The document discusses obesity, defining it as a condition of excessive body fat that is associated with various health risks, and examines its causes such as overeating, physical inactivity, and genetic factors; it also explores strategies for weight loss through diet, exercise, behavior modification, and in some cases medications, noting that most people regain lost weight without long-term lifestyle changes and support.
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
presented by HAFIZ M WASEEM
university of education LAHORE Pakistan
i am from mailsi vehari and studied in lahore
bsc in science college multan
msc from lahore
Aim of nutritional assessment
To identify nutritional problems of the community
To find the underlying cause for malnutrition
To plan and implement control of malnutrition
Maintain good nutrition of community
More than 66% of U.S. adults are categorized as overweight or obese, and the prevalence of obesity is increasing rapidly in most of the industrialized world.
Children and adolescents also are becoming more obese, indicating that the current trends will accelerate over time.
Obesity is associated with an increased risk of multiple health problems, including hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, nonalcoholic fatty liver disease, degenerative joint disease, and some malignancies.
Thus, it is important for physicians to identify, evaluate, and treat patients for obesity and associated comorbid conditions.
Aim of nutritional assessment
To identify nutritional problems of the community
To find the underlying cause for malnutrition
To plan and implement control of malnutrition
Maintain good nutrition of community
More than 66% of U.S. adults are categorized as overweight or obese, and the prevalence of obesity is increasing rapidly in most of the industrialized world.
Children and adolescents also are becoming more obese, indicating that the current trends will accelerate over time.
Obesity is associated with an increased risk of multiple health problems, including hypertension, type 2 diabetes, dyslipidemia, obstructive sleep apnea, nonalcoholic fatty liver disease, degenerative joint disease, and some malignancies.
Thus, it is important for physicians to identify, evaluate, and treat patients for obesity and associated comorbid conditions.
Childhood obesity the other aspect of malnutritionvckg1987
this presentation mainly deals with childhood obesity where the current trends of it in India and statewise has been shown, there are various classification which are made for childhood obesity but there is confusion which one to choose, so this confusion is removed in this presentation, then moving on the strategies made for preventing the childhood obesity in various countries has been mentioned.
Obesity refers to the condition of having an excessive amount of body fat.
This ppt contains a concise content regarding obesity for students of final year. I hope it will suffice you in your studies. Thank you spending your precious time in referring the same.
Obesity in Adolescent- Right Time to InterveneSujoy Dasgupta
Invited lecture by Dr Sujoy Dasgupta in a Webinar by Food, Drugs and Medicosurgical Equipment Committee of FOGSI (Federation of Obstetric and Gynaecological Societies of India) on “Adolescent Nutrition: Challenges and Way Forward” held in November, 2021.
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Overweight and Obesity
• Overweight: body weight
that exceeds some
average for stature,
perhaps age.
• Overfat: body fat that
exceeds an age- and/or
gender appropriate
average by some amt.
• Obesity: overfat
condition that
accompanies
components of obese
syndrome.
5. Obesity: A Global Epidemic
• Why is obesity accelerating in
developing countries?
• Increased consumption of
energy-dense, nutrient poor
foods combined with reduced
physical activity.
6. Obesity: A Global Epidemic
• What is the prevalence of overweight and obesity
in the United States? 66% & 31%
obesity
trend
7. 2000
Obesity Trends* Among U.S. Adults
BRFSS, 1990, 2000, 2010
(*BMI ³30, or about 30 lbs. overweight for 5’4” person)
2010
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
8. Call to Action: Impact
The State of Obesity: https://stateofobesity.org/healthcare-costs-obesity/
Direct healthcare costs:
$147-210 billion / year
$506 / employee with
obesity / year
9. How many receive
obesity treatment by
PCP?
Obesity diagnosis: 29%
Call to Action
Bleich SN, Pickett-Blakely O, Cooper LA. Physician practice patterns of obesity diagnosis
and weight-related counseling. Patient Educ Couns. 2011;82(1):123-129.
.
Waring ME, Roberts MB, Parker DR, Eaton CB. Documentation and
management of overweight and obesity in primary care. J Am Board Fam
Med. 2009;22(5):544-552
10. How many receive
components of obesity
treatment treatment by
PCP?
Call to Action
Waring ME, Roberts MB, Parker DR, Eaton CB. Documentation and management of overweight and obesity in primary care. J Am Board Fam Med. 2009;22(5):544-552
11. Causes of Obesity
• Obesity is a long term
process.
