FAB approach

  • changes to food/diet

  • increased physical activity

  • behavioural strategies

  • only effective approach is a permanent change to how people live their lives

  • benefits accrue when 5-10% of initial body weight is lost

Diet

  • all similarily effective

    • low energy

    • low glycaemic load

    • modified macoutrient approaches

  • consider sustainability

    • don’t use fad diets

  • very low energy diets require close supervision

Physical activity

  • for weight loss

    • aim ≥ 60min/day

  • reduce screen time

Behavioural strategies

  • include partner/family

  • identify changes the person wishes to work on first

Pharmaceuticals

  • consider drugs when BMI=> 30

  • orlistat (xenical)

    • inhibitor of gastrointestinal lipase

      • unable to hydrolyse dietary fat

    • low fat diet

    • lifestyle changes a mustorlistat

Surgery

  • consider referral for bariatric surgery when BMI ≥ 40 or ≥35 with significant comorbidities

Ongoing supports/contact

  • encourage weigh regularly

  • encourage person to maintain healthy diet

  • restart weight management programme immediately

    • if regain increase 1.5-2kg over goal weight

  • consider anti-obesity