Course Learning Objectives

Self-Study Module

After completing the self-study module, you will be able to:

• Describe the current prevalence of overweight and obesity.

• Identify risk factors and diseases associated with overweight/obesity.

• Identify genetic, biologic, and environmental contributors to weight status.

• Define body mass index and waist circumference, and identify indications for use.

• Define and distinguish among healthy weight, overweight, and obesity.

• Distinguish among key methods used to measure body composition.

• Recognize current evidence-based recommendations for assessment and treatment of weight management (NIH/NHLBI Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity, Position of The American Dietetic Association: Weight Management).

• Be aware of techniques (and their limitations) used to assess dietary intake in overweight and obesity .

• Identify behavioral predictors of successful weight maintenance based on outcomes of the National Weight Control Registry.

• Recognize current research evaluating the efficacy of leading popular diets and diet approaches for weight management.

• Identify the components of Metabolic Syndrome (Syndrome X) and its relation to obesity.

• Describe and begin to apply counseling skills important to successful client weight management.

• Be aware of emerging research, issues and non-traditional approaches to weight management

Onsite Workshop

After completing the onsite workshop, participants will be able to:

Current Research and Future Possibilities in Overweight and Obesity

• Recognize the prevalence and epidemiology of overweight and obesity (in general and specific to ethnic and special population groups).

• Identify the leading biologic, genetic, and environmental contributors to overweight and obesity.

• Identify medical conditions or diseases associated with obesity and describe health benefits associated with weight reduction.

• Describe key theories related to the etiology of overweight and obesity.

• Understand basic endocrinology and biological factors regulating energy intake and body weight (eg, leptin, insulin, gut peptides, grehlin, and brain neurotransmitters).

• Describe Metabolic Syndrome (Syndrome X) and its relation to weight status and treatment of obesity.

• Understand the impact of weight status (weight maintenance, weight gain, and weight loss) on quality of life, mortality, and overall health related outcomes and medical costs.

• Recognize emerging trends in the treatment of overweight and obesity.

• Recognize and apply seminal and recent research in the treatment of overweight and obesity.

Clinical Management of Overweight and Obesity

• Apply evidence-based tools for the assessment and treatment of overweight and obesity (NIH/NHLBI Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity, ADAAdult Weight Management Protocol).

• Identify clinical, functional/quality of life, and behavioral outcomes used in assessing patient/client’s weight status and response to nutrition therapies.

• Apply the technique used to measure waist circumference and discuss its application in the overweight and obese population.

• Identify and interpret laboratory data, vital signs, and other clinical tests specific to risk and complications associated with overweight and obesity.

• Recognize and apply validated methods for determining energy requirements in determining diet prescription for weight loss/management.

• Apply techniques to determine a patient/client’s readiness and motivation to begin/maintain weight management treatment (eg, tools to assess readiness (Diet Readiness Test), motivational interviewing (eg, “Ruler Method”).

• Recognize tools used to screen patient/clients that may have contraindications for weight management treatment (eg, Beck Depression Inventory, Questionnaire on Eating and Weight Patterns).

• Develop an appropriate weight management plan based on patient/client goals/expectations.

• Implement case management strategies, including follow-up and documentation of MNT outcomes to evaluate progress.

• Collaborate with the healthcare team and know when to refer to other providers and services.

Popular Diets and Weight Loss Programs

• Identify characteristics of healthy versus non-healthy weight control plans/programs.

• Assist and identify realistic and nutritionally balanced weight loss diet plans for patient/clients.

• Recognize unique features of balanced deficit diets and application to improving patient/client outcomes with or at risk for co-existing disease(s) (NCEP ATP III, Dietary Guidelines, AHA 2000 Dietary Guidelines, DASH diet, Mediterranean diet, and Volumetrics weight-control plan).

• Understand the principles of the Glycemic Index (GI) diet and application/limitations in the treatment of overweight and obesity.

• Describe diet approaches for managing Metabolic Syndrome (Syndrome X) and apply evidence-based research findings.

• Describe the differences among the leading popular diets (high fat, low-carbohydrate diets; moderate-fat balanced nutrient reduction diets; and low and very low fat diets).

• Recognize and apply current research on weight loss and metabolic outcomes using popular diets.

• Translate for patient/clients the benefits and limitations of various popular diets and weight loss programs.

• Identify technology-based/internet weight loss programs and current outcomes of existing programs.

• Recognize the leading commercial weight loss programs, evidence supporting commercial programs, and application in weight management.

Over-the-Counter (OTC) Dietary Supplements: Role in Weight Loss

• Identify the current trends in the use of dietary supplements and herbal products for weight loss/management.

• Understand the FDA’s role in approving/monitoring dietary supplements/herbal products for weight loss/management.

• Be familiar with the leading types of dietary and herbal supplements marketed for weight management (herbal stimulants, herbal diuretics, fat and starch ‘blockers’).

• Recognize and apply evidence-based research demonstrating the outcomes and efficacy of dietary supplements and herbal products in weight loss and weight maintenance.

• Describe the issues concerning the use of dietary supplements with regards to safety and efficacy.

• Assess indications/contraindications for using specific dietary supplements/herbal products for weight management based on patient/client assessment.

• Understand the dietetics professional’s role in educating patient/clients on the use of dietary supplements, communicating with the healthcare team, and documenting patient/client use and outcomes.

• Identify when to refer to the physician/pharmacist for clinical/medical monitoring.

