Clinical implications for the treatment of obesity.

Center for Obesity Research and Education, Temple University, 3223 North Broad Street, Suite 175, Philadelphia, PA 19140, USA.
Obesity (Impact Factor: 4.39). 08/2006; 14 Suppl 4:182S-185S. DOI: 10.1038/oby.2006.303
Source: PubMed

ABSTRACT FOSTER, GARY D. Clinical implications for the treatment of obesity.

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    ABSTRACT: Structured dietary interventions have been associated with improved outcomes in adult weight-control programs, but virtually no research has focused on children. Thus, we conducted an uncontrolled pilot study to determine the potential utility of structured approaches to enhance the dietary component of family-based treatment of severe pediatric obesity (body mass index [BMI] >97th percentile for age and sex). Children aged 8-12 years participated with a parent or guardian. Individualized menu plans were provided (MENU, n=12) alone, or along with meals and snacks for the child (MENU+MEAL, n=6). All families received up to $30/week reimbursement for foods included in the menus. Median BMI change was -1.2 kg/m(2) for MENU (n=12), and -1.8 kg/m(2) for MENU+MEAL (n=6). Both approaches were associated with significant reductions in BMI (p<0.05). Structured dietary interventions for severe pediatric obesity are acceptable to families and warrant further development.
    06/2013; 8(2):58-60. DOI:10.1089/bari.2013.9990
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    ABSTRACT: As obesity continues to increase throughout the world, there is still no well-defined solution to the issue. Reducing obesity poses a significant challenge for the health care system because it is a complex problem with numerous interconnections and elements. The complexity of obesity challenges traditional primary care practices that have been structured to address simple or less complicated conditions. Systems thinking provides a way forward for clinicians that are discouraged or overwhelmed by the complexity of obesity. At any given level, individuals matter and system functioning is optimized when our capacity is well matched to the complexity of our tasks. Shifting paradigms around the causes of obesity is essential for creating a health care system that promotes innovative and collaborative practice for healthcare practitioners and individuals dealing with obesity.
    12/2013; 2(4). DOI:10.1007/s13679-013-0072-9
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    ABSTRACT: Individuals seeking healthcare treatment in the context of obesity often experience difficulty engaging in discussions around their health and face challenges finding consensus with practitioners on care plans that best suit their lives. The complex set of biological, social, and environmental variables that have contributed to the higher prevalence of obesity are well illustrated in the foresight obesity system map. Effectively understanding and addressing key variables for each individual has proven to be difficult, with clinicians facing barriers and limited resources to help address patients' unique needs. However, productive discussions inspired by patient centered care may be particularly effective in promoting behaviour change. Tools based on systems science that facilitate patient centered care and help identify behaviour change priorities have not been developed to help treat adult obesity. This project created and pilot tested a card based clinical communication tool designed to help facilitate conversations with individuals engaged in health behaviour change. The health communication cards were designed to help direct conversation between patients and healthcare providers toward issues relevant to the individual. Use of the cards to facilitate patient driven conversations in clinical care may help to streamline conversations, set realistic care plan goals, and improve long term rates of compliance.
    02/2014; 2014:579083. DOI:10.1155/2014/579083