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Saturday, September 5, 2015

Management of Obesity and Overweight (OBE) (2014) - VA/DoD Clinical Practice Guidelines

Food Diary, Walking and Weight Loss Step 1: Keep a 2-week food diary in order to know how much calories you're currently consuming. Keeping a food diary is easy with apps such as MyFitnessPal and others. These apps tabulate the calories automatically. Due to monitoring bias (i.e., people unintentionally start heating differently than their usual habit just by the sheer act of keeping a food diary), a minimum diary of 2 weeks is advisable. Step 2: Reduce current caloric intake by 500 to 1000 kcal/d. How easy is it to reduce daily calories by 500 kcal? If one cuts out a daily snack like a Doritos snack bag (200 kcal) and a regular soft drink (140 kcal) that's already 340 kcal lost. Plus, take a daily 30 minute brisk walk (150 kcal). Add it up...easily ~500 kcal reduction. Consistent reduction in daily dietary caloric intake is the most successful long-term and safest weight loss strategy. Patients who follow a diet that reduces their caloric intake by 500 to 1000 kcal/d as compared with their intake that is currently maintaining weight will lose an average of 1-2 lb per week. The initial goal is a loss of 10% of total body weight. This degree of weight loss has been shown to decrease the health-related consequences of obesity, including diabetes mellitus. Exercise is an important part of a comprehensive weight loss program that focuses on lifestyle modification. However, without attention to eating habits and caloric restriction, exercise alone is not adequate for weight loss. Medications can be used in conjunction with, but not as a substitute for, diet and exercise. Source:
from Rajesh Harrykissoon, MD Home page for Obesity CPG