Weight loss strategies
that really work
With your guidance, sustained weight loss is possible—
even for the severely obese. These tips and tools will help.
Adopting weight loss
strategies needn’t be
too time-consuming;
evidence suggests that
physicians can provide
basic counseling about
healthy behaviors in
fewer than 5 minutes.
Most clinically
obese patients
are told to lose
weight, but not
given any advice
on how to do so.
Receiving
weight
management
advice from
a physician
is strongly
associated with
patient efforts
to lose weight.
Patients who
sleep too little
or too much
have been
shown to gain
more weight
compared with
those who sleep
for 8 hours.
Urge patients to
keep a record of
their food and
beverage intake
and exercise,
an activity that
helps create
awareness and
accountability.
Bariatric surgery
provides greater
sustained
weight loss
and metabolic
improvements
for severely
obese patients
than other
conventional
weight
management
treatments.
THE ROLE OF PEDIATRICIAN IN PRIMARY PREVENTION OF OBISITYmandar haval
This document discusses the role of pediatricians in preventing childhood obesity. It begins by noting the increasing prevalence of pediatric obesity and its health impacts. Pediatricians are well-positioned to help prevent obesity through long-term relationships with families and expertise in child development. The report reviews evidence for clinical approaches to obesity prevention, such as promoting reduced sugar intake, increased fruits/vegetables, and physical activity. However, research on prevention in primary care settings is limited. The report concludes that while treatment remains important, prevention must also be a priority to create sustainable solutions, and pediatricians should advocate both clinically and in communities to support healthy lifestyles.
1Running head OBESITY 4Running head OBESITY.docxvickeryr87
1
Running head: OBESITY
4
Running head: OBESITY
Obesity
NR503 Population Health, Epidemiology, & Statistical Principles
January 2018
Obesity
Obesity is a chronic medical condition and a significant health concern in the United States that is increasing worldwide. More than one third of the adults in the U.S. are obese. It is a leading cause of preventable illness and death (Centers for Disease Control and Prevention [CDC], 2016). This global epidemic is a leading concern for adults and for children who are predisposed to becoming obese as adults. This paper will discuss the significance of obesity in Florida, provide a background of the disease, review current surveillance and reporting methods, conduct a descriptive epidemiological analysis, discuss diagnosis and screening for prevention tools, develop an evidence based plan along with measureable outcomes to address obesity as an advanced practice nurse, and conclude with an overview of the main points presented.
Background and Significance
According to the CDC (2016), obesity is defined as “weight that is higher than what is considered as a healthy weight for a given height.” It involves excessive weight gain and accumulation of fat. In order to determine obesity, Body Mass Index or BMI is used to indirectly calculate a person’s body fat and health risk based on weight in relation to height. A BMI of 25.0 or above is considered overweight and 30.0 or greater is considered obese. Athletes with a greater amount of muscle mass may have a higher BMI even though they do not have excess body fat. Waist circumference is also used as a tool to diagnose obesity.
There are many causes that contribute to obesity, including behavioral, genetic, hormonal, environmental, and social factors. Increase in caloric intake, unhealthy eating habits, decrease in physical activity, certain medications, age, lack of sleep, quitting smoking, pregnancy, and certain medical disorders can contribute to weight gain (Mayo Clinic, 2018). Driving cars has replaced walking and riding bikes, technology has replaced engaging in physical activity, and easy access to cheaper foods has replaced nutritional importance. Most people are aware when weight is gained. Obvious signs and symptoms are tighter clothes, excess fat, and increased weight on a scale. Being overweight or obese increases the risk for many health diseases. Obesity may cause low endurance, breathing issues, excessive sweating, and joint discomfort. It can also lead to diabetes, gastroesophageal reflux disease, coronary heart disease, hypertension, high cholesterol, stroke, depression, and even certain types of cancer such as bowel, breast, and prostate cancer (Mayo Clinic, 2018).
Below is a map that highlights the obesity prevalence across the U.S. in 2016 according to the CDC. There is no significant difference in overall prevalence between men and women. The prevalence of women with a BMI > 35 is 18.3% compared to 12.5% of men. The.
This paper discusses obesity in Florida. Obesity rates are high, with 36% of Florida adults overweight and 26.2% obese. Obesity increases risks for diseases like diabetes and heart disease. As a future nurse practitioner, the author plans to screen patients for obesity, discuss weight management, and work with communities to increase access to healthy foods and physical activity.
Perspectives in Public Health-2011-Lloyd-177-83rkhan
This study evaluated a commercial weight loss program commissioned by the NHS in Dorset, UK. The program offered 12 free weekly sessions at Slimming World or Weight Watchers. Of the 2,456 participants referred, almost half (44%) lost over 5% of their initial body weight at 12 weeks. Those who attended more sessions ("completers") lost significantly more weight on average (6.1 kg) than dropouts (2.2 kg). The study found that predictors of successful weight loss (over 5% of initial weight) included being older, male, initially in obese class I, and attending more meetings. The study aimed to identify factors influencing weight loss in commercial programs to inform future commissioning.
The document discusses the emerging role of diet coaching in obesity treatment and weight management. It notes that while dietitians receive training in nutrition science, they often lack skills in behavior change and coaching needed to help clients maintain long-term weight loss and lifestyle changes. The document argues that dietitians should receive additional training in techniques like cognitive behavioral therapy, neuro-linguistic programming, and health coaching in order to more effectively promote sustainable behavior change and wellness among clients.
This document provides a summary of the American Dietetic Association's position on weight management. It endorses lifelong commitment to healthful lifestyle behaviors through sustainable eating and daily physical activity for successful weight management. It discusses goals of weight management, which go beyond numbers to also include prevention of weight gain and improvements in health. It also covers assessment of obesity, which involves measuring BMI, waist circumference, medical history, psychological factors, and nutrition intake to develop a care plan.
Utah Diabetes Telehealth Program --
Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)
To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html
Carol Rasmussen, MSN, NP-C, CDE is a nurse practitioner with many years of experience treating patients with diabetes. Currently Ms. Rasmussen practices at the Exodus Healthcare Network in Magna, Utah and also serves on the AADE Editorial Advisory Board for The Diabetes Educator publication. Moreover, Ms. Rasmussen received the Legislative Leadership Award from the American Association of Diabetes Educators at their 2009 Conference in Atlanta.
Her presentation will cover the challenges of increasing access to diabetes education and strategies for overcoming such obstacles, as well as various tools/resources/programs from AADE.
THE ROLE OF PEDIATRICIAN IN PRIMARY PREVENTION OF OBISITYmandar haval
This document discusses the role of pediatricians in preventing childhood obesity. It begins by noting the increasing prevalence of pediatric obesity and its health impacts. Pediatricians are well-positioned to help prevent obesity through long-term relationships with families and expertise in child development. The report reviews evidence for clinical approaches to obesity prevention, such as promoting reduced sugar intake, increased fruits/vegetables, and physical activity. However, research on prevention in primary care settings is limited. The report concludes that while treatment remains important, prevention must also be a priority to create sustainable solutions, and pediatricians should advocate both clinically and in communities to support healthy lifestyles.
1Running head OBESITY 4Running head OBESITY.docxvickeryr87
1
Running head: OBESITY
4
Running head: OBESITY
Obesity
NR503 Population Health, Epidemiology, & Statistical Principles
January 2018
Obesity
Obesity is a chronic medical condition and a significant health concern in the United States that is increasing worldwide. More than one third of the adults in the U.S. are obese. It is a leading cause of preventable illness and death (Centers for Disease Control and Prevention [CDC], 2016). This global epidemic is a leading concern for adults and for children who are predisposed to becoming obese as adults. This paper will discuss the significance of obesity in Florida, provide a background of the disease, review current surveillance and reporting methods, conduct a descriptive epidemiological analysis, discuss diagnosis and screening for prevention tools, develop an evidence based plan along with measureable outcomes to address obesity as an advanced practice nurse, and conclude with an overview of the main points presented.
Background and Significance
According to the CDC (2016), obesity is defined as “weight that is higher than what is considered as a healthy weight for a given height.” It involves excessive weight gain and accumulation of fat. In order to determine obesity, Body Mass Index or BMI is used to indirectly calculate a person’s body fat and health risk based on weight in relation to height. A BMI of 25.0 or above is considered overweight and 30.0 or greater is considered obese. Athletes with a greater amount of muscle mass may have a higher BMI even though they do not have excess body fat. Waist circumference is also used as a tool to diagnose obesity.
There are many causes that contribute to obesity, including behavioral, genetic, hormonal, environmental, and social factors. Increase in caloric intake, unhealthy eating habits, decrease in physical activity, certain medications, age, lack of sleep, quitting smoking, pregnancy, and certain medical disorders can contribute to weight gain (Mayo Clinic, 2018). Driving cars has replaced walking and riding bikes, technology has replaced engaging in physical activity, and easy access to cheaper foods has replaced nutritional importance. Most people are aware when weight is gained. Obvious signs and symptoms are tighter clothes, excess fat, and increased weight on a scale. Being overweight or obese increases the risk for many health diseases. Obesity may cause low endurance, breathing issues, excessive sweating, and joint discomfort. It can also lead to diabetes, gastroesophageal reflux disease, coronary heart disease, hypertension, high cholesterol, stroke, depression, and even certain types of cancer such as bowel, breast, and prostate cancer (Mayo Clinic, 2018).
