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26 Cards in this Set

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Self-Help Obesity treatment programs
vary widely in format, safety, effectiveness and quality; , one basic approach used for everyone
Types of Obesity Treatment programs
Self help, nonclinical, clinical
Nonclinical Obesity Treatment programs
more structured and tailored than self help programs, usually part of commercial franchises, the material is provided by company and lay representatives who may not be well supervised
Clinical Obesity Treatment Programs
Treatment provided mostly by licensed professionals, psychologists, RDs, MDs, may work alone or be part of team, individualized, thorough assessment
Weight loss consumer Bill of rights
Rapid weight loss may cause problems (>1-2 lbs week or 1% per week after 2ndwk), only permanent lifestyle changes promote long term weight loss, consult your doc before starting, qualifications of provider's staff must be available upon request, you have right to ask questions about potential health risks, nutritional content, psych support & ed components and know full $ of treatment and extras, know program duration being recommended for you
Michigan Guidelines
Apply to all clinical and nonclinical programs: All clients must be screened for med and psych conditions that would make weight loss inappropriate, all must be classified by excess body weight and overall health risk, Lvl 1 for low risk, lvl 2 for mod risk, level 3 for very obese.\/ hi risk; care should be given by trained people whose qualifications are commensurate with level of risk
IOM Criteria for evaluating Weight management program
1. Match between program and consumer 2) The soundness and safety of the program 3) what os the evidence for the outcomes of the program
Stepped-Care Model
IOM developed a model for type of intervention by risk so that Step 1 is low fat diet, physical activity, lifestyle change (<10lbs); Step 2 is more detailed assessment of health risks and more intensive efforts are needed; Step 3 when comorbid disease or high risk for weight related diseases, need more monitoring by doctor; Step 4 is for ultra low calorie diets and surgery, medicine, psychotherapy; health coach may be working with client in all four steps, depending on setting, level of professional support available and coach's education & experience level
What are standards of care for Weight loss programs
1) assessment of physical health and psych status and reappraisal, 2) Attention to diet, 3) attention to physical activity, 4) ensuring program safety, 5) Goal should be weight management, not weight loss, more about health than appearance, 6) judging program should be about health improvements, not just weight loss
Screening when and how
Want to get initial and end assessment plus every 6 mos; but don't overwhelm or sacrifice rapport for early screenings
Risks of restrictive diets
Lo calorie diets and rapid weight loss is big risk to gall bladder; <1200 calories may be nutritionally deficient, <800 only under medical supervision
What are components of successful outcome of weight management program according to IOM?
1) long-term weight loss 2) improvement in obesity related risk factors, 3) improved health practices, 4) monitoring adverse effects that might come from program
What are you screening for in initial Interview?
Is this client appropriate for this setting, assess physical and psychological health, exercise readiness, physical fitness, readiness to change, behavioral assessment (functional, motivational)
What are common tools to assess physical health screening?
Get medical clearance, do basic health screen (Musculoskeletal HQ), BP, RHR, reasonable weight
What are criteria for Medical Clearance for exercise?
Hypertension, high cholesterol/triglyceride, significant emotional problems BMI 31+, chronic kidney failure, liver disease, cardiovascular disease, pregnancy (even planned), hyper/hypo thyroid, substance abuse
What is Basic Health Screen?
If no significant current/ past health probelms check: BMI o body comp, waist circumference, BP, RHR, BP, h/o chronic illness, current med hx, family health hx, health habits, obesity related risk factor
What is normal BP for adults ? Prehypertensive? Stage 1 and 2 hypertensive?
<80/<120 is normal;
Prehypertension is 80-89/120-139
Stage 1 hypertension 90-99/140-159
Stage 2 hypertension >160/>100
What is normal RHR?
average 72 (60-100); the more fit, the lower the RHR; but beta blockers or other meds can effect it
How do you determine reasonable weight for client?
Ideal weight is no longer recommended as goal as it unusual to obtain it; instead loss of 10% of body weight over 6 month is initial goal; then focus on maintainence;
What factors should you consider when assessing psychological health of client in initial screening?
eating disorders, anxiety, depression can seem to be weight related but food is just expression of sx; ask about anxiety and stress and feeling down & encourage counseling; ask about meds that can affect weight loss
What is minimal exercise readiness screening entail?
PAR-Q, stratification of heart disease, risk factors, identification of sx of disease, eval of coronary risk profile
What is PAR-Q?
Physical Activity Readiness Questionnaire: minimal health-risk appraisal that is quick and non-invasive to administer but limited by lack of detail and may over look important stuff
What is risk stratification and why is it important?
ID CAD risk factors, risk stratification based on CAD risk factors ans determine need for med clearance

someone with only one positive risk factor will be treated diff than someone with several; recommendations for amount, type, intensity of exercise ans whether it needs to be med supervised or further exam is needed
What are factors considered in cardiovascular disease risk factor stratifcation?
Age, family hx, smoking, sedentary, obesity, hypertension, dyslipidemia, prediabetes; high HDL is negative risk factor
What are basic components of assessing physical fitness?
aerobic, flexibility, strength, body composition
What is a behavioral functional assessment?
Identifying antecedents and consequences associated with behaviors; identify behavioral excesses and deficits