• Obesity frequently begins
in childhood. Obese
parents likely have
overweight children.
• Regardless of final body
weight as adults,
overweight children
exhibit more illnesses as
adults than normal kids.
You gonna
finish that?
12. Causes of Obesity
• Excessive fatness also
develops slowly
through adulthood,
most weight gain
occurring between
ages 25 to 44 yrs.
• Typical American man
& woman gain .5 to
1.8 lb/year until 60.
13. Causes of Obesity
• Overeating and Other Factors
• Factors that cause human obesity:
genetics, environmental, metabolic, behavioral, social
• Factors that predispose a person to gain
excessive weight gain.
• Eating patternsEating environment
• Food packaging Food availability
• Body image Physical inactivity
• Basal body temp Dietary thermogenesis
• Fidgeting Biochemical differences
• Quantity & sensitivity to satiety hormones
14. Overeating and Other Factors
• Nutrition transition shifts in dietary structure toward higher
energy density with greater fat and added sugars, greater
saturated fat, reduced complex CHO and fiber, and reduced
fruits & vegetables.
• Food consumption expressed in kCal per capita per day has
increased.
• Decreased energy expenditure for all populations of the world.
15. Causes of Obesity
• Characteristics of fast food
linked to increased adiposity:
• Higher energy density
• Greater saturated fat
• Reduced complex carbohydrates
& fiber
• Reduced fruits and vegetables.
16. Causes of Obesity
• Genetics plays a role.
• How much variation in
weight gain among
individuals can be
accounted for by genetic
factors?
• Familial association is not
proof of genetic
inheritance-families share
eating & exercise habits.
• Largest transmissible
variation is cultural.
17. Causes of Obesity
• A Mutant Gene?
• What is leptin?
• A satiety hormone that influences the appetite control
in the hypothalamus.
• A defective gene may cause inadequate leptin
production.
• The brain receives an under assessment of body’s
adipose stores & urge to eat.
18. Causes of Obesity
Normally leptin blunts the urge to
eat when caloric intake maintains
ideal fat stores.
In essence, leptin availability, or
its lack, affects the
neurochemnistry of appetite and
the brain’s dynamic “wiring” to
possibly impact appetite and
obesity in adulthood.
Leptin alone does not determine
obesity or explain why some
people eat whatever they want
and gain little weight while
others become overfat with the
same caloric intake.
19. Causes of Obesity
A defective ob gene causes
inadequate leptin production.
Thus, the brain receives an
under assessment of body’s
adipose stores and urge to
eat.
May be defective leptin
receptor action.
How does Leptin affect body
fat?
• Stimulates chemicals that
suppress appetite
• Reduce levels of chemicals that
stimulate appetite.
20. Causes of Obesity
• Physical Inactivity: an
important component
• Each hour increase in
TV by adolescents 2%
increase obesity.
• Adults 15 & over spent
average 2.73 hr/day
watching TV in 2010.
• Each hour increase in
TV by adults increase
risk of death 11%.
21. Obesity
• Health Risks of Obesity
• Primary risk factor for
coronary heart disease.
• Associated with HTN, DM,
dyslipidemia, &
cerebrovascular disease.
• Obesity-related medical
complications account for
10% of national health
care.
22. Obesity
• How Much Fat is TOO Much?
• List three criteria for evaluating a person’s level of fatness.
• % Body Fat
• Fat Patterning
• Fat Cell Size and Number
23. Percent Body Fat
• Overfatness corresponds to
any body fat value 5% above
the average value for age &
sex.
• Borderline obesity in young
man > 20 & in young woman
>30%.
Standard Men Women
Essential 3-5 11-14
Athletic 8-12 12-18
Acceptable 13-20 19-25
Overfat 21-25 26-30
Obese >25 > 30
24. Fat Patterning
• Adipocytes from some
locations (gluteal & femoral)
efficiently capture excess
nutrients from the blood-stream
for storage, while others
accumulate TGs but readily
release them for use by other
tissues.
25. Fat Patterning
• Visceral (intra-
abdominal) adipose
tissue (VAT) relates to
an altered metabolic
profile.
• Abdominal fat
described as android
(apple) has higher
health risk than gynoid
(pear) obesity.
26. Fat Patterning
• Give an objective
standard for
establishing male- and
female-pattern obesity.
