by . jenny hope . published : . 09:47 est , 16 october 2013 . michelle obama 's loyal chief of staff , who 's been with her since she moved in to the white house , left the first family behind this month . kristen jarvis , 34 , is moving on from washington after seven years of acting as the first lady 's go-to gal and constant companion for nearly all her daily tasks . | . updated : . all except some of the famously fit first lady 's more intensive workout regimes . moving on : kristen jarvis -lrb- at right with sasha and malia in 2009 -rrb- has left the obamas after seven years as michelle 's fiercely loyal chief of staff . jarvis , who 's moving on to become the ford foundation president darren walker 's chief of staff , admits she did not share michelle 's love of d.c. workout craze solidcore . ` she can have that , ' the spelman college graduate told the washington post . and it 's hard to blame her . solidcore 's website says it utilizes ` slow and controlled full-body movements with constant tension to work your muscle fibers to failure ... to rebuild a more sculpted , stronger and -lsb- solid -rsb- you . ' jarvis , instead , got her workouts by helping carry the first lady through her last seven years in the white house . she was with the obamas even before that , however . jarvis entered the family 's orbit in 2005 when she joined obama 's senate office . she went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . 05:17 est , 17 october 2013 . doctors should not blame patients for being fat , according to new nhs guidance . it urges gps to be more sensitive when dealing with obese patients , using a ` respectful ' and non-judgmental tone . the approach is designed to minimise harm , according to the national institute for health and care excellence . the national institute for health and care excellence is urging gps to be more sensitive when dealing with obese patients , using a respectful and non-judgmental tone . with . britain in the grip of an obesity epidemic costing the nhs # 5billion a . her relationship with the family , insiders say , was deeply familial . ` she can have that ' : jarvis says she mostly kept up with fitness-loving michelle , but drew the line at d.c. workout craze solidcore . jarvis 's last trip on air force one with the family she 's come to know and love was especially emotional and not just because she 'd soon be leaving the presidential world behind . the trip was to selma , alabama where the first black family in the white house was traveling to the civil rights anniversary commemorations . ` it was so powerful . it felt like -lsb- both -rsb- the message of 2008 and how far we 've come as a people , ' she told wapo . perhaps just as personally meaningful was how that final trip ended back in washington , where mrs. obama invited jarvis to exit at the front of the plane with the family . year , nice calls on doctors , gps and other health workers , as well as . those who run lifestyle weight-loss programmes , to monitor their tone . ` as we walked down the steps , flotus was holding my hand , ' jarvis said , as if the first lady was happily leading her into her new life . jarvis said that michelle was an active part of her transition out of washington . ` she has been a mentor throughout this entire process , ' jarvis said . and not add to the stigma of being fat . only . people with a body mass index -lrb- bmi -rrb- under 35 -- the marker at which . people are considered morbidly obese -- should have their waist measured . surgeries , meanwhile , should be adapted to provide out-size equipment . for larger patients . last . ten years of service : jarvis , 34 , first joined the obamas ' orbit in 2005 when she took a job in then senator obama 's office . year it emerged that several nhs trusts are refusing to give certain . treatments to fat patients unless they lose weight . patients have been denied procedures such as hip and knee replacements and ivf , unless they agree to make radical changes to their lifestyle . patients have been . denied procedures such as hip and knee replacements and ivf , unless they . agree to make radical changes to their lifestyle . the nice guidance also provides instructions for public health england , which is responsible for health campaigns . it . says it should ` be aware of the effort needed to lose weight and avoid . further weight gain and the stigma adults who are overweight or obese . may feel or experience ' . it . the maryland native lost both parents and a brother before she was 30 and , jarvis 's deputy melissa winter told wapo , ` the first lady was able to fill unintentionally some areas of kristen 's life that she was missing growing up . ' jarvis , who the washington post says came to embody ` the kind of deep , personal commitment the obamas value ' , played her hand close even after her exit , telling a wapo reporter recently that , with michelle , ` honestly for her , what you see is what you get ... she just really instills the confidence in you . ' that confidence and loyalty has now won her a job near the top of a $ 10 billion corporate foundation . the ford foundation , created in 1936 by auto moguls henry and edsel ford , funds charities and individuals worldwide that encourage and ` promote among the nonprofit , government and business sectors ; and to ensure participation by men and women from diverse communities and all levels of society . ' loyal : jarvis , a spelman college grad , went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . adds : ` ensure the tone and content of all communications or dialogue is . respectful and non-blaming . the terminology used to describe the . person 's condition should respect individual preferences . ' gps . and those running weight management programmes for the nhs should . ensure patients have a realistic view of what to expect when losing . weight , telling them there is no ` magic bullet ' . instead , . obese patients should be advised of the importance of making gradual , . long-term changes to their eating habits and physical activity and how . much weight they might realistically expect to lose . the . latest draft guidance is being issued for consultation and will be . finalised next may . tam fry , of the national obesity forum , said . patients were often in denial and gps should be sensitive -- to start off . with . he said : ` one . of the big problems we have is that primary care -- gps in particular -- . have no real training about how to raise weight issues with patients . ` the abrupt style that many have taken so far have only made matters worse . ` nice . is correct to say they should be moderate in their tone . but once . they 've got the tone right and the confidence of the patient , they . should really think about tough love . ` it 's essential that patients . realise that the consequences of putting on weight are very serious . ' professor . mike kelly , director of the centre for public health at nice , said : . ` being overweight or obese can have serious consequences for an . individual 's health , not only physically with increased risk of high . blood pressure and type 2 diabetes , but it can also affect their mental . health as a result of stigma and bullying or discrimination . tough love : gps and those running weight management programmes for the nhs should ensure patients have a realistic view of what to expect when losing weight . ` levels . of obesity in england are rising , with a little over a quarter of . adults classified as obese and a further 41 per cent of men and 33 per . cent of women overweight . this is a huge proportion of our population . ` this . new draft guidance focuses on the provision of effective lifestyle . weight management services and makes a number of recommendations to . ensure that the providers of programmes , whether from the private , . public , or voluntary sector , follow good , evidence-based practice . ' a . british heart foundation spokesman added : ` taking control of your . weight can be a daunting task because changing the habits of a lifetime . is often a challenge . that 's why it 's a good idea to get support . throughout your weight-loss journey . '
kristen jarvis , 34 , is moving on to become chief of staff to the ford foundation president darren walker in new york . the spelman college graduate decided to move on as the focus in washington has shifted from the obamas to the 2016 campaign . jarvis first joined the obamas ' orbit in 2005 when she took a job in then senator obama 's office .
lose weight . patients have been denied procedures such as hip and knee replacements and ivf , unless they agree to make radical changes to their lifestyle . patients have been . denied procedures such as hip and knee replacements and ivf , unless they . agree to make radical changes to their lifestyle . the nice guidance also provides instructions for public health england , which is responsible for health campaigns . it . says it should ` be aware of the effort needed to lose weight and avoid . further weight gain and the stigma adults who are overweight or obese . may feel or experience ' . it . the maryland native lost both parents and a brother before she was 30 and , jarvis 's deputy melissa winter told wapo , ` the first lady was able to fill unintentionally some areas of kristen 's life that she was missing growing up . ' jarvis , who the washington post says came to embody ` the kind of deep , personal commitment the obamas value ' , played her hand close even after her exit , telling a wapo reporter recently that , with michelle , ` honestly for her , what you see is what you get ... she just really instills the confidence in you . ' that confidence and loyalty has now won her a job near the top of a $ 10 billion corporate foundation . the ford foundation , created in 1936 by auto moguls henry and edsel ford , funds charities and individuals worldwide that encourage and ` promote among the nonprofit , government and business sectors ; and to ensure participation by men and women from diverse communities and all levels of society . ' loyal : jarvis , a spelman college grad , went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . adds : ` ensure the tone and content of all communications or dialogue is . respectful and non-blaming . the terminology used to describe the . person 's condition should respect individual preferences . ' gps . and those running weight management programmes for the nhs should . ensure patients have a realistic view of what to expect when losing . weight , telling them there is no ` magic bullet ' . instead , . obese patients should be advised of the importance of making gradual , . long-term changes to their eating habits and physical activity and how . much weight they might realistically expect to lose . the . latest draft