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listlengths 384
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Table\t20.6\n.\nTABLE\t20.6\nResults\tof\tU.S.\tDepartment\tof\tAgriculture\tScientific\tReview\tof\tPopular\tDiets\nArea\nFinding\nWeight\tloss\nDiets\tthat\treduce\tcaloric\tintake\tresult\tin\tweight\tloss;\tall\tpopular\tdiets\n\tresult\tin\tshort-\nterm\tweight\tloss\tif\tfollowed.\nBody\ncomposition
|
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0.034246284514665604
] |
result\tin\tshort-\nterm\tweight\tloss\tif\tfollowed.\nBody\ncomposition\nAll\tlow-calorie\tdiets\tresult\tin\ta\tloss\tof\tbody\tfat.\tIn\tthe\tshort\tterm,\thigh-fat,\tlow-\ncarbohydrate,\tand\tketogenic\tdiets\tcause\ta\tgreater\tloss\tof\tbody\twater\tthan\tbody\tfat.\nNutritional\nadequacy\n•\t\nHigh-fat,\tlow-carbohydrate\tdiets\tare\tlow\tin\tvitamins\tE\tand\tA,\tthiamin,\tB\n6\n,\tand
|
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] |
6\n,\tand\nfolate;\tand\tthe\tminerals\tcalcium,\tmagnesium,\tiron,\tand\n\tpotassium.\tThey\tare\talso\nlow\tin\tdietary\tfiber.\n•\t\nVery-low-fat\tdiets\tare\tlow\tin\tvitamins\tE\tand\tB\n12\n\tand\tthe\tmineral\tzinc.\n•\t\nWith\tproper\tfood\tchoices,\ta\tmoderate-fat,\tbalanced-nutrient\treduction\tdiet\tis\nnutritionally\tadequate.\nMetabolic\nparameters\n•
|
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] |
nutritionally\tadequate.\nMetabolic\nparameters\n•\t\nLow-carbohydrate\tdiets\tcause\tketosis\tand\tmay\tsignificantly\tincrease\tblood\turic\tacid\nconcentrations.\n•\t\nBlood\tlipid\tlevels\tdecline\tas\tbody\n\tweight\tdecreases.\n•\t\nEnergy\trestriction\timproves\tglycemic\tcontrol.\n•\t\nAs\tbody\tweight\tdeclines,\tblood\tinsulin\tand\tplasma\tleptin\tlevels\tdecrease.\n•
|
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•\t\nAs\tbody\tweight\tdeclines,\tblood\tpressure\tdecreases.\nHunger\tand\ncompliance\nNo\tdiet\twas\toptimal\tfor\treducing\thunger.\nEffect\ton\nweight\nmaintenance\nControlled\tclinical\ttrials\tof\thigh-fat,\tlow-carbohydrate,\tlow-fat,\tand\tvery-low-fat\tdiets\nare\n\tlacking;\ttherefore\tno\tdata\tare\tavailable\ton\tweight\tmaintenance\tafter\tweight\tloss
|
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] |
or\tlong-term\thealth\tbenefits\tor\trisk.\nFrom\tFreedman\tM\tet\tal:\tPopular\tdiets:\ta\tscientific\treview,\t\nObes\tRes\n\t9(Suppl\t1):1S,\t2001.\nOver-the-counter\tmedications\tand\therbal\tsupplements\tfor\tweight\tloss\thave\tbeen\tpopular\tfor\tmany\nyears.\tWith\tsome\texceptions,\tthe\tmajority\tof\tthese\tsupplements\thave\tlimited\tdata\twith\n\tregard\tto
|
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] |
regard\tto\ntheir\tefficacy\tand\tsafety,\tand\tmany\tof\tthe\tmost\teffective\tsupplements\tfor\tweight\tloss\t(caffeine\tand\nephedra)\thave\tsignificant\tcardiovascular\tand\tneurologic\trisks\tor\thave\tbeen\tbanned\tby\tthe\tFood\tand\nDrug\tAdministration\t(FDA)\t(e.g.,\tephedra).\tDietitians\tshould\tbe\taware\tof\tpopular\tsupplements\tin
|
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] |
order\tto\tbest\tserve\tclients\tand\tpatients.\tAccording\tto\tthe\tFDA,\ta\thigh\tpercentage\tof\tweight\tloss\nproducts\tare\tadulterated\tand\tcontain\tillegal\tdrugs\tand\tstimulants\tthat\tare\tnot\tlisted\ton\tthe\tlabel.\nSee\t\nTable\t20.7\n\tfor\tpopular\tnutritional\tsupplements\tused\tfor\tweight\tloss.\tReliable\tinformation\ton
|
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-0.01901313103735447,
0.04220898449420929,
0.00270683690905571,
-0.021051043644547462,
-0.066285640001297,
0.04779934510588646,
0.09791258722543716,
0.014334195293486118,
0.010480965487658978,
0.05387082323431969,
0.07958873361349106,
0.012886052951216698,
0.07006267458200455,
0.011768526397645473
] |
dietary\tsupplements\tcan\tbe\tobtained\tfrom\tthe\tNIH\tOffice\tof\tDietary\tSupplements\twebsite\tas\twell\tas\nconsumer\twarnings\ton\trecalled\tand\tbanned\tproducts\tfrom\tthe\tFDA’s\twebsite\t(see\t\nChapter\t11\n).
|
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] |
TABLE\t20.7\nNonprescription\tWeight\tLoss\tProducts\nProduct\nClaim\nEffectiveness\nSafety\nAlli:\tOTC\tversion\nof\nprescription\ndrug\torlistat\n(Xenical)\nDecreases\tabsorption\tof\tdietary\tfat\nEffective;\tweight\tloss\namounts\ttypically\nless\tfor\tOTC\tversus\nprescription\nFDA\tinvestigating\nreports\tof\tliver\ninjury,\npancreatitis\nBitter\torange\n(synephrine)
|
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] |
reports\tof\tliver\ninjury,\npancreatitis\nBitter\torange\n(synephrine)\nIncreases\tcalories\tburned\nInsufficient\treliable\nevidence\tto\trate\nPossibly\tunsafe,\nincrease\tin\nheart\n\trate\tand\nblood\tpressure\nChitosan\nBlocks\tabsorption\tof\tdietary\tfat\nIneffective\tfor\tweight\nloss\nPossibly\tsafe,\tmay\ncause\tbloating\nChromium\nIncreases\tcalories\tburned,\tdecreases
|
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] |
cause\tbloating\nChromium\nIncreases\tcalories\tburned,\tdecreases\nappetite,\tand\tbuilds\tmuscle\nInsufficient\treliable\nevidence\tto\trate\nLikely\tsafe\nConjugated\nlinoleic\tacid\n(CLA)\nReduces\tbody\tfat\tand\tbuilds\tmuscle\nIneffective\tfor\tweight\nloss\nPossibly\tsafe\nEphedra\t(Ma\nHuang)\nDecreases\n\tappetite\tand\tincreases\tfat\nburned\nPossibly\teffective\nUnsafe\tdue\tto
|
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appetite\tand\tincreases\tfat\nburned\nPossibly\teffective\nUnsafe\tdue\tto\ncardiovascular\nrisk\tand\nbanned\tby\tFDA\nGreen\ttea\nextract\nIncreases\tcalorie\tand\tfat\tmetabolism\tand\ndecreases\tappetite\nIneffective\tfor\tweight\nloss\nPossibly\tsafe\nGuar\tgum\nBlocks\tabsorption\tof\tdietary\tfat\tand\nincreases\tfeeling\tof\tfullness\nIneffective\tfor\tweight\nloss\nLikely\tsafe\tbut
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] |
Ineffective\tfor\tweight\nloss\nLikely\tsafe\tbut\nincreased\ngastrointestinal\ndistress\nHoodia\tgordonii\nDecreases\tappetite\nInsufficient\treliable\nevidence\tto\trate\nInsufficient\ninformation,\nhigh\trisk\tof\nmislabeling\nSenna\nCathartic;\tlaxative,\tcauses\tdiarrhea\nInsufficient\treliable\nevidence\tto\trate\nLikely\tunsafe,\nstimulant\nlaxative\nRaspberry\nketones
|
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0.03936954215168953
] |
evidence\tto\trate\nLikely\tunsafe,\nstimulant\nlaxative\nRaspberry\nketones\nIncreases\tlipolysis\nInsufficient\treliable\nevidence\tto\trate\nLikely\tunsafe\nespecially\tfor\nhypertension\nGarcinia\ncambogia\nBlocks\tenzymes\tin\tbody\twhich\n\tconvert\nglucose\tto\tfat.\tAlso\tincreases\tserotonin\nin\tbrain,\tlimiting\tappetite\tand\tproviding\nextra\tenergy\nIneffective\tfor\tweight
|
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extra\tenergy\nIneffective\tfor\tweight\nloss\t(Esteghamati,\n2015)\nReports\tof\tliver\ndamage\nassociated\nFDA,\n\tFood\tand\tDrug\tAdministration;\t\nOTC,\n\tover\tthe\tcounter.\nAdapted\tfrom\tNatural\tMedicines\tin\tthe\tClinical\tManagement\tof\tObesity,\tNatural\tMedicines\tComprehensive\tDatabase\t(website):
|
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] |
http://naturaldatabase.therapeuticresearch.com:80/ce/ceCourse.aspx?s=ND&cs=&pc=09%2D32&cec=1&pm=;\tScott\tGN\n:\t\nIs\traspberry\tketone\neffective\tfor\tweight\tloss?\n\t\nhttp://www.medscape.com/viewarticle/775741\n,\t2012.\nAdditional\tinformation\tfrom\t\nhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4386228/\n;\tEsteghamati\tA,\tMazaheri\tT,\tVahidi\tRad\tM,\tNoshad\tS.
