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Medical Clinics of North America

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https://www.readbyqxmd.com/read/29156191/obesity-medicine-a-core-competency-for-primary-care-providers
#1
EDITORIAL
Scott Kahan, Robert F Kushner
No abstract text is available yet for this article.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156190/in-search-of-the-70-kg-man
#2
EDITORIAL
Bimal H Ashar
No abstract text is available yet for this article.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156189/obesity-in-pregnancy-optimizing-outcomes-for-mom-and-baby
#3
REVIEW
Heidi Dutton, Sarah Jean Borengasser, Laura Marie Gaudet, Linda A Barbour, Erin Joanne Keely
Obesity is common in women of childbearing age, and management of this population around the time of pregnancy involves specific challenges. Weight and medical comorbidities should be optimized both before and during pregnancy. During pregnancy, gestational weight gain should be limited, comorbidities should be appropriately screened for and managed, and fetal health should be monitored. Consideration should be given to the optimal timing of delivery and to reducing surgical and anesthetic complications. In the postpartum period, breastfeeding and weight loss should be promoted...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156188/addressing-obesity-in-aging-patients
#4
REVIEW
John A Batsis, Alexandra B Zagaria
Obesity in older adults affects not only morbidity and mortality but, importantly, quality of life and the risk of institutionalization. Weight loss interventions can effectively lead to improved physical function. Diet-alone interventions can detrimentally affect muscle and bone physiology and, without interventions to affect these elements, can lead to adverse outcomes. Understanding social and nutritional issues facing older adults is of utmost importance to primary care providers. This article will also discuss the insufficient evidence related to pharmacotherapy as well as providing an overview of using physiologic rather than chronologic age for identifying suitable candidates for bariatric surgery...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156187/guideline-recommendations-for-obesity-management
#5
REVIEW
Donna H Ryan, Scott Kahan
It is an obligation for all health care providers to participate in obesity management. This article discusses obesity guidelines from The Obesity Society; the Endocrine Society; and the American Association of Clinical Endocrinologists. It reviews and compares findings and recommendations across these guidelines, identifies areas of controversy and concordance, and suggests how primary care practices may make use of the most appropriate recommendations for their circumstances.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156186/treatment-of-obesity-in-primary-care
#6
REVIEW
Adam G Tsai, Jocelyn E Remmert, Meghan L Butryn, Thomas A Wadden
This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156185/maintenance-of-lost-weight-and-long-term-management-of-obesity
#7
REVIEW
Kevin D Hall, Scott Kahan
Weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging. Obesity interventions typically result in early weight loss followed by a weight plateau and progressive regain. This review describes current understanding of the biological, behavioral, and environmental factors driving this near-ubiquitous body weight trajectory and the implications for long-term weight management. Treatment of obesity requires ongoing clinical attention and weight maintenance-specific counseling to support sustainable healthful behaviors and positive weight regulation...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156184/bariatric-surgery-for-obesity
#8
REVIEW
Carel W le Roux, Helen M Heneghan
In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156183/medical-devices-for-obesity-treatment-endoscopic-bariatric-therapies
#9
REVIEW
Eric J Vargas, Monika Rizk, Fateh Bazerbachi, Barham K Abu Dayyeh
Endoscopic bariatric therapies (EBTs) are effective tools for the management of obesity. By mimicking restrictive and bypass surgery physiology, they provide a safe and effective treatment option with the added capabilities of reaching a broader population. Multiple efficacious medical devices, such as intragastric balloons, endoscopic suturing/plication devices, and bypass liners, at various stages of development are available in the United States. EBTs represent the newest addition to a multidisciplinary approach in obesity management...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156182/obesity-pharmacotherapy
#10
REVIEW
Katherine H Saunders, Devika Umashanker, Leon I Igel, Rekha B Kumar, Louis J Aronne
Although diet, physical activity, and behavioral modifications are the cornerstones of weight management, weight loss achieved by lifestyle modifications alone is often limited and difficult to maintain. Pharmacotherapy for obesity can be considered if patients have a body mass index (BMI) of 30 kg/m(2) or greater or BMI of 27 kg/m(2) or greater with weight-related comorbidities. The 6 most commonly used antiobesity medications are phentermine, orlistat, phentermine/topiramate extended release, lorcaserin, naltrexone sustained release (SR)/bupropion SR, and liraglutide 3...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156181/obesity-as-a-disease
#11
REVIEW
Jagriti Upadhyay, Olivia Farr, Nikolaos Perakakis, Wael Ghaly, Christos Mantzoros
Obesity is a complex disease with many causal factors, associated with multiple comorbidities that contribute to significant morbidity and mortality. It is a highly prevalent disease that poses an enormous health and economic burden to society. This article reviews the mechanisms of obesity and its related comorbidities.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156180/the-role-of-behavioral-medicine-in-the-treatment-of-obesity-in-primary-care
#12
REVIEW
