Obesity Flashcards
More than 30% adults in US are obese
-Increasing incidence of obesity in children.
Obesity
- Nutrients in food provide energy.
- Excess calories stored as fat, triglycerides
- Basal metabolic rate (BMR)
- Appetite regulated by CNS, emotions
- Hormones involved in regulating obesity
- thyroid hormone
- insulin
- Lepton
Etiology of Obesity
- Genetic
- Psychologic
- Self-esteem
- Physiologic
- Physical inactivity
- probably most important factor
- Environmental
- food supply
- fast food, vending machines
- advertising
- Sociocultural
Risk Factors assoc. with Obesity
- Defined by body mass index (BMI)
- BMI 25-29.9 kg/m2=overweight
- BMI more than or greater to 30 kg/m2=obese
Clinical Manifestations [obesity]
Central obesity
-Waist-to-hip ratio
more than 1 in men
more than 0.8 in women
Clinical Manifestations [obesity]
Peripheral obesity
-Waist-to-hip ratio less than 0.8
Clinical Manifestations [obesity]
Adverse consequences increase -Morbid obesity *more than 200% of ideal body weight *Risk of dying 12x greater Significant risk factor for Cardiovascular disease 60% have metabolic syndrome Affects reproductive function Increased weight increases risk for: -Gallstones -Several types of cancer -Osteoarthritis -Cardiovascular disease -Type 2DM -Depression -Postoperative complications
Complications of Obesity
-Waist circumference Other Tests: Thyroid profile Serum glucose Serum cholesterol Lipid profile EKG
Dx test for Obesity
Prescription and OTC -Amphetamine, non-amphetamine appetite suppressant ***Phentermine ***Sibutramine (Meridia) ***Orlistat (Xenical) _OTC--- Bulk forming agents
Pharmacologic Therapies Obesity
- Critical element
- Under care of physician
- Aerobic exercise 30-40 mins 5 days/wk
Exercise Therapy for Obesity
- Collaborate with nutritionist
- Create diet plan to create 500-1000 kcal deficit
- Low kcal, low fat, high fiber
- Very low calorie diet for client BMI more than 30
Nutrition for Obesity
- Critical component
- Food records
- Eliminating cues that precipitate eating
- Examine factors that affect eating behaviors
- Social support and group programs successful
Behavior Modification Obesity
Bariatric surgery; BMI over 40 kgm2
- Malabsorptive procedures
- Bypass portion of small intestine
- Rapid weight loss
- Restrictive procedures
- Safer
- Generally less effective in long term
- Complications
- High risk of complications
- *Gastric bypass
- *Adjustable gastric banding
- *Vertical banding
Surgery; Obesity
Health History -risk factors/fam hx -recent weight gain/loss -perceptions of weight, health -diet/food intake Physical Examination -Vital signs, height, weight -Skinfold measurements
Nursing Process: Assessment
Obesity
Imbalanced Nutrition: More than body requirements
Chronic Low Self-Esteem
Ineffective Therapeutic Regimen Management
Activity intolerance
Nursing Diagnoses for Obesity
- Client makes sensible dietary choices.
- Client follows exercise routine.
- Client relates strategies to deal with hunger
- Client will attend support group meetings.
- Client demonstrates appropriate weight loss
Plan of Care for Obesity
- Caring interventions:
- Encourage client to identify contributing factors.
- Establish realistic goals/objectives
- Assess knowledge of balanced diet plans
- Discuss behavior modification strategies
- Monitor weight loss, BP, lab data
- Exercise program:
- Assess current activity level and tolerance
- With medical clearance, plan program
- Weight-loss program
- Discuss ability, willingness to incorporate change
- Help identify behavior modification strategies
- Have client establish strategies for “stress” eating
- Self-esteem
- encourage client to verbalize experience
- Set small goals
- Offer positive feedback and encouragement
- Refer for counseling as appropriate
Implementation for Obesity
- Identification and understanding of factors contributing to weight loss
- Understanding and application of behavioral modification techniques to lose weight.
- Accomplishment of desired weight loss
- Incorporation of physical activity
Evaluation for Obesity
