A Clinical Guide for Management of Overweight and Obese Children and Adults / Edition 1

by Caroline M. Apovian, Carine M. Lenders

Overview

While unhealthy diet and sedentary behaviors are second only to smoking as the leading preventable cause of death in the U.S., less than 45 percent of adult and pediatric obese patients received any prior advice from a physician to lose weight. The low rate of identification and treatment of obesity by physicians can often be attributed to lack of awareness, lack of counseling skills, and the high rate of recidivism in overweight patients.

A Clinical Guide for Management of Overweight and Obese Children and Adults addresses deficiencies in the identification, treatment, and management of obesity through a collection of monographs written by internationally recognized authorities. Designed for healthcare practitioners, this reference provides practical distinctions and recomendations for adult and pediatric obesity in a single volume. This clinical guide outlines the management of the obese patient from the preparation of office accommodations through the long road of maintained wellness.

The editors offer evaluation and assessment strategies for the simply overweight patient to severe complex obesity with multiple comorbidities. It considers treatment modalities from lifestyle change to bariatric surgery, including exercise, diet, and pharmacotherapeutic remedies. The book highlights weight management through behavioral health considerations, the community support system, and other adjunctive therapies, as part of a comprehensive weight loss program.

Taking in to consideration the holistic methods incorporated in the new discipline of obesity medicine, A Clinical Guide for Management of Overweight and Obese Children and Adults reviews the state-of-the-art management of this burgeoning “disease” epidemic.

Product Details

ISBN-13:	9780849330858
Publisher:	Taylor & Francis
Publication date:	12/15/2006
Series:	Modern Nutrition Science
Edition description:	New Edition
Pages:	328
Product dimensions:	6.12(w) x 9.19(h) x (d)

About the Author

Caroline M. Apovian, Carine M. Lenders

Table of Contents

Getting the Office Ready for the Patient, Steps for the Medical Evaluation of the Obese Patient, Motivational Interviewing and Health Behavior Change Counseling, Dietary Therapy, Exercise Therapy for the Overweight Adult, Pharmacologic Therapy for Obesity and Overweight Adults and Adolescents, Surgical Treatment of Obesity, Gastrointestinal Complications of Bariatric Surgery, Follow-Up Strategies for the Treatment of Obesity in Primary Care Settings, Maintenance: The Ultimate Goal, A Clinical Guide to Pediatric Ambulatory Weight Management, Behavioral Health Considerations for the Management of Pediatric Obesity in Primary Care, The Community as a Resource to Support Positive Nutrition and Physical Activity: Behaviors in Youth, Index

Editorial Reviews

Reviewer: Alexandra K Adams, MD, PhD (University of Wisconsin-Madison)
Description: This is a general guidebook for the busy clinician who is managing obesity in children and adults. It provides a comprehensive review of assessment and treatment of adult and pediatric obesity with attention to the psychological issues surrounding behavior change.
Purpose: It is intended as a reference guide that will support clinicians' efforts to manage this complex disease in practice. The authors intend it as a state-of-the-art review of obesity management, addressing everything from getting the office ready to handling complex obesity with multiple comorbidities. This type of reference is very important in clinical practice as the obesity epidemic expands and the majority of clinicians are ill-prepared for handling these issues. This book provides a comprehensive and evidence-based review of these issues with excellent chapters on motivational interviewing and behavioral change strategies, follow-up issues in bariatric patients, and ambulatory pediatric weight management. However, the book's limitations make it difficult to use in a practice setting.
Audience: Busy clinicians who are assessing and treating pediatric and/or adult obesity are the intended audience. While this book has many valuable chapters, it is best used by a practice champion who will be able to digest it and simplify it for the others in the practice.
Features: The book covers obesity from basic diagnosis to the management of complex patients, post-bariatric surgery, pharmacologic treatment options, and behavioral change strategies for both adults and children. There are some excellent chapters that are easy to read and will be useful to a busy clinician. Chapters such as motivational interviewing and behavioral change strategies, follow-up issues in bariatric patients, and ambulatory pediatric weight management contain useful algorithms and examples. The authors are excellent and a majority of the chapters are sufficiently evidence-based. Unfortunately, many of the chapters on adult obesity do not contain useful algorithms and refer the reader to multiple websites without actually presenting the information. An example is the lack of BMI charts for adults or children. Having these in an appendix would have been most useful. Also, there is a lack of patient handouts or clinically useful tools that could be adapted for office use. Overall, the type is small and many charts are hard to read or missing. For example, the pharmacology chapter would have been much more useful to a busy clinician if formatted for quick reference with charts instead of paragraphs explaining each drug. The dietary therapy for pediatric patients is buried in another adult chapter and hard to find. Overall, the pediatric chapters are more usefully laid out and written than the adult chapters. The chapters are set up more as a collection of reviews than as a book. It does not flow as a book intended for the busy clinician in practice should. However, if a practitioner is the person responsible for advancing this issue in their clinic and setting up treatment strategies and has time to read it, this is a useful and thorough starting point.
Assessment: This is a useful as a reference tool for someone intending to set up an obesity practice. It is very thorough but many chapters are difficult to read. A lack of immediately useful tools such as BMI charts, patient handouts, and flow diagrams will restrict its usefulness for the busy practitioner. There are several adult and pediatric guidebooks books for the practitioner on this subject. For example, there are evidence based guidelines such as the NIH's Clinical Guidelines for the Identification, Evaluation, and Treatment of Overweight in Adults, and its companion, The Practical Guide, NIH Publication No. 98-4083, 1998. These are now somewhat out of date but are easy to use and have many useful and practical patient handouts, flow sheets, and are more useful for busy clinicians. In addition, evidence is classified at levels from A-D as physicians are used to seeing, a feature missing from this book. However, this book does include much useful pediatric information which is difficult to find elsewhere and for this alone, it may be a useful addition.

Doody's Review Service