|
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] |
;\tEsteghamati\tA,\tMazaheri\tT,\tVahidi\tRad\tM,\tNoshad\tS.\nComplementary\tand\talternative\tmedicine\tfor\tthe\ttreatment\tobesity:\ta\tcritical\treview.\t\nInt\tJ\tEndocrinol\tMetab\n\t2015;\t13:e19678;\tPittler\tMH,\tErnst\tE.\nGuar\tgum\tfor\tbody\n\tweight\treduction:\tmeta-analysis\tof\trandomized\ttrials.\t\nAm\tJ\tMed\n\t2001;\t110:724.\tUp\tto\tDate\tObesity\tin\tadults:\tDrug\tTherapy
|
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Am\tJ\tMed\n\t2001;\t110:724.\tUp\tto\tDate\tObesity\tin\tadults:\tDrug\tTherapy\nPhysical\tactivity\nPhysical\tactivity\tis\tthe\tmost\tvariable\tcomponent\tof\tenergy\texpenditure\t(see\t\nChapter\t2\n).\tIncreases\tin\nenergy\texpenditure\tthrough\texercise\tand\tother\tforms\tof\tphysical\tactivity\tare\timportant\tcomponents\nof\tinterventions\tfor\tweight\tloss\tand\tits\tmaintenance.
|
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] |
cardiovascular\tintegrity,\tincreasing\tsensitivity\tto\tinsulin,\tand\texpending\tadditional\tenergy\tand\ntherefore\tcalories.\nThe\tCDC’s\tPhysical\tActivity\tGuidelines\n\tfor\tAmericans\tsuggest\ta\tminimum\tof\t150\tminutes\tof\nphysical\tactivity\tweekly,\twith\ttwo\tsessions\tof\tweight\ttraining,\tto\tachieve\thealth\tbenefits.\tHowever,
|
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day\tof\tphysical\tactivity\t(at\tleast\t420\tminutes\tper\tweek).\nOverweight\tand\tobese\tadults\tshould\tgradually\tincrease\tto\toptimal\tlevels\tof\tphysical\tactivity.\n\tEven\nif\tan\toverweight\tor\tobese\tadult\tis\tunable\tto\tachieve\tthis\tlevel\tof\tactivity,\tthere\tis\tevidence\tthat
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] |
significant\thealth\tbenefits\tcan\tbe\trealized\tby\tparticipating\tin\tat\tleast\t30\tminutes\tof\tdaily\tactivity\tof\nmoderate\tintensity.\tTargeting\tthese\tlevels\tof\tphysical\tactivity\tcan\timprove\thealth-related\toutcomes\nand\tfacilitate\tlong-term\tweight\tcontrol.\nAerobic\texercise\tand\tresistance\ttraining\tshould\n\tbe\trecommended.\tResistance\ttraining\tincreases
|
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] |
be\trecommended.\tResistance\ttraining\tincreases\nLBM,\traising\tthe\tRMR\tand\tone’s\tability\tto\tuse\tmore\tof\tthe\tenergy\tintake,\tand\tincreases\tbone\tmineral\ndensity,\tespecially\tfor\twomen\t(see\t\nChapter\t23\n).\tAerobic\texercise\tis\timportant\tfor\tcardiovascular\nhealth\tthrough\televated\tRMR,\tcalorie\texpenditure,\tenergy\tdeficit,\tand\tloss\tof\tfat.\tIn\taddition\tto\tthe
|
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] |
physiologic\tbenefits\tof\texercise,\tother\tbenefits\tinclude\n\trelief\tof\tboredom,\tincreased\tsense\tof\tcontrol,\nand\timproved\tsense\tof\twell-being.\tThe\twhole\tfamily\tcan\tget\tinvolved\tin\tpleasurable\texercise\nactivities\t(\nFig.\t20.7\n).\nFIG.\t20.7\nGroup\tactivity\tclasses\thelp\tbuild\tcommunity\tand\tcan\tincrease\tmotivation\tto\texercise.
|
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] |
The\trecommendations\tfor\texercise\tfrom\tthe\tAmerican\tCollege\tof\tSports\tMedicine\tdiffer\tfor\tweight\nloss\tversus\tweight\tmaintenance.\tPhysical\tactivity\tof\tfewer\tthan\t150\tminutes\tper\tweek\thas\ta\tminimal\neffect\ton\tweight\tloss,\twhereas\tphysical\tactivity\tof\tgreater\tthan\t150\tminutes\tper\tweek\tusually\tresults
|
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] |
in\tmodest\tweight\tloss\t(defined\tas\t2\tto\t3\tkg),\tand\tphysical\tactivity\tbetween\t225\tand\t420\tminutes\tper\nweek\tis\tlikely\tto\tresult\tin\tthe\tgreatest\tweight\tloss\t(5\tto\t7.5\tkg).\tHowever,\tthis\thigh\tvolume\tof\nphysical\tactivity\tmay\tnot\tbe\tpractical\tfor\tthe\tgeneral\tpopulation.\tResearch\ton\tmaintaining\tweight
|
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] |
indicates\tthat\tmoderate\tto\tvigorous\tphysical\tactivity\tof\t150\tto\t250\tminutes\tper\tweek,\tat\tan\tenergy\nequivalent\n\tof\t1200\tto\t2000\tkcal\tper\tweek\t(about\t12\tto\t20\tmiles\tper\tweek\tof\tjogging\tor\trunning)\tis\nsufficient\tto\tprevent\tweight\tgain\t(\nSwift\tet\tal,\t2014\n).\tHowever,\tobese\tindividuals\twho\thave
|
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] |
Swift\tet\tal,\t2014\n).\tHowever,\tobese\tindividuals\twho\thave\nsuccessfully\tlost\tweight\tmay\trequire\ta\tsubstantial\tamount\tof\tphysical\tactivity\tto\tmaintain\tweight\nloss.\nFailure\tto\tmeet\tthe\trecommended\tlevels\tof\taerobic\tphysical\tactivity\tleads\tto\tnearly\t$117\tbillion\tin\nannual\thealth
|
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annual\thealth\n\tcare\tcosts\tand\t10%\tof\tall\tpremature\tdeaths,\taccording\tto\tthe\tDepartment\tof\tHealth\nand\tHuman\tServices\t2018\tphysical\tfitness\treport\tin\tthe\t\nJournal\tof\tthe\tAmerican\tMedical\tAssociation\n(\nPiercy\tet\tal,\t2018\n).\nPharmaceutical\tmanagement\nAppropriate\tpharmacotherapy\tcan\taugment\tdiet,\tphysical\tactivity,\tand\tbehavior\ttherapy\tas\ttreatment
|
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] |
for\tpatients\twith\ta\tBMI\tof\t30\tor\thigher\tor\tpatients\twith\t27\tor\thigher\n\twho\talso\thave\tsignificant\trisk\nfactors\tor\tdisease.\tThese\tagents\tcan\tdecrease\tappetite,\treduce\tabsorption\tof\tfat,\tor\tincrease\tenergy\nexpenditure.\tAs\twith\tany\tdrug\ttreatment,\tphysician\tmonitoring\tfor\tefficacy\tand\tsafety\tis\tnecessary.
