OMA Guidelines Bundle

Nutrition - Obesity Algorithm 2024

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Intermittent Fasting and Time-Restricted Eating As effective as continuous caloric restriction for overall caloric restriction. Time-Restricted Eating (TRE) involves limiting meals to set eating windows within a 24 hour period. For example, a 16:8 TRE pattern would involve an 8-hour eating window and 16 hour fasting window. Potential Advantages Potential Disadvantages • Reducing "decision fatigue" regarding food selection • Quickly reversible • May better f it in day-to-day patient scheduling (including Ramadan) • May reduce caloric intake with variable effects on lean body mass, resting metabolic rate, and total energy expenditure, often dependent upon physical activity • May reduce body weight and improve metabolic parameters (e.g. improve insulin sensitivity, blood pressure, lipids, and inflammatory markers) • Does not necessarily emphasize healthful meal quality • May not be appropriate for patients with eating disorders (e.g., bulimia or binge-eating disorder) • Increases the risk of hypoglycemia among patients with diabetes mellitus who do not appropriately adjust their hypoglycemic anti- diabetes drug treatments (e.g., insulin, sulfonylurea) • Unclear if sustainable on a lifetime basis for a lifelong disease (i.e., obesity) • Most long-term evidence of eff icacy, health benef its and safety are derived f rom animal studies • Prolonged fasting (not intermittent fasting) may promote gout, urate nephrolithiasis, postural hypotension, and cardiac dysrhythmias

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