For the Calorie-Controlled Diet for Weight Management, the Regular Diet is modified by reducing energy intake below what is necessary for maintenance of body weight. Intake of essential protein, vitamins, and minerals is maintained by limiting the amount of fat and sugar in the diet and substituting low-energy foods for foods of similar nutrient content that are higher in energy.
Weight loss and weight maintenance therapy should be based on a comprehensive weight management program including diet, physical activity, and behavior therapy. The combination therapy is more successful than any one intervention alone
Weight reduction is desirable because obesity is related to increased mortality and because weight loss reduces the risk factors for several chronic diseases. Thus, weight loss may help to both control diseases worsened by obesity and decrease the likelihood of developing these diseases. Strong and consistent clinical evidence supports weight loss in overweight or obese persons who have hypertension, hyperlipidemia, or type 2 diabetes, as well as in overweight or obese persons who are at risk for developing these conditions.
In overweight and obese persons, weight loss is recommended to lower blood pressure in patients with hypertension lower total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels in patients with hyperlipidemia lower blood glucose levels in patients with type 2 diabetes prevent liver disease.
Fat is lost when the body is in a state of negative energy balance, which is achieved by reduced energy intake, increased energy output (through muscle work), or both. The reduction of total energy intake vs. the macronutrient composition of the diet is the most important component for achieving negative energy balance and subsequent weight loss.
Children and adolescents
Complications of obesity in children and adolescents include hypertension, dyslipidemia, orthopedic disorders, sleep disorders, gall bladder disease, and insulin resistance
Weight reduction is not recommended for the following groups: · pregnant women (Energy restriction during pregnancy that is sufficient to produce weight loss can be dangerous for the development of the fetus.)
patients with unstable mental or medical conditions, unless medically supervised
patients with anorexia nervosa or a history of this disorder, unless medically supervised
terminally ill patients
Planning the Diet
The dietitian should plan an energy-controlled diet to meet the individual needs and lifestyle of the client. Suggestions to reduce daily energy intake include
Reduce intake of foods with high-energy density (eg, alcohol and fat). Follow the US Dietary Guidelines of less than 30% energy from fat, 10% to 20% from protein, and 50% to 60% from carbohydrates.
Reduce the total amount of food consumed by decreasing portion size and frequency of consumption. Employ behavior modification techniques to improve control over the food selection process and the act of eating.
· Establish self-management training techniques that will enhance the satiety of meals but reduce the energy intake. For example, encourage the patient to eat slowly so that the brain can register that the stomach is full, or recommend eating ample amounts of low-energy density vegetables (eg, salads with small amounts of salad dressing or fat-free dressing) to provide chewing satisfaction and fill the stomach.