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U.S. NIH’s Obesity Guidelines Part 34: Special weight loss groups
Monday, December 20, 2004 10:16 pm Email this article
Age alone should not preclude weight loss treatment in older adults up to the age of 80-years-old, however, the longevity benefits of weight loss in older adults are less clear according to the U.S. NIH's Obesity Guidelines (p. xvii and 91). Weight loss improves risk of heart disease in both old and young
Weight reduction has similar effects in improving cardiovascular disease risk factors in older and younger adults. (p. xvii and xxv)
Risks and benefits should be evaluated for each patient. (p. xvii and 91)
Smokers should quit smoking and try to prevent weight gain
All smokers, regardless of their weight, should quit smoking.
Prevention of weight gain should be encouraged and if weight gain does occur, it should be treated through dietary therapy, physical activity, and behavior therapy, maintaining the primary emphasis on the importance of abstinence from smoking.
80% of smokers gain weight after stopping
Eighty percent of people who quit smoking gain weight.
Average weight gain 5-8 lbs after stopping smoking although some gain more than 28 lbs
The average weight gain is 4.5 to 7 pounds, although, 13 percent of women and 10 percent of men gain more than 28 pounds. (p. xvii and 91)
Risk of smoking greater than risks of weight gain
Nevertheless, the risks of smoking are greater than the risks of weight gain. (p. xvii and 91)
Two-thirds of weight gain due to increased calories
Two-thirds of the weight gain following smoking cessation is due to an increase in calorie intake.
Stopping smoking reduces metabolism 100 calories per day
Whereas the other one-third is caused by a reduction in metabolism of approximately 100 calories per day. (p. 92) Dietary counselling is not very effective at preventing weight gain following smoking cessation. (p. 92)
Drugs that delay smoking cessation weight gain
Nicotine replacement, phenylpropanolamine (PPA), and Wellbutrin (bupropion) have all be shown to delay weight gain following smoking cessation. (p. 92) However, weight is usually regained once the drugs are stopped.
Comment: Ephedrine and caffeine have also been shown to help minimize smoking cessation weight gain. I assume that phentermine would also work.
Black women have lower metabolism, lose less weight
Blacks, especially black women, lose less weight than whites reducing calories by the same amount because of a lower resting metabolism. (p. 52)
Obesity treatments may work differently in different people
Standard obesity treatments may work differently in different patient populations.
Treatment should be tailored to the needs of various patients or patient groups, however, it is difficult to determine whether or not changes make a program more effective.
Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults : the evidence report / National Heart, Lung, and Blood Institute [Bethesda, Md.] : National Institutes of Health, National Heart, Lung, and Blood Institute, . NIH publication No. 98-4083.
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