Weight Management

1. Weight Management Overview

• Statistics Related to Overweight and Obesity
  • What are overweight and obesity?
  • How are overweight and obesity measured?
• Body Mass Index Table
• Waist Circumference
  • Why do statistics about overweight and obesity differ?
• Prevalence Statistics Related to Overweight and Obesity
  • How many adults are overweight?
  • How many adults are obese?
  • How many adults are at a healthy weight?
  • How has the prevalence of overweight and obesity in adults changed over the years?
  • What is the prevalence of overweight and obesity in minorities?
    • Figure 1: Age-adjusted prevalence of overweight (BMI 25-29.9) and obesity (BMI > 30)
  • What is the prevalence of overweight and obesity in children, and adolescents?
  • What is the prevalence of diabetes in people who are overweight or obese?
  • What is the prevalence of hypertension (high blood pressure) in people who are overweight or obese?
  • What is the prevalence of high blood cholesterol in people who are overweight or obese?
  • What is the prevalence of cancer in people who are overweight or obese?
  • What is the mortality rate associated with obesity?
• Economic Costs Related to Overweight and Obesity
  • What is the cost of overweight and obesity?
  • What is the cost of heart disease related to overweight and obesity?
  • What is the cost of type 2 diabetes related to overweight and obesity?
  • What is the cost of osteoarthritis related to overweight and obesity?
  • What is the cost of hypertension (high blood pressure) related to overweight and obesity?
  • What is the cost of gallbladder disease related to overweight and obesity?
  • What is the cost of cancer related to overweight and obesity?
  • What is the cost of lost productivity related to obesity?
• Other Statistics Related to Overweight and Obesity
  • How much do we spend on weight-loss products and services?
  • How physically active is the U.S. population?
  • What is the cost of lack of physical activity?
  • What are the benefits of physical activity?
• REFERENCES
• Do You Know the Health Risks of Being Overweight?
• Type 2 Diabetes
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• Heart Disease and Stroke
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• Cancer
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• Sleep Apnea
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• Osteoarthritis
  • What is it?
  • How is it linked to overweight?
• Gallbladder Disease
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• Fatty Liver Disease
  • What is it?
  • How is it linked to overweight?
  • What can weight loss do?
• How Can I Lower My Health Risks?
• Additional Resources
• Weight Loss For Life
  • Who should lose weight?
• How We Lose Weight
  • Do-it-yourself programs
  • Non-clinical programs
  • Clinical programs
• Diet
  • Calorie level
  • Good nutrition
  • Types of diets
    • Figure 2. The Food Guide Pyramid
    • Figure 3. One Serving Equals
• Physical Activity
• Behavior Change
• What Works For You?
• Additional Reading
• Other Resources
• Tips For Adults
• What Is a Healthy Diet?
• Tips For Healthy Eating
  • Lower fat versions of favorite foods
  • Quick breakfast ideas
  • Easy snack ideas
• What Makes People Overweight?
• If You Need to Lose Weight
• Getting Active
• Are You Ready To Be Even More Active?
• Be Good To Yourself
• Additional Reading
• Additional Resources
• Helping Your Overweight Child
  • Is my child overweight?
  • How can I help my overweight child?
  • Be supportive
  • Encourage healthy eating habits
  • Healthy snack foods for your child to try.
  • Encourage daily physical activity
  • Discourage inactive pastimes
  • Your health care provider
  • Weight-control program
• Other Resources
• Taking Charge of Your Health
• Family Matters
  • So, where do I start?
• Physical Activity — It Doesn’t Have To Be A Chore!
• Get Moving!
• You Are What You Eat!
  • What do you eat?
  • Where do you usually eat?
  • Why do you eat?
• Snack Attack
• Staying Healthy and Happy
• Additional Reading
• Resources and Organizations
• Dieting and Gallstones
  • What are gallstones?
  • What causes gallstones?
  • What are the symptoms of gallstones?
  • Is obesity a risk factor for gallstones?
  • Is weight-loss dieting a risk factor for gallstones?
  • Is weight cycling a risk factor for gallstones?
  • Is surgery to treat obesity a risk factor for gallstones?