Below is a map that highlights the obesity prevalence across the U.S. in 2016 according to the CDC. There is no significant difference in overall prevalence between men and women. The prevalence of women with a BMI > 35 is 18.3% compared to 12.5% of men. The.
This paper discusses obesity in Florida. Obesity rates are high, with 36% of Florida adults overweight and 26.2% obese. Obesity increases risks for diseases like diabetes and heart disease. As a future nurse practitioner, the author plans to screen patients for obesity, discuss weight management, and work with communities to increase access to healthy foods and physical activity.
Perspectives in Public Health-2011-Lloyd-177-83rkhan
This study evaluated a commercial weight loss program commissioned by the NHS in Dorset, UK. The program offered 12 free weekly sessions at Slimming World or Weight Watchers. Of the 2,456 participants referred, almost half (44%) lost over 5% of their initial body weight at 12 weeks. Those who attended more sessions ("completers") lost significantly more weight on average (6.1 kg) than dropouts (2.2 kg). The study found that predictors of successful weight loss (over 5% of initial weight) included being older, male, initially in obese class I, and attending more meetings. The study aimed to identify factors influencing weight loss in commercial programs to inform future commissioning.
The document discusses the emerging role of diet coaching in obesity treatment and weight management. It notes that while dietitians receive training in nutrition science, they often lack skills in behavior change and coaching needed to help clients maintain long-term weight loss and lifestyle changes. The document argues that dietitians should receive additional training in techniques like cognitive behavioral therapy, neuro-linguistic programming, and health coaching in order to more effectively promote sustainable behavior change and wellness among clients.
This document provides a summary of the American Dietetic Association's position on weight management. It endorses lifelong commitment to healthful lifestyle behaviors through sustainable eating and daily physical activity for successful weight management. It discusses goals of weight management, which go beyond numbers to also include prevention of weight gain and improvements in health. It also covers assessment of obesity, which involves measuring BMI, waist circumference, medical history, psychological factors, and nutrition intake to develop a care plan.
Utah Diabetes Telehealth Program --
Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)
To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html
Carol Rasmussen, MSN, NP-C, CDE is a nurse practitioner with many years of experience treating patients with diabetes. Currently Ms. Rasmussen practices at the Exodus Healthcare Network in Magna, Utah and also serves on the AADE Editorial Advisory Board for The Diabetes Educator publication. Moreover, Ms. Rasmussen received the Legislative Leadership Award from the American Association of Diabetes Educators at their 2009 Conference in Atlanta.
Her presentation will cover the challenges of increasing access to diabetes education and strategies for overcoming such obstacles, as well as various tools/resources/programs from AADE.
1Rough Draft Quantitative Research Critique And Ethical Consider.docxaulasnilda
1
Rough Draft Quantitative Research Critique And Ethical Considerations
Rough Draft Quantitative Research Critique And Ethical Considerations 2
Quantitative Research Critique and Ethical Considerations
Christiana Bona
Grand Canyon University
October 16, 2019
Childhood Obesity
Picot Question: How do the new practical approaches in the diagnosis and management help in the reduction of obesity issues as compared to the lack of reliance on the traditional approaches (diet and exercise)?
Background
Childhood obesity is considered to be a major international growing problem. Even though there is a high rate of obesity cases in the United States and other regions of the world for the past 30 years, there is still a lack of clear treatment approaches to be applied to reduce this incidence. Healthcare providers are lacking ideas on where they should find approaches related to the guidance and the process of managing the healthcare services to about one-third of the population who are affected by the healthcare issues associated with obesity. The Pediatric Obesity Algorithm is now considered to be an evidence-based approach in terms of diagnosing and managing childhood obesity. The authors of this study aimed at providing a summary of the topics from the Pediatric Obesity Algorithm related to the diagnosis of pediatric obesity, assessment, and management. Other tasks include the performance of differential diagnosis, reviewing the systems, diagnosis of the workup, physical examinations, management of age-specific, and the treatment of the associated weight gain. The outcome of this study will, therefore, help in the identification and treatment of children with obesity through using the Pediatric Obesity Algorithm which serves as a guide to healthcare providers with evidence-based approaches to the diagnosis process and managing obesity in children and offering families with the tools they require to ensure that there is healthy future.
How the article is supporting the topic
The article above is talking about some of the present gaps concerning the management and treatment of obesity among children. Through identifying that there is an absence of clear treatment approaches that can be relied on the treat and manage obesity among children, the authors of this article proposed that the Pediatric Obesity Algorithm can be successful in providing evidence-based approaches for diagnosing and amanging childhood obesity. Therefore, Pediatric Obesity Algorithm can be considered as a new approach in managing and diagnosisng obesity among children as compared to the traditional methods that involve watching the diet and exercise which is sometimes not followed by children. Pediatric Obesity Algorithm approach is helping in ensuring that there is a proper physical examination, age-specific management, use of medication and surgery, and performance of differential diagnosis among other procedures that are performed in this approach.
Method of ...
Literature Evaluation TableStudent Name Christiana Bona.Summa.docxcroysierkathey
Literature Evaluation Table
Student Name: Christiana Bona.
Summary of Clinical Issue (200-250 words):
Childhood obesity is one of the problems that affect the United States and other developed economies. Obesity among children and youths is widely recognized as an issue that generates a lot of adverse health impacts. For instance, childhood obesity is a major indicator of future mental and physical health problems. In spite of the highest rates of childhood obesity in the country in the last three decades, obesity has been linked to other more serious health problems such as cardiovascular diseases and diabetes. As nurses and other health professionals continue to grapple with this problem, there are still no clear treatment approaches. Health professionals usually do not have a comprehensive guideline on where to manage the nearly one-third of their populations who present the medical care with obesity that coexists with other medical conditions and problems. Numerous treatment models have been proposed to address this rising public health concern. These approaches often include use of the traditional interventions such as pharmacological interventions. However, overemphasis on one treatment intervention may fail to generate the desired objectives. While the traditional strategies to obesity prevention and management have placed emphasis on medications, wider attention to other dimensions of treatment is necessary. Such treatment interventions may include the multi-tiered or holistic strategies that incorporate both pharmacological and non-pharmacological interventions. For instance, a wider focus should incorporate practices such as assessing the mental health impacts of obesity on the patients. Thus, a public health multi-tiered approach to obesity that emphasizes on promotion, prevention, and individualized interventions are recommended.
PICOT Question: Is the use of multi-tiered approach to the treatment and management of childhood obesity more effective than overreliance on only pharmacological interventions in reducing obesity prevalence rates?
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Cuda, S. E., & Censani, M. (2018). Pediatric Obesity Algorithm: A Practical Approach to Obesity Diagnosis and Management. Frontiers in pediatrics, 6.
Heerman, W. J., Schludnt, D., Harris, D., Teeters, L., Apple, R., & Barkin, S. L. (2018). Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation. BMC public health, 18(1), 498.
Bazyk, S., & Winne, R. (2013). A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth. Occupational therapy in health care, 27(2), 84-98.
How Does the Article Relate to the PICOT Question?
The article is relevant to the PICOT question because it proposes the use of algorithms and technological systems that have data on all aspects of a child’s obesity prevention and management st ...
Running head NUTRITION1NUTRITION 8Nutriti.docxtodd581
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well.
Running head NUTRITION1NUTRITION 8Nutriti.docxglendar3
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well.
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well ...
Obesity- Tipping Back the Scales of the Nation 19th April, 2017mckenln
Jamie Blackshaw presented on obesity trends and efforts to address obesity in the UK. Obesity rates have significantly increased over time and pose a major health challenge. The costs of obesity to health and the economy are substantial. While attitudes recognize obesity risks, stigma persists. To tackle obesity, Public Health England is pursuing a five pillar plan focusing on leadership, community engagement, monitoring, supporting delivery, and modifying the obesogenic environment. Efforts include sugar reduction, improving weight management services, and developing healthy communities and choices through a whole systems approach.
American Heart Association Lifestyle Recommendations to Reduce.docxjesuslightbody
American Heart Association Lifestyle Recommendations to Reduce Obesity
Jane Doe
University
Project and Practicum
Summer 2022
Abstract
The prevalence of obesity and sedentary lifestyle complications are increasing at alarming rates, representing a common but preventable cause of severe medical complications like diabetes, cardiovascular diseases, and early mortality. This chronic condition has been for a long time a public health concern and social determinant. The Fitbit app offers a unique opportunity to enhance the efficacy of weight loss plans as it is used to track activity, monitor steps, heart rate, energy expenditure, sleep, and sedentary behavior. The integrative review focused on how the American Heart Association (AHA) Diet and Lifestyle recommendations and the Fitbit app are used as innovative solutions to reduce obesity in adult patients.
