Weight Management Flashcards
(10 cards)
What are the BMI categories for obesity?
What are some of the limitations of using BMI?
What are some alternative measures and what might their limitations be?
Underweight: < 18.5
Healthy Weight: 18.5 – 24.9
Overweight: 25.0 – 29.9
Obese: 30.0 - 40+
- Class 1: 30.0 - 34.9
- Class 2; 35.0 - 39.9
- Class 3; 40.0+
Limitations:
- Muscle vs. fat
- Fat distribution
- Ethnic differences (reduce by 2.5kg/m2)
Alternative measures:
- MUAC/MCC
- waist circumference
- waist to heigh ratio
N.b. can only do these reliably in people with BMI < 35 kg/m2
What is the eligibility criteria for referral to a weight management specialist service?
BMI > 35 kg/m2
OR
BMI 30.0 - 34.9 kg/m2 plus at least one weight related co-morbidity.
–> BMI threshold lowered by 2.5kg/m2 for ethnic minority groups (South Asian, Chinese, other Asian, Middle Eastern, and Black African/Caribbean)
Conventional/1st line treatment has been unsuccessful.
What are some of the things that a WM Dietitian will consider during a dietetic assessment?
What is the overall aim?
- Diet History/Food diary
- Previous diets tried
- Eating pattern
- Alcohol
- Relationship with food
- Personal goals/hopes
- Social history
- Assess readiness to change
- Behaviour Change/Motivational Interviewing
Aim: To devise an approach that meets the needs of the patient and considers their individual circumstances.
What are some dietary approaches that can be used in WM?
- Structured Meal Plans
- Portion Control
- Simple Exchanges
- weight watchers/slimming world
- VLCD / meal replacements
- Low Fat / Low Carb / Low GI
- 5:2 / Intermittent / Time Restricted Eating
Describe the VLCD.
what are the pros and cons?
12 weeks
600-800 kcal /day
(shakes, soups, bars)
pros:
rapid weight loss
remission of T2D
cons:
requires medical supervision
side effects: lethargy, dizziness, GI side effects, ++hunger
What are the post bariatric surgery diet stages?
Stage One - Fluids only
- sips initially, gradually increasing
- aim 2L/day
- avoid gulping
- milk, yoghurt, soup, complan
Stage Two - Smooth, pureed
- 4-6 meals per day (2-3 tbs each)
- smooth porridge, pureed fruit, thicker soups
Stage Three - Soft Diet
- soft foods with lumps
- eggs, potato, soaked cereal, well cooked rice/pasta
Stage Four - Solid texture
- 2-6 months after surgery
- normal diet based on healthy eating guidelines
What are some good eating habits for people following bariatric surgery?
Small bite size (5p piece)
Thorough chewing
Realistic Portion sizes
15-20mins per meal
Sit at the table
Separate E and D
Stop when full or had enough
Don’t return to left over food
What are some additional nutritional considerations for people following bariatric surgery?
hint:
protein intake
fluid intake
general diet/portion/texture
protein:
aim >60g/day
hard to meet requirement as highly reported intolerance to protein post surgery
may need high protein supplement to meet protein requirements e.g., fortisip compact protein
fortification: skimmed milk powder in glass of milk = 40g protein
fluid:
fluid intake difficult to meet
important to avoid dehydration and constipation
fluid should be zero calories
texture:
pureed and soft foods are easy to over eat, therefore, aim to increase texture as soon as possible within reason.
What are some potential complications of bariatric surgery?
Weight regain
Excess skin
Changes to hair and nails
Vomiting
Constipation
Diarrhoea
Nutritional deficiencies
Bone disease
Dumping
Alcohol misuse
‘Food intolerance’
Psychosocial
Altered body image
Altered relationships
What is dumping syndrome and what are some prevention methods?
when food moves too quickly from the stomach into the small intestine after eating
early dumping syndrome: 10-30 mins after eating
late dumping syndrome: 1-3 hours after eating
DS can cause GI symptoms and hypoglycaemia.
prevention:
- limit simple sugars
- have low GI foods
- adopt good E&D habits
- regular meal pattern (3/day w snacks)
