Treatment of the Seriously Obese Patient

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An ideal resource for practitioners working with individuals who are seriously overweight, this unique and timely volume takes a multidisciplinary approach to assessment and treatment. With 21 chapters written by experts from fields including clinical psychology, medicine, exercise physiology, nutrition, and metabolism, the book examines the many health risks of obesity, the goals and results of treatment, and findings concerning possible ...
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Overview

An ideal resource for practitioners working with individuals who are seriously overweight, this unique and timely volume takes a multidisciplinary approach to assessment and treatment. With 21 chapters written by experts from fields including clinical psychology, medicine, exercise physiology, nutrition, and metabolism, the book examines the many health risks of obesity, the goals and results of treatment, and findings concerning possible adverse effects of stringent dieting.

The volume opens with guidelines to help practitioners assess the health and mortality risks of overweight patients. Addressing the problem of integrating information about important risk-modifying factors, it presents a classification of obesity, an overview of current therapies, and a discussion on the use of very low calorie diets. The biological response to caloric restriction is explored in five chapters that cover methods of measuring body composition and the changes that occur during therapeutic weight loss; the animal literature on caloric restriction, body composition, and organ function; the fatal cardiac arrhythmias that may occur in obese consumers of liquid protein diets; and the effects of dieting and weight loss on energy expenditure.

Chapters on the consequences of therapeutic weight loss reveal that a reduction in initial weight of as little as 10% is frequently sufficient to improve or control the adverse health effects of obesity. They also outline the potentially unique advantages of using very low calorie diets with obese Type II diabetics, describe the psychological changes that can be anticipated when an obese patient loses weight, and discuss the timely issue of binge eating in the obese.

Providing a multidisciplinary, hands-on approach to treatment, six chapters then review the clinical use of very low calorie diets. A physician discusses the initial medical evaluation, as well as guidelines for monitoring patients throughout treatment. Psychologists describe the initial psychosocial evaluation and review behavioral interventions. A nutritionist/dietitian outlines the criteria for selecting the appropriate diet, methods of managing the refeeding period, and strategies for helping patients maintain a long-term, nutritious low fat diet. An exercise physiologist discusses the health benefits of physical activity and the special exercise needs of the seriously obese. The literature on predictors of weight loss and attrition from therapy is reviewed to help identify patients least likely to be successful. And, finally, in a chapter that will help sensitize clinicians to the daily challenges clients face, a former patient describes her experiences in losing weight in a combined program of very low calorie diet and lifestyle change.

The book's closing section examines the critical issue of maintenance of weight loss and alternative therapies. A theoretical model for relapse prevention is presented, as is a summary of six studies investigating methods for facilitating weight loss. Other chapters discuss pharmacological and surgical interventions for the massively obese individual.

Providing practitioners with new approaches for treatment and a better understanding of the nature of their patients' ongoing struggle with weight, Treatment Of The Seriously Obese Patient is an invaluable resource for all professionals who work with overweight individuals.
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Editorial Reviews

From the Publisher

This is a wonderfully detailed, comprehensive handbook covering psychophysiological and clinical aspects of obesity...The book's editors and authors are the pioneers of this field. It is the kind of book that professionals and advanced students in this area will be glad to get their hands on....An excellent and intergrated compilation of everything researchers and clinicians need to know....It is sure to become a classic must-have' text over the next decade for everyone involved in the treatment of obesity, diabetes, and cardiovascular disease.' --John P. Foreyt, Ph.D.

"This book, by distinguished and experienced conributors, addresses the risks of the seriously obese, many of whom have diabetes, hypertension, or disordered blood fats and cannot afford to turn away from their increased risk of mortality, and for whom some degree of caloric restriction or vigorous weight reduction is essential. It is particularly relevant to the growing and at times misdirected movement against dieting for weight loss. The authors critically examine the benefits, as well as apparent defects, of the measures available for the various types and causes of obesity. And, most important, while damaging weight cycling is so prevalent, they make practical suggestions as to how appropriate weight and lifestyle can be maintained." --Ethan A.H. Sims, M.D., Professor Emeritus of Medicine, University of Vermont

