The obesity epidemic: a mandate for a multidusciplinary approach ; ... was a closed roundtable, held on October, 27, 1997, in Boston, Mass.
Gespeichert in:
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|---|---|
| Sprache: | Undetermined |
| Veröffentlicht: |
Chicago, Ill.
American Dietetic Association
1998
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98,10, Suppl. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
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| adam_text | Journal of
THE AMERICAN
DIETETIC ASSOCIATION
OCTOBER
1998
SUPPLEMENT
2
VOLUME
98
/NUMBER
10
(ISSN
0002-8223)
55
The obesity epidemic: Challenges and opportunities
James M.
Rippe, MD
More than one third of US adults are obese. As the prevalence of obesity
continues to increase, health cart professionals are challenged to treat this
complex and intractable disease. In his opening commentary, .James
Rippe
introduces the mult ¡disciplinary group of experts whose insights into
obesity treatment constitute this special Journal supplement.
56 Obesity as an epidemic: Facing the challenge
Ann M.
Conistan,
MS,
RD, FADA
This article provides an overview of the issues surrounding obesity and its
treatment: the need to
reevaluate
the application of medical nutrition
therapy in obesity treatment, the influences of diet and genetics on the
development of obesity, the importance of stressing lifestyle changes for
long-term obesity management, and the call for a team approach to treating
patients with obesity.
S9 Obesity as a chronic disease:
Modern medical and lifestyle management
James
M
. Rippe, MD,
Snellyn Crossley,
RD,
and Rhonda Ringer, MD
Being obese greatly increases a person s risk for a number of comorbidities,
including heart disease, stroke, diabetes, respiratory problems, and
osteoarthritis, yet too often health professionals fail to recognize and treat
obesity as a chronic disease. The value of applying a chronic disease
treatment model
—
which stresses lifestyle and medical interventions
delivered by an interdisciplinary team of experts
—
is discussed. A frame¬
work for effective clinical management of obesity, including proper
nutrition, physical activity, behavior modification, and
pharmacologie
therapy, is offered.
S16 A model for chronic care of obesity through dietary treatment
Cathy A. Nonas, MS, RD
To successfully combat the widespread health problem of obesity, the
health care community must recognize the chronic nature of this disease.
Clinicians should expect patients with obesity to move between
2
major
stages: the acute stage, in which weight change is rapid and can
precipitati1
other clinical changes; and the chronic stage, in which efforts are aimed at
maintaining a steady weight. A team approach to obesity management that
calls on the skills of the primary care physician in the acute stage and those
of the dietetics professional in the chronic stage is discussed. The success
of this approach is predicated on effective communication between both
health professionals who jointly monitor patients status and progress.
EDITOR-IN-CHIEF
Klaine R. Monsen, PhD, RD
JOURNAL STAFF
Managing Editor
Klisabeth A. Crist, MA
Advertising Director
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Contributing Editors
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Gill Robertson, MS, RD
Cover Design
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Advertising Project Manager
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tito
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(ISSN
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is published monthly for
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Copyright
1998
by The American Dietetic Association. Printed in USA. Telephone: :i
12/899-0040.
The American Diet el ic Association is an Equal Opportunity Employer. Neither the Association nor
the Bdilor assumes responsibility for the opinions expressed by authors of papers abstracted,
quoted, or published in full in the .louruul.
THE AMERICAN
DIETETIC ASSOCIATION
S23 Modern medical management of obesity:
The role ol pharmaceutical intervention
Louis J.
Armine, MD
Even before the removal of the weight-loss drugs fenfluramine and
dexfenfluramine from the market, controversy was raging around
pharma¬
cologie
treatments for obesity. This article sheds light on the application of
weight-loss drugs in obesity treatment, beginning with a helpful discussion
of the physiology of weight control. The author discusses the benefits,
drawbacks, and mechanisms of action of sibutramine and orlistat and
recommends that medication for obesity, used in conjunction with other
modes of treatment, be considered only for patients with a body mass index
greater than
30,
or greater than
27
if comorbidities of obesity are present.
S27 The role of the behavioral counselor in obesity treatment
John P. Foreyt, PhD, and Walker S. Carlos Poston II, PhD
Behavior modification remains the cornerstone of obesity treatment, and
the behavioral counselor is a critical member of the obesity treatment team.
Seven crucial strategies for helping people change their behavior to lose
weight
—
self-monitoring, stimulus control, cognitive restructuring, stress
management, social support, physical activity, and relapse prevention
—
are
outlined, and future goals in obesity treatment are proposed.
