Obesity M.A.Kubtan MD - FRCS M.A.Kubtan1
Childhood Overweight and Obesity Management in Adults Setting Goals Diet Physical Activity and Exercise Behavioral Approaches Medications Complementary and Alternative Medicine Surgery M.A.Kubtan2
An initial goal of a 5% to 10% reduction in weight is reasonable. A process-oriented target (lifestyle) may be more beneficial for some than a target weight. A weight reduction rate of 1/2 to 1 Kg weekly is achievable if intake is reduced by 500 to 1000 kcal daily. Caloric restriction alone is not as effective as combining it with an exercise program. A low-energy-dense diet composed of generous quantities of vegetables and fruits promotes health and facilitates weight management. M.A.Kubtan3
Childhood obesity rarely is associated with a primary medical disorder. When present in childhood obesity, underlying disorders are almost always associated with statuary growth reduction. The risk of adult obesity increases with the age of the obese child. Intervention can be more effective in children than in adults and should involve the entire family. M.A.Kubtan4
Lifestyle. Parental involvement is a key component in childhood weight management. In addition, health care providers may overlook obesity. Adiposity rebound occurs between ages 5 and 7 years. Breastfeeding should be encouraged up to the age of 1 year. Elimination of sweetened beverages. All children older than 2 years should be receiving low-fat dairy products. Vegetables and fruits. M.A.Kubtan5
It is important to help patients become aware of the medical implications and to engage them in management. Prevention of weight gain with lifestyle therapy is indicated in any patient with BMI ≥25. M.A.Kubtan6
Readiness/motivation to undertake weight loss. Reasons/expectations for weight loss. Available support. Previous methods of weight loss and results (including why results were not successful). Potential barriers to weight loss and maintenance (time, finances, established habits). Periods of increased weight gain. M.A.Kubtan7
Triggers to eating Current (and past) exercise/activity Factors the patient believes are responsible for weight Binge eating, purging, laxative or diuretic use Family history of obesity Medications M.A.Kubtan8
Diet. Physical activity. Behavior therapy [†] [†] Pharmacotherapy. Surgery. M.A.Kubtan9
Total calorie intake must be reduced below energy expenditure for weight loss to occur. Low-carbohydrate diets. Satiety from fat are other possible mechanisms. M.A.Kubtan10
The choice of exercise depends on individual interests. The goal should be 30 minutes. M.A.Kubtan11
Self-monitoring. Identifying and avoiding environmental or social triggers Group support may be helpful. M.A.Kubtan12
Appetite suppressants work through their effects on neurotransmitters. Orlistat inhibits gastric and pancreatic lipase. M.A.Kubtan13
Ephedrine, often in combination with caffeine . Side effects : sympathetic activity, tachyarrhythmias, headache, and elevated BP, Caffeine can increase sympathetic nervous system activity. Antioxidants have been thought to have sympathetic activity. M.A.Kubtan14
Malabsorptive : Jejunoileal bypass. Biliopancreatic diversion. Restrictive : Vertical-banded gastroplasty Gastric banding. Gastric sleeve. Gastric plication. Malabsorptive and Restrictive Roux-en-Y gastric bypass M.A.Kubtan15