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: 3.73). 08/2006; 14 Suppl 4(S7):182S-185S. DOI: 10.1038/oby.2006.303
Source: PubMed


Similar findings are observed in studies that compare meal replacements (37, 38, 39, 40) or prepackaged entrees (41, 42) with self-selected diets. These studies suggest that replacing two of three meals with a liquid and/or solid meal replacement or at least two meals with a portion-controlled entrée result in greater weight loss than traditional self-selected diets and an improved nutrient intake profile (i.e., decreased dietary fat intake and improved micronutrient intake) with the exception of fiber intake, which may be low if diets using meal replacements are not supplemented with high-fiber foods (43). Although some weight regain is observed over time, a greater reduction in weight is observed even up to 4 years in individuals receiving meal replacements (38). Based on a meta-analysis by Heymsfield et al. (44), individuals consuming meal replacements lose ∼7% to 8% body weight, whereas those on a standard self-selected diet lose 3% to 7% body weight at 1 year. It is unclear, however, whether meal replacements are superior to other structured weight loss approaches that provide menus and recipes. Noakes et al. (43) found similar decreases in weight in individuals using meal replacements (9.0 kg or −9.4% body weight) and following structured diets (9.2 kg or 9.3% body weight) for 6 months (43). These findings suggests that guidance in making food choices and/or determining portion size may improve compliance to a dietary plan and make following an energy-restricted diet easier.

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    • "The behavioural and cognitive treatment of obesity is important as it is the least invasive, and it may be more successful than pharmacotherapy, especially in maintaining long term weight loss after the treatment has stopped [11]. Behavioural treatment can exist on its own, or as an important component of these other approaches [12]. Discussions inspired by patient centered care may be particularly effective in behaviour change [13]. "
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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.
    Full-text · Article · Feb 2014
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    • "Delays in particular can have powerful influence on learning from interventions and developing an evidence base. In the case of obesity, the length of time required to lose a certain amount of weight will vary greatly from individual to individual and successful weight loss may not be equal to reaching one’s ‘ideal’ weight [32, 51]. "
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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.
    Full-text · Article · Dec 2013
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    • "Para manter o peso e a composição corporal durante os anos é imprescindível um balanço energético preciso que resulte no equilíbrio entre a ingestão calórica e o gasto energético (Schutz, 1995). Com isto, as estratégias utilizadas para redução do peso corporal baseiam-se na obtenção de déficit na balança energética, alcançado pela adoção de hábitos alimentares saudáveis (Foster, 2006). "
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    ABSTRACT: Effect of diet and physical activity in the body composition in women The intake and energy expenditure resulting in energy balance, when it is unbalanced, can take accumulate or reduction of fat reserves corporal. To ascertain the effect of a calorie-restricted diet associated with physical activity on body composition in women. The study was conducted with eight individuals, all female (age 30.25 ± 6.73 years, 1.62 ± 0.06 cm). Anthropometric measurements were performed according to protocol Petroski (1999). To measure the height, we used a stadiometer accurate to 0.1 cm for body mass (BM) a balance of 100 g precision. From the height and BM was obtained BMI. To measure the perimeters used a tape measure anthropometric fiberglass, and obtained the waist to hip ratio (WHR). To estimate the body density (BD) was used equation Jackson and J Pollock (1980). From the BD was obtained the fat percentage using the equation of Siri (1961). Descriptive analysis were used the mean and standard deviation for the presentation of results. The paired Student t test was used to compare variables before and after 12 weeks. The results can be observed a significant decrease in body mass, fat percentage, BMI and WHR. Furthermore, we observed a significant increase in lean body mass.
    Full-text · Article · Sep 2013
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