肥胖患者的诊疗建议PPT课件.pptVIP

0115010821 Ballantyne MD Office Management of the Obese Patient Obesity Management in an Outpatient Office Practice Appropriate Office Environment for Obese Patients Waiting room chairs without arms Step stools next to examination tables Large gowns and blood pressure cuffs Scale that can weigh extremely obese patients, located in a private area Appropriate obesity educational materials, handouts, and treatment protocols Empathetic, respectful, and supportive office staff Initial Office Visit Include evaluation of potential obesity related diseases within history, physical examination, and laboratory tests Obtain weight history, eating, and activity behaviors Search for triggering factors, including medications Measure weight, height, and calculate body mass index Categorize obesity classification and health risk Determine readiness to lose weight Initiate treatment plan (involve other professionals if needed) Discuss goals and expectations Arrange follow-up and support Selected Medications That Can Cause Weight Gain Psychotropic medications Tricyclic antidepressants Monoamine oxidase inhibitors Specific SSRIs Atypical antipsychotics Lithium Specific anticonvulsants ?-adrenergic receptor blockers Assessing Weight Loss Readiness Motivation: Stress level: Psychiatric issues: Time availability: Obese Patients Have Unrealistic Weight Loss Goals Conclusions Obesity is a chronic disease Modest weight loss (5% -10% of body weight) can have considerable medical benefits Lifestyle change (diet and physical activity) is the cornerstone of therapy Pharmacotherapy can be useful in properly selected patients Bariatric surgery is the most effective therapy for obesity Obesity-Related ResourcesProfessional Associations North American Association for the Study of Obesity (NAASO) American Academy of Family Physicians (AAFP) American College of Sports Medicine (ACSM) American Diabetes Association (ADA) American Dietetic Association (ADA) American Gastroenterological Association (