cause people to want to eat?

2. What measures did Karen take to lose weight over the years? Why didn't these diets work for Karen?

3. According to Dr. Hill, what percentage of successful dieters are able to maintain their weight loss? What is a "fad diet"? Why are fad diets considered a poor way to maintain weight loss?

4. What requirements must people meet to be included in the National Weight Control Registry? How many people are listed in this registry? How has Professor Hill used the registry in his research?

5. What are the first two of Dr. Hill's seven tips for successful weight loss?

6. Why were Karen and Robert able to make the switch from being junk food junkies to eating healthy?

7. What health problems are linked to being overweight and obese?

8. In the segment, we learn that, before their weight loss, both Karen and Robert used food as an "emotional crutch." What does this mean? How did they break this cycle?

Segment Three: Exercise is Good

Another thing Robert Romaniello and Karen Brown have in common is that they both have a regular exercise regimen. Robert runs and does push-ups and sit-ups. Karen runs daily, lifts weights and leads ten aerobics classes a week.

It took time for both Robert and Karen to get to where they could exercise as much as they currently do. But if you can't exercise as much as Robert and Karen, Dr. Hill suggests incorporating physical activity into daily routines, like taking the stairs instead of the escalator

1. What are Dr. Hill's third, fourth and fifth tips for effective dieting?

2. Why is it important to weigh yourself often if you are trying to lose weight? How did Robert implement and benefit from this weight loss strategy?

3. How have Robert and Karen integrated exercise into their lifestyle? How has exercising on a regular basis impacted their lives? What challenges did they face during their quest to become fit?

4. In addition to planned workouts, what can people do to get more exercise?

Segment Four: Five Meals a Day

Of the many diets that claim to have the answer to losing weight, a federal government study found that a high-carbohydrate, low-fat diet is the best at keeping the weight off. Data from the weight control registry also shows that successful dieters often eat five meals a day.

Dr. Hill says the data isn't completely clear on this point. "I think it's more likely that by spreading them out over the day, what you're avoiding doing is overeating in any given situation," says Hill. Other researchers are studying whether genetics may predispose some people to being overweight and where there are drugs that can be created to help them.

1. What are Dr. Hill's sixth and seventh tips for losing weight?

2. Why does Dr. Hill recommend a high-carbohydrate, low-fat diet? What foods are included in this type of diet?

3. If you want to lose weight, why is it better to eat five small meals, rather than three large meals, a day?

4. What personal characteristics do you think Karen and Robert possess that enable them to be so successful at dieting? Why might some people have difficulty following Robert and Karen's weight loss plan?

5. Who is Dr. Steven B. Heymsfield? According to Heymsfield, why might some obese people need drugs to lose weight?

6. How might people's genes make them eat too much, or make them overweight?

7. How has studying mice helped scientists to understand the correlation between genetics and obesity?

8. What types of drugs are being developed to treat obesity?

Segment Five: Overweight Children

Karen Brown felt wonderful when she successfully lost weight. But now she's fighting the battle again, this time for her son, who has been teased by other children for being overweight.

Karen's son is not alone. Among children, the rate of obesity has doubled in the last 20 years, bringing with it serious health consequences.

Type 2 diabetes -- brought on by obesity and once found only in adults -- is becoming more and more common in children. Infants tend to self-regulate their food intake, but once children hit school age, they stop listening to their stomachs.

1. How prevalent is obesity among American children?

2. What is the correlation between childhood and adult obesity?

3. What biological and societal factors contribute to childhood obesity? At what age do children lose their ability to instinctually self-regulate their intake of food?

4. How can parents help their children to develop healthy eating habits and be physically fit?

5. What problems has Jamie Brown faced as a result of being overweight? How has his mother, Karen Brown, tried to help Jaime lose weight?

Segment Six: Fit But Fat

Brown and Romaniello have overcome genetics and changed their lifestyles to successfully lose weight, but they are the exception. Dieting failures are much more common, like the story of Lynn McAfee, who went on her first diet while still a baby.

McAfee is a part of the "fit but fat" movement, which encourages physical exercise and healthy eating, but doesn't encourage dieting because it's unlikely to work. McAfee says there is study after study showing that dieting doesn't work. "You can't yell at us louder. That's not working," she says.

