Behavior modification, weight loss

The Diabetes Prevention Program was a 3-year study that showed that lifestyle modifications, including exercise (30 minutes/day, 5 days/week) and moderate (5%-10%) weight loss, reduce the probability of developing DM by 58% in patients with pre-diabetes. Results from this study suggest that diet, exercise, and behavior modification are effective in preventing type 2 DM in high-risk patients.14... 

Non-adherence with recommended lifestyle changes may result in unsuccessful weight loss.6,25 Therefore, eliminating these barriers through behavior modification is necessary to gain maximal benefit from both dietary modification and exercise. Components to successful behavioral modification include, but are not limited to, the following steps ... 

The primary aim of behavior modification is to help patients choose lifestyles conducive to safe and sustained weight loss. Behavioral therapy is based on principles of human learning, which use stimulus control and reinforcement to substitute desirable for learned, undesirable behavior. 

FIGURE 59-1. Pharmacotherapy treatment algorithm. A select population of individuals, based on body mass index (BMI) and waist circumference (WC) together with concurrent risk factors, may benefit from medication therapy as an adjunct to a program of weight loss that includes diet, exercise, and behavioral modification. (CHD, coronary heart disease DM, diabetes mellitus, HTN, hypertension INC WC, >40 inches for males and >35 inches for females LCD, low-calorie diet.)... 

Behavioral modifications such as weight loss, avoidance of alcohol and sleeping pills, and the use of specialized pillows that encourage the person to sleep on his or her side (sleep apnea occurs most often when the person is sleeping on his or her back). 

It is appropriate to consider medication therapy if 6 months of diet, exercise, and behavioral modification fail to stimulate weight loss. 

The success of obesity therapy has been measured most often as weight loss over study periods of up to 12 months. Successful obesity treatment plans have incorporated diet, exercise, behavior modification (with or without pharmacologic therapy), and/or surgical intervention. Figure 140-4 shows the sites of action of these therapies within the energy intake, storage, and expenditure cycle. 

An appropriate weight loss goal is 1-2 pounds per week. Many Americans want a quick-fix solution to obesity, but a slow weight loss program that includes reduced calories, exercise, and behavior modification is the only proven method of sustained weight loss other than surgery. 

The authors observed that the inclusion complex of CPC with cyclodextrin decomposed at higher temperatures then the pure CPC. A decomposition temperature of 284 °C was observed for this complex, compared to 220 °C for pure CPC. This confirmed the attainment of better thermal stability of the pyridinium modification by complexing with cyclodextrin. The thermal behavior of the polystyrene nanocomposites synthesized using both CPC and the inclusion complex of CPC with cyclodextrin has been demonstrated in Figure 1.18 and is compared with that of the pure polymer. Both the nanocomposites had better thermal stability than the pure polymer however, the thermal performance of inclusion complex-intercalated clay nanocomposites was better than that of the CPC-intercalated clay nanocomposites. The temperature at 5% weight loss was observed to be 33 °C higher for the inclusion complex-intercalated clay nanocomposites as compared to the pure polymer, whereas this increase was 18 °C for the CPC-intercalated clay nanocomposites. 

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