Chapter 9 Notes

Chapter 9 Notes - Adult Weight Management Criteria for...

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1 Chapter 9 Obesity Treatment NHM 101 Adult Weight Management Criteria for choosing weight control programs: – Program claims, outcomes – Therapeutic approach Describe 3 modes of therapy: – Lifestyle – Pharmacotherapy (drug intervention) – Surgical Obesity Treatment Pyramid Surgery Pharmacotherapy Lifestyle Modification Diet Physical Activity Diet and Physical Activity Basic tenets of obesity treatment More than knowing what to do Complexities of obesity require multiple strategies and targeted therapies Dieting for Weight Loss Calories In – Calories Out = +/- Weight Change – Calories do matter! – But excess calories can be negated by increased energy expenditure – Vitamin and mineral supplementation cannot make up fully for empty calories (nutrient poor foods) – Diet composition matters, too! Encourage low energy dense foods. Is one option better than the other? The dietary strategy should be individually tailored based on risk assessment, current behaviors, and weight loss goals. Significant education regarding appropriate food choices is often necessary.
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2 Guidelines for Use of Drugs NIH Consensus Panel Drugs will not eliminate the need to change lifestyle Should be considered only after 4-6 months of lifestyle therapy Should be considered as an adjunct to lifestyle therapy only for persons with: – BMI 30 with no comorbidities or risk factors – BMI 27 with comorbidities or risk factors Hypertension, dyslipidemia (abnormal lipids), coronary heart disease, Type 2 diabetes, sleep apnea NIH Expert Panel Report, Am J Clin Nutr 1998;68:899-917 Orlistat (Xenical®) Efficacy Produces maldigestion by inhibiting intestinal lipase Resulted in 3% greater weight loss after 1 year
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