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Motivating Patients and Lifestyle Changes

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Motivating Patients and Lifestyle Changes

Evidence-Based Approaches to Weight Loss and Weight Management

1.25 hr(s) CME/CE

Goal: To prepare the learner to effectively motivate patients who need to lose weigh, train providers in assessing patient lifestyle in terms of diet and physical activity, and prepare providers to recommend effective and tailored weight-loss diets and programs for management of overweight and obesity in their patients.

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This activity is designed to change: Competence, Performance, Patient Outcome. 1.25 hr(s)

Overview

Professional Practice Gaps

Educational Objectives:

After completing this activity participants will be able to:

  • Follow the basic steps of motivational interviewing when counseling adult patients on weight loss in primary care.
  • Apply motivational interviewing techniques when counseling adult patients on weight loss in primary care.
  • Tailor counseling of adult patients on weight loss in primary care to meet individual needs. Respond effectively to common challenges that are faced when trying to motivate primary care patients to lose weight.
  • Determine treatments to recommend to patients in order to achieve weight loss based on BMI and comorbidity status
  • Recommend caloric restriction to achieve weight loss and low carbohydrate to improve adherence as needed.
  • Assess patient physical activity level and recommend evidence-based modifications for weight management.
  • Refer patients to weight-loss programs or trained interventionists for behavioral support with weight loss.
  • Recommend a plan for patients to maintain weight loss long-term
  • Explain to patients how to follow a tailored, calorie-restricted diet for weight loss.
  • Advise patients on how to change their eating behavior to produce weight loss without counting calories.
  • Refer patients to dietitians for support with weight loss.
  • Guide patients in adopting evidence-based, effective diets for weight loss.

Modules in this Training Activity

Activity Content

Pre-Assessments 1 Test
Expand
Page Content
Motivating & Lifestyle Change Pre-Test (Student)
Motivating Patients to Lose Weight
Lifestyle Change
Dietary Recommendations for Patients
Test Your Knowledge 1 Test
Expand
Page Content
Motivating Patients Post-Test (Student)
Demographics
Post-Survey
Satisfaction Survey

Training Activity References

Audience and Accreditation

Audience: Medical and Health Professional Students

A letter of completion for 1.25 hours is available for non-physicians.

A score of 70% on the post-test is required to complete the activity.

Participation Requirements

Funding

Initial development of this activity was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (#2R44DK091144-01A1) and NIDDK (#4R44DK108608-02).

Authors

As an ACCME accredited provider of continuing medical education, Clinical Tools, Inc. requires everyone who is in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest to the provider. The ACCME defines ‘relevant’ financial relationships as financial relationships in any amount occurring within the past 12 months that create a conflict of interest. Any conflicts of interest are resolved prior to the delivery of the educational activity to the learner. CTI does not permit individuals with financial conflicts of interest to participate in any stage of activity development.

T Bradley Tanner, MD (President, Clinical Tools, Inc.)
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose. Dr. Tanner is the owner of Clinical Tools.

Read Bio
T. Bradley Tanner, MD is president of Clinical Tools and responsible for the vision of the company. He has received funding via grants and contracts from NIDA, NIAAA, NIMH, NCI, AHRQ, CDC, the Dept of Defense, and NASA to develop medical and health education projects. Dr. Tanner served as principal investigator on 2 NIDA grants to develop the DATA-2000 qualifying buprenorphine training program and clinical practice tools on BupPractice.com. He also has a strong background in technology and oversees the development and delivery of all Clinical Tools websites. Dr. Tanner is also a board-certified psychiatrist with experience in inpatient, outpatient, and emergency health settings. He currently treats patients and educates medical students and residents via his role as a Clinical Associate Professor of Psychiatry at the University of North Carolina at Chapel Hill.

Karen Rossie, DDS, PhD (Research Scientist, Clinical Tools, Inc. )
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose.

Read Bio
Karen Rossie, DDS, PhD, directs projects at Clinical Tools. She majored in biology at Cleveland State University and studied dentistry at Case Western Reserve University followed by completing a Masters in pathology at Ohio State University, and later, a PhD in Psychology from the Institute of Transpersonal Psychology. She taught and practiced oral pathology and oral medicine for 15 years at the Ohio State University and the University of Pittsburgh, doing research in autoimmune disease, bone marrow transplantation, oral cancer, salivary gland disease, candidiasis, and diabetes. She has used this diverse background to lead or contribute to CTI projects related to tobacco cessation, opioid abuse treatment, anxiety, dementia care, alcohol use disorder, screening and brief interventions for substance abuse, obesity, and pain and addiction.

Reviewers

Steve Applegate, MEd, MEd (President, Applegate Consulting, )
Disclosure: Has no relevant financial relationship(s) with ineligible companies to disclose.

