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for scientific cooperation (SCOOP)
Task 7.3 – Collection of data on products intended
for use in very-low-calorie diets.
Report September 2002
Reports submitted on behalf of the VLCD European Industry Group to the SCOOP working group on very-low calorie diets between 1998 and 2001, consolidated 2001.
John Marks MA, MD, FRCP, FRCPath, FRCPsych Life Fellow, Girton College, Cambridge CB3 0JG
Jaap Schrijver . Manager Corporate Regulatory Affairs for foods for particular nutritional uses (PARNUTS) - Royal Numico NV
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Freeing patients from the tyranny of food during weight loss
When drug therapy is discontinued. When the counsellor moves on. When the patient is "cured" of excess weight. This is the point at which a dieter requires the maximum attention and assistance. Lipotrim weight maintenance programmes assist your patients in long-term weight management.
Treating weight in the pharmacy: getting results
There is now a pandemic of obesity, and the problem is getting worse instead of better. Would you know how to offer help that is worth the time and effort? Or would you simply reiterate the same platitudes that have been so ineffective over the years? Dr Stephen Kreitzman and Valerie Beeson explain how Lipotrim can help.
Healthy weight management
Messages abound in the media today about nutrition and body weight. But often these messages are more about controversy than provision of information. Dr Stephen Kreitzman and Valerie Beeson elaborate on the subject of weight management from beyond the hype.
Weight management: helping obese patients
Over 70% of the middle-aged UK population has a weight problem.Healthcare professionals cannot wait for new pharmaceutical solutions: action is needed now, if only to cope with "diabesity" - a very descriptive addition to the language.
Weight management is a medical concern
"Fat people are just greedy, says BMA chief" - www.telegraph.co.uk, 4 August 2007.
"Doctor tells fatties to eat less" - www.thesun.co.uk, 3 August 2007.
These kinds of headlines are avoidable.
Type 2 diabetes: suggest a pharmacist instead of a pharmaceutical
Type 2 diabetes is no longer an adult onset disease. Obesity is being seen in younger and younger people. There is a causal connection so people are calling it "diabesity".
Obesity Pandemic - DIABETES DETERRENCE BY WEIGHT LOSS: PHARMACY BENEFITS PRIMARY CARE
It should be reasonable to justify practice time and resources to assist overweight and obese patients lose their weight. The link to type II diabetes alone is sufficient. With rapid weight loss, normalisation of blood sugar levels is achieved in days and with further weight loss, the disease can be held in remission.
Better long term glycaemic control is achieved with rapid weight loss, even after some weight regain, than is achieved with the same weight lost more slowly. About 50% of hypertensive patients can reduce drug treatments with weight loss. Surgical interventions can be scheduled when substantial weight is lost. Fewer anti-depressants are required and overall, the frequency of GP visits is significantly lower for leaner patients.
Treating diabetes: rapid control with weight loss
progressively debilitating disease, often requiring increasingly aggressive therapy. The treatment protocols with oral hypoglycaemics usually lead to increasing body weight. The increased weight degrades insulin sensitivity and can ultimately lead to a need for insulin. With insulin, a common outcome is yet further weight gain, and the disease gets increasingly worse. This entire cascade of events can be avoided.
Sharing weight management advice with patients
We all know that the key to weight loss is eating less and exercising more. However, dropping to under 1,200 calories without supplementation leads to nutrient deficiencies, which perpetuates the myth that lower calorie diets are dangerous
Successful weight management in primary care
Weight loss goals are not utopian dreams. Diabetics off their drugs in days. Blood pressure reduced. Patients qualifying for elective surgery. Depression tempered. Fertility enhanced. Patients capable of a more active lifestyle. Blood lipid profiles improved. Self esteem and quality of life enhanced. These are goals achieved routinely by weight loss. They are being achieved by your GP colleagues and by your pharmacist colleagues. And it isn't necessary to wait for PCT funding.
Gp/Pharmacist: Synergy for obesity control
In order for weight loss programmes to be successful, it is essential to conduct post-diet monitoring and provide the overweight patient with long-term support. The Lipotrim pharmacy-based programme, therefore, encourages an interactive approach with GPs to ensure successful, sustained weight management
Treating overweight patients: what are the options?
Modest reductions in calories could theoretically result in weight loss, although the best efforts of the Swedish healthcare system could not produce any.
Of course, it can't be emphasised often enough, the modest reduction has to be from the equilibrium level, not from current intake. Standard advice has been to limit the rate of weight loss by encouraging a small calorie gap. This most often assures failure to lose substantial weight.
Arguing that slow weight loss somehow results in better weight maintenance (except perhaps maintenance of the prediet weight) was convincingly demonstrated to be false as far back as 1959. Stunkard showed that regardless of the programme for weight loss, or the expertise of the clinic, after one year 95% had put back all the lost weight.3 After two years 98% and by five years virtually all of the dieters had put the weight back on.
People suffer terribly from the consequences of their excess weight and many expect help from the health service. Here are some options:
Pharmacists are emerging as the weight management specialists, providing advice, treatments and support for the long-term maintenance of weight loss. Dr Stephen Kreitzman and Valerie Beeson offer some background information to help tie together the complex issues surrounding weight management.
Obese Patients in UK General Practices Lose 16 Tonnes
Obesity can be managed effectively under a variety of practice conditions, even in "heart sink" patients who have repeatedly failed in the past to control their weight, despite the best efforts of the clinical team
Individual practices were able to achieve a range of mean rates for weight loss in their patients. The expected rate of weight loss for full compliance with the programme is an average of 1.46kg per week (1 stone per month).
This was achieved.