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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Cold
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
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Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
Hockey Injuries
Home Gyms
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Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis & Exercise
Osteoarthritis
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Prevention of Sports Injury
Proprioception
Recreational Safety Equipment
Running
Safe Snow Shovelling
Shin Splints
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Shoes & Fit
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Sore Shoulder
Spinal Cord Injuries
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Staying Fit in the Cold
Sports Nutrition & Supplements
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Teen Sports Injuries
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7 Wonders of Walking
Adolescent Health
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Acne
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Chronic Diseases in Teens
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Dangers of Artificial Tanning
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Female Physical Exam
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Your First Job
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Childbirth
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Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
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Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
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In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
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Managing Your Own Labour
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Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Pregnancy Weight
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
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Asthma in Children
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Babysitter
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Children's Headaches
Childhood Obesity
Choosing A Babysitter
Circumcision
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Developmental Milestones
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Daytime Wetting
Introducing Solid Foods
Developmental Co-ordination Disorder
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Feeding Your Baby
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Hearing
How Children Grow
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Heart Murmers
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Iron
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
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Not Just Baby Fat
Orthodontics
Preparing for Lab Tests
Recognizing Learning Disabilities
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
School
Scoliosis
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes & Coughs
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Toddler Safety
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Vaccinations
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When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
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Dental Care Offshore
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Dentures and Healthy Jaw
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Fluoride
Fluoride Findings
First Dental Visit
Headaches
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Mouth Protection Equipment
Oral Cancer Screening
Oral Healthcare
Oral health and long term care
Oral Health Care Products
Orthodontics
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
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10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Traveling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
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ADHD in Children
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Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
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Back Pain Myths
Back Pain - Lower
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Check-Up
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Contact Lenses
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Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
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Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
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Family Doctor
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5 Ways to Stay Healthy
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Get Active!
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Stroke
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Bites and Stings
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First Aid Travel Kit
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Bisphenol A
Canada's New Blood System
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5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
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Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
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Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
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Healthy Eating on Business Travel
Healthy Ethnic Meals
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Fruits & Veggies - 5-10 a Day
Fats
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Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
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New Ingredients for Your Shopping Cart
Iron
Kid's Food
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Mercury Levels in Fish
Night Snacking
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Nutrition Questions Top 5
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Essential Omega-3
Preventing Cancer Through Nutrition
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Power of Fruits & Veggies
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Changing Role of the Pharmacist
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Family Health Magazine - FAMILY MEDICINE

Obesity
Dealing with the diagnosis

If your doctor has recently told you that you are obese, know that you are not alone. In Canada, 59 per cent of adults and 26 per cent of children are overweight and in many of these so overweight that in medical terms they are considered obese.

Tiny Bites = Big Calories

“I never eat between meals.”
“I rarely have dessert.”
“Almost everything I eat is low fat.”

Do you ever hear (or perhaps make) these comments, which are often followed by:

“So why am I still gaining weight?”

To answer that question, we often have to zoom in closer and check those ‘tiny’ bites of food that we might overlook throughout the day. For instance:

Bite 1 A quarter cup of orange juice remains in the carton. You might as well finish it, right? CALORIES: 26

Bite 2Two tablespoons of granola are left in the box. It’s hardly worth returning to the cupboard. You add it to your serving of cereal. CALORIES: 64

Bite 3You add two teaspoons powdered cream substitute in the coffee at work. Someone made really strong coffee today. Adding creamer is the only way you can stand the taste. CALORIES: 20

Bite 4 You take just a small ‘sample’ of the cake in the break room. Well, maybe a second ‘sliver’ would be okay too! CALORIES: 73

Bite 5Oops! You forgot to ask them to leave the mayo off the hamburger at noon. CALORIES: 100

Bite 6You also forgot to ask them to leave off the onion! Better have a mint or two for your breath, just in case. CALORIES: 20

Bite 7 You take a chocolate kiss from the candy jar at the front desk. You have to crank out a big report this afternoon. This is for medical purposes only. CALORIES: 25

Bite 8A second chocolate kiss from the candy jar. You finished the report – what a better way to celebrate? And besides, it’s just a tiny piece of candy. CALORIES: 25

Bite 9There you are with a handful of peanuts. The gang has gotten together for a quick drink after work to celebrate completing the report. You just order mineral water, but surely a couple of teaspoons of nuts can’t have many calories. CALORIES: 105

Bite 10 Cheese on a cracker at a grocery store. After all, it’s a small sample. CALORIES: 55

Bite 11Two tablespoons of macaroni and cheese. You’re trying out a new recipe. You taste as you cook to get the seasonings just right. CALORIES: 54

Bite 12 A fourth cup of macaroni and cheese. Your new recipe tastes great, however, there’s a small amount left over. It hardly seems worth the effort to refrigerate only a fourth cup. You don’t want to toss it so you eat it. CALORIES: 108

The Grand Total ‘Extra’ Calories For the Day: 675
If these extra calories are eaten daily, it might be possible to gain as much as one pound a week! On average, an additional 3,500 calories above your body’s needs can lead to a weight gain of a pound.

