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Respond to other studentâ€™s responses with substantive comments. Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.The postings should be at least one paragraph (approximately 100 words) and include references.
- References and citations should conform to the APA 6th edition.
- Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.Plagiarism is never acceptable â€“ give credit when credit is due – cite your sources
Obesity is of great concern and can result in many health complications of the patients. Patients who are obese are at higher risk of developing cardiovascular disease, and diabetes type 2. Each of these diseases carries severe health risk that can impact the patientâ€™s life. Patients who are seeking assistance in weight loss often times begin their journey in the primary care setting. They may be looking for advice about the best diets, what kind of exercise their bodies can handle, seeking bariatric surgery, or need counseling. Managing obesity can be a struggle and its associated risk factors and co-morbidities, clinicians encounter problems, as managing one individual element may exacerbate another. Such as.
Insulin, sulphonylureas and thiazoledinediones——————–weight gain
Beta-blockers and thiazide diuretics———————————–increased chance of diabetes
Sibutramine will induce weight loss———————————–raises blood pressure
Statins improve lipid profile——————————————–increase risk of diabetes
Niacin lowers cholesterol———————————————–increases HbA1c
Often times patients do not seek help until there is an obesity problem rather than prevention. Primary care can be a difficult setting to manage weight loss. It is important to be nonjudgmental and non-offensiviely. This conversation can begin once things like vitals, height, weight, past medical history, and blood work results are discussed with the patient. Suggestions to the patient about how weight management could help improve numbers and decrease or prevent health complications. Studies such as Counter weight and Camwel demonstrated the difficulties with primary care and weight loss. Studies like the Look Ahead study had better outcomes when focusing on long-term management and had improvements in lipids, blood pressure but these interventions were to intensive to be carried out in the primary care setting (Haslam, 2014).
In my primary care setting I feel that finding out what is important to the patient and what motivates them is important. Finding a weight loss solution is such an individual design. Find out how the patient wants to track their progress. Maybe they enjoy technology and want to input the data or maybe they want to keep records on paper and pen. What goals does the patient have? Is there a wedding or anniversary that is coming in a few months and they would like to lose a certain amount of weight by then? It is important to make realistic goal for the patient. Maybe in the long run they want to lose a certain large amount but they need to set small targets to get themselves to that point. An individual plan is important and will cater to the patientâ€™s goals and help to motivate them.
Haslam, D. (2014, May). Obesity in primary care: prevention, management and the paradox. Retrieved from BMC Medicine: https://bmcmedicine.biomedcentral.com/articles/10….
Obesity is a significant problem in the United States. Based on current trends, it is estimated that 85% of adults in the United States will be classified as overweight or obese by year 2030 (Hruby & Hu, 2015). Obesity is linked to several comorbidities, including: disability, depression, dyslipidemia, type 2 diabetes, cardiovascular disease, certain cancers, and more (Hruby & Hu, 2015). From the outside, it can appear that obesity is caused by a poor diet and lack of exercise. While these can be issues that lead to obesity, there are several other factors involved, such as: diet, activity, sleep, genetics, perinatal exposures, certain diseases, psychological conditions, drugs and medications, socioeconomic concerns, and environmental concerns (Hruby & Hu, 2015). In order to effectively help an obese patient reach their ideal weight, the practitioner needs to look at all of these factors to determine the best course of action.
Evidence based strategies for weight loss in obese patients include: behavioral/lifestyle changes, weight loss surgery, and weight loss medication (Felix & West, 2013). Behavioral and lifestyle changes are extremely effective when performed consistently (Felix & West, 2013). In most studies centered around behavioral and lifestyle changes, a reduced-calorie, low fat diet was coupled with some form of moderate physical activity (Felix & West, 2013). Weight loss counseling is often needed for individuals to maintain these changes (Felix & West, 2013). For individuals that do not have success with lifestyle change interventions, bariatric surgery is an option (Felix & West, 2013). There is modest evidence that bariatric surgery is a safe and effective weight loss strategy for older adults, however, it is not without complications (Felix & West, 2013). Many weight loss centers require going through a nutrition and lifestyle program before becoming a candidate for bariatric surgery (Felix & West, 2013). While not a common solution, weight loss medications do exist. Orlistat is one medication designed to treat obesity (Felix & West, 2013). Studies have shown that orlistat is effective in producing weight loss during the treatment phase and in limiting weight regain during the maintenance phase and has few adverse effects (Felix & West, 2013).
My first recommendation for clients will be to focus on dietary and lifestyle interventions. Each person needs to be addressed uniquely with the many factors that contribute to obesity in mind. For example, if money restrictions significantly contribute to the patientâ€™s dietary choices, how as practitioners can we help this patient make better choices? Acknowledging this patientâ€™s concerns can allow the practitioner to make appropriate suggestions that the patient will actually consider. If the education that I provide is not enough for them or it is evident they need more assistance, I will ask them to seek out a local weight loss center for further education and classes. It is my personal opinion that non-surgical and medication-free interventions should be tried first, unless clinically contraindicated. Without commitment to behavioral and lifestyle changes, the obese patient is less likely to maintain the weight loss and stay on the road to better health (Felix & West, 2013).
Felix, H. C., & West, D. S. (2013). Effectiveness of weight loss interventions for obese older adults. American Journal of Health Promotion, 27(3), 191â€“199. http://doi.org/10.4278/ajhp.110617-LIT-259
Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: A big picture. PharmacoEconomics, 33(7), 673â€“689. http://doi.org/10.1007/s40273-014-0243-x