Weight Management and Nutrition Therapy
Underweight
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Malabsorption conditions
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Eating disorders
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Cognitive impairments
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Physical disabilities
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Cancer
Underweight
Low body weight (underweight) or low body mass index (BMI) less than 18.5 can result from a number of causes including malabsorbtion conditions, eating disorders, cognitive impairments, physical disabilities and cance.
Malabsorption conditions can arise from medical conditions such as celiacs disease, crohn's or ulcerative colitis, food allergies or intolerances, parasite, bacterial or viral infections or surgical procedures including gastric banding, sleeve or bypass and removal of or part of the stomach or intestines.
Eating disorders, including extreme diets and excessive exercise can lead to unhealthy weightloss or low body weight with the most common eating disorders include anorexia nervosa (self-starvation), bulimia nervosa (bingeing and purgining) and avoidant/restrictive food intake disorder (ARFID).
Cognitive impairments and weightloss can occur over a long period of time and be subtle or a short period of time and be more obvious something is wrong. The most common cognative conditions that can lead to weightloss include intellectual disabilities, acquired brain injury, Mild Cognitive Impairment, Dementia and Alzheimer's Disease, Parkinson's Disease, Amyotrophic Lateral Sclerosis, Multiple Sclerosis. Other common mental health conditions can also lead to weightloss and low body weight including depression, anxiety and obsessive compulsive idsorder.
Physical disabilities can lead to weightloss and low body weight if the ability to access, prepare and consume (chew/swallow) food is impacted by the persons disability and physical inactivity can lead to muscle wasting. Common physical disabilities or causes include stroke, acquired brain injury, cerebral palsy and spinal cord injury, musculoskeletal deformities, spina bifida, muscular dystrophy and amputations, periodontal disease and full dental extraction.
Cancer and cancer-related treatments can lead to weightloss and low body weight. Cancer cells require high energy to rapidly divide and grow and cancer treatments such as chemotherapy, radiation therapy and surgery can have side effects including decreased appetite, nausea and vomiting, and difficulty in eating.
Overweight
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Sedentary lifestyle
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Poor quality nutrition intake
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Metabolic Syndrome
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Medically induced weight gain
Overweight
A sedentary lifestyle (physical inactivity) along with poor quality nutrition intake can lead to excessive weight gain due to increase in calorie and fat intake, a reduction in calories being "burned off", decrease in metabolism and a decreased ability to breakdown sugar and fats.
Metabolic Syndrome can be caused by a sedentary lifestyle and poor quality nutrition intake and can be caused by or lead to obesity and morbid obesity, insulin resistence and type 2 diabetes mellitus, high blood pressure, high cholesterol and heart disease.
Medically induced weight gain is often related to a medical condition or medication that increases appetite, slows down metabolism, changes nutrition absorbtion or increases fluid retention. Common medical conditions that cause weight gain include heart or kidney failure, hypothyroidism, cushing syndrome, PCOS and menopause. Common medications that cause weight gain include some antidepressants and atipsychotics, corticosteroids and hormones, beta-blockers, anti-epileptics, and some diabetic medications
Nutrition Deficiencies
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Malabsorption disorders
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Dietary preferences
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Genetic conditions
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Medications
Nutrition Deficiencies
Malabsorption disorders that can lead to nutrition deficiencies including lactose intolerance, celiac and crohn's disease, short bowel syndrome, stomach, pancreatic, liver and gallbladder diseases, gastrointestinal infections and intestinal surgeries or radiation therapy and certain medications (laxatives or antibiotcs).
Dietary preferences that exclude complete food categories can lead to nutrition deficiencies including vegan and vegitarian diet (iron, B12 and vitamin D), low or no fat diet (vitamin A, D, E andf K), keto diet (B vitamins, vitamin C, D, E, iron and folate) and carnivore diet (vitamin C, E, K and folate).
Genetic conditions that can lead to nutrition deficiencies including MTHFR gene variations (folate), ABCD4 gene defects, FUT2 gene, Imerslund-Grasbeck syndrome and congenital pernicious anaemia (B12) and Vitamin D-dependent rickets (vitamin D)
Medications that can lead to nutrition deficiencies including thiazide diuretics (B1), statins (vitamin D and E), proton pump inhibitors (vitamin B12 and C), SSRI antidepressants (vitamin D), anticonvulsants (vitamin B6, D, K, biotin and folate), oral controceptives (vitamin B6, 12, C, E and folate), metformin (B12), antibiotics (vitamin B, K and folate), corticosteroids (vitamin D) and many more.
Most nutrition deficiencies can be treated with dietary intake or nutrition therapy (supplementation oral and other routes) and can be monitored to prevent poor health outcomes from chronic deficiencies.
Nutrition Therapy
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Nutrition deficiency screening
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Nutrition planning
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Supplements
Nutrition Therapy
Nutrition deficiency screening can be performed to check for a variety of different nutrition deficiencies and/or disorders leading to nutrition deficiencies which often involved a blood or other specimen sample to be collected and sent off for laboratory testing.
Nutrition planning involves creating a nutrition therapy treatment plan to correct the diagnosed nutrition deficiencies or to prevent current or future/ongoing nutrition deficiencies caused by a disorder known to lead to nutrition deficiencies.
Supplements should not be a first line therapy, people should attempt to consume a balanced diet with adequate nutritional values, however this may not be tolerated or sufficient in maintaining nutritional status and supplementation may be required.
Nutrition therapy come in a variety of forms and available from supermarkets, pharmacies or prescription only. Patients should always consult with a health care professional before taking any complementary therapies to ensure thay are safe, suitable, necessaey and effective without causing side effects or other health complications.
Barriatric Interventions
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Lifestyle modification
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Medications
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Intragastric balloon
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Lap Banding
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Sleeve gastrectomy
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Gastric bypass
Barriatric Interventions
Lifestyle modification involves improving nutrition intake, increasing physical activity and implementing behavioural strategies that are achievable and maintainable. Dietary changes may include meal planning to managing food and calorie intake, portion size and frequency of meals. Physical activity changes may include setting schedules to get up, stretch and move every hour to prevent prolonged sitting, perform regular walking and monitor daily steps and attend a gym or fitness group. Behavious changes may include implementing tech niques to reduce or manage stress, improve sleep, modify your environment to assist with making and maintaining healthier choices, monitor progress and seek support when needed.
Medications are not a first line therapy and should be used in conjunction with lifestyle modification, all medications have side effects and can be quite expensive if used for prolonged periods of time.
Reversable interventions to reduce stomach size and nutrition intake include Intragastric Balloons and Lap Banding, both can be removed after the desired weightloss has been achieved or are no longer effective/desired. These procedures require specialist referral and assessment to ensure you are suitable for the procedure and are not guarenteed to be successful. All medical interventions and surgical procedure involve risks and should be first or second line options.
Irreversable surgical interventions include sleeve gastrectomy (surgical removal of large portions of the stomach) or gastric bypass (creating a small stomach pouch and rerouting food to the small intestines). Both procedure have life long effects on digestion and absorbtion and are high risk for nutrition deficiencies and other health complications. These procedures require specialist referral and assessment to ensure you are suitable for the procedure and are not guarenteed to be successful. These procedures should be a last resort and require psychological evaluation due to their "extremeness" and preparation for the life long changes required after surgery.