Obesity

Low-carbohydrate diets have become popular in the past few decades, with the Atkins diet being the most popular. The Atkins diet is a high-protein and/or high-fat, a very-low-carbohydrate diet that induces ketosis. The very ̶ low-carbohydrate content is critical in inducing short-term weight loss in the first 2-4 weeks; this is largely the result of […] Read More

Diets with different macronutrient compositions involve a caloric intake of greater than 1200 kcal/day. This type of diet is designed to reduce the caloric intake by 500-1000 kcal/day from the patient’s current dietary intake. The proposed composition used by the best-validated dietary programs is as follows: Protein intake of 0.8-1.5 g/kg of body weight (not […] Read More

Very–low-calorie diets (VLCDs) are best used in an established, comprehensive program. VLCDs involve reducing caloric intake to 800 kcal/day or less. When used in optimal settings, they can achieve a weight loss of 1.5-2.5 kg/wk (3.3-5.5 lb/wk), with a total loss of as much as 20 kg over 12 weeks. No good-quality evidence suggests that […] Read More

Low-calorie diets involve reducing daily caloric intake by 500-1000 kcal/day, to a level of 800-1800 kcal/day. These diets are associated with a mean weight loss of 0.4-0.5 kg per week (1-2 lb/wk). In ideal settings, the total loss can be 5-10% of starting weight (10-20 lb for a 200-lb person) over 3-6 months, occasionally higher […] Read More

Although obesity in itself is associated with increased morbidity and mortality, massive, poorly monitored weight loss and/or weight cycling can have equally dire consequences. Among the important potential complications to watch out for in the setting of weight loss are the following: Cardiac arrhythmias; Electrolyte derangements – Hypokalemia is the most important of these; Hyperuricemia; […] Read More

Evidence from the National Weight Control Registry (NWCR), which tracks indices and predictors in individuals who have lost at least 30 pounds and have maintained that loss for at least 1 year, suggests that patterns associated with successful weight maintenance include the following: Self-monitoring of weight; Consumption of a low-fat diet; Daily physical activity of […] Read More

A reasonable goal for weight loss in the setting of a medical treatment program is approximately 1-2 lb/wk. However, it is becoming increasingly apparent that the weight-loss goal for each patient must be individualized and cannot be unilaterally based on standard weight-for-height norms. In addition to the patient’s weight, factors to consider when setting individualized […] Read More

Before enrolling any patient in a weight-loss program, the clinician must have a clear idea of that individual’s expectations. A patient with unrealistic expectations should not be enrolled until these are changed to realistic and attainable goals. The clinician should guide the patient who seeks weight reduction to create goals that fit the mnemonic SMART: […] Read More

In patients with morbid obesity associated with comorbidities, bariatric surgery is the only available therapeutic modality associated with clinically significant and relatively sustained weight loss. Well-performed bariatric surgery, in carefully selected patients and with a good multidisciplinary support team, substantially ameliorates the morbidities associated with severe obesity. Read More

Obesity is associated with insulin resistance and increased serum levels of fasting insulin and C-peptide serum levels. However, insulin levels are normal in many persons who are obese. All patients with obesity should be screened for diabetes. Additional information is gained by using glucose and HbA1c tests together if the patient is fasting. The American […] Read More