  • How can I safely lose weight and decrease the risk of gallstones?
  • What is the treatment for gallstones?
  • Are the benefits of weight loss greater than the risk of getting gallstones?
• Additional Reading
• Physical Activity and Weight Control
  • Becoming physically active
  • Health benefits of physical activity
  • Aerobic activity
  • Get started!
  • Strength training
  • Get strong!
  • Mind and body exercise7;
  • Keep moving!
  • Tips to a safe and successful physical activity program
• Guide to Physical Activity
  • Activity progression
• Additional Resources
• You Can Control Your Weight As You Quit Smoking
  • Will I gain weight if I stop smoking?
  • What causes weight gain after quitting?
  • Can I avoid weight gain?
  • Accept yourself
  • Get regular moderate-intensity physical activity
  • Limit snacking and alcohol
  • Consider using medication to help you quit
  • Will weight gain hurt my health?
• Active at Any Size
  • What very large activities can a very large person do?
  • Walking
  • Dancing
  • Water workouts
  • Weight training
  • Bicycling
  • Stretching
  • Lifestyle activities
  • Safety tips
• Additional Resources
• Weight Loss Myths
• Diet Myths
• Meal Myths
• Physical Activity
• Food Myths
• Additional Reading
• Additional Resources
• Weight Cycling
  • What is weight cycling?
  • If I regain lost weight, won’t losing it again be even harder?
  • Will weight cycling leave me with more fat and less muscle than if I had not dieted at all?
  • Is weight cycling harmful to my health?
  • Is staying overweight healthier than weight cycling?
• Conclusions
• For Further Reading
• Very-Low-Calorie Diets
  • What is a very-low-calorie diet (VLCD)?
  • Who should use a VLCD?
  • Health benefits of a VLCD
  • Adverse effects of a VLCD
  • Maintaining weight loss
• Choosing a Safe and Successful Weight-Loss Program
  • A responsible and safe weight-loss program
  • Ask questions
  • What does the weight-loss program consist of?
  • What are the staff qualifications?
  • Does the product or program carry any risks?
  • How much does the program cost?
  • What results do participants typically have?
• Additional Resources
• Medical Care for Obese Patients
• Challenges in Treating Obese Patients
• Patient Barriers to Adequate Medical Care and Preventive Services
• Health Care Provider Earners to Adequate Medical Care and Preventive Services
• Additional Reading
• Patient Referrals and Information
• Medical Supplies and Equipment
• Advocacy Organizations
• Prescription Medications For the Treatment of Obesity
• Medications That Promote Weight Loss
  • Table 1. Prescription Weight-Loss Medications
• Single Drug Treatment
• Combined Drug Treatment
• Potential Benefits of Medication Treatment
• Potential Risks and Concerns When Considering Medication
• Commonly Asked Questions About Weight-Loss Medications
  • Can medications replace physical activity or changes in eating habits as a way to lose weight?
  • Will I regain some weight after I stop taking weight-loss medications?
  • How long will I need to take weight-loss medications to treat obesity?
  • What dosage of weight-loss medication would be right for me?
  • I only need to lose 10 pounds. Are weight-loss medications appropriate for me?
• What to Discuss with Your Doctor before Choosing Weight-Loss Medication
  • How will I be evaluated to determine if I am an appropriate candidate for weight-loss medication?
  • What other medical conditions or medications might influence my decision to take a weight-loss medication?
  • What type of program will be provided along with the medication to help me improve my eating and physical activity habits?
• Appropriate Treatment Goals for Using Prescription Weight-Loss Medications
• Gastrointestinal Surgery For Severe Obesity
• The Normal Digestive Process
• How Does Surgery Promote Weight Loss?
• What Are the Surgical Options?
  • Restrictive operations
  • Malabsorptive operations
• Explore Benefits and Risks
  • Benefits
  • Risks
  • Medical Costs
• Is the Surgery for You?
• Additional Reading
• Additional Resource
• Binge Eating Disorders
  • How does someone know if he or she has binge eating disorder?
  • How common is binge eating disorder, and who is at risk?
  • What causes binge eating disorder?
  • What are the complications of binge eating disorder?
  • Should people with binge eating disorder try to diet?
  • How can people with binge eating disorder be helped?
• For More Information
• Additional Reading

2. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults

• Introduction
  • Who is at risk?
  • Why treat overweight and obesity?
  • What Treatments Are Effective?
• Clinical Guidelines
  • Assessment
    • Body mass index
    • Waist circumference
      • Table 2. Classification of Overweight and Obesity by BMI
    • Risk status
    • Patient motivation
  • Evaluation and Treatment
    • Table 3. Selected BMI Units Categorized by Inches (CM) and Pounds (KG)
    • Goals of weight loss and management
    • Strategies for weight loss and weight maintenance
      • Figure 1. Treatment Algorithm
    • Adapt weight loss programs to meet the needs of diverse patients
• Summary of Evidence-Based Recommendations
  • Advantages of Weight Loss
    • Blood pressure
    • Serum/plasma lipids
    • Blood glucose
  • Measurement of Degree of Overweight and Obesity
    • BMI to assess overweight and obesity
    • BMI to estimate relative risk
    • Assessing abdominal fat
    • Sex-specific measurements
  • Goals For Weight Loss
    • Initial goal of weight loss from baseline
    • Amount of weight loss
  • How to Achieve Weight Loss
    • Dietary therapy
    • Physical activity
    • Behavior therapy
    • Summary of lifestyle therapy
    • Pharmacotherapy
    • Weight loss surgery
  • Goals For Weight Loss Maintenance
    • Weight maintenance phase
  • Special Treatment Groups
    • Smokers
    • Older adults
    • Diverse patient populations
  • Genetic Influence in the Development of Overweight and Obesity
• Evaluation and Treatment Strategy
  • Figure 2. Treatment Algorithm
• Exclusion from Weight Loss Therapy
• Patient Motivation
• Goals of Weight Loss and Management
  • Weight Loss
    • Target levels for weight loss
    • Rate of weight loss
    • Weight maintenance at lower weight
    • Prevention of further weight gain
• Strategies for Weight Loss and Weight Maintenance
  • Dietary Therapy
  • Physical Activity
    • Table 4: Low Caloried Step 1 Diet
  • Strategies to Increase Physical activity
    • Table 5: Examples of Moderate Amounts of Activity
  • Behavior therapy
  • Behavior therapy strategies used in weight loss and weight maintenance programs
    • Table 6: Duration of Various Activities to Expend 1 Kilocalories For an Average KG (154 LB) Adult
  • Treatment of Obese Individuals with Binge Eating Disorder
  • Combined therapy
  • Pharmacotherapy
    • Table 7: Weight Loss Drugs
  • Surgery for weight Loss
• Adapting Weight Loss Programs to Meet the Needs of Diverse Patient Populations
  • Table 8: Gastric Bypass Surgery Complications: 14-Year Follow Up
• Weight Reduction After Age — What Are The Issues?
• Smoking Cessation in the Overweight or Obese Patient
• Role of Health Professionals in Weight Loss Therapy
• Obesity and Sleep Apnea