Research Methodology: A systematic review was conducted to identify research articles completed in the preceding 4-5 years centered on obesity care, diet, physical activity, activity trackers, and lifestyle implications.
Results and Discussion: The databases searched were Chamberlain Library, PubMed, and CINHAL. Initial searches yielded over 2000 articles, of which 45 were chosen and examined because they fit the integrative review's theme. The 15 papers most relevant to the PICOT question were studied in further detail and appraised using the Johns Hopkins Evidence Appraisal table. The studies reported positive physical activity outcomes.
Conclusions and Further Recommendations:This systematic review supported the effectiveness of the AHA Diet and Lifestyle recommendations to reduce obesity, and clinical use generalization is recommended. Fitbit app provides new ways to improve physical activity habits, and the easy availability of electronic devices may enhance their generalizability use.
Keywords: Obesity care; Obesity complications; Lifestyle recommendations; Obesity management; Physical activity intervention using Fitbit activity trackers.
Dedication
Thanks to my family for their unwavering support of this project; their cooperation means a lot to me. To my husband Armando, thank you for your love, understanding, and patience during this time. I credit my achievement to all of you for your unwavering love and belief in me.
Acknowledgments
First, I must acknowledge the help of all my professors who inspired, encouraged, and supported me throughout the DNP program. My heartfelt thanks to my teammates, without whom I would never have completed this phase in my life. Their encouragement has had a significant influence on my strong determination during this trip.
Contents
American Heart Association Lifestyle Recommendations to Reduce Obesity 1
Abstract 2
Introduction Error! Bookmark not defined.
Dedication 3
Acknowledgments 4
American Heart Association Lifestyle Recommendations to Reduce Obesity 6
Problem Statement 6
S.
This study aims to evaluate the effectiveness of peer health coaching in improving clinical outcomes for low-income patients with poorly controlled diabetes. The study will randomize 400 patients from 6 primary care clinics in San Francisco to either receive peer coaching (n=200) or usual care (n=200) over 6 months. The primary outcome is change in HbA1c levels. Secondary outcomes include changes in blood pressure, BMI, LDL cholesterol, diabetes self-care activities, medication adherence, quality of life, self-efficacy, and depression. Clinical values and self-reported measures will be assessed at baseline and 6 months. The study also seeks to understand the perspectives of peer coaches providing this support.
Team as Treatment: Driving Improvement in DiabetesCHC Connecticut
Team-based care has been shown to improve outcomes for patients with diabetes compared to conventional care. Key members of the diabetes care team include nurses, registered dietitians, pharmacists, and community health workers. Technologies like telehealth, electronic health records, and dashboards help coordinate care and monitor patient populations. Community programs also support diabetes patients through services like the YMCA's diabetes prevention program.
The document summarizes a marketing plan for Ketofast, a ketogenic diet program. It analyzes the obesity and weight loss industry market situation, including key issues and consumer/physician attitudes. The communications platform outlines objectives to increase awareness of Ketofast among medical professionals and the morbidly obese. Strategies include targeting skeptical doctors, the helplessly obese, and other groups with tailored messages promoting Ketofast as a controlled, physician-supervised alternative to surgery. Tactics proposed include advertising, events, public relations, documentaries and online activities.
REVIEW Open AccessWeight Science Evaluating the Evidence .docxjoellemurphey
REVIEW Open Access
Weight Science: Evaluating the Evidence for a
Paradigm Shift
Linda Bacon1*, Lucy Aphramor2,3
Abstract
Current guidelines recommend that “overweight” and “obese” individuals lose weight through engaging in lifestyle
modification involving diet, exercise and other behavior change. This approach reliably induces short term weight
loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the
putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only
ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to
food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health
goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight
stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of
recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called
Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a
shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is
associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure,
blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as
self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss
treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence
and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.
Introduction
Concern regarding “overweight” and “obesity” is reflected
in a diverse range of policy measures aimed at helping
individuals reduce their body mass index (BMI)1. Despite
attention from the public health establishment, a private
weight loss industry estimated at $58.6 billion annually in
the United States [1], unprecedented levels of body dissa-
tisfaction [2] and repeated attempts to lose weight [3,4],
the majority of individuals are unable to maintain weight
loss over the long term and do not achieve the putative
benefits of improved morbidity and mortality [5].
Concern has arisen that this weight focused paradigm is
not only ineffective at producing thinner, healthier
bodies, but also damaging, contributing to food and body
preoccupation, repeated cycles of weight loss and regain,
distraction from other personal health goals and wider
health determinants, reduced self-esteem, eating disor-
ders, other health decrement, and weight stigmatization
and discrimination [6-8]. As evidence-based competen-
cies are more firmly embedded in health practitioner
standa ...
The document provides clinical guidelines from the American College of Physicians on the pharmacologic and surgical management of obesity in primary care. It summarizes the evidence from several studies.
The guidelines include 5 recommendations:
1) Counsel all obese patients on lifestyle changes like diet and exercise, and set individualized weight loss goals.
2) Pharmacologic therapy can be offered to patients who have failed to achieve goals through diet and exercise alone, after discussing side effects and lack of long-term safety data.
3) Acceptable drug options include sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion, choosing based on side effect profiles
Alive pd protocol and descriptive paperGladys Block
Alive-PD is a fully automated tailored diabetes prevention program. This journal article describes its features, and describes the protocol of the randomized controlled trial.
Alive-PD protocol and descriptive paperGladys Block
The document describes a randomized controlled trial protocol to evaluate the effectiveness of a fully automated 1-year diabetes prevention program called Alive-PD. 340 subjects with pre-diabetes were randomized to either the Alive-PD intervention group (n=164) or a delayed-entry control group (n=176). The primary outcomes are changes in HbA1c and fasting glucose levels from baseline to 6 months. Secondary outcomes include changes in additional biometric measures at 3, 6, 9, and 12 months. The intervention involves weekly tailored goal setting, challenges, and other online interactions to encourage diet and physical activity changes to prevent diabetes progression. The trial will provide evidence on the efficacy of this web-based program in reducing gly
American Heart Association Lifestyle Recommendations to Redu.docxSusanaFurman449
American Heart Association Lifestyle Recommendations to Reduce Obesity
Yuritza Medina
Chamberlain College of Nursing
NR709 Project and Practicum IV
Summer 2022
Abstract Past tense
The prevalence of obesity and sedentary lifestyle complications are increasing at alarming rates, representing a common but preventable cause of severe medical complications like diabetes, cardiovascular diseases, and early mortality. This common but chronic condition has been for a long time a public health concern and social determinant. The integrative review focused on how the American Heart Association (AHA) Diet and Lifestyle recommendations and the Fitbit app are used as innovative solutions to reduce obesity in adult patients. The Fitbit app offers a unique opportunity to enhance the efficacy of weight loss plans, as it is used to track activity, monitor steps, heart rate, energy expenditure, sleep, and sedentary behavior.
Research Methodology: A systematic review was conducted to identify research articles completed in the preceding 4-5 years centered on obesity care, diet, physical activity, activity trackers, and lifestyle implications. The databases searched were Chamberlain Library, PubMed, and CINHAL.
Results and Discussion: Initial searches yielded over 2000 articles, of which 45 were chosen and examined because they fit the integrative review's theme. The 15 papers most relevant to the PICOT question were studied in further detail and appraised using the Johns Hopkins Evidence Appraisal table. The studies reported positive physical activity outcomes. What were the key themes?
Conclusions and Further Recommendations:This systematic review supported the effectiveness of the AHA Diet and Lifestyle recommendations to prevent and reduce obesity, and clinical use is recommended. Fitbit app provides new ways to improve physical activity habits, and the easy availability of electronic devices may enhance their generalizability use.
Keywords: Obesity care; Obesity complications; Lifestyle recommendations; Obesity management; Physical activity intervention using Fitbit activity trackers.
Dedication
In dedication to my family for their steadfast support of this project; their cooperation means a lot to me. To my husband Armando, thank you for your love, understanding, and patience during this time. I credit my achievement to all of you for your unwavering love and belief in me.
Acknowledgments
First, I must acknowledge the help of all my professors from Chamberlain University, who inspired, encouraged, and supported me throughout the DNP program. My heartfelt thanks to my teammates, without whom I would never have completed this phase in my life. Their encouragement has had a significant influence on my strong determination during this trip.
Contents
American Heart Association Lifestyle Recommendations to Reduce Obesity 1
Abstract 2
Dedication 3
Acknowledgments 4
Introductio.
White Paper AGA: An Episode-of-Care Framework for the Management of ObesityMay Forsyth
White Paper AGA: An Episode-of-Care Framework for the
Management of Obesity—Moving Toward High Value, High
Quality Care: A Report From the American Gastroenterological
Association Institute Obesity Episode of Care and Bundle
Initiative Work Group
Running Head DIET AND PHYSICAL ACTIVITY.Diet and Physical Act.docxtodd271
Running Head: DIET AND PHYSICAL ACTIVITY.
