Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans. Obesity. 2008;16(5):

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2 Puhl, R. M., & Brownell, K. D. (2006). Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity,14(10), Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans. Obesity. 2008;16(5): Foster GD, Wadden TA, Makris AP, et al. Primary care physicians attitudes about obesity and its treatment. Obes Res. 2003;11(10):

3 Brown I. Nurses attitudes towards adult patients who are obese: literature review. J Adv Nurs. 2006;53(2): Schwartz MB, Chambliss HO, Brownell KD, Billington C. Weight bias among health professionals specializing in obesity. Obes Res. 2003;11(9): Carels RA, Young KM, Wott CB, et al. Weight bias and weight loss treatment outcomes in treatment-seeking adults. Ann Behav Med. 2009;37(3):

4 ผ ให บร การทางส ขภาพมากกว าร อยละ 50 มองว าการด แลบ คคลท ม น าหน กต วเก นน น ป ญหาไม ม ความส าค ญ ไม สามารถปร บพฤต กรรมได ไม สามารถปฏ บ ต ตามการร กษาและแผนการร กษาท ได ร บ ให การเคารพผ ป วยค อนข างต า ไม ด แลร กษาส ขภาพ ยากท จะให การด แล

5 ผลกระทบต อผ ร บบร การ ไม มาร บการร กษา ไม มาตรวจตามน ด ไม ออกกาล งกาย ร บประทานอาหารมากเก นความต องการของร างกาย

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7 National Institutes of Health And North American Association (2000)

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9 Sampsel, S., & May, J. (2007). Assessment and management of obesity and comorbid conditions. Dis Manag, 10(5), Kushner, R. F. (2012). Clinical assessment and management of adult obesity. Circulation, 126(24), Snow, V., Barry, P., Fitterman, N., Qaseem, A., & Weiss, K. (2005). Clinical guidelines. Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 142(7), 525.

10 CHD: myocardial infarction, angina pectoris, coronary surgery includes coronary procedures Atherosclerotic disease Type 2 DM: FBS 126 mg/dl, OGTT 200 mg/dl Sleep apnea LDL 160 mg/dl, HDL 35 mg/dl อาย 45 ป SBP 140 mg/dl, DBP 90 mg/dl ส บบ หร Sampsel & May (2007), Kushner (2012)

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13 Hindle, L., & Carpenter, C. (2011). An exploration of the experiences and perceptions of people who have maintained weight loss. Journal of Human Nutrition & Dietetics, 24(4),

14 แรงบ นดาลใจในการลดน าหน ก ประสบการณ การทดลองลดน าหน กในอด ต การสน บสน นจากครอบคร วและคนใกล ช ด การร บร ความเส ยงของโรคอ วน และข อด ของการลดน าหน ก เวลาว างในการลดน าหน ก การร บร อ ปสรรคอ นๆ เช น การเง น เป นต น

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16 เป นการค ดกรองถ งความไม พร อมในการลดน าหน ก ว าเก ดจาก 1. การขาดความร 2. เก ดจากการไม เห นความส าค ญ และไม อยากลดน าหน ก

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18 Snow, V., Barry, P., Fitterman, N., Qaseem, A., & Weiss, K. (2005). Clinical guidelines. Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 142(7), 525. Gandjour, A., Westenhöfer, J., Wirth, A., Fuchs, C., & Lauterbach, K. W. (2001). Development process of an evidence-based guideline for the treatment of obesity. International Journal for Quality in Health Care, 13(4),

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20 Effective Intervention /Strategies for weight controlled in woman / man overweight and obese adults.

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22 A diet that incorporates a partial meal replacement program can effective produce significant weight control. Heymsfield SB, van Mierlo CA, van der Knaap HC, Heo M, Frier HI. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int. J. Obes. Relat. Metab. Disord.27(5), (2003). Heymsfield SB. Meal replacements and energy balance. Physiol. Behav.100(1),90 94 (2010). Huerta S, Li Z, Li HC, Hu MS, Yu CA, Heber D. Feasibility of a partial meal replacement plan for weight loss in low-income patients. Int. J. Obes. Relat. Metab. Disord.28(12), (2004).

23 A diet that incorporates a partial meal replacement program can effective produce significant weight control. López Barrón G., Bacardí Gascón M., De Lira García C., Jiménez Cruz A.. Meal replacement efficacy on long-term weight loss: a systematic review. Nutr. Hosp. [serial on the Internet] Dec [cited 2013 Apr 10] ; 26(6): Available from:

24 How tailored behavior counseling, diet significant effect weight loss and weight maintenance in overweight and obese adult?

25 The tailored behavior counseling in adults effect lost significantly more weight than the control group (-5.0 kg and 0.1 kg for men and -3.9 kg vs kg for women.)behavior changes were related to weight loss; participants who maintained the action/maintenance stage or moved to later stages lost significantly more weight than participants who remained in the pre contemplation/contemplation/preparation stages or regressed to earlier stages. After one-year follow-up, the intervention group maintained significantly lower weights, lower energy intakes and improvements in irregular eating habits. Our behavioral approach led to diet and behavior modification, weight loss and maintenance. Because modified variables differed between men and women, gender-specific approaches may be necessary. Makiko Nakade, Naomi Aiba, Naomi Suda, et al. Behavioral change during weight loss program and one-year follow-up: Saku Control Obesity Program (SCOP) in Japan.Asia Pac J Clin Nutr. 2012; 21(1):

26 What is effective exercise for obese overweight adult?

27 a combination of aerobic and resistance exercise appears to be the most effective strategy for obese older adults Scoping review report: obesity in older adults.int J Obes (Lond) Sep ;36(9): doi: /ijo Epub 2012 Mar 13.

28 There is a growing body of scientific literature suggesting that at least 60 min of moderate-intensity physical activity may be necessary to maximize weight loss and prevent significant weight regain. Moreover, adequate levels of physical activity appear to be important for the prevention of weight gain and the development of obesity. John M Jakicic &Amy D Otto.Physical activity considerations for the treatment and prevention of obesity. Am J Clin Nutr : 1 226S-229S

29 The transtheoretical model stages of change (TTM SOC) still useful for weight controlled?

30 Even,TTM SOC was no conclusive evidence for sustainable weight loss. However, TTM SOC and a combination of physical activity, diet and other interventions tended to produce significant outcomes (particularly change in physical activity and dietary intake). The impact of TTM SOC as theoretical framework in weight loss management may depend on how it is used as a framework for intervention and in combination with other strategies like diet and physical activities. Nik Aa Tuah, Cressida Amiel, Samrina Qureshi, Josip Car, Balvinder Kaur, Azeem Majeed.Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese. Cochrane Database Syst Rev October 5; (10): CD doi: / CD pub2

31 บร การ: แตกต าง, เป นม ตร,สะดวก,ไปได ก บว ถ ช ว ต ต ดส นใจเอง ทาเอง เพ อตนเอง

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