|
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] |
Pharmacotherapy\tis\tnot\ta\t“magic\tpill”;\tdietitians\tshould\tcollaborate\twith\tother\thealth\tprofessionals\nregarding\tthe\tuse\tof\tFDA–approved\tpharmacotherapy.\tNot\tall\tindividuals\n\trespond,\tbut\tfor\tpatients\nwho\tdo\trespond,\tweight\tloss\tof\tapproximately\t2\tto\t20\tkg\tcan\tbe\texpected\tusually\tduring\tthe\tfirst\t6
|
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0.024976983666419983,
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0.07158557325601578,
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0.053117893636226654,
0.06903725117444992,
0.031753696501255035,
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0.08114318549633026,
0.02837425284087658,
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0.016186509281396866,
0.07934661954641342,
0.015425988472998142,
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0.06231875345110893,
0.09161727875471115,
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0.06356654316186905,
0.08331633359193802,
0.11106514930725098,
-0.014132468029856682
] |
months\tof\ttreatment.\tMedication\twithout\tlifestyle\tmodification\tis\tless\teffective.\nAs\tof\tApril,\t2018,\tfive\tlong-term\tweight\tloss\tdrugs\twere\tlisted\tas\tapproved\tby\tthe\tFDA:\torlistat\n(Xenical),\tliraglutide\t(Saxenda,\tVictoza),\tlorcaserin\t(Belviq),\tnaltrexone-bupropion\t(Contrave),\n\tand\nphentermine-topiramate\t(Qsymia)\t(\nTable\t20.8
|
[
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0.0064369929023087025,
0.005901889875531197,
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0.04557892307639122,
0.03648572415113449,
0.09836312383413315,
0.02775338478386402,
0.03809143230319023,
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0.034509483724832535,
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0.02023591659963131,
0.03924712538719177,
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0.03618728369474411,
0.007849551737308502,
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0.07815985381603241,
0.07043042778968811,
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0.00205689063295722,
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0.0043088817037642,
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0.006418690085411072,
0.07069234549999237,
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0.011473018676042557,
0.0242585651576519,
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0.040072549134492874,
0.04081603139638901,
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3.242776021527965e-33,
0.03522895649075508,
0.05784393846988678,
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0.045039139688014984,
0.0064530507661402225,
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0.12892909348011017,
0.00006150126864667982,
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0.04701198637485504,
0.03853029012680054,
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0.034268852323293686,
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0.027091698721051216,
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0.05860333889722824,
0.07790777087211609,
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0.1361524611711502,
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0.03985759988427162,
0.019345812499523163,
0.08072919398546219,
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-0.07147722691297531,
0.06014368683099747,
-0.10579331964254379,
0.06325998902320862,
0.06566333770751953,
0.05583028495311737,
0.04843445122241974,
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0.047660890966653824,
0.06478920578956604,
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-0.06843391060829163,
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0.0008148421184159815,
0.053648319095373154,
0.047595784068107605,
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0.01824094168841839,
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0.12612131237983704,
0.006550879217684269,
0.03438131883740425,
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0.020233428105711937,
0.0616077296435833,
0.06133318692445755,
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0.03376759588718414,
0.03921561315655708,
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0.015224610455334187,
0.04740769416093826,
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0.07315821945667267,
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0.03157047927379608,
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0.04097726196050644,
0.008825349621474743,
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0.046785686165094376,
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0.03384028747677803,
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0.026610469445586205,
0.008828624151647091,
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0.03863612189888954,
0.013959825970232487,
0.062081221491098404,
0.023236097767949104,
0.03377830237150192,
-0.0001357672008452937,
0.11441890150308609,
0.11162517964839935,
-5.206620201647638e-8,
0.05968683585524559,
-0.06659986823797226,
-0.006728741340339184,
-0.05261930450797081,
0.03637126460671425,
-0.012059878557920456,
0.03561342507600784,
-0.013708948157727718,
-0.01759379915893078,
-0.06876932084560394,
0.05911409109830856,
0.13111214339733124,
-0.08736322820186615,
-0.035682640969753265,
0.014035375788807869,
0.026859480887651443,
-0.024254458025097847,
0.11985893547534943,
-0.057270657271146774,
-0.09845218807458878,
-0.06091325357556343,
0.06367944180965424,
0.003263243706896901,
-0.06574837863445282,
0.01620658114552498,
0.004420071374624968,
0.031535804271698,
0.014813716523349285,
0.023399896919727325,
0.03076944127678871,
0.04230179637670517,
-0.0005619794246740639,
0.024702681228518486,
-0.058525510132312775,
-0.06530123949050903,
0.0780855193734169,
0.00965860951691866,
0.007722808513790369,
-0.05085862800478935,
0.1346864253282547,
-0.013182418420910835,
-0.016934677958488464,
-0.020000243559479713,
0.09222961217164993,
0.026366520673036575,
-0.0837162658572197,
-0.05392866209149361,
0.07710060477256775,
0.011827545240521431,
-0.06672854721546173,
0.017053799703717232,
0.11197120696306229,
0.009961155243217945,
-0.045335665345191956,
-0.0753825232386589,
0.0895775631070137,
0.04799508675932884,
-0.02162901870906353,
0.04398396983742714,
-0.039522960782051086,
0.04733244329690933,
0.013748956844210625,
0.08298014849424362,
0.03533344343304634
] |
and\nphentermine-topiramate\t(Qsymia)\t(\nTable\t20.8\n\tfor\tmechanisms\tof\taction\tand\tcommon\tside\teffects\tof\nprescription\tweight\tloss\tdrugs).
