Obesity - Answer Chronic multi-system disease has numerous anatomical,
physiological, and psychological implications.
5 Stages of Behavioural Change Transtheoretical Model: Precontemplation,
Contemplation, Preparation, Action, and Maintenance.
Precontemplation: ANSWER Not eager to make changes; seems resistant and
unmotivated.
Contemplation - Answer Ambivalent/uncertain about wanting to make a
behavioural adjustment.
Preparation - Answer Now consider a behaviour modification and prepare initial
measures.
Action: ANSWER Now motivated to change and sensitive to conversations about
prospective behaviour modification interventions, ready to proceed
Maintenance - ANSWER Pt. continues with behavioural modifications and
practices. Healthy techniques to preserve success.
At what point might a patient begin to see us? - Answer preparation
Elements of comprehensive lifestyle intervention - ANSWER Diet, increased
physical activity, frequency and length of treatment, behaviour interventions,
technology to support programs
, Diet - Answer Low-calorie diet (1200-1500 kcal/d for women; 1500-1800 kcal/day
for males) adopting dietary options depending on patient preferences and health
factors.
Increased physical activity - ANSWER: Increase aerobic activity from 150 to 300
minutes per week for additional benefits. Additional benefits with
muscle-strengthening activities for two or more days per week.
ANSWER >/= 14 in-person counselling sessions (individual or group) with a
skilled interventionalist (usually an RDN) in the first six months. Continued
interaction with this person for weight maintenance, comments, and assistance.
Behavioural strategies: ANSWER Use paper diaries/apps to track food
consumption and physical activity. Daily weekly monitoring of weight and tactics.
Example: goal planning, issue solving, and sensory support.
Technology to Support Programs - Telehealth Options
When to opt for merely lifestyle therapy - ANSWER 1) The patient has no
complications. 2) Mild to moderate complications when lifestyle therapy is
expected to result in enough weight loss to alleviate issues (tertiary prevention) or
based on clinical judgement.
Starting medications as a supplement to lifestyle - ANSWER 1) When lifestyle
therapy fails, medication is introduced to account for progressive weight gain or a
lack of clinical improvement in weight due to difficulties caused by lifestyle alone.
2) If weight is regained after initial success with lifestyle management, add
medications for patients who are overweight (BMI 27–29.9) or obese. 3) Presence
of wt in relation to difficulties medicines began for overweight or obese + need to
accomplish significant weight loss to alleviate issues
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