1. Adhere to prevention first, starting from children and adolescents, starting from preventing overweight, and persisting for life;
2. the weight loss plan should be adhered to for a long time, and the speed should not be too fast.
(Weight loss rate of overweight or mild obesity: 0.5- 1kg per week or 5%- 10% or 1-2kg/ month for 3-6 months)
Intervention strategy of obesity
① Overall strategy: regularly monitor the weight changes of the sample population.
② Strategies for high-risk groups: change the knowledge, concepts, attitudes and behaviors of high-risk groups.
③ Targeted intervention for patients with obesity and complications: For high-risk individuals who are overweight and obese and suffer from obesity-related diseases, it is best to prevent them from gaining weight further, and to reduce their weight; Disease management for patients with complications, such as self-monitoring weight, setting weight loss goals, and guiding corresponding drug treatment methods;
Obesity intervention measures
① Control the total energy intake: the average adult's daily energy intake is controlled at 1200- 1300kcal. In a balanced diet, protein should account for 10%- 15% of total energy, 50%-65% of carbohydrate and 20%-30% of fat.
② Increase physical activity: any form and intensity of physical activity. Pay attention to muscle strength training during weight loss.
Activity: every day 10 kilostep equivalent, 2-3 times a week muscle training, 2800 kilocalories a week.
Principle: From small to large, from weak to strong, take 1 day after exercise as the degree of self-feeling.
Precautions: Before doing high-intensity exercise, it is best to ask a doctor to check the cardiopulmonary function (treadmill) to rule out cardiovascular diseases.
③ The combination of controlling dietary energy and increasing physical activity is the best.
④ Behavioral therapy
⑤ Use drugs when necessary.
The following situations can be treated with drugs:
Appetite is strong, hunger before meals is unbearable, and the amount of food per meal is large; Complicated with hyperglycemia, hypertension, dyslipidemia and fatty liver; Combined with weight-bearing joint pain;
Dyspnea or obstructive sleep apnea syndrome caused by obesity;
After 3-6 months of simple diet control and increased activity, I still can't lose 5% of my weight, and even my weight is still rising.
Weight loss drugs:
Drugs that inhibit intestinal digestion and absorption, such as orlistat;
Appetite suppressants such as phentermine hydrochloride and amfepramone hydrochloride;
Hypoglycemic drugs with weight loss function: such as metformin, liraglutide, etc.
Drugs to avoid increasing the risk of obesity:
Such as tricyclic antidepressants and steroid hormones.
Evaluation of obesity intervention
1. Effect evaluation of individual obesity intervention
(1) Does it help the management object realize the reasons for being overweight or obese?
(2) Have you listed any ways to lose weight?
Have you found a suitable way to lose weight?
④ Evaluate the short-term weight loss effect (changes in health benefits such as blood pressure and blood lipid within 0.5 ~ 3 years).
⑤ Evaluate the short-term weight loss effect (absolute or relative reduction of body mass index or waist circumference within 1-6 months).
⑥ After trying a weight loss method failed, can I switch to another weight loss method?
⑦ Can various measures be comprehensively used to achieve the purpose of losing weight and maintain the weight loss result?
Can you use the resources around the management object to lose weight?
2. Evaluation of intervention effect on group obesity.
① The awareness rate of obesity and obesity prevention knowledge among the managed population (such as community);
(2) the proportion of management people who achieve the goal of losing weight by controlling diet and increasing physical activity;
(3) Control the proportion of obese people who meet or fail to meet the standards;
④ Information on the incidence, disability and death of cardiovascular and cerebrovascular diseases in the management population, and health economics evaluation.