Read Bio
Mr. Applegate has experience in substance use counseling, state initiatives impacting substance use, and professional training. His prior positions include director of higher education and instructional design at the North Carolina Governor’s Institute on Alcohol and Substance Abuse, project director of the North Carolina Initiative of the Mid-Atlantic Addiction Technology Transfer Center, and program director of the Addiction Sciences Center (an outpatient substance abuse treatment center at the University of Virginia Health Sciences Center). Mr. Applegate works as an on-site consultant and travels to the Clinical Tools (CTI) office on a monthly basis from his office in Richmond, VA. Mr. Applegate helped design the CTI Instructional Manual and works to continue to revise it as we expand our Instructional Design methodology. Mr. Applegate has extensive experience with online education and training, especially in the area of substance abuse. He often pushes the envelope of technology and brainstorms with Clinical Tools how we can utilize new technology in our products. He helped guide development of the curriculum plan and assessments in Phase I of the current project.

Most Recent Reviews

CTI Content Review: June 5, 2020
CTI Editorial Review: June 25, 2020

View Reviews


Reviews for this activity

Very knowledgeable

Very knowledgeable, easy to maneuver. So glad I came across this!

— Clinical Encounters: Obesity user

Motivating Patients and Lifestyle Changes
5
2021-12-08T15:38:51-05:00

— Clinical Encounters: Obesity user

Very knowledgeable, easy to maneuver. So glad I came across this!
https://obesity.clinicalencounters.com/blog/testimonials/very-knowledgeable/

Very clinically relevant

Very clinically relevant learning modules about managing the complex chronic disease of obesity in all its forms. Thank you!

— Internal Medicine

Motivating Patients and Lifestyle Changes
5
2021-12-08T15:38:51-05:00

— Internal Medicine

Very clinically relevant learning modules about managing the complex chronic disease of obesity in all its forms. Thank you!
https://obesity.clinicalencounters.com/blog/testimonials/very-clinically-relevant/

Wonderful

Wonderful resources for review.

— Family Medicine

Motivating Patients and Lifestyle Changes
5
2021-12-08T15:38:51-05:00

— Family Medicine

Wonderful resources for review.
https://obesity.clinicalencounters.com/blog/testimonials/wonderful/
5
3
Motivating Patients and Lifestyle Changes


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Primary Sidebar

Activity Home Expand All
Pre-Assessments
1 Test
Motivating & Lifestyle Change Pre-Test (Student)
Motivating Patients to Lose Weight
Lifestyle Change
Dietary Recommendations for Patients
Test Your Knowledge
1 Test
Motivating Patients Post-Test (Student)
Demographics
Post-Survey
Satisfaction Survey
Funding Information Development of this website was funded entirely by grant #2R44DK091144-01A1 and #5R44DK108608-04 from the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The website contents are solely the responsibility of the authors and do not necessarily represent the official views of NIDA. Ongoing development and maintenance is funded by the training fee and Clinical Tools, Inc. No commercial support is received.
Clinical Tools is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

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Professional Practice Gaps

Evidence-based guidelines recommend that providers use motivational interviewing techniques as a tool for encouraging behavior change when managing and preventing obesity in adults (Fitch et al., 2013). Studies suggest that training in motivational interviewing skills will benefit physicians in helping their patients lose weight (Barnes & Ivezaj, 2015). Use of motivational interviewing by physicians with obese patients in clinical trials was associated with a reduction in body mass, body weight, BMI (Armstrong et al., 2011).

Despite these recommendations and findings, primary care physicians do not consistently counsel or advise patients who are overweight or obese (Smith et al., 2011). Barriers to providing motivational counseling for weight management in primary care include time constraints/too high a workload, lack of experience or training, lack of access to trained weight loss interventionists, and patients’ financial limitations with respect to being able to afford a weight loss clinic(Barnes & Ivezaj, 2015).

In our needs analysis survey (N=25), 96% of providers felt they needed the training to counsel patients on weight control based on best practice recommendations. Only 35% of providers acknowledged using motivational interviewing techniques with overweight or obese patients, while 92% of providers acknowledged a need for additional training using counseling or motivational interviewing (Tanner, 2011).

Evidence-based guidelines also recommend for overweight and obese individuals who would benefit from weight loss, that providers prescribe a calorie-restricted diet, increased physical activity, and (for most of these patients) participation for ≥ 6 months in a comprehensive lifestyle program that assists participants in adhering to these lifestyle changes through the use of behavioral strategies (Jensen et al., 2013).

