Transcript Document

Nutritional Counseling
Unit 5
Leslie Young MS,RD,LDN
Kaplan University Instructor
Counseling
Background on weight loss
surgeries
Lap-Band- non invasive
Traditional gastric bypass
Pictures taken from www.lapband.com
comparisons
LAP-BAND® System
Support
In addition to support from
the experts at your doctor’s
office, you’ll get practical
tracking tools, recipes, articles,
and advice available
exclusively through My LAPBAND® Journey, an online
clinical support program
Diet and Exercise
Freedom to choose the type
of foods and exercise you
like. Unfortunately, selfimposed diet and exercise
don’t always come with expert
support or practical tools for
sustaining weight loss
results
Lap Band surgery
Although weight loss of up to three pounds a week is
possible, LAP-BAND® System patients average a healthy
one-to-two pound reduction a week.8 Best of all, once
patients meet their target weight, they often maintain it
for years. In fact, according to a clinical study (N=100),
LAP-BAND® System patients averaged up to a 59%
reduction in excess weight after eight years9*
*The LAP-BAND® System was approved in the United
States on the basis of a nonrandomized, single-arm study
(N=299). Significant improvement in percent of excess
weight loss vs. baseline was achieved at 12 months
(34.5%), 24 months (37.8%), and 36 months (36.2%). The
mean reduction in BMI was 8.5 at 12 months, 9.4 at 24
months and 8.8 at 36 months.1
And for those with a Body Mass Index (BMI) between 30
and 40, a new study (N=149) shows that the LAP-BAND®
System provides significant results.10
In the first 12 months (N=143):
•The mean Excess Weight Loss (EWL) was 64.5%
•The mean reduction in Body Mass Index(BMI) was 6.5
points
•The mean reduction in waist circumference(in inches) for
men was 6.1 inches; women 5.9 inches
•Weight loss was maintained at year 2
regular diet/exercise
Unfortunately, diet, fitness, and
medication to treat obesity offer only
short-term results. Studies show that
obese patients on diets, exercise
programs, or weight loss medications
lose approximately 10% of their body
weight, but tend to regain two-thirds
within one year — and most of the
weight within five years3
Adapted from:
http://www.lapband.com/en/learn_ab
out_lapband/compare_lapband/
Case Study #1- Lap Band Surgery
J.T. is a 39 year old male who is coming to visit you because he is obese and has high
cholesterol. The doctor’s office called prior to his visit to let you know he is interested in lap
band surgery and in order for his insurance to agree to pay for the surgery; he needs to
see you once a month for 12 months. The doctor’s office sent a current height of 6’2” and
a weight of 395 lbs; however this was a stated weight because their scale only goes up to
350 lbs. But in your office the scale weighs up to 500 lbs. The doctor’s office also tells you
he is currently drinking a high protein shake twice a day. J.T. comes in to see you.
Labs: Fasting Glucose 105, Total Cholesterol 260 mg/dL, LDL 145 mg/dL, HDL 28 mg/dL,
Triglycerides 450 mg/dL
Meds: Tricor, Lasix
What is the first thing you would do?
What is his BMI?
What do his labs mean to you?
What stage of change is he in?
What information would you collect from him?
What education would you provide to him- how many calories would you give him? What
other nutrient information would you provide him with?
What goals would you establish with him?
Case Study #2- Follow up Weight
Management
R.M. is a 40 year old female that has seen you last month and is now coming in for a follow
up appointment. She is trying to lose weight, but has not lost anything within the past
month and in fact has gained 5 pounds. The first time you had seen her, she was only
eating 1 meal per day and drinking 3-20oz bottles of Mountain Dew per day, snacked on
chocolate kisses and was not a fan of fruits or vegetables, but could try to drink V8 and
100% fruit juice. She was unable to exercise because of her severe arthritis and back
pain. The last time you had seen her, you had both discussed a 1600 calorie diet that
broke down to 50% of total carbohydrates, 25% of total fat and 25% of total protein. The
goals you had established at that time was for her to eat 3 meals at consistent times and
find out if there was a water aerobics class at the local pool. Her height measured at 5’2”
and her weight the first visit was 180 pounds and is currently 185 pounds.
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What is her current BMI? Is her weight gain severe or not?
What is her stage of change?
What type of information would you provide her with?
What type of goals would you establish with her?
When would you follow up with her?
ADA- Empowering the Client
We are going to review a slide presentation on how we
can change a scenario with a client. After reviewing the
slide let’s discuss what we will do.
http://www.facilitatingbehaviorchange.org/Chapter-Page.aspx?ChapterPage.SectionID=228