• Male > .95 W:H ratio
• Female > .80 W:H
27. Fat Cell Number and Size
• Increases in adipose tissue
occurs in two ways:
1. Fat cell hypertrophy
2. Fat cell hyperplasia
28. Fat Cell Number and Size
• After reaching a biological upper limit for fat cell size, cell number
becomes a key factor that determines obesity.
29. Weight Control
• What is the prognosis for long term weight
control?
• Participants who remain in supervised weight
loss program regain almost all within 5 years.
30. Weight Control
• One pound of fat
contains 3,500 kcal
• Unbalance the Energy
Equation (First Law
Thermodynamics)
1. Reduce kcal intake
2. Increase kcal output
3. Reduce intake and
increase output
31. Altering the Energy Balance
• Total energy intake (not macronutrient mixture)
determines effectiveness of weight loss with diet.
• Rapid weight loss during first few days comes
mainly from body water loss and glycogen
depletion.
• Continued weight reduction occurs at expense of
greater fat loss per unit weight loss.
32. Altering the Energy Balance
• Resting Metabolic
Rate Lowered.
• Blunted metabolism
conserves energy
causing diet to
become progressively
less effective.
• Could lead to difficulty
losing weight.
33. Fat Cell Size and Number
• What happens to fat cell size and fat cell number
when adults lose weight?
• Fat cells shrink to a smaller size than adipocytes of
nonobese people, number remains same.
• The large # of relatively small adipocytes may relate
to appetite control; person craves food, overeats &
gains lost weight.
• Total number of fat cells increases 3 general periods:
Last trimester pregnancy, 1st year life, adolescence
34. What works?
SELF-HELP: 45% of National Weight Control Registry participants lost
weight without program or professional help
PROFESSIONAL-LED LIFESTYLE INTERVENTION:
Many different models proven effective
WEIGHT MANAGEMENT MEDICATIONS:
Underutilized. Many patients w/ obesity could benefit.
WEIGHT LOSS SURGERY:
Most significant & sustained health
improvements. Underutilized.
Relatively low-risk surgery.
35. Setting Expectations
Behavioral intervention:
Initial weight loss goal of 5 -10% typical
Pharmacologic therapy + behavioral therapy:
10 - 15% is a very good response
Weight loss > 15% is considered excellent
response
36. What works?
• USPSTF Grade B recommendation: screen all adult patients
for obesity and offer intensive counseling and behavioral
interventions
• CMS definition of intensive behavioral therapy for obesity:
• - Weekly visits for Month 1;
• - Biweekly visits for months 2-6;
• - Monthly visits for months 7-12
Coding: G0447 if spend >15 minutes counseling
5A’s model
BOTTOM LINE:
At least monthly visits
Preventive Services Task Force. Screening for obesity in adults: recommendations and rationale. Ann Intern Med 2003;139:930-932
CMS Decision Memo for Intensive Behavioral Therapy for Obesity (CAG-00423N)
37. Fat Cell Size and Number
• In non-obese subjects with moderate weight gain, adipocyte
size increased substantially with no change in cell number.
• Weight gain among severely obese, new adipocytes develop in
addition to hypertrophy of existing cells.
38. Select a Diet Program
Method Principle Disadvantage
Low CHO –
ketogenic
Increased ketone excretion
removes energy-containing
substances from body.
Ketogenic
High fat intake
contraindicated.
High
protein
Low caloric intake favors
negative energy balance.
Elevated thermic effect.
Expensive, repetitious;
difficult to maintain,
dehydrates.
Semi-
starvation
Decreased energy input
assures negative balance.
Possible malnutrition,
lethargy, LBM.
High CHO,
low fat
Low carbohydrate favors
negative balance.
Initial water retention.
39. Exercising to Tip Energy Balance
• Increased physical activity combined with dietary
restraint maintains weight loss more effectively than
caloric restriction alone.
• For previously sedentary, overweight, moderate
increases in physical activity do not necessarily
increase food intake.
• Recommend minimum of 3 days per week.
Intensity individualized, minimum 300 kcal/session
40. Diet Plus Exercise
• Combining exercise
and diet offers more
flexibility for weight
loss.
• Exercise facilitates fat
mobilization from
adipose depots and fat
catabolism. Preserves
fat free body mass,
blunts decrease in
RMR, improves insulin
sensitivity.