Guidelines further recommend an algorithm that responds to the patients’ readiness to start a weight-loss program. In our survey of obesity experts (N=7), 71% believe that primary care providers need additional training in interviewing patients regarding current diet and level of physical activity (Tanner, 2011). Furthermore, evidence-based guidelines recommend long-term follow-up of patients during and after a weight-loss program, with an intensive program including continued reduced caloric intake, recommended levels of physical activity or higher, and behavioral supports (Jensen et al., 2013). However, of the primary care providers we surveyed, (N=25) only 40% monitored their patients’ during weight loss, while only 32% monitored patients after weight loss.

And evidence-based guidelines recommend that providers prescribe a calorie-restricted diet for obese and overweight individuals who would benefit from weight loss, based on the patient’s preferences and health status, and in most instances, behavioral supports in the form of weight-loss programs or trained interventionists for counseling (Jensen et al., 2013).

However, physicians frequently report a lack of training and competence in weight management in general (Dietz et al., 2015; Sabin, Marini, & Nosek, 2012; STOP Obesity Alliance, 2010). More specifically, both obesity experts and primary care providers in our needs analysis surveys reported a gap in provider training on recommending diets. In our survey of obesity experts, (N=7), 86% believed that primary care providers need more training in what diet to recommend to patients. In our needs analysis, 84% of the primary care providers surveyed reported that they needed training to counsel patients on proper diet recommendations (Tanner, 2011).

Practice Gap References

  • Armstrong, M. J., Mottershead, T. A., Ronksley, P. E., Sigal, R. J., Campbell, T. S., & Hemmelgarn, B. R. (2011). Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 12(9), 709–723. https://doi.org/10.1111/j.1467-789X.2011.00892.x

  • Barnes, R. D., & Ivezaj, V. (2015). A systematic review of motivational interviewing for weight loss among adults in primary care. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 16(4), 304–318. https://doi.org/10.1111/obr.12264

  • Dietz, W., Baur, L., Hall, K., Puhl, R., Taveras, E., Uauy, R., & Kopelman, P. (2015). Management of obesity: improvement of health-care training and systems for prevention and care. The Lancet. http://dx.doi.org/10.1016/S0140-6736(14)61748-7

  • Fitch, A., Everling, L., Goldberg, J., Heim, C., Johnson, K., Kennedy, E., … Webb, B. (2013, May). Health Care Guideline: Prevention and Management of Obesity for Adults. Retrieved April 8, 2019, from Institute for Clinical Systems Improvement website: https://www.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/cntrb_037112.pdf

  • Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., … Yanovski, S. Z. (2013). 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 01.cir.0000437739.71477.ee. https://doi.org/10.1161/01.cir.0000437739.71477.ee

  • Sabin, J. A., Marini, M., & Nosek, B. A. (2012). Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender. PLOS ONE, 7(11), e48448. https://doi.org/10.1371/journal.pone.0048448

  • Smith, A. W., Borowski, L. A., Liu, B., Galuska, D. A., Signore, C., Klabunde, C., … Ballard-Barbash, R. (2011). U.S. primary care physicians’ diet-, physical activity-, and weight-related care of adult patients. American Journal of Preventive Medicine, 41(1), 33–42. https://doi.org/10.1016/j.amepre.2011.03.017

  • STOP Obesity Alliance. (2010). Provider/Patient Survey on Obesity in the Primary Care Setting. STOP Obesity Alliance. Retrieved from http://www.stopobesityalliance.org/research-and-policy/research-center/survey-results/

  • Tanner, B. (2011). Improving Obesity Outcomes Through Interactive Web-Based Clinical Skills Training | SBIR.gov. Retrieved April 3, 2019, from https://www.sbir.gov/sbirsearch/detail/389149

