Question

Your client asks your opinion about different weight loss options beyond diet and exercise. Her BMI is 37 and she has type 2 diabetes, high blood pressure and high cholesterol. What clinical weight loss procedures is she eligible for based on the clinical continuum or care for obesity? How did you determine this?.

Answer 1

The bottom is line that eating a healthy dietand getting more physical activity can help prevent obesity.

• Consume less “bad” fat and more “good” fat.
• Consume less processed and sugary foods.
• Eat more servings of vegetables and fruits. ...
• Eat plenty of dietary fiber.
• Focus on eating low–glycemic index foods
• Weight loss. Dropping extra pounds can help. While losing 5% to 10% of your body weight is good, losing 7% and keeping it off seems to be ideal. That means someone who weighs 180 pounds can change their blood sugar levels by losing around 13 pounds. Weight loss can seem overwhelming, but portion control and eating healthy foods are a good place to start.
• Healthy eating . There’s no specific diet for type 2 diabetes. A registered dietitian can teach you about carbs and help you make a meal plan you can stick with. Focus on:
  • Eating fewer calories
  • Cutting back on refined carbs, especially sweets
  • Adding veggies and fruits to your diet
  • Getting more fiber
• Exercise. Try to get 30 to 60 minutes of physical activity every day. You can walk, bike, swim, or do anything else that gets your heart rate up. Pair that with strength training, like yoga or weightlifting. If you take a medication that lowers your blood sugar, you might need a snack before a workout.
• Watch your blood sugar levels: Depending on your treatment, especially if you’re on insulin, your doctor will tell you if you need to test your blood sugar levels and how often to do it.
• Medications.
• Metformin (Fortamet, Glucophage, Glumetza, Riomet). This is usually the first medication used to treat type 2 diabetes. It lowers the amount of glucose your liver makes and helps your body respond better to the insulin it does make.
• Sulfonylureas. This group of drugs helps your body make more insulin. They include glimepiride (Amaryl), glipizide (Glucotrol, Metaglip), and glyburide (DiaBeta, Micronase).
• Meglitinides. They help your body make more insulin, and they work faster than sulfonylureas. You might take nateglinide (Starlix) or repaglinide (Prandin).
• Thiazolidinediones. Like metformin, they make you more sensitive to insulin. You could get pioglitazone (Actos) or rosiglitazone (Avandia). But they also raise your risk of heart problems, so they aren’t usually a first choice for treatment.
• DPP-4 inhibitors. These medications -- linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia) -- help lower your blood sugar levels, but they can also cause joint pain and could inflame your pancreas.
• GLP-1 receptor agonists. You take these medications with a needle to slow digestion and lower blood sugar levels. Some of the most common ones are exenatide (Byetta, Bydureon), liraglutide (Victoza), and semaglutide (Ozempic).
• SGLT2 inhibitors. These help your kidneys filter out more glucose. You might get canagliflozin (Invokana), dapagliflozin (Farxiga), or empagliflozin (Jardiance).
• Insulin. You might take long-lasting shots at night, such as insulin detemir (Levemir) or insulin glargine (Lantus).