Guide Obesity: The Medical Practitioners Essential Guide

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Blackstone is recognized as a leading expert in the medical and surgical treatment of obesity, metabolic disease, and obesity-related diseases. She has performed more than 5, surgeries in the 13 years since she established the original Scottsdale Select Parent Grandparent Teacher Kid at heart. Age of the child I gave this to:. Hours of Play:. Tell Us Where You Are:. Preview Your Review. Thank you.

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Your review has been submitted and will appear here shortly. Extra Content. Table of Contents Foreword Preface Acknowledgment 1. Epidemiology, Measurement, and Cost of Obesity 2.

Obesity: The Medical Practitioner's Essential Guide by Robin P. Blackstone

The Biology of Adipose Tissue 5. They reasoned that the recommendation should help to confine its use to those more likely to benefit from surgery, so the higher threshold was chosen. In a few other instances, the OGDC had to decide how to deal with interventions that were questioned in the public consultation. In such instances, the OGDC debated the available evidence afresh, particularly considering potential harms attributable to an intervention. For example, a public submission suggested that very low-energy diets caused significant adverse effects including eating disorders.

Members of the OGDC differed in their views on the relative benefits and harms of very low-energy diets, based on their own experience in practice. The OGDC further reviewed the evidence given in the submission and noted that there was little evidence of harm from very low-energy diets when administered under medical supervision—harm appeared more likely to arise with unsupervised restrictive eating. This was noted in Section 6. They were modified slightly to ensure consistent grammar, syntax and wording with the other recommendations as per the NHMRC Standard and to reflect the Australian context.

Additional considerations surrounding the modified wording of the recommendations are outlined in Table C32 of the original guideline document. The SIGN grading system and evidence underpinning the recommendations are still maintained for these recommendations. For each recommendation, the OGDC discussed potential implications for practice. The systematic review carried out to inform these Guidelines identified insufficient evidence to make a recommendation on the duration and intensity of physical activity to support weight loss or prevent weight regain.

The SIGN recommendation advised a lesser amount of physical activity than that identified in more recent evidence for primary prevention of weight gain. Early in the guideline development process, OGDC members realised that research-based evidence did not exist for many important aspects of contemporary practice in the prevention and management of overweight and obesity.


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Exclusion of these aspects would have greatly reduced the usefulness of the Guidelines. The OGDC was reluctant to set down consensus-based recommendations because the diversity of the issues and the diversity of expertise among members seemed likely to preclude a comprehensive consensus process. Members therefore decided to offer 'practice points' that would give advice on what health professionals might do in dealing with particular clinical situations.

Obesity: Facts and Fictions

As the development of the Guidelines progressed and as feedback was incorporated from the public consultation, some of the practice points were modified. All changes were discussed and the wording of each practice point was carefully reviewed by the OGDC. Information included in the narrative was drawn from the background text of the systematic review, discussion by the OGDC at meetings and teleconferences, and other guidelines and materials identified by the OGDC. The high prevalence of overweight and obesity imposes a large burden on primary health care to manage both weight and the associated comorbidities for individuals, with the potential benefit of improving health outcomes and reducing further costs to the health system.

The Obesity Guidelines Development Committee OGDC considered potential cost and resource implications of the recommendations for patients and practice. The potential effect of each recommendation on clinical practice is described in the text, and data are referenced where available. The health and cost burdens of overweight and obesity follow a protracted time line, and much of the data available in Australia are more relevant to population and preventative health outcomes than to clinical management.

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The draft Guidelines were released for a day public consultation period, as required in the National Health and Medical Research Council Act , on 29 March Submissions were received from health departments, nongovernment organisations, health services and individuals, with a total of 42 submissions. Key issues and how these were addressed are outlined in Appendix B of the original guideline document. The Guidelines were reviewed by two independent peer reviewers.

The review highlighted some areas where clarity was required to meet mandatory requirements. Additional text was included to ensure consistency between the Guidelines and the technical report and to provide clearer explanation of:. National Health and Medical Research Council.

Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. A national clinical guideline. Edinburgh: Scottish Intercollegiate Guidelines Network. Declarations of conflicts of interest were called for and updates requested as a standing agenda item at the beginning of each committee meeting. While the evidence was being discussed, members were requested to declare any involvement in upcoming related publications, or involvement in any publications that had been included in the systematic review process.

New information was recorded in a register of conflicts of interest. Where committee members were identified as having a significant real or perceived conflict of interest, the Chair could decide that the member either leave the room, or remain present but not participate in the discussion or in decision-making on the specific area relating to the conflict. There were no instances in the development process where the Chair required a member to leave the room during the discussion of the evidence because of a significant perceived or real conflict of interest.

The process to manage conflicts of interest and consensus for decision making was in accordance with the NHMRC Members' responsibility regarding disclosure of interest and confidentiality document, which applies to all members of the Council of the NHMRC, Principal Committees and Working Committees in accordance with the requirements of the National Health and Medical Research Council Act All declarations of interest were added to a register of interests see Appendix B in the original guideline document. When the committee had concerns about conflicts of interest related to particular studies, this was noted in the relevant evidence statement.

Where the committee was made aware of potential conflicts of interest after the evidence review process, this is noted next to the reference to the relevant study in the Guidelines. Advice for consumers on how to achieve and maintain a healthy weight is available from the Australian Government Department of Health Web site.

