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<SlideText><![CDATA[Welcome to a WiRED Educational Course Click arrow to continue ]]></SlideText>
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<SlideText><![CDATA[Obesity Welcome to a WiRED Educational Course Click arrow to continue ]]></SlideText>
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<SlideText><![CDATA[Introduction to Obesity Obesity is defined as having an excessive amount of body fat. Obesity is more than just  about a person’s appearance. It also increases the risk of diseases and health problems such as diabetes and high blood pressure. Section Overview ]]></SlideText>
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<SlideText><![CDATA[Introduction to Obesity  (continued) Obesity, which means having too much body fat, is different from being overweight, which means weighing too much. One’s excess weight may come from muscle, bone, fat, and/or body water. However, both terms mean that a person's weight is greater than what is considered healthy for his or her height. ]]></SlideText>
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<SlideText><![CDATA[Introduction to Obesity  (continued) Obesity occurs over time when people eat more calories* than they use. The balance between calories taken in and calories used differs for each person. Factors that might tip the balance include genetic makeup, overeating, eating high-fat foods, and not being physically active.  * A calorie is defined as a unit of energy supplied by food regardless of its source, whether it is carbohydrates, fats, sugars, or proteins; all of them contain calories. ]]></SlideText>
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<SlideText><![CDATA[Introduction to Obesity  (continued) Being obese increases the risk of diabetes, heart disease, stroke, arthritis, and some cancers. Losing even 5% to 10% of one’s weight can delay or prevent some of these diseases.   Doctors often use a formula based on height and weight, called the body mass index (BMI), to determine if a person is obese.  We will look at the BMI more closely later in this module.  ]]></SlideText>
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<SlideText><![CDATA[Complications from Obesity Obesity most likely causes a number of potentially serious health problems, including:   Blood lipid (fat) abnormalities. Cancer, including cancer of the  	uterus, cervix, ovaries, breast, colon,  	rectum, and prostate. Depression. Gallbladder disease. Gynecological problems, such  	as infertility and irregular periods. Heart disease. High blood pressure. Metabolic syndrome. Nonalcoholic fatty liver disease. Osteoarthritis.  ]]></SlideText>
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<SlideText><![CDATA[Complications from Obesity  (continued) Obesity most likely causes a number of potentially serious health problems, including:   Skin problems, such as intertrigo (an inflammatory condition of skin folds aggravated by heat, moisture, maceration, friction, and lack of air circulation) and impaired wound healing. Sleep apnea. Stroke. Type 2 diabetes. A lower overall quality of life. People may not be able to get around or perform normal daily activities. They may have trouble participating in family activities, avoid public places, and may even encounter discrimination. Other issues may affect the quality of life, such as: Depression Disability Physical discomfort Sexual problems Shame Social isolation ]]></SlideText>
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<SlideText><![CDATA[Treatment The goal of obesity treatment is to achieve and maintain a healthy weight to reduce the risk of serious health problems and enhance quality of life. A person may need to work with a team of health professionals, including a nutritionist, dietitian, therapist, or obesity specialist, to help him or her understand and make changes in eating and activity habits. Together, they can determine a healthy goal weight and how to achieve it.  ]]></SlideText>
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<SlideText><![CDATA[Treatment (continued) The initial goal may be for the person to lose 5% to 10% of his or her body weight within 6 months. People can start feeling better and seeing improvements in their health with just minor weight loss (5% to 10%). That means that if a person weighs 200 lb (91 kg) and is obese by BMI standards, he or she would need to lose only about 10 to 30 lb (4.5 to 13.6 kg) to start seeing benefits. ]]></SlideText>
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<SlideText><![CDATA[Specific Treatment Methods  There are many ways to treat obesity and reach a healthier weight. The treatment methods that are right for a person depend on the level of obesity, overall health, and his or her willingness to participate in the weight-loss plan. People need to think of their treatment plan as a way to make changes that they can stick with for a lifetime to keep the weight off.   	Treatment methods include:   Dietary changes. Physical activity. Behavior change. Prescription weight-loss medications. Weight-loss surgery. Section Overview ]]></SlideText>
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<Title><![CDATA[Dietary Changes ]]></Title>