Diet and Physical Activity.
Diet and Physical Activity.
04/11/2019
Diet and Physical Activity.
The body requires a healthy diet and once at a time physical activity to ensure healthy lives, but contrary to that unhealthy diets and inactivity contribute to chronic diseases such as diabetes, cancer or cardiovascular diseases. Improving diets and physical activity will actually reduce disease and deaths on the target community that is currently is something World Health Organization started an initiative for member states to adopt diet, physical activity, and disease prevention.
This health promotion activity is directed towards the local community and specifically the elderly, mainly because they are the section of the population that is likely to be attacked by such diseases, but also the other population section is affected. So, the focus will be on the physicians and nutritionists who will come in and help with this campaign. This is because the younger population like the millennials mostly focus on healthy living with going vegan or regularly visiting the gym in the pursuit of following trends. This will not be a problem for this age group.
The possible stakeholders will be both the government and the private sectors, in the sense that other workplaces have policies in place that support physical activity and proper diet for their workers for the sole purpose of productivity in the workplace. They initiatives in place that include: maybe having walking meetings, provide healthy diet solutions at the workplace by inviting nutritionists and many other ways. The expected results include a healthy community, and maybe possibly pass the message wide enough that it can be a worldwide movement that is of course after ensuring the point is taken in this local community. Hence this is the best health promotion activity for this target population because I believe knowledge is power whereby it acts as prevention, which will bring the collaboration of various professions in the clinical practice.
References
Diet and Physical Activity: a public health priority, retrieved from https://www.who.int/dietphysicalactivity/public-health-priority/en/
4/26/19, 8*54 PMRubric Assessment - NSG6002 Health Policy and Health Promotion in Advanced Nursing Practice FL01 - South University
Page 1 of 4https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_resu…&viewTypeId=3&rubricId=98837&groupId=0&d2l_body_type=5&closeButton=1&showRubricHeadings=0
Criteria
No Evidence
0 points
Unsa!sfactory
51 points
Sa!sfactory
59 points
Proficient
66 points
Exemplary
75 points
Health Topic
Describe a single
health
promo!on/disease
preven!on
problem from the
Healthy People
2020 Objec!ves
Introduc!on to
popula!on or
problem Describe
incidence,
prevalence,
epidemiology, cost
burden etc.,
Student did not
submit assignment
Work minimally
meets assignment
expect.
The Diet for Life Work Group identified barriers to lifelong nutritional treatment for individuals with inborn errors of metabolism (IEM) detected through newborn screening. The group agreed on 7 components needed for a Michigan-specific approach to ensure access to treatment.
Current funding for medical formula through the Newborn Screening Program has reached $825,000 annually but costs are exceeding revenue, threatening sustainability. Over 30 metabolic disorders require medical nutrition therapy identified through screening over 50 conditions. Without treatment, affected individuals experience severe health problems, developmental delays and even death.
The work group recognized treatment involves various forms of medical food, low protein modified foods and supplements tailored individually and adjusting over time based on factors like age, pregnancy and illness.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
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1Rough Draft Quantitative Research Critique And Ethical Consider.docxaulasnilda
1
Rough Draft Quantitative Research Critique And Ethical Considerations
Rough Draft Quantitative Research Critique And Ethical Considerations 2
Quantitative Research Critique and Ethical Considerations
Christiana Bona
Grand Canyon University
October 16, 2019
Childhood Obesity
Picot Question: How do the new practical approaches in the diagnosis and management help in the reduction of obesity issues as compared to the lack of reliance on the traditional approaches (diet and exercise)?
Background
Childhood obesity is considered to be a major international growing problem. Even though there is a high rate of obesity cases in the United States and other regions of the world for the past 30 years, there is still a lack of clear treatment approaches to be applied to reduce this incidence. Healthcare providers are lacking ideas on where they should find approaches related to the guidance and the process of managing the healthcare services to about one-third of the population who are affected by the healthcare issues associated with obesity. The Pediatric Obesity Algorithm is now considered to be an evidence-based approach in terms of diagnosing and managing childhood obesity. The authors of this study aimed at providing a summary of the topics from the Pediatric Obesity Algorithm related to the diagnosis of pediatric obesity, assessment, and management. Other tasks include the performance of differential diagnosis, reviewing the systems, diagnosis of the workup, physical examinations, management of age-specific, and the treatment of the associated weight gain. The outcome of this study will, therefore, help in the identification and treatment of children with obesity through using the Pediatric Obesity Algorithm which serves as a guide to healthcare providers with evidence-based approaches to the diagnosis process and managing obesity in children and offering families with the tools they require to ensure that there is healthy future.
How the article is supporting the topic
The article above is talking about some of the present gaps concerning the management and treatment of obesity among children. Through identifying that there is an absence of clear treatment approaches that can be relied on the treat and manage obesity among children, the authors of this article proposed that the Pediatric Obesity Algorithm can be successful in providing evidence-based approaches for diagnosing and amanging childhood obesity. Therefore, Pediatric Obesity Algorithm can be considered as a new approach in managing and diagnosisng obesity among children as compared to the traditional methods that involve watching the diet and exercise which is sometimes not followed by children. Pediatric Obesity Algorithm approach is helping in ensuring that there is a proper physical examination, age-specific management, use of medication and surgery, and performance of differential diagnosis among other procedures that are performed in this approach.
Method of ...
Literature Evaluation TableStudent Name Christiana Bona.Summa.docxcroysierkathey
Literature Evaluation Table
Student Name: Christiana Bona.
Summary of Clinical Issue (200-250 words):
Childhood obesity is one of the problems that affect the United States and other developed economies. Obesity among children and youths is widely recognized as an issue that generates a lot of adverse health impacts. For instance, childhood obesity is a major indicator of future mental and physical health problems. In spite of the highest rates of childhood obesity in the country in the last three decades, obesity has been linked to other more serious health problems such as cardiovascular diseases and diabetes. As nurses and other health professionals continue to grapple with this problem, there are still no clear treatment approaches. Health professionals usually do not have a comprehensive guideline on where to manage the nearly one-third of their populations who present the medical care with obesity that coexists with other medical conditions and problems. Numerous treatment models have been proposed to address this rising public health concern. These approaches often include use of the traditional interventions such as pharmacological interventions. However, overemphasis on one treatment intervention may fail to generate the desired objectives. While the traditional strategies to obesity prevention and management have placed emphasis on medications, wider attention to other dimensions of treatment is necessary. Such treatment interventions may include the multi-tiered or holistic strategies that incorporate both pharmacological and non-pharmacological interventions. For instance, a wider focus should incorporate practices such as assessing the mental health impacts of obesity on the patients. Thus, a public health multi-tiered approach to obesity that emphasizes on promotion, prevention, and individualized interventions are recommended.
PICOT Question: Is the use of multi-tiered approach to the treatment and management of childhood obesity more effective than overreliance on only pharmacological interventions in reducing obesity prevalence rates?
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Cuda, S. E., & Censani, M. (2018). Pediatric Obesity Algorithm: A Practical Approach to Obesity Diagnosis and Management. Frontiers in pediatrics, 6.
Heerman, W. J., Schludnt, D., Harris, D., Teeters, L., Apple, R., & Barkin, S. L. (2018). Scale-out of a community-based behavioral intervention for childhood obesity: pilot implementation evaluation. BMC public health, 18(1), 498.
Bazyk, S., & Winne, R. (2013). A multi-tiered approach to addressing the mental health issues surrounding obesity in children and youth. Occupational therapy in health care, 27(2), 84-98.
How Does the Article Relate to the PICOT Question?
The article is relevant to the PICOT question because it proposes the use of algorithms and technological systems that have data on all aspects of a child’s obesity prevention and management st ...
Running head NUTRITION1NUTRITION 8Nutriti.docxtodd581
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well.
Running head NUTRITION1NUTRITION 8Nutriti.docxglendar3
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well.
Running head: NUTRITION 1
NUTRITION 8
Nutrition
Student’s Name
Institutional Affiliation
Date
Nutrition
Introduction/Key Points
Topic and Question
Topic five: Interventions to improve additional nutritional status: What type of interventions improve adherence to recommendations on nutritional intake?
Define the Topic and Question
This topic question is defined by interventions to enhance adherence to dietary advice for preventing and managing chronic diseases in adults. By introducing these interventions earlier, it will be possible to prevent people from being affected by chronic diseases.
Overview/Significance of the Problem
The acceptance and implementation of a healthy diet has been recognized as the foundation for managing, preventing, and fighting chronic diseases. However, the inability to be dynamic and diversify one’s life diet can lead to significant problems. It is also vital that people know that people acknowledge the importance of obeying dietary counsel since one’s adherence level can determine the efficiency of dietary treatment. The ability of one to diversify his diet reduces the risk of developing food allergy and intolerance (Ball et al., 2016). Additionally, the lack of education has been mostly associated with a poor quality and less diversified diet in people with diabetes (Tiew, Chan, Lye & Loke, 2014). It is, therefore, evident how the ability to diversify and be dynamic on one’s diet improves the nutritional status.