41. Diet Plus Exercise
The Ideal Combination
• Exercise enhances fat
mobilization from
body’s adipose depots
and fat catabolism by
active muscles.
• Protects against
protein loss in skeletal
muscle and improves
insulin sensitivity.
42. Maintenance of Goal Body Weight
• Most weight loss occurs
during first 6 months.
Up to 85% those
starting a weight loss
program drop & regain.
• IOM recommend that
obese reduce initial
body weight by 5% to
15% as realistic.
43. Maintenance of Goal Weight
• Selective fat reduction at
specific body areas by
spot reduction does NOT
work.
• Exercise stimulates fatty
acid mobilization through
hormones and enzyme
action that target fat
depots throughout the
body.
44. Gaining Weight
• Resistance training complemented by well-balanced diet
increases muscle mass.
• If all calories consumed in excess of energy requirement during
resistance training would go towards muscle growth, 2000 to
2500 extra calories would support 0.5 kg increase in lean
tissue.
• Intense aerobic training will detract from maximal increases in
muscle mass.
45. Assist: 5-10% Weight
Loss
Results in significantly increased odds of achieving:
• 0.5% point reduction in HbA1c
• 5-mmHg decrease in diastolic & systolic blood pressure
• 5 mg/dL increase in HDL cholesterol
• 40 mg/dL decrease in triglycerides
(Compared to weight
stable patients)
Odds even greater in
those who lost 10-15%
46. Assist: 5-10% Weight
Loss
Often achievable through behavioral
interventions alone
Patients feel it is realistic & achievable
<10% does not seem to trigger defense of
“set point”
48. Strategies for achieving 5-10%
Weight Loss
What works best? The plan that is sustainable
long-term
Evidence for:
Low-fat or low-carb
Mediterranean diet
Keys: avoid hunger, make it easy
Gardner, Trepanowski, Del Gobbo, et al. Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults
and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial. JAMA, 2018.
Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D.R., Witkow, S., Greenberg, I. et al, Weight loss with a low-carbohydrate,
Mediterranean, or low-fat diet. N Engl J Med. 2008;359:229–241.
49. Strategies for achieving 5-10%
Weight Loss
Caloric deficit of 250-500 calories/day
But there are some pitfalls…
Don’t:
Overly focus on # of calories
without also paying attention
to quality of calories
Do:
Set specific behavioral goals &
track progress closely with
regular check-ins
50. Measurable
Example #1: I want to lose 10 lbs over the
next 3 months
Example #2: I will eat 2 servings of
vegetables, 5 out of 7 days per week. I will
track using notes section on phone and
review weekly by myself and monthly with
PCP. Next appointment: ___
Example #3: I will walk 4/5 weekdays
during lunch break for 20 minutes. I will
track using physical calendar displayed at
my desk. Will review weekly by myself and
monthly with PCP. Next appointment: ___
TIP: Ask them to WRITE their
goal down and read back to you
51. DO / INCREASE AVOID / DECREASE
Stop eating when full Going hungry
Consistent meal schedule Skipping meals
Follow the Healthy Eating Plate
model
Grazing between meals
Eating late at night
Processed foods like canned
meats or frozen meals
White (sugar, breads, pasta)
Sugary drinks
Alcohol
Trans fats or saturated fats (butter,
red meats, fried foods, chips)
52. • Healthy fats, not low-fat
• Limit red meat, cheese,
dairy and processed
meats
• More specific directions re
quality of calories
53. Strategies for maintaining
weight loss: NWCR
1. Physical activity becomes extremely
important
77%: 60 mins daily, walking most frequently cited
2. 78%: eat breakfast daily
3. 77%: weigh at least weekly
Catch slips before they turn into relapse
4. Consistent eating habits, independent weekday vs
weekend
54. Weight Management Medications
BMI >30
BMI >27 with obesity-related comorbidity
Khera R, Murad MH, Chandar AK, et al. Association of pharmacological treatments for obesity with weight loss and
adverse events: A systematic review and meta-analysis. JAMA 2016; 315:2424. doi: 10.1001/jama.2016.7602
61. Illustration References
• McArdle, William D., Frank I. Katch, and Victor L. Katch. 2000.
Essentials of Exercise Physiology 2nd ed. Image Collection.
Lippincott Williams & Wilkins.
• Plowman, Sharon A. and Denise L. Smith. 1998. Digital Image
Archive for Exercise Physiology. Allyn & Bacon.