1. Why are Karen's and Robert's weight loss successes considered unusual?

2. Who is Lynn McAfee? What problems did she encounter during her quest to lose weight? Why did she decide to stop dieting? How has she incorporated exercise into her life?

3. What is the "fit but fat" movement? What does it mean to be physically fit? To what extent is exercise important in achieving and maintaining weight loss and good physical health? Do you think the "fit but fat" movement will help stop the obesity epidemic in the U.S.?

Suggested Activities

1. Challenge students to conduct research to learn more about the likely diet and activities of prehistoric humans. What did our ancestors eat? How often did they eat? What kinds of activities were part of their daily lives? In class discussion, have students compare their information to their own daily food intake and activity. What diseases and conditions would be less common if we ate and engaged in physical activity like prehistoric humans did?

2. Have small groups of students conduct research to determine the health risks associated with poor nutrition and being overweight. Have groups share their findings. To help students become more aware of their eating habits, have each student keep a log for three days of all the food he/she eats and his/her mood prior to eating. Working in groups, have students analyze the nutritional content of their food to determine if their meals and snacks are nutritionally balanced. Have group members suggest ways to make their diets more nutritious. Refer students to their data to determine if they ate to make themselves feel better. Ask students to determine if there is a correlation between their emotional states and the quality of their diet.

Your students may want to observe CNNstudentnews.com's Body Mass Index Weight-to-Height Tableexternal link (http://fyi.cnn.com/interactive/health/0207/obesity.chart/frameset.exclude.html), or they can go to http://www.cdc.gov/nccdphp/dnpa/bmi/index.htmexternal link to calculate their Body Mass Index.

3. What are the differences between a healthy diet and a fad diet? Refer students to their texts and online resources to identify different types of diets and the components of a good weight management program. Have students share their research and write their findings on the board. Then, group students and assign each group a type of diet plan. Have each group conduct research to learn more about the benefits and drawbacks of the diet, including the potential health risks associated with the diet, and the extent to which the diet incorporates emotional, educational, behavioral, and environmental strategies to control weight gain. After each group presents its findings, ask the class to determine if the diet is a fad diet or a healthy eating plan. Ask students: Why do you think some diets are more successful than others?

4. Inform students that fast food, a main staple for many teenagers, has been linked to obesity and heart disease. As a class, generate a list of the fast food restaurants in your area. Group students and have each group select a restaurant from the list. Challenge each group to analyze the nutritional content, including the fat and caloric content, of a cross section of the restaurant's menu. Point out to students that many fast food chains post the nutritional content of their food. Students can also access fast food nutritional information here (http://www.foodfacts.info/external link). Have each group determine which of these fast foods are better for their health, and if these foods fit in with a balanced diet.

5. Challenge students to make a list of key public heath issues, other than obesity, that exist in America today. These issues might include smoking, alcohol and substance abuse, child abuse/neglect, and AIDS. Then ask: What factors influence people's attitudes on these public heath issues? To what extent do people's attitudes influence government intervention and legislation on public health issues? What are the pros and cons of legislating public health issues? Give examples.

Then, inform students that most Americans do not recognize the severity of the obesity epidemic in the United States. A new report released by Harvard's Kennedy School of Government reveals that though "most Americans are well informed about food and nutrition, only a minority believe obesity is a "very serious" health problem.... (And that) contrary to the views of health experts, most Americans view obesity as resulting from individual failure rather than environmental or genetic sources." Ask students:

1. How does obesity compare to other health issues such as smoking, alcohol or substance abuse, or child abuse/neglect?

2. Why do you think most Americans look at obesity as a result of individual failure?

3. Should obesity be considered a public health issue? Why or why not?

Following the class discussion, instruct students to write position papers that outline their views on obesity and how the U.S. government should respond to the issue. For example, should the U.S. government regulate or tax food products; should television ads that promote unhealthy foods for children be banned; or should parents of obese children be held legally responsible if their children become obese? Have students share their papers with the class and discuss.

Keywords

obesity, fad diets, cravings, genetics, fat, Body Mass Index

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