Article Search
Current and Credible Sources
When searching for my article, I established the Chamberlain Library as an essential tool to assist during the search. I started with my electronic database known as CINHAL where I successfully found the article.
Database search-terms and methods/ Number of articles located
While I was searching for the article, among the terms that I used was; what type of interventions improve adherence to recommendations on nutritional intake? The search provided me with 1,123 articles to refer from. Other search terms that I used were compliance, telemedicine, nutrition, dietary intervention, chronic disease, and adults. The types of articles were limited to be from the Chamberlain Library, written in English, academic journals, descriptive statistics, and full-text peer-reviewed articles. The publication year on the search filter was restricted to 2015 to 2020 to provide the most recent data.
List additional sources outside of ATI module
Main article, “Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focused consultations,” written by (Ball et al., 2016). Another article is “Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus,” published by (Tiew, Chan, Lye & Loke, 2014). Another article is “Prevent Type 2 Diabetes in Kids” by (CDC, 2017).
Article Findings
Why this article?
I chose this article because it has been well ...
Obesity- Tipping Back the Scales of the Nation 19th April, 2017mckenln
Jamie Blackshaw presented on obesity trends and efforts to address obesity in the UK. Obesity rates have significantly increased over time and pose a major health challenge. The costs of obesity to health and the economy are substantial. While attitudes recognize obesity risks, stigma persists. To tackle obesity, Public Health England is pursuing a five pillar plan focusing on leadership, community engagement, monitoring, supporting delivery, and modifying the obesogenic environment. Efforts include sugar reduction, improving weight management services, and developing healthy communities and choices through a whole systems approach.
American Heart Association Lifestyle Recommendations to Reduce.docxjesuslightbody
American Heart Association Lifestyle Recommendations to Reduce Obesity
Jane Doe
University
Project and Practicum
Summer 2022
Abstract
The prevalence of obesity and sedentary lifestyle complications are increasing at alarming rates, representing a common but preventable cause of severe medical complications like diabetes, cardiovascular diseases, and early mortality. This chronic condition has been for a long time a public health concern and social determinant. The Fitbit app offers a unique opportunity to enhance the efficacy of weight loss plans as it is used to track activity, monitor steps, heart rate, energy expenditure, sleep, and sedentary behavior. The integrative review focused on how the American Heart Association (AHA) Diet and Lifestyle recommendations and the Fitbit app are used as innovative solutions to reduce obesity in adult patients.
Research Methodology: A systematic review was conducted to identify research articles completed in the preceding 4-5 years centered on obesity care, diet, physical activity, activity trackers, and lifestyle implications.
Results and Discussion: The databases searched were Chamberlain Library, PubMed, and CINHAL. Initial searches yielded over 2000 articles, of which 45 were chosen and examined because they fit the integrative review's theme. The 15 papers most relevant to the PICOT question were studied in further detail and appraised using the Johns Hopkins Evidence Appraisal table. The studies reported positive physical activity outcomes.
Conclusions and Further Recommendations:This systematic review supported the effectiveness of the AHA Diet and Lifestyle recommendations to reduce obesity, and clinical use generalization is recommended. Fitbit app provides new ways to improve physical activity habits, and the easy availability of electronic devices may enhance their generalizability use.
Keywords: Obesity care; Obesity complications; Lifestyle recommendations; Obesity management; Physical activity intervention using Fitbit activity trackers.
Dedication
Thanks to my family for their unwavering support of this project; their cooperation means a lot to me. To my husband Armando, thank you for your love, understanding, and patience during this time. I credit my achievement to all of you for your unwavering love and belief in me.
Acknowledgments
First, I must acknowledge the help of all my professors who inspired, encouraged, and supported me throughout the DNP program. My heartfelt thanks to my teammates, without whom I would never have completed this phase in my life. Their encouragement has had a significant influence on my strong determination during this trip.
Contents
American Heart Association Lifestyle Recommendations to Reduce Obesity 1
Abstract 2
Introduction Error! Bookmark not defined.
Dedication 3
Acknowledgments 4
American Heart Association Lifestyle Recommendations to Reduce Obesity 6
Problem Statement 6
S.
This study aims to evaluate the effectiveness of peer health coaching in improving clinical outcomes for low-income patients with poorly controlled diabetes. The study will randomize 400 patients from 6 primary care clinics in San Francisco to either receive peer coaching (n=200) or usual care (n=200) over 6 months. The primary outcome is change in HbA1c levels. Secondary outcomes include changes in blood pressure, BMI, LDL cholesterol, diabetes self-care activities, medication adherence, quality of life, self-efficacy, and depression. Clinical values and self-reported measures will be assessed at baseline and 6 months. The study also seeks to understand the perspectives of peer coaches providing this support.
Team as Treatment: Driving Improvement in DiabetesCHC Connecticut
Team-based care has been shown to improve outcomes for patients with diabetes compared to conventional care. Key members of the diabetes care team include nurses, registered dietitians, pharmacists, and community health workers. Technologies like telehealth, electronic health records, and dashboards help coordinate care and monitor patient populations. Community programs also support diabetes patients through services like the YMCA's diabetes prevention program.
The document summarizes a marketing plan for Ketofast, a ketogenic diet program. It analyzes the obesity and weight loss industry market situation, including key issues and consumer/physician attitudes. The communications platform outlines objectives to increase awareness of Ketofast among medical professionals and the morbidly obese. Strategies include targeting skeptical doctors, the helplessly obese, and other groups with tailored messages promoting Ketofast as a controlled, physician-supervised alternative to surgery. Tactics proposed include advertising, events, public relations, documentaries and online activities.
REVIEW Open AccessWeight Science Evaluating the Evidence .docxjoellemurphey
REVIEW Open Access
Weight Science: Evaluating the Evidence for a
Paradigm Shift
Linda Bacon1*, Lucy Aphramor2,3
Abstract
Current guidelines recommend that “overweight” and “obese” individuals lose weight through engaging in lifestyle
modification involving diet, exercise and other behavior change. This approach reliably induces short term weight
loss, but the majority of individuals are unable to maintain weight loss over the long term and do not achieve the
putative benefits of improved morbidity and mortality. Concern has arisen that this weight focus is not only
ineffective at producing thinner, healthier bodies, but may also have unintended consequences, contributing to
food and body preoccupation, repeated cycles of weight loss and regain, distraction from other personal health
goals and wider health determinants, reduced self-esteem, eating disorders, other health decrement, and weight
stigmatization and discrimination. This concern has drawn increased attention to the ethical implications of
recommending treatment that may be ineffective or damaging. A growing trans-disciplinary movement called
Health at Every Size (HAES) challenges the value of promoting weight loss and dieting behavior and argues for a
shift in focus to weight-neutral outcomes. Randomized controlled clinical trials indicate that a HAES approach is
associated with statistically and clinically relevant improvements in physiological measures (e.g., blood pressure,
blood lipids), health behaviors (e.g., eating and activity habits, dietary quality), and psychosocial outcomes (such as
self-esteem and body image), and that HAES achieves these health outcomes more successfully than weight loss
treatment and without the contraindications associated with a weight focus. This paper evaluates the evidence
and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.
Introduction
Concern regarding “overweight” and “obesity” is reflected
in a diverse range of policy measures aimed at helping
individuals reduce their body mass index (BMI)1. Despite
attention from the public health establishment, a private
weight loss industry estimated at $58.6 billion annually in
the United States [1], unprecedented levels of body dissa-
tisfaction [2] and repeated attempts to lose weight [3,4],
the majority of individuals are unable to maintain weight
loss over the long term and do not achieve the putative
benefits of improved morbidity and mortality [5].
Concern has arisen that this weight focused paradigm is
not only ineffective at producing thinner, healthier
bodies, but also damaging, contributing to food and body
preoccupation, repeated cycles of weight loss and regain,
distraction from other personal health goals and wider
health determinants, reduced self-esteem, eating disor-
ders, other health decrement, and weight stigmatization
and discrimination [6-8]. As evidence-based competen-
cies are more firmly embedded in health practitioner
standa ...
The document provides clinical guidelines from the American College of Physicians on the pharmacologic and surgical management of obesity in primary care. It summarizes the evidence from several studies.
The guidelines include 5 recommendations:
1) Counsel all obese patients on lifestyle changes like diet and exercise, and set individualized weight loss goals.
2) Pharmacologic therapy can be offered to patients who have failed to achieve goals through diet and exercise alone, after discussing side effects and lack of long-term safety data.
3) Acceptable drug options include sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion, choosing based on side effect profiles
Alive pd protocol and descriptive paperGladys Block
Alive-PD is a fully automated tailored diabetes prevention program. This journal article describes its features, and describes the protocol of the randomized controlled trial.