Training Activity References

Motivating Patients to Lose Weight

  • Armstrong, M. J., Mottershead, T. A., Ronksley, P. E., Sigal, R. J., Campbell, T. S., & Hemmelgarn, B. R. (2011). Motivational interviewing to improve weight loss in overweight and/or obese patients: a systematic review and meta-analysis of randomized controlled trials. Obesity Reviews: An Official Journal of the International Association for the Study of Obesity, 12(9), 709–723. https://doi.org/10.1111/j.1467-789X.2011.00892.x
  • Barnes, R. D., & Ivezaj, V. (2015). A systematic review of motivational interviewing for weight loss among adults in primary care. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 16(4), 304–318. https://doi.org/10.1111/obr.12264
  • DiLillo, V., & West, D. (2011). Motivational interviewing for weight loss. Psychiatric Clinics of North America, 34(4), 861–869. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22098809
  • Fitch, A., Everling, L., Goldberg, J., Heim, C., Johnson, K., Kennedy, E., … Webb, B. (2013, May). Health Care Guideline: Prevention and Management of Obesity for Adults. Retrieved April 8, 2019, from Institute for Clinical Systems Improvement website: https://www.healthpartners.com/ucm/groups/public/@hp/@public/documents/documents/cntrb_037112.pdf
  • Jay, M., Kalet, A., & Ark, T. (2009). Physicians’ attitudes about obesity and their associations with competency and specialty: a cross-sectional study. BMC Health Services Research, 9(106). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705355/
  • Miller, W., & Rollnick, S. (2011). An Overview of Motivational Interviewing. Retrieved from https://www.umass.edu/studentlife/sites/default/files/documents/pdf/Motivational_Interviewing_Definition_Principles_Approach.pdf
  • Miller, W., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change (3rd ed.). Retrieved from http://www.guilford.com/books/Motivational-Interviewing/Miller-Rollnick/9781609182274
  • Rahm, A., Boggs, J., Martin, C., & et al. (2015). Facilitators and barriers to implementing SBIRT in primary care in integrated health care settings. Substance Abuse, 36(3), 281–288. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25127073
  • Reims, K., & Ernst, D. (2016). Using Motivational Interviewing to Promote Healthy Weight. Family Practice Management, 23(5), 32–38. Retrieved from https://www.aafp.org/fpm/2016/0900/p32.html
  • Smith, A. W., Borowski, L. A., Liu, B., Galuska, D. A., Signore, C., Klabunde, C., … Ballard-Barbash, R. (2011). U.S. primary care physicians’ diet-, physical activity-, and weight-related care of adult patients. American Journal of Preventive Medicine, 41(1), 33–42. https://doi.org/10.1016/j.amepre.2011.03.017
  • Tanner, B. (2011). Improving Obesity Outcomes Through Interactive Web-Based Clinical Skills Training | SBIR.gov. Retrieved April 3, 2019, from https://www.sbir.gov/sbirsearch/detail/389149
  • Westra, H. (2012). Motivational interviewing in the treatment of anxiety. Retrieved from https://www.guilford.com/books/Motivational-Interviewing-in-the-Treatment-of-Anxiety/Henny-Westra/9781462525997