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<SlideText><![CDATA[Dietary Changes  Reducing one’s daily calorie intake and eating healthier are vital to overcoming obesity. Slow and steady weight loss of 1 or 2 lb (1/2 to 1 kg) a week is considered the safest way to lose weight and the best way to keep it off permanently. Drastic and unrealistic diet changes, such as crash diets, should be avoided because they are unlikely to help people keep excess weight off for the long term. People can choose from a number of different dietary strategies, all of which can lower one’s calorie intake.  ]]></SlideText>
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<Title><![CDATA[Dietary Changes (continued)]]></Title>
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<SlideText><![CDATA[Dietary Changes (continued) Dietary strategies include:   Reducing calorie intake. The key to weight loss is reducing the number of calories one consumes. Together with their health care providers, people can review their typical eating and drinking habits to see how many calories they normally consume and where they can cut back. They may be eating larger portions than they thought or realize that their diet includes lots of fast food, sweets, or sugary drinks. They can decide how many calories they need to take in each day to achieve weight loss, but a typical amount is 1000 to 1600 calories. ]]></SlideText>
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<Title><![CDATA[Dietary Changes (continued)]]></Title>
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<SlideText><![CDATA[Dietary Changes (continued) Dietary strategies include:   Feeling full while eating less food. The concept of energy density can help people satisfy their hunger with fewer calories. All foods have a certain number of calories within a given amount (volume). Some foods, such as desserts, candies, and processed foods, are high in energy density.  This means that a small volume of that food has a large number of calories. In contrast, other foods, such as fruits and vegetables, have low energy density. These foods provide a larger portion size with a fewer number of calories. By eating larger portions of foods that are less packed with calories, people satisfy hunger pangs, take in fewer calories, and feel better about their diet. ]]></SlideText>
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<Title><![CDATA[Dietary Changes (continued)]]></Title>
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<SlideText><![CDATA[Dietary Changes (continued) Dietary strategies include:   Adopting a healthy eating plan. A healthy eating plan includes:     Eating more plant-based foods such as fruits, vegetables, and whole grains.  Choosing protein that comes from plant sources, such as beans, lentils, and soy.  Choosing lean meats and trying to include seafood twice a week.  Limit salt and added sugar.  Use low-fat dairy products. Fats should come from healthy sources, such as nuts and olive, canola, and nut oils.   When people adopt an overall healthier diet, rather than trying a crash diet, they are more likely to follow it for the long term. ]]></SlideText>
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<Title><![CDATA[Physical Activity ]]></Title>
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<SlideText><![CDATA[Physical Activity  A general rule is that for people to maintain a healthy weight, their energy in (food) should equal their energy out (exercise).  To lose weight, you can:   Decrease energy in, increase energy out, or both. ]]></SlideText>
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<Title><![CDATA[Physical Activity (continued)]]></Title>
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<SlideText><![CDATA[Physical Activity (continued) Caution: Before beginning any exercise program, people are advised to see their healthcare provider.  Especially for people who are overweight and haven’t had much exercise, a doctor’s clearance is advised. Too much exercise, too quickly can be dangerous. ]]></SlideText>
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<Title><![CDATA[Physical Activity  (continued)]]></Title>
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<SlideText><![CDATA[Physical Activity  (continued) Obesity occurs over time when people eat more calories than they use. The balance between calories taken in and calories used differs for each person. Factors that might tip the balance include genetic makeup, overeating, eating high-fat foods, and not being physically active. ]]></SlideText>
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<Title><![CDATA[Physical Activity  (continued)]]></Title>
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<SlideText><![CDATA[Physical Activity  (continued) Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, such as walking. The goal of activity and exercise for weight loss is to burn more calories, and it offers many other health benefits as well. The number of calories burned depends on how often, how long and how rigorous your activity is. One of the best ways to lose body fat is through regular aerobic (gets the heart going) exercise, such as walking, cycling, and stair climbing or swimming. At least 150 minutes a week of moderate-intensity physical activity is necessary to prevent further weight gain or to lose a modest amount of weight.  ]]></SlideText>
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<Title><![CDATA[Physical Activity  (continued)]]></Title>