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Please visit our privacy policy page for more information. Already a member? Toggle navigation. Create Note View All Notes. Page Notes There are no notes to display. Search Content. Recently Added Please register or log in to create and use your library. Full Text Guideline Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Recommendations Major Recommendations. B Waist Circumference For adults, use waist circumference, in addition to BMI, to refine assessment of risk of obesity-related comorbidities.

C Other Factors in Assessment of Health Risk in Adults Physical Comorbidities Current Australian guidelines should be used to guide assessment and management of absolute cardiovascular risk and type 2 diabetes in adults. PP Current Australian guidelines should be used to guide assessment and management of physical comorbidities associated with excess weight in adults. PP Weight History Weight history, including previous weight loss attempts, should be part of the assessment of people who are overweight or obese.

PP Readiness to Change For adults who are overweight or obese, discuss readiness to change lifestyle behaviours. D Advise Explaining the Benefits of Lifestyle Change and Weight Loss Adults who are overweight or obese can be strongly advised that modest weight loss reduces cardiovascular risk factors. A Adults with prediabetes or diabetes can be strongly advised that the health benefits of modest weight loss include prevention, delayed progression or improved control of type 2 diabetes.

C Adults who are overweight or obese can be advised that quality of life, self-esteem and depression may improve, even with small amounts of weight loss. C Assist Lifestyle Interventions For adults who are overweight or obese, strongly recommend lifestyle change—including reduced energy intake, increased physical activity and measures to support behavioural change.

PP For adults who are overweight or obese, design dietary interventions for weight loss to produce a kilojoule per day energy deficit and tailor programs to the dietary preferences of the individual. A Increasing Physical Activity Current Australian Physical Activity Guidelines should be used as the basis of advice on preventing weight gain through physical activity.

PP For adults who are overweight or obese, prescribe approximately minutes of moderate-intensity activity, or minutes of vigorous activity, or an equivalent combination of moderate-intensity and vigorous activities each week combined with reduced dietary intake.


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CBR For adults who are overweight or obese, particularly those who are older than 40 years, there should be an individualised approach to increasing physical activity. PP Supporting Behavioural Change Individual or group-based psychological interventions may improve the success of weight management programs. PP There is very limited evidence on the potential benefits or harms of complementary therapies in treating overweight and obesity.

PP Intensive Interventions Very Low-energy Diets Very low-energy diets are a useful intensive medical therapy that is effective in supporting weight loss when used under medical supervision. A Bariatric surgery, when indicated, should be included as part of an overall clinical pathway for adult weight management that is delivered by a multidisciplinary team including surgeons, dietitians, nurses, psychologists and physicians and includes planning for continuing follow-up.

PP Supporting Self-management For adults, include a self-management approach in weight management programs. C Regular self-weighing e. PP Planning for Review and Monitoring For active weight management in adults, arrange fortnightly review for the first 3 months and plan for continuing monitoring for at least 12 months, with additional intervention as required.

B Arrange Review and Monitoring Early Review of the Suitability of the Weight Loss Program The weight loss plan should be reviewed after 2 weeks to determine its suitability for that individual and to assess whether it needs to be modified. PP Long-Term Weight Management For adults who achieve initial weight loss, strongly recommend the adoption of specific strategies, appropriate to their individual situation, to minimise weight regain.

A Discussing Long-term Weight Management For long-term weight management, adults can be advised of the importance of taking action e. This is a concise but comprehensive textbook for plastic surgery residents reviewing for in-service and certifying examinations as well as practicing plastic surgeons preparing for Maintenance of Certification. The book is divided into chapters based on the 24 so-called common plastic surgical procedures. This will allow a discussion of the procedure prior to embarking on surgery and serve as a basis for the development of a basic fund of knowledge in the specialty of Plastic, Reconstructive, and Aesthetic Surgery.

Contributors have been selected based on their clinical expertise and academic excellence. Kim Barnas. Hospitals have long relied on the heroics of one brilliant nurse or doctor to save the day. Such heroics often result in temporary workarounds and quick fixes that leave not only patients and quality care at risk, but also increase costs.

This is the story of an organization breaking that habit. Like a growing number of healthcare organizations around the world, ThedaCare, Inc. Kim Barnas, former SVP of ThedaCare, shows us how she and her team created a management system that is stable and lean, to spur continuous improvement. Ninh T. Volume 1: Bariatric Surgery covers the basic considerations for bariatric surgery, the currently accepted procedures, outcomes of bariatric surgery including long-term weight loss, improvement and resolution of comorbidities and improvement in quality of life.

A section focuses on revisional bariatric surgery and new innovative endoscopic bariatric procedures. Other special emphasis given to the topics of metabolic surgery and surgery for patients with lower BMI Volume II: Integrated Health is divided into 3 sections: bariatric medicine, psychosocial and nutritional aspects of bariatric surgery. The first section deals with the psychosocial issues associated with morbid obesity.

The second section deals with the role of bariatric physicians in preoperative and postoperative support of the bariatric patients. The nutritional section discusses the preoperative and postoperative nutritional support for the bariatric patient. The ASMBS Textbook of Bariatric Surgery will be of great value to surgeons, residents and fellows, bariatric physicians, psychologists, psychiatrists and integrated health members that manage the morbidly obese.