By rray, 11 December, 2014 Consider adjuncts to comprehensive lifestyle intervention, if motivated to ↓ wt:
By rray, 11 December, 2014 If BMI ≥40 (or ≥35 w/ obesity-associated comorbidity): offer referral to experienced bariatric surgeon for eval/consult6 for pts not sufficiently responsive to behavioral tx w/ or w/o obesity-drug tx [S/A]
By rray, 11 December, 2014 Drug:5 Consider individualized risk/benefit of optional FDA-approved obesity-drug adjunct to comprehensive lifestyle intervention [E]
By rray, 11 December, 2014 Plus comprehensive lifestyle intervention [S/A]:3 high-intensity, on-site4 ≥14 sessions/6 mo (group/individual) on diet/activity/behavior by trained interventionist
By rray, 11 December, 2014 Diet based on pt preference, health status; nutrition professional preferred [S/A]:
By rray, 11 December, 2014 Food type (evidence-based): Restrict foods such as high-carb, low-fiber, or high-fat foods
By rray, 11 December, 2014 Daily calorie limit:2women: 1,200–1,500 kcal/day, men: 1,500–1,800 kcal/day
By rray, 11 December, 2014 Obese. Initial goal: 5-10% wt ↓ in 6 mo via lifestyle intervention (+/- adjunctive tx). Manage comorbidities, address/treat CVD risk factors1 (HTN/dyslipidemia/DM/prediabetes) & other obesity-related comorbidities (eg, sleep apnea)