Obesity Management: Advise, Agree, Asist Flashcards
clinical weight loss definitions/percentages (3)
<3% weight maintenance
3-5% modest weight loss
5-10% significant weight loss
what is ‘clinically meaningful reductions’ and the percentage in clinical weight loss
The benefits of weight loss. Sustained 3-5% results in significant decrease in CVD risk factors
-trigylerides
-blood glucose
-HbA1C LEVELS
-Risk of developing T2D
Advise: why does obesity weight management need a long term strategey?
-Is a heterogenous condition
-how the body responds to treatment and fat loss varies widely
-no single treatment works for all
-currently no cure. Any successful plan requires long term strategy
how to advise on obesity (4)
-advise on obesity risks
-explain benefits of modest weight loss
-explain need for long term strategy
-discuss treatment options
Advise: Obesity Risks (2)
-risks are more related to obesity stage than to BMI
-Focus on treatment should be on improving health & well being than size of body
Advise: Treatment options
-sleep, time, stress
-diet
-physical activity
-psychology
-low calorie diets
-anti obesity med
-bariatric surgery
how much initial weight (%) is lost with behavioural intervention alone (not med or surgery)
3-5 %
Agree: Diet expectations (3)
-many will want/expect a permanent weight loss, when regain is normal
-issues may arise if expectations are high and outcomes are lower than desired
-disapointment if effort and outcome are mistmatched
Agree: weight loss expectations (4)
-unrealistic expectations can lead to disapointment & non adhearence
-reasonable weight loss target is 5-10% with behavioural only techniques. After that it will plateau
-faster weight loss with med. will not result in better long term outcomes
-some patients may need prevention/slowing weight gain > weight loss
Agree: treatment plans should… (3)
-should be realistic
-address the drivers of weight gain (stress, depression, sleep apnea, chronic pain etc..)
-success of treatment measures the improvements in health & well being (BP, energy, mobility, fitness etc…)
Agree: Behavioural goals & health outcomes
Specific
Measurable
Achievable
Rewarding
Timely
Assist: identify & address drivers (types of barriers/factors)
-drivers & barriers can include environment, socioeconomical, emotional, medical
-obesogenic factors (med. side effects) can make obesity management difficult
-physical barriers that limit access (transit, work, rec facilities)
define OARS + I
open ended questions
affirmations
reflective listening
summarizing
info gicing
Assist: rescources
-seek out credible weight management info/resources
Assist: refer
-interdisciplinary team approach to obesity management
-choice of provide should help address the drivers & barriers & complications to weight management
Arrange: follow up
-follow up is essential
-success is related to frequency of provider contact
-weight regain should not be viewed as a failure, rather it is expected