S31 The role of physical activity in the prevention
and management of obesity
James M.
Rippe, MD,
and Stacey Hess, MS
Physical activity is not only an important way to prevent weight gain, it is an
essential component of comprehensive obesity treatment. Engaging in
regular physical exercise during weight loss can improve a person s metabo¬
lism, body composition, psychological well-being, and quality of life; reduce
risk for disease; and increase the likelihood that weight loss will be main¬
tained. Walking is usually the best form of exercise to prescribe for obese
persons.
S39 Managing obesity in patients with comorbidities
Marion J. Franz, MS, RD
Historically, treatment for obesity and its comorbidities (type
2
diabetes,
cardiovascular disease, and hypertension) has been oversimplified to a
single goal: weight loss. But what happens when patients gain weight, lose
weight, and regain it, as they often do? The goal of medical nutrition
therapy for patients with comorbidities should be refocused on attaining
and maintaining healthier metabolic parameters, with moderate weight loss
being only
1
of several recommended strategies.
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Please refer to customer number or include mail¬
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EDITORIAL CORRESPONDENCE The
Jour¬
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publishes refereed reports of
original
re¬
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and diet
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Joi/
ran/. Guide¬
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t
lie January issue
of
lhe
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<www.eat right.org/journal/guidelines.
ht
mb.
Submit manuscripts to Elaine R. Monsen, PhD,
RD, Editor, BOX
353410,
University of Washing¬
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W
A
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The Editor welcomes brief items, such as let¬
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ADVERTISING All correspondence concerning
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Publication of
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Journal of
THE AMERICAN DIETETIC ASSOCIATION
S44 A multidisciplinary approach to obesity management:
The physician s role and team care alternatives
Arthur Frank, MD
What implications lie on the horizon for the health care system as obesity
becomes medicalized? If a simple medical model is applied, the current
system would be overwhelmed by the sheer numbers of patients seeking
treatment. A new model, integrating physicians, dietitians, and other
support personnel such as psychologists and exercise therapists, must be
adopted. Three possible models are sketched for multidisciplinary team
management of obesity, and the strengths and limitations of each are
presented.
S49 The dietitians philosophy and practice
in multidisciplinary weight management
Sharron
Dalton,
PhD, RD
For health care professionals to manage obesity with consistent effective¬
ness, they must formulate philosophical and practical protocols for its
treatment. Numerous questions prompt dietetics professionals to define
their approach to obesity treatment: Who should be considered obese? Is
obesity a short- or long-term health issue? Should
pharmacologie
agents be
used? The article also outlines the roles of various team players, including
dietetics professionals, in a multidisciplinary approach to weight manage¬
ment.
S55 Panel discussion: The obesity epidemic—a mandate for a
multidisciplinary approach
James M.
Rippe, MD,
Louis
J.
Aronne,
MD,
Ann
M.
Coulston, MS,
RD, FADA,
Sharron
Dalton,
PhD, RD,
John P. Foreyt, PhD, Arthur Frank, MD, Marion J. Franz, MS, RD,
and Cathy A. Nonas, MS, RD
A roundtable discussion covers such treatment issues as how physicians
and dietitians can work together more effectively; the need for new
measures of treatment success; strategies for assembling a treatment team
that includes both clinicians and patients; how to engage physician interest
in and commitment to team-based obesity management; the need for
greater understanding of behavior modification principles; and the
dietitian s participation in
pharmacologie
treatment of obesity.
ACCESSING INFORMATION
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Visit our Web site for the latest informa¬
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news from The American Dietetic Association
at http://www.eatriglit.org
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To search for a particular Journal article,
please refer to the Subject/Author Index
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| title | The obesity epidemic a mandate for a multidusciplinary approach ; ... was a closed roundtable, held on October, 27, 1997, in Boston, Mass. |
| title_auth | The obesity epidemic a mandate for a multidusciplinary approach ; ... was a closed roundtable, held on October, 27, 1997, in Boston, Mass. |
| title_exact_search | The obesity epidemic a mandate for a multidusciplinary approach ; ... was a closed roundtable, held on October, 27, 1997, in Boston, Mass. |
| title_full | The obesity epidemic a mandate for a multidusciplinary approach ; ... was a closed roundtable, held on October, 27, 1997, in Boston, Mass. James M. Rippe, guest ed. |
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| title_short | The obesity epidemic |
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