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<SlideText><![CDATA[Physical Activity  (continued) Exercise     People are advised to gradually increase their level of exercise as their endurance and fitness improve. To make exercise goals more manageable, it is advised that exercise be broken up into several sessions throughout the day—for example, for just five or six minutes at a time. People should not set their goals unrealistically high or they may give up.  Even though regular aerobic exercise is the most efficient way to burn calories and shed excess weight, any extra movement helps burn calories. Making simple changes throughout the day can add up to big benefits.  ]]></SlideText>
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<Title><![CDATA[Behavior Changes]]></Title>
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<SlideText><![CDATA[Behavior Changes To lose weight and keep it off, people need to change their behavior and their attitudes toward food and exercise. They should examine their habits to look for things in their lives that contribute to obesity.  They should explore their eating and exercise habits to start changing behaviors.  For instance, some people may eat when they’re stressed, some may eat when they’re nervous or frightened.  Knowing this can begin a process of change. Once people understand which habits undermine their weight-loss efforts, they can take steps to create a new, healthier lifestyle.    ]]></SlideText>
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<Title><![CDATA[Behavior Changes (continued)]]></Title>
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<SlideText><![CDATA[Behavior Changes (continued) Mental health professionals can help address emotional and behavioral issues related to eating. They can help people understand why they overeat and learn healthy ways to cope with anxiety. People can learn how to monitor their diet and activity, understand eating triggers, and cope with food cravings.  ]]></SlideText>
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<Title><![CDATA[Prescription Weight-Loss Medication ]]></Title>
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<SlideText><![CDATA[Prescription Weight-Loss Medication  Weight-loss medications may not work for everyone, and when they do work, their effects tend to level off after 6 months of use. Some people may need to take weight-loss medication for the rest of their lives; otherwise, they are likely to regain much or all of the weight they lost. Persons taking these medications need to be monitored closely by health care providers.  ]]></SlideText>
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<Title><![CDATA[Prescription Weight-Loss Medication  (continued)]]></Title>
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<SlideText><![CDATA[Prescription Weight-Loss Medication   (continued) Weight-loss medications may not work for everyone, and when they do work, their effects tend to level off after 6 months of use. Some people may need to take weight-loss medication for the rest of their lives; otherwise, they are likely to regain much or all of the weight they lost. Persons taking these medications need to be monitored closely by health care providers.  ]]></SlideText>
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<Title><![CDATA[Prescription Weight-Loss Medication  (continued)]]></Title>
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<SlideText><![CDATA[Prescription Weight-Loss Medication   (continued) Weight-loss medication is recommended if:   Other methods of weight loss have not worked.  The body mass index is greater than 27 with medical complications of obesity, such as diabetes, high blood pressure, or sleep apnea. ]]></SlideText>
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<Title><![CDATA[Obesity Quiz 4]]></Title>
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<Title><![CDATA[Weight-Loss Surgery ]]></Title>
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<SlideText><![CDATA[Weight-Loss Surgery  In some cases, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery offers the best chance of losing the most weight, but it can pose serious risks. Weight-loss surgery limits the amount of food eaten, inhibits the absorption of food and calories, or both. ]]></SlideText>
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<Title><![CDATA[Weight-Loss Surgery (continued)]]></Title>
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<SlideText><![CDATA[Weight-Loss Surgery (continued) Weight-loss surgery for obesity may be considered in the following circumstances:   A person is extremely obese, with a body mass index (BMI) of 40 or higher. A person’s BMI is 35 to 39.9 and he or she has a serious weight-related health problem, such as diabetes or high  blood pressure. A person is committed to making  	the lifestyle changes that are necessary  	for surgery to work. Weight-loss surgery often can help people lose as much as 50% of their excess body weight. However, it is not a miracle obesity cure; it does not guarantee the loss of all of the excess weight or that it will be kept off long term. ]]></SlideText>
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<Title><![CDATA[Weight-Loss Surgery (continued)]]></Title>
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<SlideText><![CDATA[Weight-Loss Surgery (continued) Numerous types of weight-loss surgery are performed.   Some types are restrictive, causing weight loss by restricting how much the stomach can hold.   Others types are malabsorptive, because they prevent the body from absorbing calories and nutrients.   Others are a combination of these two types. ]]></SlideText>
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<Title><![CDATA[Types of Weight-Loss Surgery]]></Title>