|
[
-0.03870966657996178,
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0.006942640990018845,
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0.027845917269587517,
0.09996494650840759,
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0.0814826712012291,
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0.0124978581443429,
0.09494878351688385,
0.0018941682064905763,
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0.02335619181394577,
0.021346688270568848,
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0.012589968740940094,
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] |
TABLE\t20.8\nPrescription\tDrugs\tApproved\tfor\tObesity\tTreatment\n*\nWeight\tLoss\tDrug\nApproved\nFor\nHow\tIt\tWorks\nCommon\tSide\tEffects\nOrlistat\nSold\tas\tXenical\nby\nprescription;\nover-the-\ncounter\nversion\tsold\nas\tAlli\nXenical:\nadults\tand\nchildren\nages\t12\nand\tolder\nAlli:\nadults\nonly\nInhibits\tgastrointestinal\tlipase,\nwhich\treduces\tthe\tamount\tof
|
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] |
only\nInhibits\tgastrointestinal\tlipase,\nwhich\treduces\tthe\tamount\tof\nfat\tabsorbed\tfrom\tfood\tby\napproximately\t1/3—up\tto\t150\nto\t200\tcalories\tless\tper\tday.\nStomach\tpain,\tgas,\tdiarrhea,\tand\nleakage\tof\toily\tstools\nLowered\tfat-soluble\tvitamin\nabsorption;\tsupplements\nare\ttypically\trecommended\nand\tshould\tbe\ttaken\t>2\nhours\tapart\tfrom\tdrug
|
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] |
and\tshould\tbe\ttaken\t>2\nhours\tapart\tfrom\tdrug\nNote:\tRare\tcases\tof\tsevere\nliver\tinjury\treported.\nShould\tnot\tbe\ttaken\twith\ncyclosporine.\nLorcaserin\nSold\tas\tBelviq\nAdults\nActs\ton\tthe\tserotonin\treceptors\tin\nthe\tbrain.\tThis\tmay\thelp\tyou\neat\tless\tand\tfeel\tfull\tafter\neating\tsmaller\tamounts\tof\tfood.\nHeadaches,\tdizziness,\tfeeling\ntired,\tnausea,\tdry\tmouth,
|
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] |
Headaches,\tdizziness,\tfeeling\ntired,\tnausea,\tdry\tmouth,\ncough,\tand\tconstipation.\nShould\tnot\tbe\ttaken\twith\nselective\tserotonin\treuptake\ninhibitors\t(SSRIs)\tand\nmonoamine\toxidase\tinhibitor\n(MAOI)\tmedications\nPhentermine-\ntopiramate\nSold\tas\tQsymia\nAdults\nA\tmix\tof\ttwo\tdrugs:\tphentermine\n(suppresses\tyour\tappetite\tand\ncurbs\tyour\tdesire\tto\teat)\tand
|
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] |
(suppresses\tyour\tappetite\tand\ncurbs\tyour\tdesire\tto\teat)\tand\ntopiramate\t(used\tto\ttreat\nseizures\tor\tmigraine\nheadaches).\n\tMay\tmake\tyou\tfeel\nfull\tand\tmake\tfoods\ttaste\tless\nappealing.\nTingling\tof\thands\tand\tfeet,\ndizziness,\ttaste\talterations\n(particularly\twith\tcarbonated\nbeverages),\ttrouble\tsleeping,\nconstipation,\tdry\tmouth,\tand\nincreased\theart\trate
|
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] |
constipation,\tdry\tmouth,\tand\nincreased\theart\trate\nNote:\tSold\tonly\tthrough\ncertified\tpharmacies.\nMay\tlead\tto\tbirth\tdefects.\tDo\nnot\ttake\tQsymia\tif\tyou\tare\npregnant\tor\tplanning\ta\npregnancy.\nOther\tappetite\nsuppressant\ndrugs\n(drugs\tthat\tcurb\nyour\tdesire\tto\neat),\twhich\ninclude\nphentermine\nbenzphetamine\ndiethylpropion\nphendimetrazine\nSold\tunder\tmany
|
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] |
benzphetamine\ndiethylpropion\nphendimetrazine\nSold\tunder\tmany\nnames\nAdults\nIncrease\tchemicals\tin\tthe\tbrain\nthat\taffect\tappetite.\tMake\tyou\nfeel\tthat\tyou\tare\tnot\thungry\tor\nthat\tyou\tare\tfull.\nNote:\tOnly\tFDA\tapproved\tfor\ta\nshort\tperiod\tof\ttime\t(up\tto\n12\tweeks).\nDry\tmouth,\tdifficulty\tsleeping,\ndizziness,\theadache,\tfeeling\nnervous,
|
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] |
Dry\tmouth,\tdifficulty\tsleeping,\ndizziness,\theadache,\tfeeling\nnervous,\n\tfeeling\trestless,\tupset\nstomach,\tdiarrhea,\tand\nconstipation\n*\nNote:\tMetformin,\tused\tfor\ttype\t2\tdiabetes,\tis\ta\tprescription\tdrug\twhich\thas\tbeen\tused\tby\tphysicians\tas\tan\t“off-label”\ttreatment\tof\tobesity.\nAdapted\tfrom\t\nwww.niddk.nih.gov\n\tMar\t3,\t2014.
|
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] |
Adapted\tfrom\t\nwww.niddk.nih.gov\n\tMar\t3,\t2014.\nPadwal\tR,\tLi\tSK,\tLau\tDC:\tLong-term\tpharmacotherapy\tfor\tobesity\tand\toverweight,\tCochrane\tDatabase\tof\tSyst\tRev\t(4):CD004094,\t2003.\nPerrault\tL:\tObesity\n\tin\tadults:\tDrug\tTherapy.\tIn\tPost\tTW,\teditor:\tUpToDate,\tWaltham,\tMA,\t2018,\tUpToDate.
|
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The\tchoice\tof\tweight\tloss\tdrug\tis\tdetermined\tby\tthe\tphysician\tin\tpartnership\twith\tthe\tpatient.\tIn\ngeneral,\tmedications\tcan\tbe\tcategorized\tas\tcentral\tnervous\tsystem\t(CNS)-acting\tagents\tand\tnon-\nCNS-acting\tagents.\tSome\tCNS-acting\tagents\tfocus\ton\tthe\tbrain,\tincreasing\tthe\tavailability\tof\nnorepinephrine.\tDrug\tEnforcement
|
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norepinephrine.\tDrug\tEnforcement\n\tAgency\tSchedule\tII\tanorexic\tagents\tsuch\tas\tamphetamines\thave\na\thigh\tpotential\tfor\tabuse\tand\tare\tnot\trecommended\tfor\tobesity\ttreatment.\tOther\tCNS-acting\tagents\nact\tby\tincreasing\tserotonin\tlevels\tin\tthe\tbrain.\tTwo\tsuch\tdrugs,\tfenfluramine\t(commonly\tused\tin
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] |
combination\twith\tphentermine,\tknown\tas\t“fen-phen”)\tand\tdexfenfluramine,\twere\tremoved\tfrom\tthe\nmarket\tin\t1997\tafter\tconcerns\twere\traised\n\tregarding\tthe\tpossible\tside\teffects\tof\tcardiac\nvalvulopathy,\tregurgitation,\tand\tprimary\tpulmonary\thypertension.\tCommon\tside\teffects\tof\tmany\nCNS-acting\tagents\tare\tdry\tmouth,\theadache,\tinsomnia,\tand\tconstipation.
|
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0.0679524764418602,
0.04662007838487625,
0.054355524480342865,
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] |
Vitamins\tand\tsupplements\tmay\tbe\thelpful\tin\taddressing\ta\tpatient’s\tnutrition\tconcerns\twhile\ttrying\nto\tlose\tweight.\tOTC\tand\tnatural\tweight\tloss\tproducts\thold\tvarying\tdegrees\tof\tsafety\tand\n\tefficacy.\tSee\nTable\t20.7\n\tfor\tadditional\tinformation.\nNondiet\tapproach\nThe\tnondiet\tapproach\t(also\tknown\tas\t\nHealth\tat\tEvery\tSize;\tHAES®
|
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] |
The\tnondiet\tapproach\t(also\tknown\tas\t\nHealth\tat\tEvery\tSize;\tHAES®\n)\tis\tdescribed\tas\ta\tweight-\nneutral\tapproach\tthat\tproposes\tthat\tthe\tbody\twill\tattain\tits\tnatural\tweight\tif\tthe\tindividual\teats\nhealthfully,\tbecomes\tattuned\tto\thunger\tand\tsatiety\tcues,\tand\tincorporates\tphysical\tactivity.\nAdvocates\tfor\tthis\tapproach\tpromote\tsize
|
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Advocates\tfor\tthis\tapproach\tpromote\tsize\n\tacceptance,\trespect\tfor\tthe\tdiversity\tof\tbody\tshapes\tand\nsizes,\tand\tpromotion\tof\tintuitive\teating.\tThe\tapproach\tis\tdescribed\tas\tfocusing\ton\tachieving\thealth
|
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rather\tthan\tattaining\ta\tcertain\tweight.\nA\tfat-acceptance\tmovement\tresponding\tto\tweight\tbias\tand\tstigma,\twhich\tpersist\tboth\twithin\tand\noutside\tof\tthe\thealth\tcare\tsystem,\tpreceded\tthe\tnondiet\tmovement\t(see\tsection\ton\tWeight\tStigma\nand\tSocial\n\tJustice).\tAdvocates\tfor\tthis\tapproach\tgenerally\tfeel\tthat\tCR\tis\tharmful\t(leading\tto\teating
|
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] |
disorders,\tbody\tdissatisfaction,\tlow\tself-esteem,\tand\tpsychological\tharms).\tNondiet\tadvocates\tdo\tnot\nbelieve\tthat\tobesity\tin\tand\tof\titself\tis\ta\trisk\tfactor\tfor\tchronic\tdisease\tand\tand\tassert\tthat\tthe\tmedical\ncommunity\tis\tcomplicit\tin\tthe\t“medicalization\tand\tpathologizing\tof\tfatness”\t(\nUlian\tet\tal,\t2018a\n).