Alive-PD protocol and descriptive paperGladys Block
The document describes a randomized controlled trial protocol to evaluate the effectiveness of a fully automated 1-year diabetes prevention program called Alive-PD. 340 subjects with pre-diabetes were randomized to either the Alive-PD intervention group (n=164) or a delayed-entry control group (n=176). The primary outcomes are changes in HbA1c and fasting glucose levels from baseline to 6 months. Secondary outcomes include changes in additional biometric measures at 3, 6, 9, and 12 months. The intervention involves weekly tailored goal setting, challenges, and other online interactions to encourage diet and physical activity changes to prevent diabetes progression. The trial will provide evidence on the efficacy of this web-based program in reducing gly
American Heart Association Lifestyle Recommendations to Redu.docxSusanaFurman449
American Heart Association Lifestyle Recommendations to Reduce Obesity
Yuritza Medina
Chamberlain College of Nursing
NR709 Project and Practicum IV
Summer 2022
Abstract Past tense
The prevalence of obesity and sedentary lifestyle complications are increasing at alarming rates, representing a common but preventable cause of severe medical complications like diabetes, cardiovascular diseases, and early mortality. This common but chronic condition has been for a long time a public health concern and social determinant. The integrative review focused on how the American Heart Association (AHA) Diet and Lifestyle recommendations and the Fitbit app are used as innovative solutions to reduce obesity in adult patients. The Fitbit app offers a unique opportunity to enhance the efficacy of weight loss plans, as it is used to track activity, monitor steps, heart rate, energy expenditure, sleep, and sedentary behavior.
Research Methodology: A systematic review was conducted to identify research articles completed in the preceding 4-5 years centered on obesity care, diet, physical activity, activity trackers, and lifestyle implications. The databases searched were Chamberlain Library, PubMed, and CINHAL.
Results and Discussion: Initial searches yielded over 2000 articles, of which 45 were chosen and examined because they fit the integrative review's theme. The 15 papers most relevant to the PICOT question were studied in further detail and appraised using the Johns Hopkins Evidence Appraisal table. The studies reported positive physical activity outcomes. What were the key themes?
Conclusions and Further Recommendations:This systematic review supported the effectiveness of the AHA Diet and Lifestyle recommendations to prevent and reduce obesity, and clinical use is recommended. Fitbit app provides new ways to improve physical activity habits, and the easy availability of electronic devices may enhance their generalizability use.
Keywords: Obesity care; Obesity complications; Lifestyle recommendations; Obesity management; Physical activity intervention using Fitbit activity trackers.
Dedication
In dedication to my family for their steadfast support of this project; their cooperation means a lot to me. To my husband Armando, thank you for your love, understanding, and patience during this time. I credit my achievement to all of you for your unwavering love and belief in me.
Acknowledgments
First, I must acknowledge the help of all my professors from Chamberlain University, who inspired, encouraged, and supported me throughout the DNP program. My heartfelt thanks to my teammates, without whom I would never have completed this phase in my life. Their encouragement has had a significant influence on my strong determination during this trip.
Contents
American Heart Association Lifestyle Recommendations to Reduce Obesity 1
Abstract 2
Dedication 3
Acknowledgments 4
Introductio.
White Paper AGA: An Episode-of-Care Framework for the Management of ObesityMay Forsyth
White Paper AGA: An Episode-of-Care Framework for the
Management of Obesity—Moving Toward High Value, High
Quality Care: A Report From the American Gastroenterological
Association Institute Obesity Episode of Care and Bundle
Initiative Work Group
Running Head DIET AND PHYSICAL ACTIVITY.Diet and Physical Act.docxtodd271
Running Head: DIET AND PHYSICAL ACTIVITY.
Diet and Physical Activity.
Diet and Physical Activity.
04/11/2019
Diet and Physical Activity.
The body requires a healthy diet and once at a time physical activity to ensure healthy lives, but contrary to that unhealthy diets and inactivity contribute to chronic diseases such as diabetes, cancer or cardiovascular diseases. Improving diets and physical activity will actually reduce disease and deaths on the target community that is currently is something World Health Organization started an initiative for member states to adopt diet, physical activity, and disease prevention.
This health promotion activity is directed towards the local community and specifically the elderly, mainly because they are the section of the population that is likely to be attacked by such diseases, but also the other population section is affected. So, the focus will be on the physicians and nutritionists who will come in and help with this campaign. This is because the younger population like the millennials mostly focus on healthy living with going vegan or regularly visiting the gym in the pursuit of following trends. This will not be a problem for this age group.
The possible stakeholders will be both the government and the private sectors, in the sense that other workplaces have policies in place that support physical activity and proper diet for their workers for the sole purpose of productivity in the workplace. They initiatives in place that include: maybe having walking meetings, provide healthy diet solutions at the workplace by inviting nutritionists and many other ways. The expected results include a healthy community, and maybe possibly pass the message wide enough that it can be a worldwide movement that is of course after ensuring the point is taken in this local community. Hence this is the best health promotion activity for this target population because I believe knowledge is power whereby it acts as prevention, which will bring the collaboration of various professions in the clinical practice.
References
Diet and Physical Activity: a public health priority, retrieved from https://www.who.int/dietphysicalactivity/public-health-priority/en/
4/26/19, 8*54 PMRubric Assessment - NSG6002 Health Policy and Health Promotion in Advanced Nursing Practice FL01 - South University
Page 1 of 4https://myclasses.southuniversity.edu/d2l/lms/competencies/rubric/rubrics_assessment_resu…&viewTypeId=3&rubricId=98837&groupId=0&d2l_body_type=5&closeButton=1&showRubricHeadings=0
Criteria
No Evidence
0 points
Unsa!sfactory
51 points
Sa!sfactory
59 points
Proficient
66 points
Exemplary
75 points
Health Topic
Describe a single
health
promo!on/disease
preven!on
problem from the
Healthy People
2020 Objec!ves
Introduc!on to
popula!on or
problem Describe
incidence,
prevalence,
epidemiology, cost
burden etc.,
Student did not
submit assignment
Work minimally
meets assignment
expect.
The Diet for Life Work Group identified barriers to lifelong nutritional treatment for individuals with inborn errors of metabolism (IEM) detected through newborn screening. The group agreed on 7 components needed for a Michigan-specific approach to ensure access to treatment.
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1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/45167955
Weight loss strategies that really work
Article in The Journal of family practice · July 2010
Source: PubMed
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<<<Weight Loss Process System Link>>>
2. 378 THE JOURNAL OF FAMILY PRACTICE | JULY 2010 | VOL 59, NO 7
Weight loss strategies
that really work
With your guidance, sustained weight loss is possible—
even for the severely obese. These tips and tools will help.
I
t’s not only obese patients who are resistant to weight loss
strategies.Manyphysicianscontributetothegapbetween
current practice and optimal management of adult obe-
sity, as well. There are a number of reasons for this—a dearth
of knowledge, time, and reimbursement among them.1,2
What’s more, physicians are often pessimistic about how
much headway patients can make in their weight loss ef-
forts. That’s not surprising, given that the average weight loss
achieved in well-controlled clinical trials tends to be mod-
est and the recidivism rate is extremely high.3
Yet these same
trials are cause for optimism, with substantial subsets of pa-
tients often achieving clinically meaningful long-term weight
loss. The National Weight Control Registry, a long-term pro-
spective study of “successful losers,” is another hopeful indi-
cator: The registry includes approximately 6000 individuals
who have lost, on average, more than 70 lb, and kept it off for
an average of 6 years.4
(Listen to the audiocast at jfponline.
com to find out how.)
Weight loss does not have to be huge to be clinically sig-
nificant. Even a modest loss (5%-10% of total body weight) can
have major health benefits. There’s much you can do to help.
Evidence suggests that patients are considerably more
likely to lose weight when they are advised to do so and sup-
ported by their primary care physician.5-9
Because there is
no way to predict which approach will be most effective for
which patient, family physicians (FPs) should offer a variety
of evidence-based treatments, including dietary change, in-
creased physical activity, medication for selected patients,
and surgery for severely obese adults (TABLE 1).