<SlideText><![CDATA[Types of Weight-Loss Surgery]]></SlideText>
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<Title><![CDATA[Prevention of Regaining Weight after Obesity Treatment ]]></Title>
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<SlideText><![CDATA[Prevention of Regaining Weight  after Obesity Treatment  Unfortunately, it is common to regain weight no matter what obesity treatment methods are used. The best way to prevent regaining the weight that has been lost is to follow the same steps that were taken to lose weight:    Exercise regularly.  Eat healthy meals and snacks. Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables, and whole grains. Avoid saturated fat and limit sweets and alcohol. Remember that no one food offers all the nutrients one needs. Choose a variety of foods throughout the day. Identify situations that trigger out-of-control eating by keeping a journal and writing down the type of food eaten, the amount consumed, and the time it was eaten. ]]></SlideText>
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<Title><![CDATA[Prevention of Regaining Weight after Obesity Treatment (continued)]]></Title>
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<SlideText><![CDATA[Prevention of Regaining Weight  after Obesity Treatment (continued) The following strategies help people avoid regaining weight after obesity treatment:   People who weigh themselves at least once a week are more successful in keeping off excess pounds. Monitoring their weight tells them whether their efforts are working and can help them detect small weight gains before they become big problems. Sticking to a healthy-weight plan during the week, on weekends, and while on vacation and during holidays as much as possible increases the chances of long-term success. ]]></SlideText>
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<SlideText><![CDATA[Strategies to Use at Home  for Overcoming Obesity Efforts to overcome obesity are more likely to be successful when these strategies are followed at home in addition to the formal treatment plan:    Changing a long-standing lifestyle can be difficult. However, together with health providers, people can develop new ideas or new approaches if they find their physical activity or eating goals slipping.  People who take weight-loss medications or medications to treat obesity-related conditions, such as high blood pressure or diabetes, should take them exactly as prescribed and talk to their doctor if they have a problem sticking with the medication regimen or have unpleasant adverse effects. ]]></SlideText>
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<SlideText><![CDATA[Strategies to Use at Home  for Overcoming Obesity (continued) Efforts to overcome obesity are more likely to be successful when these strategies are followed at home in addition to the formal treatment plan: Becoming educated about obesity can help people learn more about why they became obese and what they can do about it. With education, they may feel more empowered to take control and stick to their treatment plan.    The support of family and friends should be enlisted by making sure they understand how important weight loss is to health. ]]></SlideText>
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<SlideText><![CDATA[Strategies to Use at Home  for Overcoming Obesity (continued) People should set realistic goals to lose a significant amount of weight. For example, daily or weekly goals should be set for exercise and weight loss, and small dietary changes should be made rather than attempting drastic changes that cannot be maintained for long periods.           People should practice saying no to eating unhealthy foods and big portions and eat only when they are actually hungry. ]]></SlideText>
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<Title><![CDATA[Calculating Body Fat]]></Title>
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<SlideText><![CDATA[Calculating Body Fat In a moment, we will look more closely at the Body Mass Index  (BMI).  It is important to remember that although BMI is an indicator of the amount of body fat a person has, BMI does not directly measure body fat. As a result, some people, such as athletes, may have a BMI that identifies them as overweight even though they do not have excess body fat.  Here are some methods of estimating body fat and body fat distribution:  Measurements of skin fold thickness. Waist circumference.  Calculation of waist-to-hip circumference ratios. Techniques such as ultrasound, computed tomography, and magnetic resonance imaging. ]]></SlideText>
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<SlideText><![CDATA[Body Mass Index  In addition those methods of measuring body fat, the method most easily used is the Body Mass Index (BMI). The BMI is a measure of body fat based on height and weight. In a minute, we will provide you with a calculator so you can determine your own BMI. For adults 20 years old and older, BMI is interpreted using standard categories that are the same for all ages and for both men and women. The standard weight status categories associated with BMI ranges for adults are shown in the following table. BMI Weight Status    Below 18.5 Underweight    18.5 – 24.9 Normal    25.0 – 29.9 Overweight    30.0 and above Obese    ]]></SlideText>