|
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] |
Ulian\tet\tal,\t2018a\n).\nNondiet\tadvocates\tbelieve\tthat\tobesity\tis\tnatural\t(genetically\tdetermined)\tand\tunrelated\tto\tenergy\nbalance,\tand\tthey\tpoint\tto\trelapse\tdata\tas\tproof\tthat\tattempts\tto\tlose\tweight\toften\tdo\tnot\twork.\nTo\tdate\tthere\thave\tbeen\t10\tstudies\t(described\tin\t15\tresearch\tpapers)\tusing\ta\tnondiet\tapproach
|
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] |
published\tbetween\t1999\tand\t2016.\tAmong\tthese\t10\tstudies\twere\ta\ttotal\tof\t697\tsubjects\twho\twere\nalmost\texclusively\n\twhite\twomen\tages\t30\tto\t50.\tTwo\tof\tsix\tpapers\treported\ta\tsignificant\timprovement\nin\ttotal\tand\tlow-density\tlipoprotein\t(LDL)\tcholesterol\t(\nBacon\tet\tal,\t2002\n;\t\nMensinger\tet\tal,\t2016\n),\tand
|
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] |
Bacon\tet\tal,\t2002\n;\t\nMensinger\tet\tal,\t2016\n),\tand\none\tpaper\treported\ta\tsignificant\timprovement\tin\thigh-density\tlipoprotein\t(HDL)\t(\nCarroll\tet\tal,\t2007\n).\nTwo\tof\tthree\tpapers\treported\ta\tsmall\tchange\tin\tsystolic\tor\tdiastolic\tblood\tpressure\t(\nBacon\tet\tal,\n2002\n;\t\nCarroll\tet\tal,\t2007
|
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] |
Bacon\tet\tal,\n2002\n;\t\nCarroll\tet\tal,\t2007\n).\tOnly\tone\tstudy\t(which\tprovided\tsupervised\texercise)\treported\ta\tclinically\nand\tstatistically\tsignificant\tchange\tin\tbody\tmass,\t3.6%\tloss\tof\tinitial\tbody\tweight\t(3.5\tkgs)\t(\nUlian\tet\nal,\t2015\n).\tOnly\tthree\ttrials\thave\tcompared\ta\tnondiet\tapproach\twith\ttraditional\tweight\tloss\ninterventions\t(\nBacon\tet\tal,\t2002
|
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] |
interventions\t(\nBacon\tet\tal,\t2002\n;\t\nMensinger\tet\tal,\t2016\n;\t\nSteinhardt\tet\tal,\t1999\n).\nThe\tnondiet\tstudies\tdo\tconsistently\tshow\timprovements\n\tin\tpsychological\tvariables\t(self-esteem,\nquality\tof\tlife,\tand\tdepression).\tWhen\tbehavioral-type\tweight\tloss\tstudies\tcollect\tdata\ton
|
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] |
psychological\tvariables\t(self-esteem,\tbody\timage,\thealth-related\tquality\tof\tlife)\tthey\tconsistently\nreport\timprovements\tas\twell\t(\nBlaine\tet\tal,\t2007\n;\t\nLasikiewicz\tet\tal,\t2014\n).\tFurthermore,\tin\tcontrast\tto\nthe\tidea\tthat\tintentional\tweight\tloss\tprecipitates\tmood\tdisturbance,\n\treductions\tin\tdepressive
|
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] |
reductions\tin\tdepressive\nsymptoms\tare\tconsistent\tvia\tany\tactive\ttreatment\t(lifestyle\tmodification,\texercise,\tnondiet,\tetc.)\n(\nFabricatore\tet\tal,\t2011\n).\nA\t5%\tweight\tloss\tleads\tto\tclinically\tsignificant\timprovements\tin\tmetabolic\tvariables.\tOn\taverage\nprofessional\tweight\tloss\tinterventions\tinduce\ta\t9.5%\tweight\tloss\tfrom\tbaseline\tand\tmaintain\t54%\tof
|
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] |
the\tloss\tat\t1\tyear\t(\nRamage\tet\tal,\t2014\n).\tWeight\n\tregain\tdata\tfrom\tclinical\tweight\tloss\tinterventions\nhowever\tare\tnot\trandomizable\t(applicable)\tto\tthe\tgeneral\tpopulation.\tThe\tmost\trecent\tavailable\tdata\n(collected\tvia\tthe\tNHANES)\tfound\tthat\t36.6%\tof\t14,306\tU.S.\tadults\twere\tmaintaining\tat\tleast\ta\t5%\nweight\tloss\t(\nKraschnewski\tet\tal,\t2010\n).
|
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weight\tloss\t(\nKraschnewski\tet\tal,\t2010\n).\nWhile\tyoung\twomen\twith\tbody\timage\tdisturbance\tare\tat\thigher\trisk\tfor\tthe\tdevelopment\tof\teating\ndisorders,\n\tintentional\tweight\tloss\tprograms,\twhen\tadministered\tby\ta\ttrained\tand\tempathetic\nprofessional,\tdo\tnot\tappear\tto\tincrease\tthe\tincidence\tof\teating\tdisorders.\tIn\tfact,\tsome\tstudies\treport
|
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] |
increased\tbody\tsatisfaction\tand\ta\thealthier\trelationship\twith\tfood\tin\taddition\tto\tweight\tloss\t(\nNational\nTask\tForce\ton\tthe\tPrevention\tand\tTreatment\tof\tObesity,\t2000\n;\t\nPalavras\tet\tal,\t2017\n;\t\nWadden\tet\tal,\n2004\n).\nWell-designed\n\tbehavioral\tweight\tloss\tinterventions\tare\table\tto\treduce\tweight,\timprove\tmetabolic
|
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profiles,\tand\timprove\tpsychological\toutcomes.\tBehavioral\tprograms\tvary\tbut\ttypically\taddress:\t(1)\nemotional\teating\ttriggers;\t(2)\tbalanced\tnutrition;\t(3)\tsocial\tsupport;\tand\t(4)\texercise,\tand\tsometimes\nalso\tinclude\tcognitive\trestructuring\tvia\texploration\tof\tdysfunctional\tthoughts\tregarding\tweight,\tbody\nshape,\n\tor\tdieting.
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shape,\n\tor\tdieting.\nPursuing\tweight\tloss,\tor\tnot,\tis\tan\tindividual\tchoice.\tFor\tindividuals\twho\tchoose\tnot\tto\tfocus\ton\nweight,\ta\tnondiet\tapproach\tcan\tlead\tto\timproved\tbody\timage\tand\tpsychological\tvariables.\tThe\neffects\ton\tmetabolic\tvariables\tand\tthe\tquality\tof\tdietary\tintake\tare\tunclear\t(\nLeblanc\tet\tal,\t2012\n;\nUlian,\t2018b
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Leblanc\tet\tal,\t2012\n;\nUlian,\t2018b\n)\tand\tpassive\tweight\tloss\tis\tnot\tan\texpected\tan\toutcome.\nBariatric\tsurgery\nBariatric\tsurgery\n\tis\tcurrently\tconsidered\tthe\tonly\tlong-term\teffective\ttreatment\tfor\textreme\tor\nclass\tIII\tobesity\twith\ta\tBMI\tof\t40\tor\tgreater,\tor\ta\tBMI\tof\t35\tor\tgreater\twith\tcomorbidities.\tAccording
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] |
to\tthe\tAmerican\tSociety\tfor\tMetabolic\tand\tBariatric\tSurgery,\t228,000\tbariatric\tsurgeries\twere\tdone\nin\t2017\twith\tan\tincrease\tof\t16%\tfrom\t2015.\tSleeve\tgastrectomy\tand\tRoux-en-Y\tgastric\tbypass\n(RYGB)\tare\tthe\n\ttwo\tmost\tcommon\tbariatric\tsurgeries\tin\tthe\tUnited\tStates,\twith\t58.1%\tand\t18.7%
|
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0.03286229819059372,
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0.052194204181432724,
0.06695664674043655,
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0.069784976541996,
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] |
performed,\trespectively.\tThe\tlaparoscopic\tadjustable\tgastric\tbanding\t(LAGB)\tand\tbiliopancreatic\ndiversion\twith\tduodenal\tswitch\t(BPD/DS)\tare\tstill\tdone,\tbut\tprevalence\tis\tdecreasing;\twith\tLAGB\nmaking\tup\t3.4%\tof\tbariatric\tsurgeries,\tand\tBPD/DS,\t0.6%\t(\nAmerican\tSociety\tfor\tMetabolic\tand\nBariatric\tSurgery\t[ASMBS],\t2016\n).
