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Chapter 075. Evaluationand
Management ofObesity
(Part 1)
Harrison's Internal Medicine > Chapter 75. EvaluationandManagement
of ... andManagement
of Obesity
Evaluation andManagementof Obesity: Introduction
Over 66% of U.S. adults are currently categorized as overweight or obese,
and the prevalence ofobesity is increasing ... National Heart, Lung, and Blood
Institute (NHLBI) and a number of medical societies. The five main steps in the
evaluation ofobesity are described below and include (1) focused obesity- related
history,...
... Pickwickian syndrome
Pulmonary embolism Asthma
Chapter 075. Evaluationand
Management ofObesity
(Part 2)
Excess abdominal fat, assessed by measurement of waist circumference or
waist-to-hip ratio, ... treatment
approach.
Obesity- Associated Comorbid Conditions
The evaluationof comorbid conditions should be based on presentation of
symptoms, risk factors, and index of suspicion. All patients ... pigmentation of legs
Lymphedema
Symptoms and diseases that are directly or indirectly related to obesity are listed
in Table 75-4. Although individuals vary, the number and severity of organ-
specific...
... Lung, and Blood Institute:
Clinical guidelines on the identification, evaluation, and treatment of overweight
andobesity in adults: The evidence report. Washington, DC, US Department of
Health ... to change and also serves as a basis for further dialogue.
Obesity: Treatment
The Goal of Therapy
The primary goal of treatment is to improve obesity- related comorbid
conditions and reduce ... decision of how aggressively to treat the patient, and which modalities
to use, is determined by the patient's risk status, expectations, and available
resources. Therapy for obesity always...
... specializing in obesity care.
Chapter 075. Evaluationand
Management ofObesity
(Part 4)
Lifestyle Management
Obesity care involves attention to three essential elements of lifestyle: ... eating more fruits and
vegetables, consuming more whole-grain cereals, selecting leaner cuts of meat and
skimmed dairy products, reducing fried foods and other added fats and oils, and
drinking ... limiting cholesterol to <300 mg/d; and keeping total fat between 20 and 35%
of daily calories and saturated fats to <10% of daily calories. Application of these
guidelines to specific calorie...
... discontinued.
Chapter 075. Evaluationand
Management ofObesity
(Part 5)
Physical Activity Therapy
Although exercise alone is only moderately effective for weight loss, the
combination of dietary ... discontinuation of the medication. A dose of 10–15 mg/d causes an average
increase in systolic and diastolic blood pressure of 2–4 mmHg and an increase in
heart rate of 4–6 beats/min. For this reason, ... change and reinforce new
dietary and physical activity behaviors. Strategies include self-monitoring
techniques (e.g., journaling, weighing, and measuring food and activity); stress
management; ...
... limit the amount ofChapter 075. Evaluationand
Management ofObesity
(Part 6)
Peripherally Acting Medications
Orlistat (Xenical) is a synthetic hydrogenated derivative of a naturally
occurring ... diameter of this band is adjustable by way of its connection
to a reservoir that is implanted under the skin. Injection or removal of saline into
the reservoir tightens or loosens the band's ...
Cannabinoid receptors and their endogenous ligands have been implicated
in a variety of physiologic functions, including feeding, modulation of pain,
emotional behavior, and peripheral lipid...
...
National Heart, Lung,
and Blood Institute, North American Association for
the Study of Obesity: Practical guide: Identification, evaluation, and treatment of
overweight andobesity in adults. ... 17498514]
Chapter 075. Evaluationand
Management ofObesity
(Part 7)
The three restrictive-malabsorptive bypass procedures combine the
elements of gastric restriction and selective ...
systematic review and meta-
analysis of randomized controlled trials. Int J Obesity
27:1437, 2003 [PMID: 12975638]
Wadden TA et al: Lifestyle modification for the managementof obesity.
Gastroenterology...
... 3
proband
8 families with type
3 probands
13 families with type 3
probands
22 families with type 3
probands
1 family with type 3
probands
4 families with type 3
probands
1 family with type 3
proband
15 ... Division of Blood Diseases
and Resources of the NHLBI. The Panel was
coordinated by the Division for the Application of
Research Discoveries (DARD), formerly the Office
of Prevention, Education, and ... for
enhancing knowledge and improving clinical and
laboratory diagnostic tools for VWD. Furthermore,
there are needs for better knowledge ofand treatment
options for managementof VWD and bleeding or
bleeding...
