Management of TB Patient - Overweight/Obese

The patient is overweight/obese and thus require additional care

Assess

Evaluate the patient for diabetes. Advise an appropriate balanced diet and lifestyle modifications if diabetic

Advise 
Diet

• Adequate and balanced
  Cereals and Pulses
  Milk
  Oils and Nuts
  Fruits and Vegetables
  Eggs, Flesh Foods
   
• Patients should be advised to restrict their intake of calories and fat and increase activity levels as permissible to bring the BMI to below 25kg/m2 eventually
• Frequent feeds initially when appetite is likely to be poor
• Later, when normal appetite returns, advise 3 meals and at least 2 snacks

Supplements

• Costlier foods and nutritional supplements are not necessarily better than locally available foods
• A multivitamin pill is adequate to meet micronutrient requirements if intake is very poor

Healthy lifestyle

• Advice patient to be active as possible. It improves appetite and muscle mass
• Smoking and alcohol are harmful to TB patients and should be avoided

Monitor

Weight Gain

• Weigh every month
• If follow up BMI is > 25kg/m2 advise restriction of calories and increase activity levels
• If patients lose weight after returning from work, and BMI falls below 21 kg/m2, advise extra intake of calories and proteins

Drug Toxicity

• Assess patient for drug toxicity if, after initial improvement, appetite decreases or if there is vomiting