0521779407-15 CUNY1086/Karliner 0 521 77940 7 June 7, 2007 18:43
Obesity 1073➣salt
➣alcohol
■50–60% carbohydrate calories,≤30% fat calories (≤10% saturated
fat), 10–20% protein calories
■Size acceptance approach (maintain healthy behavior, body size de-
emphasized)
■Calorie-reduced diets (500–1000 kcal/day deficit for 1–2 lb. weight
loss/week)
■VLCD (Very low calorie diets)
➣400–800 kcal/day usually liquid form
■BMI≥ 30
➣Generally 12–16 weeks with 3–6 weeks for carbohydrate reintro-
duction
■Pre-packaged Meal Programs
■Fad diets (promise miracle cures, minimal effort)
■Physical activity/exercise (goal:≥30 minutes physical activity daily)
■Behavior modification
■Pharmacotherapy
➣Combined with low-calorie, low-fat diet, increased physical
activity, behavioral therapy
■Prescriptions only for BMI≥30 kg/m2 or≥27 kg/m2 with comor-
biditiesSurgery
■Only if BMI≥40 kg/m2 or 35–40 kg/m2 with high risk comorbidities
■Include structured behavioral modification, extensive follow-up
Alternative Weight Loss Products(ie, ephedra, caffeine, chitosan,
pyruvate)
■Side Effects and Complications
Revised Dietary Guidelines for Americans(USDA)
■No gimmicks, not “glamorous”
■Slow/no results if volume eaten not reduced
Size Acceptance Approach
■Increased yo-yo dieting (slower basal metabolic rate, loss of lean
body mass, increased body fat)
■Sense of failure, low self-esteem
■Eating and exercise disorders
Calorie-Reduced Diets
■Poor long-term weight loss maintenance
■Total calorie reduction causes weight loss