Basic Lifestyle Modifications for Weight-Loss

  • Academy of Nutrition and Dietetics. (2009). Position of the American Dietetic Association: Weight Management. Journal of the Academy of Nutrition and Dietetics, 109, 330–346. Retrieved from http://www.andeal.org/files/Docs/WM%20Position%20Paper.pdf
  • Aller, E., Larsen, T., Claus, H., & et al. (2014). Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index: the DIOGENES trial 12-month results. 38, 1511–1517. Retrieved from https://www.nature.com/articles/ijo201452?WT.ec_id=IJO-201412
  • Bays, H., Seger, J., Primack, C., & et al. (2017). Obesity Algorithm, presented by the Obesity Medicine Association [Informative]. Retrieved July 18, 2017, from Obesity Medicine Association website: https://obesitymedicine.org/obesity-algorithm/
  • Canadian Society for Exercise Physiology. (2002). PAR-Q & You. Retrieved from http://www.exerciseismedicine.org/assets/page_documents/Par-Q.pdf
  • Coleman, K., Ngor, E., Reynolds, K., & et al. (2012). Initial validation of an exercise “vital sign” in electronic health records. Official Journal of the American College of Sports Medicine. https://doi.org/10.1249/MSS.0b013e3182630ec1: 2071-2076
  • Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition [Informative]. Retrieved September 29, 2017, from Office of Disease Prevention and Health Promotion website: https://health.gov/paguidelines/guidelines/
  • Fernald, D., Tsai, A., Vance, B., & et al. (2013). Health assessments in primary care a how-to guide for clinicians and staff [Informative]. Retrieved September 26, 2014, from AHRQ website: http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/health-assessments/index.html
  • Garber, A. J., Abrahamson, M. J., Barzilay, J. I., Blonde, L., Bloomgarden, Z. T., Bush, M. A., … Davidson, M. H. (2015). AACE Comprehensive Diabetes Management Handbook. Endocrine Practice, 21(4). Retrieved from https://www.aace.com/files/aace_algorithm.pdf
  • Garvey, W. T., Mechanick, J. I., Brett, E. M., Garber, A. J., Hurley, D. L., Jastreboff, A. M., … Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. (2016). American Association of Clinical Endocrinologists and American College of Endocrinology Comprehensive Clinical Practice Guidelines for Medical Care of Patients with Obesity. Executive Summary. Complete Guidelines available at https://www.aace.com/publications/guidelines. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 22(7), 842–884. https://doi.org/10.4158/EP161356.ESGL
  • Grunvald, E. (2014). Medical Management of Obesity: A Comprehensive Review. Clinical Obstetrics & Gynecology, 57(3), 465–484. Retrieved from http://journals.lww.com/clinicalobgyn/Abstract/2014/09000/Medical_Management_of_Obesity__A_Comprehensive.6.aspx
  • Gudzune, K., Beach, M., Roter, D., & Cooper, L. (2013). Physicians build less rapport with obese patients. Obesity (Silver Spring, Md), 21(10). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694993/
  • Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., … Yanovski, S. Z. (2013). 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 01.cir.0000437739.71477.ee. https://doi.org/10.1161/01.cir.0000437739.71477.ee
  • Jensen, M., Ryan, D., Apovian, C., & et al. (2013). 2013 Report on the Management of Overweight and Obesity in Adults: Full Panel Report Supplement. Retrieved from The National Heart, Lung, and Blood Institute website: http://jaccjacc.cardiosource.com/acc_documents/2013_FPR_S5_Obesity.pdf
  • Koolhaas, C. M., Kocevska, D., Te Lindert, B. H. W., Erler, N. S., Franco, O. H., Luik, A. I., & Tiemeier, H. (2019). Objectively measured sleep and body mass index: a prospective bidirectional study in middle-aged and older adults. Sleep Medicine, 57, 43–50. https://doi.org/10.1016/j.sleep.2019.01.034
  • Management of Overweight and Obesity Working Group. (2014). VA/DoD clinical practice guideline for screening and management of overweight and obesity (p. 178) [Guideline]. Retrieved from Department of Veterans Affairs, Department of Defense website: https://www.guideline.gov/summaries/summary/48461?
  • Morselli, L., Leproult, R., Balbo, M., & et al. (2010). Role of sleep duration in the regulation of glucose metabolism and appetite. 24(5), 687–702. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018785/
  • National Heart, Lung, and Blood Institute. (2011). How Is Insomnia Treated? [Informative]. Retrieved December 1, 2014, from NHLBI Website website: https://www.nhlbi.nih.gov/health/health-topics/topics/inso/treatment
  • Petridou, A., Siopi, A., & Mougios, V. (2019). Exercise in the management of obesity. Metabolism: Clinical and Experimental, 92, 163–169. https://doi.org/10.1016/j.metabol.2018.10.009
  • Ryu, S., Chang, Y., Jung, H., & et al. (2015). Relationship of sitting time and physical activity with non-alcoholic fatty liver disease. Journal of Hepatology, 63(5), 1229–1237. Retrieved from http://www.journal-of-hepatology.eu/article/S0168-8278(15)00473-0/abstract
  • Sallis, R. (2011). Developing healthcare systems to support exercise: exercise as the fifth vital sign. British Journal of Sports Medicine, 45, 473–474. Retrieved from http://bjsm.bmj.com/content/45/6/473
  • Schwartz, A., & Doucet, E. (2011). Relative changes in resting energy expenditure during weight loss: a systematic review. 11(7), 531–547. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19761507
  • Shlisky, J., Hartman, T., Kris-Etherton, P., & et al. (2012). Partial Sleep Deprivation and Energy Balance in Adults: An Emerging Issue for Consideration by Dietetics Practitioners. 112(11), 1785–1797. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23102177
  • Smith, T. O., McKenna, M. C., Salter, C., Hardeman, W., Richardson, K., Hillsdon, M., … Jones, A. P. (2017). A systematic review of the physical activity assessment tools used in primary care. Family Practice, 34(4), 384–391. https://doi.org/10.1093/fampra/cmx011
  • Strasser, B., Arvandi, M., & Siebert, U. (2012). Resistance training, visceral obesity and inflammatory response: a review of the evidence. Obesity Reviews, 13(7), 578–591. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1467-789X.2012.00988.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false
  • Tanner, B. (2011). Improving Obesity Outcomes Through Interactive Web-Based Clinical Skills Training | SBIR.gov. Retrieved April 3, 2019, from https://www.sbir.gov/sbirsearch/detail/389149
  • Thomas, D., Martin, C., & Redman, L. (2014). Effect of dietary adherence on the body weight plateau: a mathematical model incorporating intermittent compliance with energy intake prescription. 100, 787–795. Retrieved from http://ajcn.nutrition.org/content/early/2014/07/30/ajcn.113.079822
  • Tuomilehto, H., Seppä, J., & Uusitupa, M. (2013). Obesity and obstructive sleep apnea – Clinical significance of weight loss. Sleep Medicine Reviews, 17(5), 321–329. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23079209
  • US Department of Health and Human Services, & US Department of Agriculture. (2015, December). Dietary Guidelines for Americans 2015-2020 [Informative]. Retrieved March 3, 2014, from health.gov website: https://www.cnpp.usda.gov/dietary-guidelines
  • U.S. Preventive Services Task Force. (2012). Screening for and Management of Obesity in Adults: U.S. Preventive Services Task Force Recommendation Statement. Retrieved from https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-adults-screening-and-management
  • Wadden, T., Butryn, M., & Hong, P. (2014). Behavioral treatment of obesity in patients encountered in primary care settings: a systematic review. JAMA, 312, 1779–1791. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=1920976