guidance is being issued for consultation and will be . finalised next may . tam fry , of the national obesity forum , said . patients were often in denial and gps should be sensitive -- to start off . with . he said : ` one . of the big problems we have is that primary care -- gps in particular -- . have no real training about how to raise weight issues with patients . ` the abrupt style that many have taken so far have only made matters worse . ` nice . is correct to say they should be moderate in their tone . but once . they 've got the tone right and the confidence of the patient , they . should really think about tough love . ` it 's essential that patients . realise that the consequences of putting on weight are very serious . ' professor . mike kelly , director of the centre for public health at nice , said : . ` being overweight or obese can have serious consequences for an . individual 's health , not only physically with increased risk of high . blood pressure and type 2 diabetes , but it can also affect their mental . health as a result of stigma and bullying or discrimination . tough love : gps and those running weight management programmes for the nhs should ensure patients have a realistic view of what to expect when losing weight . ` levels . of obesity in england are rising , with a little over a quarter of . adults classified as obese and a further 41 per cent of men and 33 per . cent of women overweight . this is a huge proportion of our population . ` this . new draft guidance focuses on the provision of effective lifestyle . weight management services and makes a number of recommendations to . ensure that the providers of programmes , whether from the private , . public , or voluntary sector , follow good , evidence-based practice . ' a . british heart foundation spokesman added : ` taking control of your . weight can be a daunting task because changing the habits of a lifetime . is often a challenge . that 's why it 's a good idea to get support . throughout your weight-loss journey . '
jarvis , who 's moving on to become the ford foundation president darren walker 's chief of staff , admits she did not share michelle 's love of d.c. workout craze solidcore . ` she can have that , ' the spelman college graduate told the washington post . and it 's hard to blame her . solidcore 's website says it utilizes ` slow and controlled full-body movements with constant tension to work your muscle fibers to failure ... to rebuild a more sculpted , stronger and -lsb- solid -rsb- you . ' jarvis , instead , got her workouts by helping carry the first lady through her last seven years in the white house . she was with the obamas even before that , however . jarvis entered the family 's orbit in 2005 when she joined obama 's senate office . she went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . 05:17 est , 17 october 2013 . doctors should not blame patients for being fat , according to new nhs guidance . it urges gps to be more sensitive when dealing with obese patients , using a ` respectful ' and non-judgmental tone . the approach is designed to minimise harm , according to the national institute for health and care excellence . the national institute for health and care excellence is urging gps to be more sensitive when dealing with obese patients , using a respectful and non-judgmental tone . with . britain in the grip of an obesity epidemic costing the nhs # 5billion a . her relationship with the family , insiders say , was deeply familial . ` she can have that ' : jarvis says she mostly kept up with fitness-loving michelle , but drew the line at d.c. workout craze solidcore . jarvis 's last trip on air force one with the family she 's come to know and love was especially emotional and not just because she 'd soon be leaving the presidential world behind . the trip was to selma , alabama where the first black family in the white house was traveling to the civil rights anniversary commemorations . ` it was so powerful . it felt like -lsb- both -rsb- the message of 2008 and how far we 've come as a people , ' she told wapo . perhaps just as personally meaningful was how that final trip ended back in washington , where mrs. obama invited jarvis to exit at the front of the plane with the family . year , nice calls on doctors , gps and other health workers , as well as . those who run lifestyle weight-loss programmes , to monitor their tone . ` as we walked down the steps , flotus was holding my hand , ' jarvis said , as if the first lady was happily leading her into her new life . jarvis said that michelle was an active part of edsel ford , funds charities and individuals worldwide that encourage and ` promote among the nonprofit , government and business sectors ; and to ensure participation by men and women from diverse communities and all levels of society . ' loyal : jarvis , a spelman college grad , went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . adds : ` ensure the tone and content of all communications or dialogue is . respectful and non-blaming . the terminology used to describe the . person 's condition should respect individual preferences . ' gps . and those running weight management programmes for the nhs should . ensure patients have a realistic view of what to expect when losing . weight , telling them there is no ` magic bullet ' . instead , . obese patients should be advised of the importance of making