New Tools For Health Care Providers And The Public To Combat Overweight And Obesity

A "practical guide" to help health care providers manage the treatment of their overweight and obese patients, an online interactive menu planner, and consumer tips on behavior change for weight management are some of the new tools being unveiled by the National Heart, Lung, and Blood Institute (NHLBI) this month to help tackle America's battle of the bulge.

The need for these tools couldn't be more pressing.  Recent statistics from the National Health and Nutrition Examination Survey (NHANES) show that between 1994 and 1999 the U.S. experienced a 5 percent increase in the number of adults who are overweight or obese.

"This is 61 percent of the U.S. adult population -- almost 108 million people -- who because of their weight are at greater risk for several major diseases including heart disease, stroke, diabetes, and cancer," said NHLBI Director Dr. Claude Lenfant.

To help these people and their health care team, NHLBI's Obesity Education Initiative in cooperation with the North American Association for the Study of Obesity convened a working group to prepare "The Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults".  Based on the clinical guidelines released by NHLBI in 1998, the practical guide is just that -- a practical manual with tools and tips for weight loss.

"This guide gives health care providers the fundamentals needed to evaluate and treat this important health problem and contains information which has not been provided elsewhere in their training," said Dr. Louis J. Aronne, chair of the committee that developed the guide and clinical associate professor of medicine at Weill-Cornell Medical College in New York City.

The guide's new features, which were not in the original obesity guidelines, include a 10-step plan and a quick reference tool to help physicians assess, classify, and treat overweight and obesity.  The guide also includes detailed sections on dietary therapy, physical activity, and behavior therapy.  In addition, the handbook discusses the appropriate use of weight loss drugs (with recommended doses of specific drugs) and indications for surgery as a treatment for obesity.

A key section of the guide is the appendices, which were written for patients and include practical information on diet, physical activity, and tools for behavior change. There is also a weight management chart, sample walking and jogging programs, and tips for dining out, shopping, and cooking.

"All of these tools reflect the fact that simple, small changes in the way we eat and engage in physical activity can add up over time to a healthier weight," said Karen Donato, coordinator of the NHLBI's Obesity Education Initiative.

Consumers -- and health care professionals -- can find all of these tools online on the NHLBI Web site (www.nhlbi.nih.gov). The Institute's Web site will also post a PalmOS (R) format version of the practical guide. In addition, the site already contains a body mass index (BMI) calculator for PalmOS (R) devices.  The calculator accepts English or metric input and includes a BMI classification table for adults.

A new feature on the Institute's Web site is the ultimate "cyber" tool for devising low calorie meals -- an interactive menu planner.  The menu planner allows the user to plan a single meal or a whole day's meals.  To use the planner, you choose your total calories for the day, and select a meal.  You then select foods from a list, according to the food groups included in the American Dietetic Association/American Diabetes Association exchange list.  Finally, you choose the number of servings you want and the calories are calculated for you.

"It's easy and it actually makes calorie counting fun," said Donato who suggested consumers try the site during March -- National Nutrition Month.