BMI
Underweight = <18.5 |
Healthy = 18.5-24.9 |
Overweight = BMI 25-29 (Asian = 23-24.9) |
Obese = BMI 30+ (Asian = >25) |
Risk Factors
Alcohol & beverage intake |
Dieting hx |
Meal patterns & portions |
Medications (↑wt anti-psychotics, insulin, steroids) |
Physical Activity |
Medications (↓wt orlistat, sibutramine, rimonabant, taranabant) |
Hypo/hyperthyroidism (TSH) |
Emotional State/Mental Health |
Co-morbidities
T2DM |
HTN |
EDs |
Familial obesity |
Dyslipidaemia |
CVD |
GORD |
Asthma |
PCOS |
Sleep Apnoea (OSA) |
NAFLD |
Infertility |
CKD |
Kidney stones |
Gout |
Increased surgical risk |
Reproductive issues |
Shortness of breath |
Stroke |
Cataracts |
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Example PESS
Excessive energy intake, Frequent consumption of large portions, energy intake (kj) |
Overweight/obesity, Frequent consumption of energy-dense foods and limited physical activity, BMI > 25 |
Nut Reqs
-1kg/week = ~ -4600kJ/day |
~25% protein, 30% fat, 45% carbohydrate (in a deficit) |
Slow weight loss overweight/obese: Calculate AdjBW (this acts as the weight loss factor) -> Mifflin -> Add activity factor |
Fibre F: 25, M: 30g |
Fluid (AI): 2.1L, M: 2.6L |
Nut Intervention
ideal 5-10% weight loss = reduction of BP/impaired glucose/lipids etc |
Weight management counselling – reasons to lose weight & health risks – consider level of motivation |
Education: Energy balance |
Education: Mindful eating |
Education: Portion size |
Education: Regular balanced meals |
Education: YoYo dieting cycle |
Counselling: Stress management and eating triggers – building healthier habits. Barriers & body image issues |
*Reduction in weight can be beneficial to people with comorbidities – even in “healthy weight range” |
↑ PA (150 min/week moderate intensity) |
Strategies
↓CHO/↑P |
Smaller plates |
↓E/↑fibre swaps |
Non-alc/sugar-free alternatives |
Even distribution of meals throughout day |
Avoid eating while distracted (e.g. watching TV) |
Meal prep – avoid impulsive eating |
Eating out options - choosing lower energy options |
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DDR Prompts
Weight gain happens when we consistently eat more energy than our body uses |
Being above or below a healthy weight can place strain on the body |
Weight management focuses on small changes you can keep up for life – not fad diets |
CONSIDER
Pts emotions, self-esteem, stress levels, sleep, mobility, culture |
Guidelines & References
National Health and Medical Research Council. (n.d.).Summary guide for the management of overweight and obesity in adults, adolescents and children in Australia |
National Obesity Strategy: 2022-2032. Commonwealth of Austrlia. Health Ministers Meeting: |
DA 10-point plan to manage overweight and obesity |
Handbook p147 |
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