gradual , . long-term changes to their eating habits and physical activity and how . much weight they might realistically expect to lose . the . latest draft guidance is being issued for consultation and will be . finalised next may . tam fry , of the national obesity forum , said . patients were often in denial and gps should be sensitive -- to start off . with . he said : ` one . of the big problems we have is that primary care -- gps in particular -- . have no real . blood pressure and type 2 diabetes , but it can also affect their mental . health as a result of stigma and bullying or discrimination . tough love : gps and those running weight management programmes for the nhs should ensure patients have a realistic view of what to expect when losing weight . ` levels . of obesity in england are rising , with a little over a quarter of . adults classified as obese and a further 41 per cent of men and 33 per . cent of women overweight . this is a huge proportion of our population . ` this . new draft guidance focuses on the provision of effective lifestyle . weight management services and makes a number of recommendations to . ensure that the providers of programmes , whether from the private , . public , or voluntary sector , follow good , evidence-based practice . ' a . british heart foundation spokesman added : ` taking control of your . weight can be a daunting task because changing the habits of a lifetime . is often a challenge . that 's why it 's a good idea to get support . throughout your weight-loss journey . '
by. jenny hope. published :. 09:47 est, 16 october. michelle obama 's loyal chief, with moved left the first family behind this month kristen jarvis, 34 is moving washington after acting nearly all her daily tasks |. updated :. all except some the famously fit first lady 's more intensive workout regimes. moving on : kristen jarvis -lrb- at right with sasha malia 2009 has left the obamas after as michelle 's fiercely loyal chief. jarvis, who 's moving become the ford foundation president darren walker 's chief admits did share michelle 's love d.c. workout craze solidcore ` she can have that, ' the spelman college graduate the washington post and it 's hard blame. solidcore 's website utilizes ` slow and controlled full-body movements constant tension work failure... to rebuild more sculpted, stronger -lsb- solid -rsb- you. ' jarvis, instead, got her workouts by helping carry the first lady she with the obamas even that, however. jarvis entered the family 's orbit obama 's senate office. she went work obama 's 2008 campaign michelle 's staff leading before. 05:17 est, 17 october. doctors should blame patients being fat, new nhs guidance it urges gps sensitive dealing obese patients, using a ` respectful ' and non-judgmental tone the approach designed harm, according the national institute health and care excellence the national institute health and care excellence is urging gps be sensitive when dealing obese patients, using with. britain in the grip costing the nhs # 5billion a. her relationship, insiders deeply familial ` she can have that ' : jarvis says she mostly kept fitness-loving michelle, drew d.c. workout craze solidcore. jarvis 's last trip on air force one with the family she 's come especially emotional not soon the presidential world behind. the trip selma, alabama where the first black family traveling ` it so powerful. it felt -lsb- both the message 2008 how far ' as, ' she wapo perhaps just personally meaningful was how that final trip ended back washington, mrs obama invited jarvis exit at the family. year, nice calls doctors gps as. those run lifestyle weight-loss programmes, to monitor their tone. ` as we walked, flotus holding ' jarvis said as if the first lady happily leading into jarvis said that michelle an active part her transition out washington. ` she has a mentor throughout, ' jarvis and not add the stigma fat. only. people -lrb- bmi -rrb- under 35 -- the marker at. people considered morbidly -- should have measured. surgeries, meanwhile should adapted provide out-size equipment. for larger patients. last. ten years service : jarvis, 34 first joined the obamas ' orbit 2005 when took then year it emerged several nhs trusts refusing certain. treatments to fat patients unless lose. patients have denied procedures such hip ivf, unless agree make radical changes. patients have. denied procedures such hip ivf, unless. agree make radical changes their lifestyle. the nice guidance also provides instructions public health england, responsible health campaigns. it. says should ` be aware the effort needed lose. further weight gain the stigma adults who. may feel or experience '. it. the maryland native lost both parents before 30, jarvis 's deputy melissa winter told wapo, ` the first lady able fill unintentionally some areas missing growing. ' jarvis, who the washington post says came embody ` the kind deep, personal commitment the obamas value ' played her hand close even telling a wapo reporter recently, with michelle ` honestly for what see... she just really instills. ' that confidence loyalty has now won near a $ 10 billion corporate foundation. the ford foundation, created 1936 auto moguls henry edsel ford funds charities individuals worldwide encourage ` promote among the nonprofit, government and business sectors ; ensure participation men from all levels ' loyal : jarvis, a spelman college