In 2009, the National Committee on Quality Assurance
added body mass index (BMI) to the list of effectiveness-of-
care measures that health plans and physicians are rated on.10
That addition, coupled with a recent study indicating that obe-
sity accounts for more than 9% of annual health care expendi-
tures,11
highlights the growing recognition that obesity should
beconsideredamedicalcondition—notjustariskfactor.While
Kathryn M. Kolasa, PhD, RD,
LDN; David N. Collier, MD,
PhD; Kathy Cable, MLS
Departments of Family
Medicine (Dr. Kolasa) and
Pediatrics (Drs. Kolasa and
Collier), and Brody School of
Medicine (Ms. Cable) at
East Carolina University,
Greenville, NC
kolasaka@ecu.edu
Dr. Kolasa reported that she serves
on a nutrition advisory committee to
Burger King International. Dr. Collier
and Ms. Cable reported no potential
conflicts of interest relevant to this
article. PRACTICE
PRACTICE
RECOMMENDATIONS
RECOMMENDATIONS
› Calculate body mass
index and diagnose obesity
to increase the likelihood
that obese patients will take
steps to lose weight. B
› Prescribe a low-calorie
diet for at least 6 months
to help patients achieve a
weight loss of at least 5%
to 10%; prescribe physical
activity for weight loss and
weight maintenance. A
› Review the benefits and
risks of bariatric surgery with
patients who are severely
obese, and provide a refer-
ral, when appropriate. A
Strength of recommendation (SOR)
Good-quality patient-oriented
evidence
Inconsistent or limited-quality
patient-oriented evidence
Consensus, usual practice,
opinion, disease-oriented
evidence, case series
A
B
C
National Weight
Control Registry:
Lessons from
“successful losers”
J. Graham Thomas,
PhD, NWCR
co-investigator
<<<Click Here For Weight Loss System>>>
4. 380 THE JOURNAL OF FAMILY PRACTICE | JULY 2010 | VOL 59, NO 7
Diagnose obesity without delay
While most patients can report their height
and weight with reasonable accuracy, few
obese adults consider themselves to be
obese.19
And, although the USPSTF 2009 rec-
ommendations call for screening all adults
for obesity and introducing behavioral inter-
ventions to promote sustained weight loss
as needed,20
most obese men and women
receive neither a diagnosis nor an obesity
management plan.21
Yet both are key compo-
nents of long-term weight control. Physicians
should calculate and document the BMI of all
adult patients, and routinely diagnose obesity
in patients with a BMI ≥30 kg/m2
(TABLE 1).
Get the patient’s perspective
In addition to using BMI and waist circum-
ference measures and identifying comor-
bidities such as diabetes and hypertension,
it is important to determine whether the pa-
tient is motivated to change. You can start
by asking whether he or she has previously
been told to lose weight; adults who have
received weight control counseling in the
past are more likely to be in a greater state of
readiness.7
❚ Review the patient’s medications.
Once you have identified obesity, look for
iatrogenic causes—most notably, current use
of 1 or more medications that are associated
with weight gain or known to affect satiety. If
you identify any such drugs, it may be pos-
sible to find a suitable alternative (TABLE 3).
❚ Factor in literacy. Patients with low
literacy are less likely to fully comprehend
the health benefits of weight loss or to re-
port that they are ready to lose weight, as
compared with those with higher literacy
levels.22
Talking to such patients to deter-
mine what will spark their interest and mo-
tivation—ie, looking and feeling better, being
able to play with children or grandchildren—
can help.
❚ Assess the patient’s dietary patterns.
This can be done with the Rapid Eating As-
sessment for Participants (REAP), an office-
based tool of adequate reliability and validity
for nutrition assessment and counseling that
can be administered in a few minutes.23
This office-based survey, available at
http://bms.brown.edu/nutrition/acrobat/
REAP%206.pdf, provides information that
can be the basis for an action plan. While
there is no direct evidence that having a plan
leads to weight loss, receiving advice from a
physician is strongly associated with efforts to
lose weight.6
Be aware that obese individuals
may not be as responsive to weight manage-
ment counseling from a physician as those
who are overweight, so they may require
more assistance.21
TABLE 1
BMI, health risks, and weight loss: Which intervention for which patients?15
Disease risk Intervention
BMI, kg/m2
(weight status)
Normal waist
measurement
Elevated waist
measurement
Diet and physical
activity Medication Surgery
25-29.9
(overweight)
Increased High 25-26.9: Yes, for
patients with
comorbidities
27-29.9: Yes
25-26.9: NA
27-29.9: Yes, for
patients with
comorbidities
NA
30-39.9
(obese)
30-34.9: High
35-39.9: Very high
Very high Yes Yes 30-34.9: Yes, for
patients with
comorbidities
35-39.9: Yes
≥40
(extremely obese)
Extremely high Extremely high Yes Yes Yes
BMI, body mass index; NA, not appropriate.
<<<Click Here For Weight Loss System>>>
5. 381
JFPONLINE.COM
WEIGHT LOSS STRATEGIES
VOL 59, NO 7 | JULY 2010 | THE JOURNAL OF FAMILY PRACTICE
Most clinically
obese patients
are told to lose
weight, but not
given any advice
on how to do so.
Set a goal, prescribe a food plan
After discussing possible interventions
based on the patient’s BMI and weight status
(TABLE 1), set a safe and achievable goal to
reduce body weight at a rate of 1 to 2 lb per
week for 6 months to achieve an initial weight
loss goal of up to 10%. Not only does such a
target have proven health benefits,15,24
but
defining success in realistic and achievable
terms helps maintain patient motivation.
Although no single dietary approach has
been found to have a metabolic advantage or be
mostlikelytosupportlong-termweightmainte-
nance,15,25-28
energy balance is central. It is criti-
cal to induce a negative energy balance—with a
deficit of 250 to 500 calories per day to achieve a
weight loss of 0.5 to 2 lb per week.
Which diet is best?
Diets emphasizing varying contents of carbo-
hydrate, fat, and protein have generally been
found to be equally successful in promoting
clinically meaningful weight loss and main-
tenance over the course of 2 years, although
some studies have found specific approaches
to encourage initial weight loss.26
Because dif-
ferent strategies have proven helpful to various
patients, your best bet is to analyze the patient’s
eating pattern and prescribe the diet he or she
is most likely to adhere to for at least 6 months.
❚ If the patient has comorbidities, choose
thedietexpectedtohavethegreatestimpact—a
low-glycemic diet for an obese patient with dia-
betes, for example, and the Dietary Approaches
to Stop Hypertension (DASH) food plan for
a patient with hypertension.27
For premeno-
pausal women, diets low in carbohydrates have
beenfoundtofacilitateweightlosswithoutneg-
ative health consequences.25
Offer specific—and actionable—strategies
Most clinically obese patients (63%, according
to 1 study) do not receive weight loss counsel-
ing from their primary care physician. Often,
they are told to lose weight, but not given ad-
vice on how to do so. Providing specific strate-
gies can help patients stay motivated.
One set of specific weight-loss messages
comes from the Centers for Disease Control
and Prevention (CDC)’s Research to Practice
Series.29
Patients are advised to:
• limit eating away from home
• select healthy options when eating out
• eat more fruits and vegetables
• avoid large portion sizes
• eat low energy-dense foods (ie, foods
that are high in micronutrients but low
in calories per gram).
The CDC also encourages new moms to
breastfeed. In addition to helping the women
themselves control their weight, breastfed in-
fants appear to be more likely to maintain a
normal body weight—an important consid-
eration as overweight children are more like-
ly than children of normal weight to become
overweight adults.30
(To learn more about
pediatric obesity, see “How best to help kids
lose weight” on page 386.)
The “5-3-2-1-almost none” plan offers
additional advice. Every day, patients should:
• Eat ≥5 servings of fruits and vegetables
• Have 3 structured meals (including
breakfast)
• Limit TV/video game use to ≤2 hours
• Engage in ≥1 hour of moderate to
vigorous physical activity
• Limit sugar-sweetened drinks to almost
none.31
❚ Encourage patients to keep a diary.
Suggesting that patients track their food and
beverage intake, as well as their physical ac-
tivity, is another helpful strategy, as self-mon-
itoring creates a sense of accountability and
awareness. Patients are likely to need ongoing
encouragement to do so, however, because re-
cord keeping typically declines with time.32,33
Prescribe physical activity, and sleep
Physical activity guidelines vary for active
adults, older adults, and those with disabili-
ties. To attain health benefits, however, the
general recommendation is for ≥150 minutes
of moderate-intensity physical activity per
week, plus muscle strengthening activities at
least twice a week.33,34
Help patients identify
strategies that will improve adherence, such
as wearing a pedometer to gauge miles walked
per day or working out with a buddy.34
❚ Sleep duration, too, may affect
weight. Although there is insufficient evi-
dence to support the idea that sleep is an in-
dependent risk factor for obesity,35
it appears
that those who sleep too much (9-10 hours
<<<Click Here Fore Weight Loss System>>>
6. 382 THE JOURNAL OF FAMILY PRACTICE | JULY 2010 | VOL 59, NO 7
Receiving
weight
management
advice from
a physician
is strongly
associated with
patient efforts
to lose weight.
per night) or too little (5-6 hours) have a 3- to
5-lb weight gain compared with those who
sleep for 8 hours. One possible explanation
is that there is a disruption in the production
of hormones that affects appetite.4
Advise
patients that getting enough sleep can help
them control their weight.
Consider meal replacement,
pharmacotherapy
For select patients, adherence to a low-
calorie diet can be facilitated by the use of
meal replacement products, as well as by
pharmacotherapy. Each approach yields
about a 5% to 7% weight loss.36
High-protein,
high-fiber calorie-controlled shakes or bars
can be particularly helpful for patients who
have difficulty with food selection or por-
tion control and can be effectively moni-
tored by a physician or dietitian.37,38
Dietary
fiber is also helpful in decreasing food intake
and hunger.