"Comprehensive and expert coverage...practitioners who work with the seriously obese will want to add this volume to their library." --John P. Foreyt, Ph.D. and G. Ken Goodrick, Ph.D., Baylor College of Medicine in Eating Disorders: The Journal of Treatment & Prevention

Booknews
For practitioners working with individuals who are seriously overweight, this volume takes a multidisciplinary approach to assessment and treatment. In 21 chapters contributed by experts from fields including clinical psychology, medicine, exercise physiology, nutrition, and metabolism, it examines the many health risks of obesity, the goals and results of treatment, and findings concerning possible adverse effects of stringent dieting. Annotation c. Book News, Inc., Portland, OR (booknews.com)
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Product Details

  • ISBN-13: 9780898628791
  • Publisher: Guilford Publications, Inc.
  • Publication date: 6/19/1992
  • Edition number: 1
  • Pages: 524

Meet the Author


Thomas A. Wadden, Ph.D., is Professor of Psychology and Director of Clinical Training at Syracuse University, where he is also Director of the University's Center for Health and Behavior. From 1981 to 1991, he was a faculty member in the Department of Psychiatry at the University of Pennsylvania School of Medicine, where he began his research on the treatment of obesity. Dr. Wadden is currently Associate Editor of the Annals of Behavioral Medicine and serves on six other editorial boards. His work has been recognized by the President's New Researcher Award from the Association for Advancement of Behavior Therapy and by a Research Scientist Development Award from the National Institute of Mental Health.
Theodore B. VanItallie, M.D., is Professor Emeritus of Medicine at Columbia University's College of Physicians and Surgeons. He was Director of Medicine at St. Luke's Hospital Center from 1957 - 1975. In 1974, he founded the Obesity Research Center at the Hospital Center, which he directed until 1988. Dr. VanItallie has been the recipient of a number of awards and citations including the McCollum Award from the American Society for Clinical Nutrition and the Joseph B. Goldberger Award from the American Medical Association. He is a founder and past president of the American Society for Clinical Nutrition and former editor of its journal.
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Table of Contents

Pt. 1 Introduction and Overview
1 Assessment of Morbidity and Mortality Risk in the Overweight Patient 3
2 An Overview of Current Treatments for Obesity 33
3 Very Low Calorie Diets: An Overview and Appraisal 44
Pt. 2 Biological Response to Caloric Restriction
4 Effect of Energy Restriction on Body Composition and Nitrogen Balance in Obese Individuals 83
5 Marked Caloric Restriction and Organ Response in Normal-Weight and Obese Experimental Animals 107
6 Cardiac Structure and Function in Markedly Obese Patients before and after Weight Loss 136
7 Effect of Caloric Restriction and Weight Loss on Energy Expenditure 163
8 The Effects of Increased Physical Activity on Food Intake, Metabolic Rate, and Health Risks in Obese Individuals 190
Pt. 3 Health Consequences of Therapeutic Weight Loss
9 Reducing Primary Risk Factors by Therapeutic Weight Loss 213
10 Very Low Calorie Diets in the Treatment of Type II Diabetes: Psychological and Physiological Effects 231
11 Psychological Aspects of Obesity and Dieting 252
Pt. 4 Clinical Use of Very Low Calorie Diets
12 Medical Evaluation and Monitoring of Patients Treated by Severe Caloric Restriction 273
13 Behavioral Assessment and Treatment of Markedly Obese Patients 290
14 Nutritional Counseling during Severe Caloric Restriction and Weight Maintenance 331
15 A Clinical Approach to Exercise in the Markedly Obese 354
16 Predictors of Attrition and Weight Loss in Patients Treated by Moderate and Severe Caloric Restriction 383
17 The Challenge of Weight Control: A Personal View 411
Pt. 5 Maintenance of Weight Loss and Alternative Therapies
18 Relapse and the Treatment of Obesity 437
19 Improving Maintenance of Weight Loss Following Treatment by Diet and Lifestyle Modification 456
20 Long-Term Pharmacological Treatment of Obesity 478
21 Surgical Treatment of Obesity 496
Index 507
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