Dietary Recommendations for Patients

  • Academy of Nutrition and Dietetics. (2009a). Position of the American Dietetic Association: Vegetarian Diets. Eat Right, 109, 1266–1282. Retrieved from http://eatright.org/
  • Academy of Nutrition and Dietetics. (2009b). Position of the American Dietetic Association: Weight Management. Journal of the Academy of Nutrition and Dietetics, 109, 330–346. Retrieved from http://www.andeal.org/files/Docs/WM%20Position%20Paper.pdf
  • Academy of Nutrition and Dietetics. (2014). It’s About Eating Right. Eat Right. Retrieved from http://www.eatright.org/
  • Aller, E., Larsen, T., Claus, H., & et al. (2014). Weight loss maintenance in overweight subjects on ad libitum diets with high or low protein content and glycemic index: the DIOGENES trial 12-month results. 38, 1511–1517. Retrieved from https://www.nature.com/articles/ijo201452?WT.ec_id=IJO-201412
  • American Heart Association. (2013). Top 10 Cooking Tips. American Heart Association. Retrieved from http://www.heart.org/HEARTORG/Caregiver/Replenish/Top10CookingTips/Top-10-Cooking-Tips_UCM_301837_Article.jsp#
  • American Heart Association. (2014). The American Heart Association’s Diet and Lifestyle Recommendations. Retrieved from http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/HealthyEating/The-American-Heart-Associations-Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp
  • Bays, H., Seger, J., Primack, C., & et al. (2017). Obesity Algorithm, presented by the Obesity Medicine Association [Informative]. Retrieved July 18, 2017, from Obesity Medicine Association website: https://obesitymedicine.org/obesity-algorithm/
  • Brust, J. (2010). Ethanol and cognition: indirect effects, neurotoxicity and neuroprotection: a review. International Journal of Environmental Research and Public Health, 7(4), 1540–1557. https://doi.org/10.3390/ijerph7041540
  • Burguera, B., Tur, J., & Escudero, A. (2015). An intensive lifestyle intervention is an effective treatment of morbid obesity: the TRAMOMTANA study — A two-year randomized controlled clinical trial. https://doi.org/10.1155/2015/194696
  • Burke, L. E., Wang, J., & Sevick, M. A. (2011). Self-Monitoring in Weight Loss: A Systematic Review of the Literature. Journal of the American Dietetic Association, 111(1), 92–102. https://doi.org/10.1016/j.jada.2010.10.008
  • Caldwell, K., Baime, M., & Wolever, R. (2012). Mindfulness based approaches to obesity and weight loss maintenance. Journal of Mental Health Counseling, 34. Retrieved from http://www.biomedsearch.com/article/Mindfulness-based-approaches-to-obesity/297915511.html
  • Chang, J., & Kashyap, S. (2014). The protein-sparing modified fast for obese patients with type 2 diabetes: What to expect. Cleveland Clinic Journal of Medicine, 81(9), 557–565. Retrieved from http://www.clevelandclinicmeded.com/online/journal/09_September-2014/0531316/
  • Chang, S., Stoll, C., & Song, J. (2014). The Effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. 149, 275–287. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24352617
  • Collins, J., & Bentz, J. (2009). Behavioral and psychological factors in obesity. The Journal of Lancaster General Hospital, 4. Retrieved from http://www.jlgh.org/Past-Issues/Volume-4—Issue-4/Behavioral-and-Psychological-Factors-in-Obesity.aspx
  • Craig, W. (2010). Nutrition concerns and health effects of vegetarian diets. 25(6), 613–620. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21139125
  • Davis, L., Coleman, C., Kiel, J., Rampolla, J., Hutchisen, T., Ford, L., … Hanlon-Mitola, A. (2010). Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance. Nutrition Journal, 9(11). https://doi.org/10.1186/1475-2891-9-11
  • Dietary Guidelines Advisory Committee. (2015). Scientific Report of the 2015 Dietary Guidelines Advisory Committee. Retrieved February 24, 2015, from health.gov website: http://health.gov/dietaryguidelines/2015-scientific-report/
  • Dietz, W., Baur, L., Hall, K., Puhl, R., Taveras, E., Uauy, R., & Kopelman, P. (2015). Management of obesity: improvement of health-care training and systems for prevention and care. The Lancet. http://dx.doi.org/10.1016/S0140-6736(14)61748-7
  • Dwyer, J., & Freitas, J. (2014). Food Culture. In Encyclopedia of Human Nutrition (Third Edition). Retrieved from http://www.sciencedirect.com/science/article/pii/B9780123750839001185
  • Estruch, R., Ros, E., Salas-Salvadó, J., Covas, M., Corella, D., Arós, F., … Martínez-González, M. (2013). Primary Prevention of Cardiovascular Disease with a Mediterranean Diet. New England Journal of Medicine, 368, 1279–1290. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMoa1200303
