Management of Obesity

1
Management of Obesity

• M. Burns, PhD, RD
• FCS 3755

2
Goals of treatment

• Weight management
• Healthy weight
• Small weight loss counts
• Comprehensive assessment

3
Components of obesity mgt.

• Figure 23-5, pg 497
• Causes of obesity
• Pathophysiology
• Medical management
• Nutritional management

4
Causes

• Energy imbalance due to
• Excess energy intake
• Inadequate physical activity
• Physiologic, metabolic, or genetic factors

5
Pathophysiology

• Classification of obesity
• BMIgt25, excessive body fat, regional distribution
  of fat
• Syndrome X
• Unexplained glucose intolerance, insulin
  resistance, hyperlipidemia, hypertension

6
Management

• Medical
• Lifestyle
• Psychological support
• Drug therapy
• Surgery

• Nutritional
• Food choices
• Education
• Maintain healthy nutritional status

7
Weight maintenance programs

• Dietary
• Exercise
• Behavior modifications

8
Dietary modifications

• Restricted-energy diets
• Moderate deficiency
• Low-calorie diet
• Very-low-calorie diet (VLCD)
• Importance of fiber

9
Restricted-energy diets

• Dr. Ornish
• Exchange system
• Meal replacement
• Commerical programs
• VLCD

10
VLCD

• Hypocaloric
• Rich in protein
• 100 RDAs
• 12-16 week program
• BMI gt 30
• Types

11
Types of VLCD

• Protein-sparing modified fast
• 1.5 g pro/kg
• High N loss
• Very low fat and minimal CHO

• Commercially formulated liquid
• 33-70 g pro
• 30-45 g CHO
• Minimal fat
• Numerous side effects

12
Use of VLCD

• 30 overweight, BMIgt32
• No contraindicated medical conditions
• Committed to modify behaviors
• Motivated for maintenance
• Combined with nutrition education, psychological
  counseling, exercise, and behavior modification

13
Exercise

• Aerobic promotes lipolysis
• Resistance training increases LBM, RMR, mineral
  deposition
• Improves self-esteem
• Increases sense of control
• Program components

14
Behavior modification

• Self-monitoring
• Problem solving
• Stimulus control
• Cognitive restructuring
• Table 23-4, pg 503

15
Morbidly obese

• Drug therapy
• Suppress appetite
• Increase BEE or TEF
• Interfere with fat absorption

• Surgery
• Gastroplasty
• Gastric bypass
• Jaw wiring
• Liposuction
• Fig. 23-7

16
Weight management in peds

• 25 of children are overweight
• Energy imbalance
• Inadequate energy out
• Poor food choices
• Grow into weight
• Family effort is the key!

17
Current issue Fad diets

• Unrealistic expectations that set the dieter for
  failure, and subsequent guilt
• Evaluation tips