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Obesity ManagementAka: Weight Reduction

See Also
1. Exercise in Obesity
Select appropriate target weight loss
1. Body Mass Index (BMI) > 30: Current BMI - 2
2. Body Mass Index (BMI) <= 30: Lose 10% of current weight
Establish basic weight loss program
1. Healthy eating and reduced caloric intake
  1. See Energy Deficit Calculation
  2. See Food Pyramid
  3. Eat a minimum of 3 times daily (esp. Breakfast)
  4. Drink non-sugar, non-caffeine fluid >64 ounces/day
  5. Observe serving size and ingredients closely
    1. Super-sized meals dramatically increases calories
    2. One 8 ounce soda contains 15 teaspoons of sugar
  6. Write down everything you eat
    1. Weight watchers
    2. Handheld log
      1. Balance Log
        
        http://www.healthetech.com
      2. Vivonic
        
        http://www.vivonic.com
      3. Calorie Chart
        
        http://www.caloriechart.org
  7. Use high bulk, low density foods
    1. Eat Foods with high water, fiber, and lean protein
    2. Fruit: 3/4 pound grapes = 1.5 ounces chocolate cals
    3. Vegetables: 1 pound carrots = 1 ounce peanuts cals
    4. Reference
      1. Thompson (2005) Mayo Reviews Lecture, Rochester
  8. Choose dietary management for the longterm
    1. Diets are equally effective in weight loss
    2. Dansinger (2005) JAMA 293:43
2. Increase Physical Activity
  1. See Exercise in Obesity
  2. Start with 10 minutes everyday and build
  3. Exercise is key in a weight loss
3. Incorporate Lifestyle change strategies
4. Consider organized weight loss program
  1. Weight Watchers
    1. http://www.weightwatchers.com
  2. TOPS (Take Off Pounds Sensibly)
    1. http://www.tops.org
Modify weight loss program based on Obesity Risk
1. Moderate Risk
  1. Basic weight loss program
  2. Consider low calorie diet
2. High and very high risk
  1. Basic weight loss program
  2. Consider very low calorie diet
  3. Consider Obesity Medication
3. Extremely high risk
  1. Basic weight loss program
  2. Consider very low calorie diet
  3. Consider Obesity Medication
  4. Consider surgical intervention
References
1. Frank (1998) J Am Diet Assoc 98:S44
2. Lyznicki (2001) Am Fam Physician 63(11):2185
3. Rippe (1998) J Am Diet Assoc 98:S9
4. Speer (1997) Phys Sportsmed 25:94
5. (1998) AOA Treatment Adult Obesity, 2nd edition

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This page was written by Scott Moses, MD, and was last revised 1/26/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.