  • FDA. (2015, October). FDA cuts trans fat in processed foods [Informative]. Retrieved October 17, 2015, from FDA U.S. Food and Drug Administration website: https://humansciences.okstate.edu/fcs/site-files/research/FDA-Cuts-Trans-Fat-in-Processed-Food.pdf
  • Forman-Hoffman, V., Little, A., & Wahls, T. (2006). Barriers to obesity management: a pilot study of primary care clinicians. BMC Family Practice, 7, 35. https://doi.org/10.1186/1471-2296-7-35
  • Gibson, A., Seimon, R., Lee, C., & et al. (2014). Do ketogenic diets really suppress appetite? A systematic review and meta-analysis. Obesity Reviews, 16(1), 64–76. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/obr.12230/abstract?campaign=wolearlyview
  • International Food Information Council (IFIC) Foundation. (2010). 2010 Food & Health Survey Consumer Attitudes Toward Food Safety, Nutrition, & Health [Executive Summary and Key Trends]. Retrieved from https://foodinsight.org/wp-content/uploads/2010/07/FINAL-2010-Food-and-Health-Exec-Summary-Final.pdf
  • Jay, M., Kalet, A., & Ark, T. (2009). Physicians’ attitudes about obesity and their associations with competency and specialty: a cross-sectional study. BMC Health Services Research, 9(106). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2705355/
  • Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., … Yanovski, S. Z. (2013). 2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 01.cir.0000437739.71477.ee. https://doi.org/10.1161/01.cir.0000437739.71477.ee
  • Jensen, M., Ryan, D., Apovian, C., & et al. (2013). 2013 Report on the Management of Overweight and Obesity in Adults: Full Panel Report Supplement. Retrieved from The National Heart, Lung, and Blood Institute website: http://jaccjacc.cardiosource.com/acc_documents/2013_FPR_S5_Obesity.pdf
  • Jilcott, S., Keyserling, T., Samuel-Hodge, C., & et al. (2007). Validation of a brief dietary assessment to guide counseling for cardiovascular disease risk reduction in an underserved population. Journal of the American Dietetic Association, 107(2), 246–255. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17258961
  • Johnson, R., Appel, L., Brands, M., & et al. (2009). Dietary sugars intake and cardiovascular health – A scientific statement from the American Heart Association. Circulation, 120, 1011–1020. Retrieved from http://circ.ahajournals.org/content/circulationaha/120/11/1011.full.pdf
  • Kristeller, J., & Wolever, R. (2011). Mindfulness-based eating awareness training for treating binge eating disorder: the conceptual foundation. Eating Disorders, 19, 49–61. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21181579
  • Livestrong. (2018). How Many Calories Does 1 Gram of Alcohol Contain? Retrieved April 22, 2019, from LIVESTRONG.COM website: https://www.livestrong.com/article/294819-how-many-calories-does-one-gram-of-alcohol-equal/
  • Magee, E. (2014). Slideshow: Surprising sources of hidden sugar [Informative]. Retrieved February 27, 2015, from WebMD website: https://www.webmd.com/diet/ss/hidden-sugar-slideshow
  • Mayo Clinic Staff. (2013). DASH diet: Healthy eating to lower your blood pressure. Retrieved July 16, 2013, from Mayo Clinic website: http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456
  • Mulholland, Y., Nicokavoura, E., Broom, J., & et al. (2012). Very-low-energy diets and morbidity: a systematic review of longer-term evidence. British Journal of Nutrition, 108(5), 832–851. https://doi.org/10.1017/S0007114512001924
  • National Heart, Lung and Blood Institute. (2013). Managing Overweight and Obesity in Adults. Retrieved from http://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/obesity-evidence-review
  • National Heart, Lung, and Blood Institute (NHLBI). (2013, February 13). Balance Food and Activity [Informative]. Retrieved April 25, 2019, from US Department of Human and Health Services website: https://www.nhlbi.nih.gov/health/educational/wecan/healthy-weight-basics/balance.htm
  • Pan, A., Hu, F., & Berkowitz. (2011). Effects of carbohydrates on satiety: differences between liquid and solid food. Current Opinion in Clinical Nutrition and Metabolic Care, 14(4), 385–390. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21519237
  • Pasiakos, S., Lieberman, H., & Fulgonia III, V. (2015). Higher-protein diets are associated with higher HDL cholesterol and lower BMI and waist circumference in US adults. 145, 605–614. Retrieved from http://asn-cdn-remembers.s3.amazonaws.com/fe9e14a7ac61fb6dc2ef4bf6ec0a655f.pdf