grad went obama 's 2008 campaign michelle 's staff leading before adds : ` ensure the tone content all communications or dialogue. respectful and non-blaming. the terminology. person 's condition should respect individual preferences. ' gps. and those running weight management programmes the nhs should. ensure patients to losing. weight, telling them there no ` magic bullet. instead,. obese patients should advised making gradual,. long-term changes their eating habits and how. much weight they might realistically. the. latest draft guidance is being consultation. finalised next may. tam fry, of the national obesity forum said. patients were often in denial gps should sensitive -- to start. with. he : ` one. of the big problems is that primary care -- gps in particular. have no real training about raise weight issues with patients. ` the abrupt style that many so have only. ` nice. is correct they should moderate. but once. they 've the tone the confidence the patient,. should really think tough love. ` it essential patients. realise the consequences putting on weight. ' professor. mike kelly, director the centre nice, :. ` being overweight an. individual 's health, not only physically with increased risk high. blood pressure, but their mental. health as stigma bullying or. tough love : gps and those running weight management programmes the nhs should ensure patients to losing. ` levels. of obesity england are rising, with. adults classified obese a further 41 per cent 33. cent of women overweight. this a huge proportion. ` this. new draft guidance focuses the provision effective lifestyle. weight management services makes. ensure providers programmes, whether from,. public, or voluntary sector follow good, evidence-based practice ' a. british heart foundation spokesman added : ` taking control. weight can because changing the habits. is often a challenge. that 's why support. throughout. '
edsel ford , funds charities and individuals worldwide that encourage and ` promote among the nonprofit , government and business sectors ; and to ensure participation by men and women from diverse communities and all levels of society . ' loyal : jarvis , a spelman college grad , went on to work on obama 's 2008 campaign and then michelle 's staff leading up to the election before becoming her top personal aide . adds : ` ensure the tone and content of all communications or dialogue is . respectful and non-blaming . the terminology used to describe the . person 's condition should respect individual preferences . ' gps . and those running weight management programmes for the nhs should . ensure patients have a realistic view of what to expect when losing . weight , telling them there is no ` magic bullet ' . instead , . obese patients should be advised of the importance of making gradual , . long-term changes to their eating habits and physical activity and how . much weight they might realistically expect to lose . the . latest draft guidance is being issued for consultation and will be . finalised next may . tam fry , of the national obesity forum , said . patients were often in denial and gps should be sensitive -- to start off . with . he said : ` one . of the big problems we have is that primary care -- gps in particular -- . have no real training about how to raise weight issues with patients . ` the abrupt style that many have taken so far have only made matters worse . ` nice . is correct to say they should be moderate in their tone . but once . they 've got the tone right and the confidence of the patient , they . should really think about tough love . ` it 's essential that patients . realise that the consequences of putting on weight are very serious . ' professor . mike kelly , director of the centre for public health at nice , said : . ` being overweight or obese can have serious consequences for an . individual 's health , not only physically with increased risk of high . blood pressure and type 2 diabetes , but it can also affect their mental . health as a result of stigma and bullying or discrimination . tough love : gps and those running weight management programmes for the nhs should ensure patients have a realistic view of what to expect when losing weight . ` levels . of obesity in england are rising , with a little over a quarter of . adults classified as obese and a further 41 per cent of men and 33 per . cent of women overweight . this is a huge proportion of our population . ` this . new draft guidance focuses on the provision of effective lifestyle . weight management services and makes a number of recommendations to . ensure that the providers of programmes , whether from the private , . public , or voluntary sector , follow good , evidence-based practice . ' a . british heart foundation spokesman added : ` taking control of your . weight can be a daunting task because changing the habits of a lifetime . is often a challenge . that 's why it 's a good idea to get support . throughout your weight-loss journey . '
 The text discusses the importance of respecting individuals' preferences and promoting healthy lifestyles. It emphasizes that healthcare providers should be sensitive to patients' needs, avoid blaming or judging them, and focus on providing respectful care. Additionally, it highlights the significance of addressing obesity as a public health issue, rather than stigmatizing individuals who are overweight or obese.