NS420: Seminar 5 Weight Management Sue Roberts, MPH MS RD/CN

Counseling

Behind every success is a succession of failures. -Rick Beneteau

It’s a matter of Lifestyle… If you keep the same commitments, the same relationships, the same thought patterns the same food, the same way of nurturing yourself, you’ll get the same results.

SLOWING DOWN… Observe Evaluate Make plans Alter present actions Practice new actions

Let’s go to the web….

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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. 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

You are the nutrition therapist… 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? 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 calories from carbohydrates, 25% from fat and 25% from protein. The goals you had established at that time were for her to eat 3 meals at consistent times and find out if there was a water aerobics class at the local pool. At her first visit, her height was measured at 5’2” and her weight was 180 lbs. Currently she weighs 185 lbs.

You are her nutrition therapist…. 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?