Management of Obesity Flashcards
5 A’s
ask assess- obesity related risks advise- treatment options, risks agree- on goals assist- appropriate resources and providers
why does weight loss improve diabetes control?
increase glucose tolerance and insulin sensitivity
and lowers the need for meds
cardiovascular benefits with WL
TG levels
raises HDL, lower LDL
improves CVD risk
reduce med need
WL benefits for hypertension
lowers BP, BV, cardiac output and sympathetic activity and less meds
angina
main in chest for decreased blood flow to heart
dietary intervention steps:
1- estimate daily ER ( either REE x PAL or TEE fro IOM )
- in example use Mifflin
2. subtract 500kcal to lose 0.5 kg/week
rule of thumb for weight loss
1lb of adipose tissue is 87% fat= 395 g fat= 3500kcal
to lose 3500kcal per week = -500 kcal per day
is all lost fat?
Lean mass is also lost to a variable extend, depending on initial body fat and degree of weight loss
the more severe the energy restriction the more…
protein they need
why did serum TG lower in the HP diet for weight lose vs the SP
bc less carbohydrates ( excess carbs related to TG levels in circulation )
results of HP vs SP diet for weight loss?
HP had greater reduction in BW, Fat mass, serum TG
no difference in CH, LDL-C, HDL-C, BP, fasting glucose and insulin
but less reduced REE ( this is good )
HP - LGI was best for
no weight regain after dieting compared to other variations ( HP-HGI, etc)
the balanced diet
weight reduction diet for 6-12 months with high protein and moderate fat within AMDR
- meal replacements may be considered
active adults have at least _____ % reduced risk of premature mortality
20-35%
Canadian PA guidelines
at least 150 mins mod to vigorous aerobic PA per week ( 10 mins or more)
muscle and bone stengthing at least 2 days per week
orlistat
lipase inhibitor that acts in the GI tract
- 30% less fat absorbed, fat excreted in faces and will not obtain calories from fat
taken for up to 2 years, 50% efficacy
- side effects: everyday effect, fatty stools, fecal urgency losses of fat sol vitamins ( must take supplements)
appetite suppressants
act on CNS - serotonin agonists, amphetamine derivatives
- short term
- side effects: nausea, dizziness, headaches, bad sleeps consipation
- may cause addiction
behavior modifications
- increase awareness to change eating habits
- increase PA
support systems
educate about nutrition
readiness assessment
are they able to increase PA
success at previous weight loss attempts
ability to practice self control
- attitude about weight loss, confidence to lose weight
social support
life circumstances
changing eating habits
enhance self awareness
minimize exposure to food
interrupt negative behaviour chains
PAL low, mod, high
1.3, 1.5, 1.8
aim for healthy BMI or?
modest weight loss ( 5-10%)
results of high protein diets for weight loss
- great reduction in body weight, fat has, serum TG
- less fat free mass loss
- 4 studies showed LESS reduction in REE
no difference in ____,______,___ in high protein diet
total CH, LDL, HDL, BP, fasting glucose and insulin
what favoured maintenance of body weight after weight loss?
moderate increase in PRO and modest reduction in GI index foods
active adults have a ____ % reduced risk of premature mortality
20-35%
what are guidelines for activity
- 18-64 yr 150 mins moderate to vigorous intensity aerobic PA per week, in bouts of 10
- strength training at least 2 day/week
- more PA provides better health benefits
behaviour modifications for weight management
increase awareness increase PA alter attitudes develop support systems educate about nutrition
how to assess readiness
Behaviour
Psychological
Environmental
how could we help someone change their eating habits
enhance self-awarness
minimize constant exposure to food
interrupt negative behaviour chains
how to enhance self awarness
expanded food dairy