Reprinted with permission of Calgary Health Region

Over the years, many of us remember hearing that we could stand to drop a few pounds. In the past, doctors rarely said more. If they did, their advice was seldom useful, along the lines of – “It’s easy, just eat a little less and move a little more!”

Times are changing. Excess weight is now seen as a disease rather than a lifestyle choice or character flaw. No one plans to eat more than necessary or thinks of being overweight as enjoyable. This new approach helps doctors to diagnose and treat weight problems.

Top Canadian researchers have prepared new guidelines for your doctor to use. (Visit www.cmaj.ca for more information.)

If you are concerned about your weight, ask for advice. Your doctor will probably be more comfortable discussing weight issues with you than ever before. If you do not mention it, do not be surprised if the topic comes up.

Your doctor will ask you about your weight history, and whether anyone else in your family shares the same struggles. We know that genetics plays a role in weight. If your parents are overweight, you are at high risk of having the same problem. Since a relationship exists between mood and weight, expect to be asked about depression and unusual eating behaviours.

How can I tell whether my weight is healthy?

A few different methods of assessing weight exist. The most common is the body mass index (BMI), calculated as weight in kg/height in metres squared. You can do this calculation yourself on the Internet. Many different BMI calculators are out there – try the one at ww2.heartandstroke.ca.

A healthy BMI is 18.5 to 24.9. A measurement between 25 and 29.9 is defined as overweight. Anything over 30 registers as that dreaded word, obese.

Many of us find the ‘o’ word harsh and hurtful. If you are told you are overweight or obese, remember that it is simply a definition of a height and weight calculation, not a judgment. Cut your doctor some slack. Many are just learning how to diagnose and manage the most common disease in North America.

Another measure of healthy weight is waist circumference. It should be less than 35 inches (88 cm) in women and less than 40 inches (102 cm) in men. After measuring your waist, the doctor will examine you and measure your blood pressure and heart rate.

Expect to make a trip to your local lab. Common tests include cholesterol, blood glucose (sugar), liver function, and kidney function. Extra weight can increase your risk of developing other problems, like diabetes and fatty liver. Detecting these early can improve your overall health and length of life.

Managing your weight

Now that you know you are overweight, it’s time to find a solution. Weight can be managed in four different ways: through nutrition, activity, medication, and surgery.

Nutrition – It is wise to bring a journal of everything you eat over three days to your doctor’s appointment. Do not be embarrassed. Your doctor will not judge you. This journal gives you and your doctor the chance to look at what you enjoy eating, and at circumstances that make you more likely to eat.

Some foods are not an obvious concern, but are less healthy choices. While the quality of sugary snacks is a no-brainer, some food items may surprise you. Your doctor will likely review Canada’s Food Guide with you. You may also want to consider contacting a registered dietitian. This professional can thoroughly evaluate your diet and help you create a healthy meal plan.

Activity – Exercise does not have to be exciting or expensive. Try to get 30 minutes of activity or more daily. You do not need to sweat! If you are inactive, start with five minutes (or less) a day. For instance, if you have trouble walking, start with chair exercises while watching television. Move any joint in your body until you are tired, then go on to the next joint.

Exercise therapists are great and can often get you started in one visit. Once you are exercising regularly, they can help you to progress.

Medications – If you have a BMI greater than 30, or greater than 27 along with other health problems, medications may be necessary. They only work well if nutrition and activity are in place.

Two main prescription drugs are available in Canada. Meridia™ helps by increasing your metabolism and decreasing your drive to eat. Xenical™ prevents your body from absorbing much of the fat you eat. In spite of people’s stories of ‘Xenical moments’, I find it really works at speeding up weight loss if you are eating well.
Medications are expensive and are not always covered by insurance plans. This is changing as our attitudes about weight change.

Consider other over-the-counter options like caffeine-free green tea and omega 3 oils (1200 mg/day) after consulting with your doctor.

Surgery – Surgery is reserved for those with a BMI greater than 40, or greater than 35 when other diseases are present. Again, this only works well if you have a good diet and are exercising. Surgery is a good option for some, but the surgeon must be experienced with the procedures. Check to be sure there is a good pre and post surgery program.

Our kids and the future

Parents sometimes pass on weight problems. If we are overweight, our kids are also at risk. However, by learning to eat reasonably and becoming more active, we can pass healthier habits on to our kids so they do not share our struggles with weight.

The basics of weight management

Remember, carrying too much weight is a chronic condition. No matter what you weigh, you will always have to be careful. Learn to manage weight for the long term, not just get rid of it in the short term. Be reasonable in your approach but don’t expect perfection. Partner with your doctor and work together. Most importantly, be kind to yourself.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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