|
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] |
American\tSociety\tfor\tMetabolic\tand\nBariatric\tSurgery\t[ASMBS],\t2016\n).\nBefore\tany\textremely\tobese\tperson\tis\tconsidered\tfor\tsurgery,\tfailure\tof\ta\tcomprehensive\tprogram\nthat\tincludes\tcalorie\treduction,\texercise,\tlifestyle\tmodification,\tpsychological\tcounseling,\tand\tfamily
|
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] |
involvement\tmust\tbe\tdemonstrated.\tFailure\tis\tdefined\tas\tan\tinability\tof\tthe\tpatient\tto\treduce\tbody\nweight\tby\tone\tthird\tand\tbody\tfat\tby\tone\thalf,\tand\tan\tinability\tto\tmaintain\tany\tweight\tloss\tachieved.\nSuch\tpatients\thave\tintractable\tmorbid\tobesity\tand\tshould\tbe\tconsidered\tfor\tsurgery.
|
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] |
If\tsurgery\tis\tchosen,\tthe\tpatient\tis\tevaluated\textensively\twith\trespect\tto\tphysiologic\tand\tmedical\ncomplications,\tpsychological\tproblems\tsuch\tas\tdepression\tor\tpoor\tself-esteem,\tand\tmotivation.\nBehavioral\tcounseling,\tespecially\tin\tthe\tpostoperative\tperiod,\tcan\timprove\tweight\tloss\t(\nStewart\tand\nAvenell,\t2016\n).\tPostoperative
|
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Stewart\tand\nAvenell,\t2016\n).\tPostoperative\n\tfollow-up\trequires\tevaluation\tat\tregular\tintervals\tby\tthe\tsurgical\tteam\nand\ta\tregistered\tdietitian\tnutritionist\t(RDN).\tIn\taddition,\tbehavioral\tor\tpsychological\tsupport\tis\nnecessary.\tStudies\tindicate\tsome\tpositive\tphysiologic\tchanges\tin\tliver\tfibrosis,\tBMI,\tbranched\tchain
|
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] |
amino\tacid\tproduction,\tand\treversal\tof\tinsulin-induced\tincreases\tin\tbrain\tglucose\tmetabolism\n(\nAbdennour\tet\tal,\t2014\n;\t\nTuulari\tet\tal,\t2013\n).\nSleeve\tgastrectomy,\tgastric\tbypass,\tand\tlaparoscopic\tadjustable\tgastric\tbanding\nWeight\tloss\tsurgery\tprocedures\treduce\tthe\tamount\tof\tfood\tthat\tcan\tbe\teaten\tat\tone\ttime\tand
|
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] |
produce\tearly\tsatiety\t(\nFig.\t20.8\n).\tThe\tnew\tstomach\tcapacity\tmay\tbe\tas\tsmall\tas\t30\tmL\tor\napproximately\t2\ttablespoons.\tAfter\tsurgery\tthe\tpatient’s\tdiet\tprogresses\tfrom\tclear\tliquid\tto\tfull\nliquid\tto\tpuree,\tsoft,\tand\tfinally\n\tto\ta\tregular\tdiet\tas\ttolerated,\twith\temphasis\ton\tprotein\tand\tfluid\nintake\t(\nTable\t20.9
|
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] |
intake\t(\nTable\t20.9\n).\tThe\tresults\tof\tgastric\tsurgery\tare\tmore\tfavorable\tthan\tthose\tfrom\tthe\tintestinal\nbypass\tsurgery\tpracticed\tduring\tthe\t1970s.\tOn\taverage,\tthe\treduction\tof\texcess\tbody\tweight\tafter\ngastric\trestriction\tsurgery\tcorrelates\tto\tapproximately\t30%\tto\t40%\tof\tinitial\tbody\tweight.\tIn\taddition\nto\tthe\tgreater\tabsolute\tweight
|
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0.12078473716974258,
0.06482121348381042,
0.07738082855939865,
-0.040021948516368866
] |
to\tthe\tgreater\tabsolute\tweight\n\tloss\tobserved,\tthe\tgastric\tbypass\ttends\tto\thave\tsustainable\tresults\nwith\tsignificant\tresolution\tof\thypertension,\ttype\t2\tdiabetes\tmellitus,\tosteoarthritis,\tback\tpain,\ndyslipidemia,\tcardiomyopathy,\tnonalcoholic\tsteatohepatitis,\tand\tsleep\tapnea.\tHowever,\tlate
|
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] |
complications\tmay\tbe\tseen,\tsuch\tas\tvitamin\tdeficiencies,\telectrolyte\tproblems,\tor\teven\tintestinal\nfailure.\tPatients\tshould\tbe\tnutritionally\n\tassessed\tregularly\t(see\t\nAppendices\t11\n\tand\t\n12\n).\tThirty-day\nmajor\tcomplication\trates\tfor\tall\tbariatric\tprocedures\thave\tbeen\tfound\tto\tbe\t1.15%\tanastomotic\tleak,
|
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] |
0.37%\tmyocardial\tinfarction,\tand\t1.17%\tpulmonary\tembolism\t(\nChang\tet\tal,\t2018\n).\nFIG.\t20.8\nBariatric\tsurgeries.\tDietitians\tin\tNutrition\tSupport\tnewsletter,\tJune\t2014,\tP.\t10,\tVol.\t6,\tNo.\t3.
|
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] |
TABLE\t20.9\nDiet\tProgression\tAfter\tSleeve\tGastrectomy\tand\tRoux-en-Y\tGastric\tBypass\nStage\tof\nDiet\nDuration\nFoods\tAllowed\nClear\nLiquids\nStart\twithin\t24\nhours\tafter\nsurgery.\nDuration\t2-3\nmeals\nSugar-free\tclear\tliquids,\tsuch\tas\twater,\tunsweetened\tdecaffeinated\ttea,\nsugar-free\tgelatin,\n\tsugar-free\tpopsicles,\tbroth\nStage\t2\t–\nFull\nLiquid\nDiet
|
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sugar-free\tpopsicles,\tbroth\nStage\t2\t–\nFull\nLiquid\nDiet\nA\tfew\tdays\tto\t1\nweek\nProtein\tdrink,\tfat-free\t(skim)\tmilk,\tunsweetened\tnondairy\tmilk,\tstrained\ncream\tsoups\nStage\t3\t–\nPureed\nA\tfew\tweeks\tto\nabout\t1\tmonth\nFoods\tthat\tare\tthe\tconsistency\tof\ta\tsmooth\tpaste\tor\tthick\tliquid,\twithout
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] |
any\tsolid\tpieces.\tExamples\tinclude\tlow-fat\tcottage\tcheese,\tlow-fat\tor\tfat-\nfree\tricotta\tcheese,\tblended\tmeats,\tfish,\n\teggs,\tbeans,\tfruits,\tand\nvegetables\nStage\t4\t–\nSoft\nfoods\nAbout\t1\tmonth\nGround\tor\tfinely\tdiced\tmeats,\tcanned\tor\tsoft\tfresh\tfruit,\tcooked\tvegetables\nwithout\tskin,\teggs,\tbeans\nStage\t5\t–\nSolid\nfoods\nStart\tabout\t8\nweeks\tpost\nsurgery
|
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] |
Stage\t5\t–\nSolid\nfoods\nStart\tabout\t8\nweeks\tpost\nsurgery\nGradually\tincorporate\tfirmer,\tdiced,\tor\tchopped\tfoods.\nhttps://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/gastric-bypass-diet/art-20048472\nThe\t\nlaparoscopic\tsleeve\tgastrectomy\t(LSG)\n\tinitially\twas\tused\tfor\tpatients\twith\ta\tBMI\tgreater
|
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0.06770307570695877,
0.05248638242483139,
0.08538064360618591,
0.06341991573572159,
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] |
stomach\n\tlongitudinally.\tThe\tpyloric\tsphincter\tis\tleft\tintact\t(\nMeek\tet\tal,\t2016\n).\tComplications\nassociated\twith\tthe\tLSG\tcan\tinclude\tgastric\tbleeding,\tstenosis,\tleak,\tand\treflux.\tOne\tof\tthe\tmost\ncommon\tcomplications\tfrom\tsleeve\tgastrectomy\tinvolves\tacid\treflux,\toccurring\tin\t20%\tto\t30%\tof\npatients\t(\nBraghetto\tet\tal,\t2012
|
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] |
patients\t(\nBraghetto\tet\tal,\t2012\n).\tOccasionally,\tRYGB\tis\tnecessary\tto\tresolve\treflux\tcomplications\n(\nWeiner\tet\tal,\t2011\n)\t(see\t\nFig.\t20.6\n).\nGastric\tbypass\n\tinvolves\treducing\tthe\tsize\tof\tthe\tstomach\twith\tthe\tstapling\tprocedure\tbut\tthen\nconnecting\ta\tsmall\topening\tin\tthe\tupper\tportion\tof\tthe\tstomach\tto\tthe\tsmall\tintestine\tby\tmeans\tof\tan
|
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] |
intestinal\tloop.\tThe\toriginal\toperation\tin\tthe\tlate\t1960s\tevolved\tinto\tthe\tRYGB.\tBecause\tuse\tof\tthe\nlower\tpart\tof\tthe\tstomach\tis\tomitted,\tthe\tgastric\tbypass\tpatient\tmay\thave\tdumping\n\tsyndrome\tas\tfood\nempties\tquickly\tinto\tthe\tduodenum\t(see\t\nChapter\t26\n).\tThe\ttachycardia,\tsweating,\tand\tabdominal\tpain
|
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] |
Chapter\t26\n).\tThe\ttachycardia,\tsweating,\tand\tabdominal\tpain\nare\tso\tuncomfortable\tthat\tthey\tmotivate\tthe\tpatient\tto\tmake\tthe\tappropriate\tbehavioral\tchanges\tand\nrefrain\tfrom\tovereating\tand\tchoosing\tless\thealthful\tfoods,\tsuch\tas\tsugar-sweetened\tbeverages.\nEventually\tthe\tpouch\texpands\tto\taccommodate\t4\tto\t5\toz\tat\ta\ttime.\tSometimes\tgastric\tbypass
|
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] |
surgery\ncan\tlead\tto\tbloating\tof\tthe\tpouch,\tnausea,\tand\tvomiting.\tA\tpostsurgical\tfood\trecord\tnoting\tthe\ntolerance\tfor\tspecific\tfoods\tin\tparticular\tamounts\thelps\tin\tdevising\ta\tprogram\tto\tavoid\tthese\nepisodes.\nUp\tto\t16%\tof\tpatients\tmay\texperience\tpostoperative\tcomplications\t(\nBeebe\tand\tCrowley,\t2015\n).
