weight loss

Question 1

exclusions for self treatment for weight loss

Answer 1

• severe obesity
• pregnancy or breast-feeding
• <18 years of age or >65 years of age
• eating disorder

Question 2

Non pharm

Answer 2

Caloric restriction, Physical exercise, Weight-loss program, Behavioral Therapy, Food Additives, Meal Replacement

Question 3

Caloric restriction,

Answer 3

● Deficit of 300 to 1000 kcal/day
● Low calorie diet (LCD) of about 800-1500 kcal/day
● Goal to lose 1-2 lb/week
● Very low calorie diet (VLCD) <800 kcal/day.
○ Restricted to pt with BMI >30 and used under supervision of PCP
● Long term results of VLCD are no better than LCD.
● Best results to decrease saturated fat
● 500 kcal deficit you will lose 1 lb/week
● Goal is a 5-10% loss of weight over 6 months

Question 4

Physical exercise,

Answer 4

● Needs to be something the pt enjoys if it is to be sustained over long periods of time.
● Moderate exercise: 150 min/week = 30 min/day for 5 days.
Intense exercise: 75 min/week = 10 min/day for 7 days
• Children >or equal to 60 min 3x week

Question 5

Weight-loss program,

Answer 5

● Weight Watchers, Jenny Craig, Take Off Pounds Sensibly (TOPS)

Question 6

Food Additives, Meal Replacement

Answer 6

● Conflicting evidence with artificial sweeteners and fat substitutes for weight loss

Question 7

Meal Replacement

Answer 7

● Usually replacing 2 meals a day with a liquid, snack bar, or measured frozen meal
● Effective strategy for short term weight loss and weight maintenance

Question 8

Pharm

Answer 8

Non prescription weight loss drugs are not safe

Dietary Supplement not recommended

Orlistat (alli),

Question 9

Orlistat (alli),

Answer 9

● as a prescription (120mg) and non prescription (60mg) weight-loss medication. Taken 3 times/day
● Prescription strength okay to use with anyone >12 yo. Nonprescription okay to use with anyone >18 yo.
● For BMI >30 or BMI >27 with risk factors (diabetes, hypertension, dyslipidemia)
● Decreases absorption of fat by inhibiting pancreatic lipase.
● Can affect fat soluble vitamins: vitamin A,D,E,K
○ Take multivitamin 2 hours before/after taking Orlistat
● Consult with a doctor or pharmacist before taking Orlistat in pt with diabetes or thyroid disease. Is it okay with pt taking insulin? Ask about diabetes and if it’s okay to take orlistat?
● Be careful with pt taking warfarin. Pt needs consistent diet. Increased vitamin K in diet, you need a higher dose of warfarin. Decreased vitamin K in diet, you need a lower dose of warfarin. Green leafy vegetables contain high vitamin K
● DO NOT GIVE in pt with pancreatitis, gallbladder disease (nephrolithiasis), or kidney stones (cholelithiasis) in chronic conditions.
● Take orlistat 4 hours after taking levothyroxine
● Orlistat taken before meals containing fat. No need for fat free meals.
● Follow up after 1 month. Should expect 5-8 lb in 6 months. If pt does not reach goal then refer.

Question 10

Complementary therapies

Answer 10

• Ephedra
• Hydroxycut
• Cinnamon
• Bitter orange (Citrus aurantium)
• Caffeine

Question 11

• Caffeine

Answer 11

• Caffeine
  ● Be careful with pt in hypertension or have trouble sleeping.
  ○ Green tea/green coffee bean work as diuretic

Question 12

• Bitter orange (Citrus aurantium)

Answer 12

● Very dangerous. Acts like epinephrine and norepinephrine which can cause heart issues. Manufacturers try to sneak it into their products. DO NOT RECOMMEND

Question 13

• Cinnamon

Answer 13

Cinnamon
● Okay to use in pt with hypertension
● HIGHLY RECOMMENDED

Question 14

Ephedra

Hydroxycut

Answer 14

Ephedra
● Banned. No longer used

Hydroxycut
● Green coffee beans

Question 15

Provide education to patients for obesity and overweight management

Answer 15

• risk of obesity
• gradual changes
• nutritional diet