  • Paxton, A., Strycker, L., Toobert, D., & et al. (2011). Starting the conversion: Performance of a brief dietary assessment and intervention tool for health professionals. American Journal of Preventive Medicine, 40(1), 67–71. Retrieved from http://www.ajpmonline.org/article/S0749-3797%2810%2900586-6/fulltext
  • Pennington Biomedical Research Center. (2016). Weight Loss Predictor [Education]. Retrieved May 20, 2016, from PenningtonBiomedicalResearchCenter.org website: http://www.pbrc.edu/research-and-faculty/calculators/weight-loss-predictor/
  • Rautiainen, S., Wang, L., Lee, I., & et al. (2016). Dairy consumption in association with weight change and risk of becoming overweight or obese in middle-aged and older women: a prospective cohort study. The Journal of Clinical Nutrition, 103(4), 979–988. Retrieved from http://ajcn.nutrition.org/content/103/4/979.abstract
  • Sabin, J. A., Marini, M., & Nosek, B. A. (2012). Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender. PLOS ONE, 7(11), e48448. https://doi.org/10.1371/journal.pone.0048448
  • Shankar, P., Ahuja, S., & Sriram, K. (2013). Non-nutritive sweeteners: Review and update. Nutrition, 29(11–12), 1293–1299. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23845273
  • STOP Obesity Alliance. (2010). Provider/Patient Survey on Obesity in the Primary Care Setting. STOP Obesity Alliance. Retrieved from http://www.stopobesityalliance.org/research-and-policy/research-center/survey-results/
  • Tanner, B. (2011). Improving Obesity Outcomes Through Interactive Web-Based Clinical Skills Training | SBIR.gov. Retrieved April 3, 2019, from https://www.sbir.gov/sbirsearch/detail/389149
  • Te Morenga, L., Levers, M., Williams, S., & et al. (2011). Comparison of high protein and high fiber weight-loss diets in women with risk factors for the metabolic syndrome: a randomized trial. 10, 40. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105953/
  • Thomas, D., Schoeller, D., Redman, L., Martin, C., Levine, J., & Heymsfield, S. (2010). A computational model to determine energy intake during weight loss. 92(6), 1326–1331. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/20962159
  • US Department of Health and Human Services, & US Department of Agriculture. (2015, December). Dietary Guidelines for Americans 2015-2020 [Informative]. Retrieved March 3, 2014, from health.gov website: https://www.cnpp.usda.gov/dietary-guidelines
  • USDA. (2014). Dietary Reference Intakes [Informative]. Retrieved January 6, 2015, from USDA National Agricultural Library website: https://fnic.nal.usda.gov/dietary-guidance/dietary-reference-intakes
  • Volek, J., Phinney, S., Forsythe, C., & et al. (2009). Carbohydrate restriction has a more favorable impact on the metabolic syndrome than a low fat diet. Lipids, 44(4), 297–309. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19082851
  • WebMD. (2014). Portion Size and Weight Loss [Informative]. Retrieved July 15, 2013, from WebMD – Diet & Weight Management website: https://www.webmd.com/diet/control-portion-size
  • Westman, E. (2014). ASBP Review: Diet. American Society of Bariatric Physicians Review Course Fall 2014 Syllabus.
  • Willacy, H. (2013). Health Benefits of the Mediterranean Diet [Informative]. Retrieved December 30, 2014, from Patient.info website: http://patient.info/health/health-benefits-of-the-mediterranean-diet
  • Wycherley, T., Brinkworth, G., Clifton, P., & et al. (2012). Comparison of the effects of 52 weeks weight loss with either a high-protein or high-carbohydrate diet on body composition and cardiometabolic risk factors in overweight and obese males. 2, e40. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3432181/
  • Yakoob, M., Shi, P., Willett, W., & et al. (2016). Circulating biomarkers of dairy fat and risk of incident diabetes mellitus among US men and women in two large prospective cohorts. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.115.018410
  • Yamada, Y., Uchida, J., Izumi, H., & et al. (2014). A Non-calorie-restricted Low-carbohydrate Diet is Effective as an Alternative Therapy for Patients with Type 2 Diabetes. Internal Medicine, 53, 13–19. Retrieved from https://www.jstage.jst.go.jp/article/internalmedicine/53/1/53_53.0861/_pdf
  • Yannakoulia, M., Poulimeneas, D., Mamalaki, E., & Anastasiou, C. A. (2019). Dietary modifications for weight loss and weight loss maintenance. Metabolism: Clinical and Experimental, 92, 153–162. https://doi.org/10.1016/j.metabol.2019.01.001
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