❚ Discuss the risks of supplements.
Patients are bombarded by advertisements
for dietary supplements. You can help by ini-
tiating a discussion of the lack of evidence
of the efficacy and/or safety of most such
products.
The most widely used herbal supple-
ment, ephedrine, was taken off the market
in 2006 for safety reasons. The US Food and
TABLE 2
Obesity: Key components of evaluation and treatment
Assess • Severity of obesity with calculated BMI, waist circumference, and comorbidities
• Food intake and physical activity in context of health risks and appropriate
dietary approach
• Medications that affect weight or satiety
• Readiness to change behavior and stage of change
Advise • Diagnosis of overweight, obese, or severe obesity
• Caloric deficit needed for weight loss
• Various types of diets that lead to weight loss and ease of adherence
• Appropriateness, cost, and effectiveness of meal replacements, dietary
supplements, over-the-counter weight aids, medications, surgery
• Importance of self-monitoring
Agree • If patient is not ready, discuss at another visit
• If patient is motivated and ready to change, develop treatment plan
• If patient chooses diet, physical activity, and/or medication, set weight loss
goal 10% from baseline
• If patient is a potential candidate for surgery, review the options
Assist • Provide a diet plan, physical activity guide, and behavior modification guide
• Provide Web resources based on patient interest and need
• Identify method for self-monitoring (eg, diary)
• Review food and activity diary on follow-up. (Reassess if initial goal is not met.)
Arrange • Follow-up appointments to meet patient needs
• Referral to registered dietitian and/or behavioral specialist for individual
counseling/monitoring or weight management class
• Referral to surgical program
• Maintenance counseling to prevent relapse or weight regain
BMI, body mass index.
<<<Click Here For Weight Loss System>>>
7. 383
JFPONLINE.COM
WEIGHT LOSS STRATEGIES
VOL 59, NO 7 | JULY 2010 | THE JOURNAL OF FAMILY PRACTICE
Drug Administration recommends avoid-
ing many over-the-counter dietary products
because a significant number of them have
been found to contain undeclared active pre-
scription ingredients.39
In general, published trials of dietary
supplements are of suboptimal quality. There
is limited evidence that caffeine may have a
positive effect on thermogenesis and fat oxi-
dation.4
A review of 1 promising dietary sup-
plement, chitosan, found that the effect was
minimal and unlikely to be of clinical signifi-
cance.40
The evidence is weak for meaningful
changes in weight or body composition for
green tea catechins, conjugated linoleic acid,
and chromium picolinate. Dietary calcium
appears to aid in weight management, but
the magnitude is controversial.41
Preliminary
data about amino acids and neurotransmit-
ter modulation are promising, but too little
is currently known about these approaches.42
Fiber supplements, unlike most dietary sup-
plements, are recommended, as dietary fiber
decreases food intake and hunger.
TABLE 3
Drugs that promote weight gain—and alternatives to consider46,52,53
COX, cyclooxygenase; MAOI, monoamine oxidase inhibitor; NSAIDs, nonsteroidal anti-inflammatory drugs.
*Table is not meant to imply equal efficacy for all choices for a given indication.
†
Valproic acid and carbamazepine are associated with weight gain, but less than that associated with lithium.
‡
Topiramate may not be adequate as a single agent.
Indication/drug class/medication Alternatives*
Anticonvulsants/psychotropics
Anticonvulsants
Valproic acid,†
carbamazepine†
Topiramate‡
Antimanic (bipolar)
Lithium Valproic acid,†
carbamazepine†
Antipsychotics
Atypical: Olanzapine, clozapine, risperidone,
quetiapine
Ziprasidone
Typical: Chlorpromazine, thiothixene,
haloperidol
Molindone, loxapine
Antidepressants
MAOI: Phenelzine Tranylcypromine, moclobemide
Tricyclics: Amitriptyline, imipramine Nortriptyline, protriptyline, desipramine
Antidiabetics
Sulfonylureas
Glipizide, glyburide Gliclazide, metformin, acarbose
Antihypertensives
Alpha-adrenergic blockers
and centrally acting agents
Clonidine, guanabenz, methyldopa, prazosin,
terazosin
Beta-blockers
Propranolol
Calcium channel blockers
Nisoldipine
Guanfacine, doxazosin
Acebutolol, atenolol, betaxolol, bisoprolol,
labetalol, metoprolol, nadolol, pindolol
Amlodipine, diltiazem, felodipine, nicardipine,
nifedipine, verapamil
Anti-inflammatories
Corticosteroids NSAIDs, COX inhibitors
Patients who
sleep too little
or too much
have been
shown to gain
more weight
compared with
those who sleep
for 8 hours.
CONTINUED
Click Here For Weight Loss System>>>
8. 384 THE JOURNAL OF FAMILY PRACTICE | JULY 2010 | VOL 59, NO 7
❚ Pharmacotherapy may boost weight
loss. Two types of weight loss drugs—a lipase
inhibitor(orlistat[Xenical])andanappetitesup-
pressant (sibutramine [Meridia])—are on the
market. Research shows that pharmacotherapy,
when combined with diet or physical activity,
may enhance weight loss (usually <11 lb/year)
in some adults, although the optimal duration
ofdrugusehasnotbeendetermined.16,17,43,44
The
choiceofmedicationshouldbebasedontheex-
pected response to the medication. There is no
evidence that either medication promotes more
sustained weight loss than the other. In clinical
trials, however, sibutramine produced a weight
loss of 4.9 lb more than orlistat.44
While patients with hypertension have
been found to achieve modest weight loss using
either agent, orlistat reduced both diastolic and
systolic pressure, while diastolic blood pressure
increased with sibutramine.45
Metformin may
help prevent excess weight gain associated with
short-term use of atypical antipsychotics, al-
though its use for this purpose is off-label.46
When to consider bariatric surgery
Bariatric surgery continues to provide greater
sustained weight loss and metabolic improve-
ments than other conventional treatments.47
Identify patients who have failed at compre-
hensive weight loss programs and who are at
high risk for obesity-associated morbidity and
mortality(TABLE 1),anddiscussthebenefits(eg,
reduction in comorbidities and at least a short-
term improvement in health-related quality of
life) and risks (eg, pulmonary embolism, anas-
tomosis leakage, procedure-specific problems
such as band slippage and erosion [after gastric
banding], and possibly even death) of bariatric
surgery.Referpotentialcandidatestoanappro-
priate surgeon and facility.
Be aware, however, that the field of bariatric
surgery is rapidly changing in terms of types of
procedures, standards for perioperative care, pa-
tient selection, and reimbursement policies,48,49
and patients need to check with their insurance
companybeforemakinganytreatmentdecisions.
Common bariatric procedures include
Roux-en Y gastric bypass (the gold standard);
adjustable gastric banding; biliopancreatic
diversion; and sleeve gastrectomy. Most are
done laparoscopically. The sleeve gastrec-
tomy, in which a vertical sleeve is created
while much of the stomach is removed, may
be useful for patients who are high-volume
eaters, or to prepare extremely obese patients
for gastric bypass. Patient selection is impor-
tant, and multidisciplinary care is generally
considered essential. After the surgery, the FP
will play a key role, monitoring the patient’s
medications, nutrition, physical activity,
chronic conditions, and overall quality of life.
Adopt a team approach
Encourage your office staff to review the Sur-
geon General’s Vision for a Healthy and Fit Na-
tion 2010 (www.surgeongeneral.gov/library/
obesityvision/obesityvision2010.pdf), which
focuses on promoting, modeling, and working
with patients to achieve a healthy lifestyle. The
Surgeon General advocates a team approach
to weight management, and recommends that
patients have referrals to dietitians, psycholo-
gists, and community services.17,50
Interventions that include not only life-
style modifications, but also behavioral modi-
fications, such as hypnosis, can also be helpful.
Computer-based strategies, such as Internet-
based weight management programs and au-
tomated messaging, may be useful, as well, to
break down barriers resulting from factors such
ascost,timeconstraints,andlackoftransporta-
tion or child care.51
Even when such programs
are in use, however, it is important to remem-
ber that patients value—and benefit from—the
support of their primary care physician. JFP
JFP
ACKNOWLEDGEMENT
This work has been presented in various Continuing Medical
Education programs to audiences in North Carolina.
CORRESPONDENCE
Kathryn M. Kolasa, PhD, RD, LDN, Department of Family
Medicine, Mailstop 626, Brody School of Medicine at East
Carolina University, Greenville, NC 27834; kolasaka@ecu.edu
References
Urge patients to
keep a record of
their food and
beverage intake
and exercise,
an activity that
helps create
awareness and
accountability.
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Bariatric surgery
provides greater
sustained
weight loss
and metabolic
improvements
for severely
obese patients
than other
conventional
weight
management
treatments.
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