Overweight And Obesity 2

Question 1

Portion control/ calorie counting

Answer 1

Use of calorie controlled diet using calorie counting
Can use fixed meal plan
Use of apps
Must still achieve net energy reduction
May still need micronutrient supplementation if below 4-5MJ/d

Question 2

Macronutrient distribution

Answer 2

High fat/ low cho (30-75% F, 4-45% cho) is equally as effective as achieving weight loss as a higher carb/ low fat diet (20-25%F, 50-60% cho) when protein and energy are matched
Med diet is equally as effective as other strategies with or without energy restriction
Low GI/ GL diet without energy restriction is or different to a higher Gi and Libitum diet in achieving weight loss

Question 3

Commercial products

Answer 3

Weight watchers
Jenny Craig - meal replacement and support
Lite and easy meal replacement

Question 4

Develop behavioural strategies

Answer 4

Self monitoring: records of eating, exercise and weight
Stimulus control; reducing/ avoiding triggers to eating/ inactivity
Problem solving skills
Contingency plans, alternatives for disrupted routines, use of non food rewards

Question 5

Behavioural strategies

Answer 5

Cognitive restructuring (self talk): reduce negative thinking
Social supports
Referral to psychologist for behavioural therapy/ stress management
Sleep hygiene if required
Meal planning
Shopping

Question 6

Mindfulness

Answer 6

Patterns of nib hungry eating
Patterns of eating irregularly
Eating in front of tv, on the ring from the pot, over the sink
Eating due to emotions, boredom etc

Question 7

Disordered eating

Answer 7

Preoccupation with good and bad foods 
Patterns of restrained eating 
Patterns of binge eating 
Low feelings of self worth/ negative thoughts associated with foods 
Disconnection from appetite
Psychological stress associated with food 
Yoyo dieting 
Use of laxatives, diuretics, vomiting
Feeling out of control

Question 8

Establish goals

Answer 8

Ensure they are realistic
Establish goals specifically related to diet and nutritional treatment, and overall goals- considering client stage of change, eating attitudes and behaviours, nutrient intake and food preparation and purchasing patterns, behavioural modification techniques, client preference for type of dietary treatment

Goals should be SMART and client centres
Eg eat more fruit vs eat 1-2 pieces of fruit 6-7 days per week
Eat leads takeaway vs limiting eating out/ takeaway to 3 times per week

Question 9

Establish a review plan

Answer 9

Review the treatment undertaken
Have goals be implemented to assess changes in diet and physical activity
Establish any other benefits weight and metabolic
Modify goals as required

Question 10

Plateau

Answer 10

Often occurs during weight loss
May require a new dietary approach
May require a new physical activity prescription
Can be frustrating and lead to abandonment of positive changes made
Pre- plateau counselling may help

Question 11

Medications to be aware of

Answer 11

Saxenda (liraglitide) injectable GLP-1 receptor agonist (similar to Byetta)
Orlistat (Xenical) lipase inhibitor blocks fat digestion and absorption
Metformine (phentermine) appetite suppressant
Drug with weight gain side effect (many)
Beta blockers ie atenolol
Anti depressants Eg SSRI
Anti psychotics eg olanzapine
Anti anxiety SSRI
anti epileptic valproate