|
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] |
Beebe\tand\tCrowley,\t2015\n).\nThese\tinclude\tanastomotic\tleaks,\tstrictures,\tperforation,\tgastric\tfistulas,\tbowel\tobstructions,\n\twound\ninfections,\trespiratory\tfailure,\tand\tintractable\tnausea\tand\tvomiting.\nLaparoscopic\tadjustable\tgastric\tbanding\t(LAGB),\tthe\tband\tcreating\tthe\treduced\tstomach\tpouch,
|
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] |
can\tbe\tadjusted\tso\tthat\tthe\topening\tto\tthe\trest\tof\tthe\tstomach\tcan\tbe\tmade\tsmaller\tor\tenlarged.\tThe\nband,\tfilled\twith\tsaline,\thas\ta\ttube\texiting\tfrom\tit\tto\tthe\tsurface\tof\tthe\tbelly\tjust\tunder\tthe\tskin;\tthis\nallows\tfor\tthe\tinjection\n\tof\tadditional\tfluid\tor\treduction\tof\tfluid\tinto\tthe\tband.\tRates\tof\tlap-band
|
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] |
placement\thave\tbeen\tdecreasing\tacross\tthe\tUnited\tStates,\twith\tsome\tbariatric\tcenters\tand\tsurgeons\nno\tlonger\tperforming\tthe\tprocedure.\tMany\tpatients\tare\tdrawn\tto\tthe\tband\tas\tan\toption\tas\tit\tis\nreversible;\thowever,\tmany\tpractitioners\tand\tresearchers\tfind\tthe\tcomplications\toutweigh\tthe\nbenefits\t(\nIbrahim\tet\tal,\t2017\n).\nBariatric
|
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0.00700516439974308,
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0.02476126328110695,
0.10857797414064407,
0.06142527982592583,
0.07922021299600601,
0.016737572848796844
] |
benefits\t(\nIbrahim\tet\tal,\t2017\n).\nBariatric\n\tsurgery\tplaces\tan\tindividual\tat\trisk\tfor\tmalnutrition\tthat\trequires\tlifelong\tfollow-up\tand\nmonitoring\tby\tthe\tmultidisciplinary\tteam.\tNutritional\tstatus\tshould\tbe\tfrequently\tevaluated\tby\tan\nRDN.\tMonitoring\tshould\tinclude\tan\tassessment\tof\ttotal\tbody\tfat\tloss\tand\ta\tfull\tmicronutrient
|
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0.022120477631688118,
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] |
assessment.\tPre-\tand\tpostsurgical\tmicronutrient\tassessment\tshould\tinclude\tthiamine,\tvitamin\tB\n12\n,\nfolate,\tiron,\tvitamin\n\tD,\tcalcium,\tother\tfat-soluble\tvitamins,\tzinc,\tand\tcopper.\tIn\tmany\tcases,\ta\tliquid\nmultivitamin\tmineral\tsupplement\tis\tused.\tRecommended\tvitamin\tsupplementation\tafter\tbariatric\nsurgery\tcan\tbe\tfound\tin\t\nTable\t20.10\n\t(
|
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0.06010369583964348,
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0.012445849366486073,
0.025228586047887802,
0.04278844967484474,
0.08749131858348846,
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0.043899886310100555,
0.03724830597639084,
0.0901382714509964,
0.09207320213317871,
-4.8195552437846345e-8,
0.011551418341696262,
-0.05110454186797142,
-0.0360998660326004,
-0.016138730570673943,
0.001503731939010322,
-0.02788538485765457,
0.011979049071669579,
-0.010289207100868225,
0.01963905058801174,
-0.0691051036119461,
0.043840907514095306,
0.08626456558704376,
-0.07974477857351303,
-0.07563126087188721,
0.06505390256643295,
0.008953099139034748,
0.007663203869014978,
0.1235569417476654,
-0.03812044486403465,
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-0.03285635635256767,
0.03282766044139862,
-0.025779224932193756,
-0.008395319804549217,
-0.012998158112168312,
0.004212911706417799,
-0.029961679130792618,
0.015515787526965141,
-0.05959435924887657,
0.02944430708885193,
0.04732723534107208,
-0.01056995801627636,
0.007833258248865604,
-0.07021031528711319,
-0.0001437260943930596,
0.071950763463974,
-0.024874111637473106,
-0.018671832978725433,
0.007993706502020359,
0.15200936794281006,
-0.035988111048936844,
-0.03641291707754135,
-0.036093756556510925,
0.05652520805597305,
0.07968317717313766,
-0.07548573613166809,
-0.02046426571905613,
0.08309512585401535,
0.061486270278692245,
-0.09716799855232239,
0.01625037007033825,
0.09292829781770706,
-0.019824588671326637,
-0.05659014359116554,
-0.06885959208011627,
0.05695277452468872,
0.07030557841062546,
0.01038990169763565,
-0.053121019154787064,
-0.04401833191514015,
0.08201451599597931,
0.09792272001504898,
0.0620141439139843,
0.0028843365143984556
] |
surgery\tcan\tbe\tfound\tin\t\nTable\t20.10\n\t(\nParrott\tet\tal,\t2017\n).