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<SlideText><![CDATA[Body Mass Index  (continued) For example, here are the weight ranges, the corresponding BMI ranges, and the weight status categories for a sample height of 5 feet and 9 inches (1.8 m). Height Weight Range BMI Weight Status  5' 9" (1.8 m) 124 lb (56.2 kg) or less Below 18.5 Underweight  5' 9" (1.8 m) 125 to 168 lb (56.7 to 76.2 kg) 18.5 to 24.9 Normal  5' 9" (1.8 m) 169 to 202 lb (76.7 to 91.6 kg) 25.0 to 29.9 Overweight  5' 9" (1.8 m) 203 lb (92.1 kg) or more 30 or higher Obese  ]]></SlideText>
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<SlideText><![CDATA[BMI Measurement Note:  It is not appropriate to use the adult BMI categories for children and teens. For young people, we must also add information about age and gender. So, we calculate BMI’s differently for adults than we do for children and teens. ]]></SlideText>
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<SlideText><![CDATA[BMI Measurement (continued) Items to consider when calculating BMI for: Adults Height Weight Children Height Weight Age Gender ]]></SlideText>
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<SlideText><![CDATA[Calculating BMI for Adults Before calculating BMI, obtain accurate height and weight measurements. Click the following link to calculate your BMI: BMI Calculator ]]></SlideText>
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<Title><![CDATA[Section Overview]]></Title>
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<SlideText><![CDATA[In Conclusion This concludes our discussion of obesity. The remaining slides contain:   A technical note about calculating BMI. Additional resources for additional information and low-calorie recipes. References for this module. Final quiz. Obesity ]]></SlideText>
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<SlideText><![CDATA[Technical Note Technical point for students: The body mass index is defined as the individual's body weight divided by the square of his or her height (US measurement requires a conversion factor of 703). BMI = mass (kg) [height (m)] 2 BMI = mass (lb) [height (in)]  x 703 2 So, for the same height:  Heavier people have higher BMI. Lighter people have lower BMI. BMI = 22 BMI = 27 ]]></SlideText>
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<SlideText><![CDATA[Additional Resources Healthy Weight Facts Portion Size Obesity Recipe Book 2 Recipe Book 4 Recipe Book 1 Recipe Book 3 Recipe Book 5 Recipe Book 6 CDC Recipe Books for Healthy Living ]]></SlideText>
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<SlideText><![CDATA[References Obesity http://www.cdc.gov/healthyweight/assessing/bmi/index.html http://www.nhlbi.nih.gov/health/pubs/pub_gen.htm#obesity http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/index.htm http://www.nhlbi.nih.gov/health/public/heart/obesity/PortionSize_ZCard_taggd.pdf http://www.nhlbi.nih.gov/health/prof/heart/obesity/aim_kit/healthy_wt_facts.pdf  ]]></SlideText>
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<SlideText><![CDATA[Final Quiz Obesity The following final quiz will cover the entire training module. Upon completion, you will receive a score. You may review your answers, retry the quiz, or finish the quiz. If you do not receive a passing score, you will be provided with the option of replaying the training module from the beginning. ]]></SlideText>
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<SlideText><![CDATA[Due to your score on the Final Quiz, we encourage you to complete the module again.  If you would like to do so, click the “Restart Module” button. If you would instead like to end this module without successfully completing it, please click the “Finish Module” button. Decision Slide Finish Module Restart Module ]]></SlideText>
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<Title><![CDATA[Disclaimer/Contact Info]]></Title>
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<SlideText><![CDATA[WiRED International   Disclaimer Obesity Contact Information WiRED International P.O. Box 371132 Montara, CA 94037 USA Email:  CHIprogram@wiredinternational.org Web:  www.wiredinternational.org Some WiRED Community Health Information modules may provide links to material prepared by other institutions. These are offered as a convenience. WiRED is not responsible for the content of this material, nor does WiRED endorse, warrant or guarantee the products, services or information described or offered.  It is not WiRED’s intention to provide specific medical advice to users of its modules. Instead we provide information to help users better understand health issues and the current approaches related to treatment, prevention, screening, and supportive care. WiRED urges users to consult with a qualified health care professional for diagnosis and answers to their personal medical questions. WiRED does not charge NGOs, community groups and other not-for-profit organizations for the use of this Community Health Information database. However, any individual or group wishing to use this material must receive written permission from WiRED before the material can be copied or displayed. Moreover, no individual or group using this material may charge for access. The material from the WiRED modules may not be revised, extracted or used outside the context of the modules as they appear in the original database. Use of this Information © 2011 WiRED International. All rights reserved. ]]></SlideText>
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<SlideText><![CDATA[Thank you for participating in a WiRED Educational Course ]]></SlideText>
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