Scott Kahan, Dawn K Wilson, Allison M Sweeney
Behavioral medicine provides a framework for supporting patients to achieve changes in target health behaviors, such as dietary and physical activity changes. Behavioral medicine fits alongside traditional medical treatments, can minimize the need for more intensive medical treatments, improves outcomes of these treatments, and improves adherence to medication prescriptions or postsurgical recommendations. This article provides an overview of behavioral medicine counseling for obesity in primary care, rooted in the "5 As" approach to health behavior change, and the basic outline of behavioral skills interventions in which health care providers use self-regulatory and behavioral strategies to improve health-related behaviors among patients with obesity...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156179/dietary-management-of-obesity-cornerstones-of-healthy-eating-patterns
#13
REVIEW
Alissa D Smethers, Barbara J Rolls
Several dietary patterns, both macronutrient and food based, can lead to weight loss. A key strategy for weight management that can be applied across dietary patterns is to reduce energy density. Clinical trials show that reducing energy density is effective for weight loss and weight loss maintenance. A variety of practical strategies and tools can help facilitate successful weight management by reducing energy density, providing portion control, and improving diet quality. The flexibility of energy density gives patients options to tailor and personalize their dietary pattern to reduce energy intake for sustainable weight loss...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29156178/introduction-the-state-of-obesity-in-2017
#14
REVIEW
Robert F Kushner, Scott Kahan
Obesity continues to be a major national and global health challenge and a risk factor for an expanding set of chronic diseases. In 2015, high body mass index contributed to 4.0 million deaths globally, which represented 7.1% of the deaths from any cause. Obesity is now regarded as a disease, and multiple health care societies have begun to tackle obesity as a discrete target for assessment and treatment that is supported by several position statements and guidelines. Nonetheless, a perception and treatment gap continues to exist between health care providers and patients regarding the provision of obesity care...
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992864/the-many-facets-of-cancer-survivorship
#15
EDITORIAL
Kimberly S Peairs
No abstract text is available yet for this article.
November 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992863/a-lifelong-battle
#16
EDITORIAL
Bimal H Ashar
No abstract text is available yet for this article.
November 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992862/palliative-care-for-cancer-survivors
#17
REVIEW
Sydney M Dy, Sarina R Isenberg, Nebras Abu Al Hamayel
The palliative care approach for survivors begins with comprehensive assessment of communication and advance care planning needs and the physical, psychological and psychiatric, social, spiritual and religious, and cultural domains. Communication and decision-making about difficult issues should include responding to emotions, planning for future communication needs, and considering reasons for miscommunication. Key palliative approaches to symptom management include addressing physical and psychosocial concerns, and using nonpharmacologic approaches first or together with medications...
November 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992861/screening-for-recurrence-and-secondary-cancers
#18
REVIEW
Jillian L Simard, Sheetal M Kircher, Aarati Didwania, Mita Sanghavi Goel
The population of adult cancer survivors is increasing over time and they are at risk of developing recurrent and secondary cancers, even years after completion of treatment. Post-treatment care of survivors is increasingly the responsibility of primary care providers. Surveillance for recurrence and screening for secondary malignancies related to treatment depend largely on the primary malignancy, treatment regimen, and presence of a hereditary cancer syndrome, such as a BRCA mutation. This article presents surveillance strategies for the most common malignancies...
November 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992860/diet-physical-activity-and-body-weight-in-cancer-survivorship
#19
REVIEW
Karishma Mehra, Alyssa Berkowitz, Tara Sanft
Diet, physical activity, and body weight have been shown to play an important role in cancer survivorship. The impact of each of these lifestyle factors differs slightly among cancer types, and adherence to recommended diet and physical activity guidelines has been associated with positive outcomes, including decrease in the risk of cancer recurrence and improvement of quality of life. Although there are compelling data that appropriate diet, physical activity, and body weight have beneficial effects in cancer survivorship, additional trials are needed to understand the relationship...
November 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28992859/hormonal-changes-and-sexual-dysfunction
#20
REVIEW
Eric S Zhou, Natasha N Frederick, Sharon L Bober
Sexual dysfunction is a common concern for many patients with cancer after treatment. Hormonal changes as a result of cancer-directed therapy can affect both male and female sexual health. This has the potential to significantly impact patients' quality of life, but is underreported and undertreated in the oncology setting. This review discusses commonly reported sexual issues and the role that hormonal changes play in this dysfunction. Although medical and psychosocial intervention strategies exist, there is a clear need for further research to formally develop programming that can assist people whose sexual health has been impacted by cancer treatment...
November 2017: Medical Clinics of North America
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