|
[
-0.07156450301408768,
0.05529943108558655,
0.03747502341866493,
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0.0383162684738636,
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0.05618029087781906,
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0.04856330156326294,
0.08512993901968002,
0.043009184300899506,
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0.03665833920240402,
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0.024210745468735695,
0.11858579516410828,
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0.04616212844848633,
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0.017495425418019295,
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0.09537974745035172,
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0.03348642587661743,
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0.011371925473213196,
0.03955717384815216,
0.039828311651945114,
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0.019579730927944183,
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0.04170740023255348,
0.07198592275381088,
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0.045217230916023254,
0.10855372995138168,
0.08674575388431549,
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0.029417628422379494,
0.022650662809610367,
-0.005777193233370781,
-0.08237694203853607,
0.004925279878079891,
-0.0012345790164545178,
-1.896481790518222e-33,
0.05325397104024887,
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0.0709007978439331,
0.0236893929541111,
0.07448111474514008,
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0.022233791649341583,
0.004730463959276676,
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0.000051064544095424935,
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0.055427756160497665,
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-0.03494410589337349,
0.1266915649175644,
-0.08620970696210861,
-0.03526586294174194,
0.0034343465231359005,
0.12878170609474182,
-0.010667992755770683,
0.017942341044545174,
0.0628449097275734,
0.024067658931016922,
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-0.06130121648311615,
-0.025268085300922394,
0.04258623346686363,
-0.033957719802856445,
0.034635722637176514,
0.045941609889268875,
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0.07654743641614914,
0.03047741949558258,
0.022456170991063118,
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0.007503267843276262,
0.046537674963474274,
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0.08502813428640366,
0.08825201541185379,
0.004485786892473698,
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0.018578888848423958,
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0.05834367871284485,
0.06856948137283325,
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0.07111288607120514,
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0.006167086772620678,
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0.0063439225777983665,
0.008098268881440163,
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0.008182568475604057,
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0.07339344918727875,
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0.04089124873280525,
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0.09070643037557602,
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0.03257083520293236,
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0.045379601418972015,
0.010501079261302948,
0.030942169949412346,
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0.06118036061525345,
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0.0667535662651062,
0.08255799859762192,
0.017907440662384033,
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0.03804778680205345,
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0.04135292395949364,
0.002353130141273141,
0.03372976556420326,
0.01798785664141178,
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0.017199160531163216,
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0.04633038118481636,
0.022968582808971405,
0.05344434455037117,
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0.013463068753480911,
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0.06498827785253525,
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0.02881508320569992,
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0.07291113585233688,
0.016056083142757416,
0.000858599494677037,
0.006528847850859165,
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0.021470773965120316,
0.023344848304986954,
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0.07225409150123596,
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-0.003094421001151204,
0.02905033342540264,
-0.047778282314538956,
0.007552246563136578,
-0.06028999760746956,
0.07134286314249039,
0.020879115909337997,
-3.837280715401903e-8,
0.02200394868850708,
0.03614674136042595,
-0.02971697598695755,
-0.032301705330610275,
-0.00039464770816266537,
-0.0662527084350586,
-0.05398257076740265,
0.06974375993013382,
0.04639650508761406,
0.010348336771130562,
0.02857058495283127,
0.08400215208530426,
-0.00795377790927887,
-0.06109191104769707,
0.028980406001210213,
-0.012618777342140675,
-0.06848051398992538,
0.14657935500144958,
-0.005347507540136576,
-0.14328335225582123,
-0.08731941878795624,
-0.005280948244035244,
0.045707426965236664,
0.045704133808612823,
-0.049405768513679504,
0.006014029961079359,
0.03730730712413788,
0.028760096058249474,
-0.019876636564731598,
0.10229644179344177,
0.07731827348470688,
-0.04225953668355942,
0.018116336315870285,
0.02845104970037937,
-0.0796276107430458,
0.0018916517728939652,
0.015571115538477898,
-0.013314226642251015,
0.0019141800003126264,
0.0687236562371254,
0.05546797439455986,
-0.044462498277425766,
0.023333238437771797,
0.10476411134004593,
-0.007194854784756899,
-0.0711684376001358,
-0.03168947249650955,
0.016364160925149918,
-0.061311446130275726,
-0.06568165868520737,
0.02823895774781704,
0.07198702543973923,
-0.011572656221687794,
-0.00647888146340847,
-0.03078022226691246,
0.09571795910596848,
0.11145871132612228,
0.0019174712942913175,
0.012620375491678715,
0.0725262239575386,
0.04014972224831581,
0.015233665704727173,
0.060454756021499634,
0.02050132490694523
] |
TABLE\t20.10\nRecommended\tVitamin\tSupplementation\tAfter\tBariatric\tSurgery\nSupplement\nRecommendation\nThiamine\nAt\tleast\t12\tmg\tdaily,\tand\tpreferably\ta\tdose\n\tof\t50\tmg\tthiamine\tfrom\ta\tB-complex\tsupplement\nor\tmultivitamin\tonce\tdaily\nVitamin\tB\n12\n350-500\tμg\torally\tby\tdisintegrating\ttablet,\tsublingual,\tor\tliquid\tdaily\tOR\tnasal\tspray\tas
|
[
0.023978089913725853,
-0.037409793585538864,
0.01726023480296135,
-0.02801796793937683,
-0.08014733344316483,
-0.011757253669202328,
0.008208186365664005,
0.03908323869109154,
-0.07141811400651932,
0.05479136481881142,
0.09867263585329056,
-0.06993607431650162,
0.014499538578093052,
-0.01161772571504116,
-0.056273914873600006,
-0.022863708436489105,
0.00902804546058178,
0.0017543083522468805,
-0.04833183437585831,
0.03356756269931793,
0.036582667380571365,
0.09319346398115158,
0.0507650300860405,
0.00863933376967907,
0.06197855621576309,
0.06331413984298706,
-0.05084037408232689,
0.04431552439928055,
0.01451227068901062,
-0.05100032314658165,
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0.06198146566748619,
0.010939277708530426,
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0.044396448880434036,
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0.026497073471546173,
0.0688587948679924,
0.03933698683977127,
-0.023400327190756798,
-0.10146986693143845,
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] |
directed\tby\tmanufacturer\tOR\t1000\tμg\tmonthly\tparenterally\nFolate\t(Folic\nAcid)\n400-800\tμg\tdaily\tfrom\ta\tmultivitamin.\tWomen\tof\tchildbearing\tage\tshould\ttake\t800-1000\tμg\ndaily.\nIron\nPost-RYGB,\tLSG,\tand\tBPD/DS\tpatients\tshould\n\ttake\tat\tleast\t45-60\tmg\telemental\tiron\ncumulatively\tdaily\t(from\tmultivitamin\tand\tother\tsupplements).\tThose\twith\tlow\trisk\tof
|
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] |
deficiency,\tsuch\tas\tmales\twith\tLAGB\tprocedures,\tshould\ttake\tat\tleast\t18\tmg\tfrom\ttheir\nmultivitamin\tdaily.\tOral\tsupplementation\tshould\tbe\tin\tdivided\tdoses,\tseparately\tfrom\ncalcium\tsupplement,\tacid-reducing\tmedications,\tand\tfoods\thigh\tin\tphytates\tand\npolyphenols.\nCalcium\nLAGB,\tLSG,\tRYGB:\t1200-1500\tmg\tdaily\nBPD/DS:\t1800-2400\tmg\tdaily
|
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] |
LAGB,\tLSG,\tRYGB:\t1200-1500\tmg\tdaily\nBPD/DS:\t1800-2400\tmg\tdaily\nCalcium\tshould\tbe\tgiven\tin\tdivided\tdoses\tto\tenhance\tabsorption.\tCalcium\tcarbonate\nshould\tbe\ttaken\twith\tmeals\tto\tincrease\tabsorption,\tcalcium\tcitrate\thas\tgood\nabsorption\twhen\ttaken\twith\tmeals\tand\talso\ton\tan\tempty\tstomach.\nVitamin\tD
|
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Vitamin\tD\nDosage\tof\tvitamin\tD\tis\tbased\ton\t25(OH)D\tlevels.\t3000\tIU\tdaily\tof\tvitamin\tD\tis\trecommended\nuntil\t25(OH)D\n\tlevels\tare\t>30\tng/L.\nVitamins\tA,\nE,\tand\tK\nLAGB:\tvitamin\tA\t5000\tIU\tand\tvitamin\tK\t90-120\tμg\tdaily\nRYGB\tand\tLSG:\tvitamin\tA\t5000-1000\tIU\tand\tvitamin\tK\t90-120\tμg\tdaily\nBPD/DS:\tvitamin\tA\t1000\tIU\tand\tvitamin\tK\t300\tμg\tdaily
|
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] |
BPD/DS:\tvitamin\tA\t1000\tIU\tand\tvitamin\tK\t300\tμg\tdaily\nAll\tweight\tloss\tsurgeries:\tvitamin\tE\t15\tmg\tdaily\nSpecial\tattention\tshould\tbe\tpaid\tto\tpostsurgical\tsupplementation\tof\tvitamins\tA\tand\tK\tin\npregnant\twomen.\nZinc\nBPD/DS:\tMultivitamin\n\twith\tminerals\tcontaining\t200%\tof\tthe\tRDA\t(1622\tmg/d)
|
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] |
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