Role of Physical Activity In Weight Loss and Maintenance

• Understand the dietetics professional’s role in promoting physical activity as part of weight management programs.

• Distinguish and translate for patient/clients the difference between exercise and lifestyle physical activity.

• Understand the physiological role physical activity plays in the various stages of weight management (weight loss versus weight maintenance).

• Identify and distinguish the role aerobic and strength-training types of physical activities have on weight loss/weight maintenance.

• Provide strategies for integrating and accumulating physical activity as part of patient/client’s weight management program.

• Understand and apply current evidence-based guidelines and recommendations for physical activity.

• Identify and apply tools for assessing readiness and medical clearance for physical activity programs (eg, PAR-Q, Physical Activity Questionnaire).

• Identify self-monitoring tools for assessing activity level and energy expenditure (eg, pedometers, physical activity records).

• Identify when to refer to other health professionals (exercise specialists/physician).

Behavioral Management

• Understand and implement key principles of behavioral management.

• Recognize the difference/similarities between motivational interviewing, patient-centered counseling, and self-management training.

• Assist patients/clients in establishing realistic/achievable weight loss goals and treatment outcomes.

• Identify personal biases and potential barriers/attitudes toward counseling patient/client’s that are overweight and obese.

• Establish a therapeutic relationship conducive to promoting patient/client behavior change.

• Understand and apply behavioral treatment strategies for facilitating behavior change short and long-term (eg, self-monitoring, stimulus control, cognitive restructuring, problem-solving, stress management, social support, contingency management, relapse prevention).

• Identify and apply behavioral treatment strategies in managing issues related to adherence.

• Identify and apply attributes of effective counseling skills.

• Identify when to refer to other health professionals (psychologist, behavioral specialists/physician).

• Recognize and apply tools for facilitating self-management training and behavior change.

Formulas as a Treatment Option

• Recognize liquid formula regimens and over-the-counter (OTC) meal replacement products.

• Define and describe very low calorie diets (programs) and application and use in weight management.

• Identify criteria for using very low calorie diets (VLCDs) with patient/clients.

• Assess indications for using liquid formulas and OTC meal replacement products as part of a weight loss/management plan.

• Evaluate the composition of formulas and role of macronutrients in promoting a nutrient-balanced formula for safe weight loss.

• Determine the amount of protein, carbohydrate, and fat in promoting safe weight loss and preventing medical complications.

• Recognize and apply evidence-based research regarding the use and efficacy of VLCDs and liquid formula programs.

• Identify and evaluate monitoring parameters during use of VLCDs and formula programs.

• Identify the limitations and benefits of using formulas and VLCDs in weight management.

Medical Complications of Treatments

• Recognize the dietetics professional’s role in facilitating medical monitoring during weight management treatment.

• Understand the medical implications of rapid weight loss.

• Understand the meaning and possible cause of varying rates of weight loss.

• Define and translate healthy weight loss to patient/client and health care team members.

• Understand the impact of nutrient intake on the composition of weight loss.

• Apply evidence-based research in understanding and preventing medical complications of weight loss.

• Identify and apply clinical monitoring to assess tolerance and efficacy of weight loss treatment.

• Identify and recognize clinical signs, symptoms and medical complications associated with stressors of weight loss (eg, gallbladder disease, dehydration, arrhythmias).

• Assess and identify medication regimens that may need to be altered due to weight loss.

• Identify when to refer to the physician for clinical/medical monitoring

Nutrition Management of Bariatric Surgery Patients

• Understand and distinguish the physiologic and metabolic changes associated with various bariatric surgery procedures.

• Identify short and long-term health related complications and risks associated with bariatric surgery procedures.

• Recognize and apply evidence-based research demonstrating the outcomes and efficacy of bariatric surgery in promoting weight loss and weight maintenance.

• Understand the dietetics professional role in facilitating surgery as a treatment option.

• Assess patient/client eligibility criteria for surgical treatment intervention.

• Recognize the progression of food and meal planning through the various stages following bariatric surgery to optimize nutritional status and promote weight loss.

• Understand the need for specific nutritional supplementation following bariatric surgery.

• Identify specific foods and liquids that may or may not be tolerated following bariatric surgery.

• Design and translate meal planning for patients/client’s to optimize tolerance and weight loss outcomes.

• Identify and implement clinical monitoring to assess tolerance and nutritional outcomes before and after surgical procedures.

• Identify when to refer to the physician for clinical/medical monitoring.

Pharmacotherapy as a Treatment Option

• Identify the current FDA approved medications prescribed for weight loss/management.

• Understand the pharmacological mechanism of leading prescribed medications (Sibutramine, Orlistat, and Phentermine) for weight management.

• Recognize and apply evidence-based research demonstrating the outcomes and efficacy of pharmacotherapy in weight loss and weight maintenance.

• Understand the dietetics professional’s role in facilitating pharmacotherapy as a treatment option.

• Assess patient/client eligibility criteria for pharmacotherapy treatment.

• Assess indications/contraindications for using prescribed medications for weight management based on patient/client assessment.

• Recognize the dosage, peak concentration, timing, and side effects of commonly prescribed medications.

• Identify and implement clinical monitoring to assess tolerance to prescribed medications and weight loss outcomes.

• Design and translate diet and behavioral plans that optimize pharmacotherapy effectiveness and outcomes.

• Recognize commonly prescribed or over-the-counter (OTC) medications that may cause/exacerbate weight gain or interact with treatment medications.

• Identify when to refer to the physician for clinical/medical monitoring.

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