... the
management of dyslipidemia and the prevention of cardiovascular disease:
summary of the 2003 update. CMAJ 2003;169:921-4.
Diagnosis, Evaluation, andManagementof the Hypertensive Disorders of ... of
coagulopathy and in the presence of an adequate platelet
count. (I-A)
Diagnosis, Evaluation, andManagementof the Hypertensive Disorders of Pregnancy
S28
l MARCH JOGC MARS 2008
Chapter 4
Future ... prophylaxis of all women with ges
-
tational hypertension to a selective approach for only
Diagnosis, Evaluation, andManagementof the Hypertensive Disorders of Pregnancy
S32
l MARCH JOGC MARS 2008
Chapter...
... Mechanism, EvaluationandManagementof a Complex Disorder40
Preface
Understanding the rapid changes in the evaluationandmanagementof peripheral neuropa‐
thies, as well as the complexity of their ... of cannabinoids and stem cells for the treatment of pe‐
ripheral neuropathy. Dr Mendoza and Dr Salgado reviewed the diagnosis and management
of compressive neuropathies in the first chapterof ... Francesco Rossi and Vito de Novellis
Section 2 EvaluationandManagementof Peripheral Neuropathy 101
Chapter 4 Compression Neuropathies 103
Javier López Mendoza and Alexandro Aguilera Salgado
Chapter...
... Study to Help
Improve Early evaluationandmanagementof risk factors Leading
to Diabetes (SHIELD)
Susan Grandy
1
and Kathleen M Fox*
2
Address:
1
Health Economics and Outcomes Research, AstraZeneca ... EQ-5D scores of individuals diagnosed with dia-
betes and those with varying levels of cardiometabolic
risk, using data from the Study to Help Improve Early
evaluation andmanagementof risk factors ... available from >75% of
each cohort (5,639 of 7,403 for low risk, 5,370 of 6,742
for high risk, and 3,849 of 5,000 for type 2 diabetes). The
sociodemographic characteristics of the baseline respond-
ents...
... 4
Introduction 5
The Problem of Overweight andObesity 5
Treatment Guidelines 7
Assessment and Classification of Overweight andObesity 8
Assessment of Risk Status 11
Evaluation and Treatment Strategy ... determination of the degree ofobesity
and the absolute risk status.
Management includes the reduction of excess weight and
maintenance of this lower body weight, as well as the institution
of additional ... LUNG, AND BLOOD INSTITUTE
NORTH AMERICAN ASSOCIATION FOR THE STUDY OF OBESITY
The Practical
Guide
Identification,
Evaluation,
and Treatment
of Overweight and
Obesity in Adults
NHLBI Obesity...
... However, the age and
maturity of the child and the preferences of the child and the
parents should be taken into account.
1.2.2 Identification and classification of overweight andobesity
1.2.2.1 ... prevention andmanagementofobesity should be a priority for all,
because of the considerable health benefits of maintaining a healthy weight
and the health risks associated with overweight and obesity. ... the approach to managementof a child’s overweight
or obesity (including assessment and agreement of goals
and actions) should be made in partnership with the child and
family, and be tailored...
... identification, assessment
and managementof overweight andobesity in adults and children in England
and Wales. The guidance aims to:
ã stem the rising prevalence ofobesityand diseases associated ... However, the age and
maturity of the child and the preferences of the child and the
parents should be taken into account.
1.2.2 Identification and classification of overweight andobesity
1.2.2.1 ... organisations such as the NHS
and local authorities, should address the prevention and
management of obesity, because of the considerable impact on the
health of the workforce and associated costs to...
... in this area of management. A review of the origins and uses of the term
strategy in the literature displays a wide range of definitions which confuse and
compound the basic idea of strategy—the ... concomitant and implicit concepts of goals and
purpose; the conditional concepts of environment and resources; the ensuing concepts of
implementation and tactics. Disencumbering the concept of strategy ...
‘grand strategy’ serves to bring out the sense of ‘policy in execution’. For the
role of grand strategy—higher strategy—is to co-ordinate and direct all the
resources of a nation, or band of...