3. Dietary Guidelines for Americans

• Dietary Guidelines for Americans
  • Introduction
    • What should Americans eat to stay healthy?
    • Eating is one of life’s greatest pleasures
    • Diet is important to health at all stages of life
    • Foods contain energy, nutrients, and other components that affect health
    • Physical activity fosters a healthful diet
    • What is a healthful diet?
    • The Recommended Dietary Allowances refer to nutrients
    • The Dietary Guidelines describe food choices that promote good health
    • Food labels and the Food Guide Pyramid are tools to help you make food choices
  • Eat a Variety of Foods
    • To obtain the nutrients and other substances needed for good health, vary the foods you eat
      • Figure 1. Food Guide Pyramid
    • Use foods from the base of the Food Guide Pyramid as the foundation of your meals
      • Box 1: Choose Food From Each of Five Food Groups
    • What counts as a “serving”?
    • Choose different foods within each food group
    • What about vegetarian diets?
    • Foods vary in their amounts of calories and nutrients
    • Growing children, teenage girls, and women have higher needs for some nutrients
      • Box 2: What Counts As a Serving?
      • Box 3: Some Good Sources of Calcium
    • Enriched and fortified foods have essential nutrients added to them
      • Box 4: Some Good Sources of Iron
    • Where do vitamin, mineral, and fiber supplements fit in?
    • Advice for today
      • Figure 2. Nutrition Facts
  • Balance the Food You Eat With Physical Activity-Maintain or Improve Your Weight
    • How to maintain your weight
      • Box 5: To Increase Calorie Expenditure by Physical Activity
    • How to evaluate your body weight
      • Figure 3: Are You Overweight
    • Location of body fat
    • Problems with excessive thinness
    • If you need to lose weight
    • Weight regulation in children
      • Box 6: To Decrease Calorie Intake
    • Advice for today
  • Choose a Diet with Plenty of Grain Products, Vegetables, and Fruits
    • Most of the calories in your diet should come from grain products, vegetables, and fruits
    • Plant foods provide fiber
    • Plant foods provide a variety of vitamins and minerals essential for health
    • Advice for today
      • Box 7: Some Good Sources of Carotenoids
      • Box 8: Some Good Sources of Folate
      • Box 9: For a Diet With Plenty of Grain Products, Vegetables, and Fruits, Eat Daily
  • Choose a Diet Low in Fat, Saturated Fat, and Cholesterol
    • Foods high in fat should be used sparingly
    • Choose a diet low in fat
    • Choose a diet low in saturated fat
      • Figure 4. Nutrition Facts
      • Box 10. Maximum Total Fat Intake at Different Calorie Levels
      • Box 11: For a Diet Low in Fat, Saturated Fat, and Cholesterol
    • Choose a diet low in cholesterol
    • Advice for children
    • Advice for today
  • Choose a Diet Moderate in Sugars
    • Sugars come in many forms
    • Sugars, health, and weight maintenance
      • Box 12: On a Food Label Sugars Include
    • Sugar substitutes
    • Sugars and dental caries
      • Box 13: For Healthier Teeth and Gums
    • Advice for today
  • Choose a Diet Moderate in Salt and Sodium
    • Sodium and salt are found mainly in processed and prepared foods
    • Sodium is associated with high blood pressure
    • Other factors affect blood pressure
      • Box 14: Some Good Sources of Potassium
    • Most Americans consume more salt than is needed
    • Most people consume more than this amount
    • Advice for today
      • Box 15: To Consume Less Salt and Sodium
  • If You Drink Alcoholic Beverages, Do So in Moderation
    • Who should not drink?
    • Advice for today
      • Box 16: What is Moderation?
  • Food Exchange List
  • Fat-Free Versus Regular Calorie Comparison
  • Low-Calorie, Lower-Fat Alternatives
  • How Much Are You Eating?
    • How much do you eat?
    • Pyramid Recommendations
    • Portions and servings — What’s the difference?
      • Chart 1: How to Use The Food Guide Pyramid
      • Chart 2: Sample Food Portions Larger Than 1 Pyramid Servings
    • How can you follow pyramid recommendations?
  • Tips to Help You Choose Sensible Portions
    • Don’t he fooled by large portions
    • Nutrition facts label serving sizes
    • The bottom line

4. Finding a Weight Loss Program That Works For You

• Ad Nauseam: The year 2000 Ads Nauseam include the following dubious claims
• Nutrition Action Health letter Rates Diet Books
  • Weight Loss
    • What’s involved in following the program?
    • What are the staff qualifications?
    • What are the risks of using the product or services?
    • What are all the costs of this program?
    • How can I improve my chances for keeping the weight off?
    • How successful are other people who follow this program?
    • What if a provider claims to follow the guidelines, but won’t answer my questions?
  • Being Overweight: A Risky Business
    • Rate your risk
    • Find your body mass index (BMI)
    • Weighing your risk
  • Personal Health Profile Evaluation Checklist
  • Checklist for Evaluating Weight Loss Programs and Services
  • Membership List
  • The Partnership for Healthy Weight Management

5. Medical Care for Obese Patients: Advice for Health Care Professionals

• Table 1: Classification of Weight by Body Mass Indent
• Body Mass Index Chart
• Figure 1: Body Mass Index Chart
• Access to Care
  • Physical setting
    • Table 2: Adapting the Office for Obese Patients
• Weighing Patients
• Special Health Needs of Patients Who Are Extremely Obese
  • Table 3: Conditions for Which Obese Patients Are at Special Risk
• Preventive Care and Health Counseling
• Resources
• Enhancing Self-Acceptance
• Members of the National Task Force on the Prevention and Treatment of Obesity
• REFERENCES

6. Rationale for the Surgical Treatment of Morbid Obesity

• REFERENCES
  • Introduction
  • Rationale for the Surgical Treatment of Morbid Obesity
  • Non-Operative Patient
  • Surgical Treatment Goals
  • Patient Selection
  • Risks of Surgical Treatment
  • Childbearing
  • Nutritional Consequences of Gastric Restrictive Surgery for Obesity
  • FDA Approves Implanted Stomach Band to Treat Severe Obesity
  • What Specific Recommendations Can Be Made For the Treatment of Severe Obesity
  • Preoperative Psychological Testing

7. Obesity, Physical Activity, and Weight Control Glossary

• Additional Sources